运动干预对中老年2型糖尿病患者体脂成分和肝脏脂肪的影响:随机对照试验研究OA
The effects of exercise intervention on body lipid composition and liver fat in middle-aged and elderly patients with type 2 diabetes mellitus:a randomized controlled trial
目的 评估与比较个性化运动干预方案对中老年2型糖尿病患者体脂成分及肝脏脂肪代谢指标的影响.方法 本研究采用前瞻性随机对照开放试验设计,纳入80例2型糖尿病(T2DM)患者,干预组(n=40)接受12周个性化运动处方(中至高等强度有氧+抗阻训练),对照组(n=40)接受常规健康宣教.受试者经问卷筛选和1周适应性训练后(依从性≥70％)入组.本研究以12周体脂率为主要结局指标,次要结局指标包括体质指数(BMI)、肝脏脂肪受控衰减指数(CAP)及肝脏硬度值(E值)、肝功能及糖脂代谢指标等,组间比较采用t检验或秩和检验,采用协方差分析调整基线资料对指标的影响.结果 本研究一共纳入80例,其中干预组40例,年龄为(58.75±9.01)岁;对照组40例,年龄为(61.10±9.95)岁,女性占比43.8％.符合方案分析显示:BMI在运动干预后呈显著下降(ΔBMI:-0.20 kg/m2,P＜0.05),组间差异显著(P＜0.001);干预组内高密度脂蛋白(HDL-C)显著上升(ΔHDL-C:0.07 mmol/L,P＜0.05);采用协方差分析调整基线测量值后,干预组的糖化血红蛋白显著下降(Adjusted P=0.015).但未发现CAP及E值在两组中存在明显的差异.结论 12周个性化运动干预可显著改善中老年T2DM患者的体质量相关指标(如降低BMI)和体脂成分(如降低体脂率),升高HDL-C及降低糖化血红蛋白,但对肝脏脂肪含量及硬度未见显著影响,需要更长期的干预试验加以证实.
Objective To systematically compare the effects of a personalized exercise intervention program on body fat composition and liver fat metabolism among middle-aged and elderly patients with type 2 diabetes melli-tus(T2DM).Methods This study adopted a prospective,randomized,controlled,open-label trial design.A to-tal of 80 patients diagnosed with T2DM were enrolled.The intervention group(n=40)received the personalized exercise prescription(moderate to high-intensity aerobic and resistance training)in twelve weeks,while the con-trol group(n=40)received routine health education.Participants were included after questionnaire screening and a one-week adaptive training period(compliance rate ≥70％).This study used the twelfth-week's body fat percentage as the primary outcome measure,and the secondary outcome measures included bod mass index(BMI),liver fat-controlled attenuation parameter(CAP),liver stiffness value(E value),liver function,and glycolipid metabolism indicators,etc.Independent-sample T-tests or Mann-Whitney U tests were used for inter-vention group comparisons,and analysis of covariance(ANCOVA)was applied to adjust for the influence of baseline data on outcome measures.Results A total of 80 participants were included,with 40 in the intervention group[age:(58.75±9.01)years]and 40 in the control group[age:(61.10±9.95)years];43.8％partici-pants were female.Per-protocol analysis showed that BMI demonstrated a significant decreasing trend subsequent to the exercise intervention(ΔBMI=-0.20 kg/m2,P＜0.05),with a notable between-group variance(P＜0.001).Within the intervention group,high-density lipoprotein cholesterol(HDL-C)showed a significant in-creasing trend(ΔHDL-C=0.07 mmol/L,P＜0.05).After adjusting for baseline values using ANCOVA,Gly-cated hemoglobin(HbA1c)in the intervention group decreased significantly(Adjusted P=0.015).However,no significant differences were observed between the two groups in CAP or E-value.Conclusion A 12-week per-sonalized exercise intervention can significantly improve weight-related indicators(such as reducing BMI)and body fat composition(such as lowering body fat percentage)in middle-aged and elderly patients with T2DM,in-creased HDL-C,and decreased HbA1c.However,no significant effects were observed on liver lipids content or stiffness,which necessitates further validation through longer-term intervention trials.
黄少芬;刘嘉紫;宋远凤;施汶言;武晓岩
桂林医科大学公共卫生学院,广西桂林 541199||深圳市前海蛇口自贸区医院公共卫生科,广东 深圳 518067暨南大学公共卫生和预防医学系,广东 广州 510632深圳市南山区慢性病防治院肿瘤伤害与营养科,广东 深圳 518054深圳市前海蛇口自贸区医院公共卫生科,广东 深圳 518067桂林医科大学公共卫生学院,广西桂林 541199
医药卫生
运动干预2型糖尿病体脂成分随机对照试验研究
exercise interventiontype 2 diabetes mellitusbody fat compositionrandomized controlled trial
《遵义医科大学学报》 2026 (3)
280-287,8
深圳市科技计划资助项目(NO:JCYJ20210324125004013).
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