مقایسۀ آثار تمرینات استقامتی تداومی و تناوبی بر فاکتورهای گلیسمیک بیماران مبتلا به دیابت نوع دو: مرور نظام‌مند و فراتحلیل مقالات داخل ایران

نوع مقاله : مقاله پژوهشی

نویسندگان

1 استادیار فیزیولوژی ورزشی، دانشگاه شهرکرد، گروه علوم ورزشی

2 استاد فیزیولوژی ورزشی، دانشگاه اصفهان، گروه علوم ورزشی

3 دانشیار فیزیولوژی ورزشی، دانشگاه شهرکرد، گروه علوم ورزشی دانشگاه شهرکرد

چکیده

پژوهش‌های زیادی تأثیر فعالیت ورزشی را بر عوامل مرتبط با بیماری دیابت بررسی کرده‌اند. هدف اصلی از انجام‌شدن پژوهش حاضر، مقایسۀ آثار تمرینات استقامتی تداومی و تناوبی بر فاکتورهای گلیسمیک بیماران مبتلا به دیابت نوع دو، به‌صورت مرور نظام‌مند و فراتحلیل مطالعات داخل ایران بود. در پژوهش حاضر، پایگاه‌های اطلاعاتی Science Direct،PubMed ، Scopus، Web of Science، SID، Magiran و Google Scholar از سال‌های ۱۳۸۰ تا ۱۳۹۸، همراه با کلمات کلیدی جست‌وجو شدند. بعد از غربالگری اولیه، متن کامل مقالات ارزیابی شد و مقالاتی که معیارهای ورود به پژوهش داشتند، تحلیل شدند. تعداد ۲۳1 مقاله بررسی اولیه شدند و از این میان 25 مقاله معیارهای ورود به مرور سیستماتیک و فراتحلیل را داشتند؛ براین‌اساس ۹۰۸ فرد دیابتی که به دو گروه تجربی و گروه کنترل به‌ترتیب تعداد ۴۹۴ و ۴۱۴ نفر تقسیم ‌شدند، در گروه تجربی (30۵ زن، 189 مرد) و در گروه کنترل (۲۷۸ زن، ۱۳۶ مرد) قرار گرفتند. میانگین سنی آزمودنی‌ها در پژوهش حاضر ۵۰ سال بود. نتایج متاآنالیز نشان داد که تمرینات تناوبی و تداومی هر دو موجب بهبود شاخص‌های گلیسمی می‌‌شوند. تمرینات استقامتی تداومی و تمرینات تناوبی موجب کاهش معنادار سطوح گلوکز ((P=0.001; SE=0.18, 95% CI= -1.24 - 0.86, Z=-10 و انسولین ((P=0.001; SE= 0.18, 95% CI= -1.62 - 0.917, Z=-7 و مقاومت به انسولین (P=0.001; SE= 0.05, 95% CI= -0.34 - 0.13, Z=-4.52) شدند. بین تمرین تداومی و تناوبی در سطوح گلوکز و انسولین اختلاف معنادار مشاهده شد (P=0.002، P=0.0001)، اما این اختلاف در مقاومت به انسولین مشاهده نشد (P=0.42). تمرینات استقامتی تداومی و تناوبی موجب بهبود سطوح گلوکز خون، انسولین و مقاومت به انسولین می‌‌شوند و تمرینات تناوبی در بهبود عملکرد شاخص‌های گلیسمی مؤثرتر هستند؛ اگرچه در این زمینه به انجام‌دادن مطالعاتی بیشتر و با کیفیت بهتر نیاز است.

