高强度间歇训练对2型糖尿病患者运动干预的效果：基于《WHO关于身体活动和久坐行为的指南》和WHO-FICs

doi:10.3969/j.issn.1006-9771.2022.06.004

摘要/Abstract

摘要：

目的评价高强度间歇训练(HIIT)对2型糖尿病(T2DM)患者干预的效果。方法 2021年5月至10月,互联网招募T2DM患者12例。基于《WHO身体活动和久坐行为指南》(简称《指南》)和WHO国际健康分类家族(WHO-FICs),构建HIIT干预方案,对患者进行有氧运动结合肌肉强化训练的多组合全身性HIIT干预,每次30~35 min,每周3次,共8周。干预前后,分别测定患者血糖水平、血脂水平、胰腺脂肪含量和身体成分。结果脱落1例。干预后,患者空腹血糖、餐后2 h血糖、糖化血红蛋白、空腹血清胰岛素、胰岛素抵抗指数、血清总胆固醇、血清甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、胰腺脂肪分数、体质量、体质量指数、体脂率均改善(t > 2.258, P < 0.05)。结论基于《指南》和WHO-FICs构建的HIIT运动干预可改善T2DM患者的相关功能,表现在血糖水平、血脂水平、胰腺脂肪含量和身体成分方面,并可以减少降糖药物用量。

关键词: 2型糖尿病, 高强度间歇运动, 糖脂代谢, 胰腺

Abstract:

Objective To evaluate the effects of high intensity interval training (HIIT) on patients with type 2 diabetes mellitus (T2DM). Methods From May to October, 2021, twelve patients with T2DM were recruited with internet. An HIIT exercise intervention based on WHO Guidelines on Physical Activity and Sedentary Behaviour and World Health Organization Family of International Classifications (WHO-FICs) was constructed. They received aerobic combined with resistance training in a multi-combination HIIT using whole-body exercise, 30 to 35 minutes a time, three times a week, for eight weeks. Before and after intervention, their blood glucose levels, lipid levels, pancreatic fat content and body composition were measured. Results One cased was dropped. After intervention, the fasting glucose, 2-hour postprandial glucose, hemoglobin A1c, fasting serum insulin, insulin resistance index, serum total cholesterol, serum triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, pancreatic fat content, body weight, body mass index, and body fat percentage improved (t > 2.258, P < 0.05). Conclusion HIIT exercise intervention based on the Guidelines and WHO-FICs could improve the related functions of patients with T2DM, such as blood glucose levels, blood lipid levels, pancreatic fat content and body composition, and reduce the consumption of hypoglycemic drugs.

Key words: type 2 diabetes mellitus, high intensity interval training, glucose and lipid metabolism, pancreas

中图分类号:

R587.1

冯臣,药家明,周国瑾,李慕瑶,王黎,王梅. 高强度间歇训练对2型糖尿病患者运动干预的效果：基于《WHO关于身体活动和久坐行为的指南》和WHO-FICs[J]. 《中国康复理论与实践》, 2022, 28(6): 646-652.

FENG Chen,YAO Jiaming,ZHOU Guojin,LI Muyao,WANG Li,WANG Mei. Effects of high intensity interval training on patients with type 2 diabetes mellitus using WHO Guidelines on Physical Activity and Sedentary Behaviour and WHO-FICs[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(6): 646-652.

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WHO-FICs	类别		内容
ICD-11	疾病诊断	05内分泌、营养或代谢疾病：内分泌疾病：糖尿病	纳入确诊为T2DM (5A11)的患者。此外,由于不适合参与高强度运动,排除伴有不稳定性糖尿病(5A24)、糖尿病性低血糖伴昏迷(5A21.1)等严重并发症的患者
ICHI β2	身体活动干预	有氧运动	身体大肌群参与的持续性、节律性的运动,如跳跃、跑步等运动
ICHI β2	身体活动干预	发展肌肉的活动	针对特定肌群的负荷训练,如哑铃、弹力带等器械性运动
ICF	身体活动效果	身体功能和身体结构	b430血液系统功能：血糖、血脂相关指标,b530体重维持功能：身体成分指标,s550胰的结构：胰腺脂肪含量
		活动和参与	d240控制应激和其他心理需求(d2400承担责任、d2401控制应激、d2402应付危险、d2408其他特指的控制应激和其他心理需求、d2409控制应激和其他心理需求,未特指),d750非正式社会关系(d750与朋友的非正式关系、d7501与邻居的非正式关系、d7502与熟人的非正式关系、d7503与同住者的非正式关系、d7504与同伴的非正式关系、d7508其他特指的非正式社会关系、d7509非正式社会关系,未特指),d760家庭人际关系(d7600父母-子女关系、d7601子女父母关系、d7602亲属关系、d7603大家族关系、d7608其他特指的家庭关系、d7609家庭关系,未特指),d9201运动,d9205社会活动

阶段		训练时长/min	训练强度
适应阶段(1~2周)	准备活动	5	20%~40%HRmax、RPE 9~12级
适应阶段(1~2周)	HITT干预	20	40%~60%HRmax、RPE 11~15级
强化阶段(3~8周)	准备活动	10	30%~60%HRmax、RPE 12~15级
强化阶段(3~8周)	HITT干预	20	70%~90%HRmax、RPE 16~19级

指标	干预前	干预后	t值	P值
FPG/mmol·L^-1	7.71±1.29	6.12±0.75	4.886	0.001
2hPG/mmol·L^-1	18.60±5.94	14.21±3.84	5.795	< 0.001
HbA1c/%	7.46±1.17	6.46±0.72	2.258	0.048
Ins/mmol·L^-1	12.62±6.44	11.52±6.12	4.790	0.001
HOMA-IR	2.22±1.03	1.95±0.98	6.170	0.001
TC/mmol·L^-1	5.11±1.25	4.44±1.02	3.465	0.006
TG/mmol·L^-1	1.53±0.69	1.10±0.64	4.533	0.001
HDL-C/mmol·L^-1	1.19±0.38	1.44±0.35	-5.394	< 0.001
LDL-C/mmol·L^-1	2.90±0.87	2.37±0.81	4.681	< 0.001
PFF/%	6.83±2.14	6.21±1.95	6.976	< 0.001
体质量/kg	65.43±16.14	62.49±15.94	5.501	< 0.001
BMI/kg·m^-2	24.49±3.85	23.35±3.78	3.058	0.012
体脂率/%	29.67±3.98	28.67±3.88	18.540	< 0.001
瘦体质量/kg	45.66±10.70	46.10±10.78	-1.662	0.128