کلیدواژه‌ها

موضوعات


  1. Appuhamy JADRN, Kebreab E, Simon M, Yada R, Milligan LP, France J. Effects of diet and exercise interventions on diabetes risk factors in adults without diabetes: Meta-analyses of controlled trials. Diabetol Metab Syndr. 2014; 6(127):1758-1768
  2. Larejani B, Zahedi F. epidemiology of diabetes mellitus in Iran. Iran J Diabetes Lipid Disord . 2001;1(1):1–8.
  3. O’Brien JA, Shomphe LA, Kavanagh PL, Raggio G, Caro JJ. Direct medical costs of complications resulting from type 2 diabetes in Hie US. Diabetes Care. 1998;21(7):1122–8.
  4. Enteshary M, Esfarjani F, Reisi J. The Comparison of 8 week combined training with two different intensity on level of serum Irisin, and glycemic indices of type 2 diabetic women. Med J mashhad Univ Med Sci. 2018;61(2):971–84.
  5. Esteghamati A, Larijani B, Aghajani MH, Ghaemi F, Kermanchi J, Shahrami A, et al. Diabetes in Iran: prospective analysis from first nationwide diabetes report of national program for prevention and control of diabetes (NPPCD-2016). Sci Rep. 2017;7(1):134-61.
  6. Hoerger TJ, Bethke AD, Richter A, Sorensen SW, Engelgau M, Thompson T, et al. Cost-effectiveness of intensive glycemic control, intensified hypertension control, and serum cholesterol level reduction for type 2 diabetes. J Am Med Assoc. 2002;287(19):2542–51.
  7. Rahmati M, Gharakhanlou R, Movahedin M, Mowla SJ, Khazani A, Fouladvand M, et al. Treadmill training modifies KIF5B moter protein in the STZ-induced diabetic rat spinal cord and sciatic nerve. Arch Iran Med. 2015;18(2).1-10.
  8. Yang Z, Scott CA, Mao C, Tang J, Farmer AJ. Resistance exercise versus aerobic exercise for type 2 diabetes: a systematic review and meta-analysis. Sports Medicine. 2014;44:487–99.
  9. Colberg SR, Sigal RJ, Fernhall B, Regensteiner JG, Blissmer BJ, Rubin RR, et al. Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement. Diabetes Care. 2010;33(12):e147–67.
  10. Lee IM, Sesso HD, Oguma Y, Paffenbarger RS. Relative intensity of physical activity and risk of coronary heart disease. Circulation. 2003; 107(8):1110-6
  11. Tanasescu M, Leitzmann MF, Rimm EB, Willett WC, Stampfer MJ, Hu FB. Exercise type and intensity in relation to coronary heart disease in men. J Am Med Assoc. 2002; 288(16):1994-2000.
  12. Little JP, Gillen JB, Percival ME, Safdar A, Tarnopolsky MA, Punthakee Z, et al. Low-volume high-intensity interval training reduces hyperglycemia and increases muscle mitochondrial capacity in patients with type 2 diabetes. J Appl Physiol. 2011; 111(6), 1554-1560
  13. Wisløff U, Støylen A, Loennechen JP, Bruvold M, Rognmo Ø, Haram PM, et al. Superior cardiovascular effect of aerobic interval training versus moderate continuous training in heart failure patients: a randomized study. Circulation. 2007; 115:3086–3094.

 

 

  1. Shepherd S, Cocks M, Ranasinghe A, Barker T, McClean A, Wagenmakers AJMJM, et al. High intensity interval and traditional endurance training both increase insulin sensitivity, V̇infO2peak/inf and skeletal muscle perilipin 2 and perilipin 5 content in sedentary obese males. Japanese J Phys Fit Sport Med. 2014;63(1):2013.
  2. Higgins JP. Cochrane handbook for systematic reviews of interventions version 5.0. 1. The Cochrane Collaboration. http://www. cochrane-handbook. org. 2008.
  3. Downs SH, Black N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Community Health. 1998; 52(6):377-84.
  4. Abedi B, Okhovat E. The effect of eight weeks of high intensity intermittent exercise (Hiit) on serum adiponectin levels and insulin resistance in type 2 diabetic women. J Sport Biol Sci. 2016;8(3):411–25.
  5. Afrasyabi S, Marandi SM Kargar Fard M. The effect of 12 weeks of high intensity training on IL-6, GLP-1 and lipid profiles in type 2 diabetic patients. 1397. 18 (1):29-40
  6. Aghamohammadi M, Habibi A, Ranjbar R. The effect of selective aerobic training on serum irisin levels and insulin resistance index in women with type 2 diabetes. Arak Med Univ J. 2016;8:1–9.
  7. Afshon Pour M, Habibi A, Ranjbar R., AM H, RA R. Effects of continuous aerobic exercise training on plasma concentration of apelin and insulin resistance in type 2 diabetic men. Armaghane-Danesh. 2016; 21(1):1-15
  8. Azizi M, Tadib V, Behpoor N. The effect of aerobic exercise training on circulating levels of adipsin and insulin resistance among obese type-2 diabetic females. Jundishapur Med Sci J. 2016;1-15.
  9. Bazyar F, Banitalebi E, Amirhosseini S.. The comparison of two methods of exercise (intense interval training and concurrent resistance- endurance training) on fasting sugar, insulin and insulin resistance in women with mellitus diabetes.  Armaghane danesh . 2016;21(2):123–34.
  10. Esmaeili M, Bijeh N, Moghadam MG. Effect of combined aerobic and resistance training on aerobic fitness, strength, beta-endorphin, blood glucose level, and insulin resistance in women with type II diabetes mellitus. The Iranian Journal of Obstetrics, Gynecology and Infertility . 2018;21(6):34–46.
  11. Ghardashi A, Gaeini A, Gholami B. The effect of aerobic interval training on endothelial vasculature function in type 2 diabetes patient. Iran J Rehabil Res Nurs. 2016;2(7)1-10.
  12. Gholaman M, Gholami M. Effect of Eight Weeks' Endurance Training along with Fenugreek Ingestion on Lipid Profile, Body Composition, Insulin Resistance and VO2max in Obese Women's with Type2 Diabetes %J Journal of Medicinal Plants. 2018;17(65):83-92.
  13. Gholami F, Nikookheslat S, … YS-N. Effect of aerobic training on nerve conduction in men with type 2 diabetes and peripheral neuropathy: A randomized controlled trial. Neurophysiologie Clinique.2018;48(4):195–202.
  14. Ilkhani B, Fathei M, Hejazi K, Jafari Ghaleh N. The effects of aerobic interval training on adiponectin, hemoglobin A1c, and insulin resistance index in older adult men with type 2 diabetes. Nursing Journal of the Vulnerable. 2017;4(10):1–12.

 

  1. Mir E, Attarzadeh Hosseini SR, Hejazi K, Mir Sayeedi M. Effect of eight weeks of endurance and resistance training on serum adiponectin and insulin resistance index of inactive elderly men. J Gorgan Univ Med Sci. 2016;18(1):57.
  2. Khorshidi D, Matinhomaee H, Azarbayjani MA. Effect of one period of aerobic exercise on serum levels of alkaline phosphatase and osteocalcin in patients with type 2 diabetes. Journal Of Shahid Sadoughi University Of Medical Sciences And Health Services. 2012:(80);676-85.
  3. Mogharnasi M, Tabas AT. The effect of 10 weeks of endurance training of cycle ergometer on nesfatin-1 levels and insulin resistance in women with type 2 diabetes. J Sport Biosci. 2011;8(1):1–8.
  4. Motallebi F, Shakerian S, Ranjbar R. Effect of 8 weeks aerobic interval training on glycosylated hemoglobin and insulin resistance index in diabetic mellitus type 2 women. Q Horiz Med Sci. 2016;22(2):137–43.
  5. Mousavian As, Darvakh H. Effect of combined aerobic exercise on serum level of liver gamma glutamil transferase and glycemic index of middle-aged diabetic women %J The Iranian Journal of Obstetrics, Gynecology and Infertility. 2016;19(14):9-19.
  6. Nezamdoust Z, Saghebjoo M, Barzgar A. Effect of twelve weeks of aerobic training on serum levels of vaspin, fasting blood sugar, and insulin resistance index in women patients with type 2 diabetes. Iran J Diabetes Metab. 2014;104(2):99–105.
  7. Shahrjerd S, Shavandi N, Sheikh-Hoseini R, Shahrjerd S. The effect of strengthening and endurance training on metabolic factors, quality of life and mental health in women with type П diabetes. J Shahrekord Univ Med Sci. 2010;12(3):85–93.
  8. Heidari B, Sharif Abadi FT. The impact of intensity interval training and supplementation of green tea on serum levels of irisin, insulin resistance in obese women with type 2 diabetes women. Iran J Diabetes Metab. 2018;17(6):1-10
  9. Shavandi N, Saremi A, Ghorbani A, Parastesh M. Effects of aerobic training on resistin, adiponectin and insulin resistance index in type 2 diabetic men. Sport Physiol. 2011;3(10).
  10. Souri R, Ranjbar SH, Wahabi K, Shabiziz F. The effect of aerobic exercise on serum RBP4 and insulin resistance index in type 2 diabetic patients. J Iran Diabetes Metab. 2011;10(4):388–97.
  11. Yavari A, Hajiyev AM, Naghizadeh F. The effect of aerobic exercise on glycosylated hemoglobin values in type 2 diabetes patients. J Sports Med Phys Fitness. 2010;50(4):501–5.
  12. Yavari A, Najafipoor F, Aliasgarzadeh A, Niafar M, Mobasseri M. Effect of aerobic exercise, resistance training or combined training on glycaemic control and cardio-vascular risk factors in patients with type 2 diabetes. Biol Sport. 2012;29(2):135–43.
  13. Aminilari Z, Daryanoosh F, Kooshki J, Mohamadi M. The effect of 12 weeks aerobic exercise on the apelin, omentin and glucose in obese older women with diabetes type 2 Arak Medical University Journal. 2014.17(3):1-12
  14. Dabagh S, Nikbakht M. Glycemic control by exercise and urtica dioica supplements in men with type 2 diabetes. Jundishapur J Chronic Dis Care.. 2016;5(1).
  15. Azari N, Rahmati M, Fathi M. The effects of endurance exercise on blood glucose, insulin and insulin resistance in patients with type ii diabetes: a systematic review and meta-analysis of studies in Iran. Iran J Diabetes Lipid Disord. 2018;17(2).

 

  1. Rahmati M, Shariatzadeh M, Joneydi NA. The effects of endurance exercise on some related variables of type ii diabetes: systematic review and meta-analysis of studies in Iran. Sport Physiol. 2019;11(41):81–104.
  2. Motahari-Tabari N, Ahmad Shirvani M, Shirzad-e-Ahoodashty M, Yousefi-Abdolmaleki E, Teimourzadeh M. The effect of 8 weeks aerobic exercise on insulin resistance in type 2 diabetes: a randomized clinical trial. Glob J Health Sci. 2015;7(1):115–21.
  3. Grace A, Chan E, Giallauria F, Graham PL, Smart NA. Clinical outcomes and glycaemic responses to different aerobic exercise training intensities in type II diabetes: a systematic review and meta-analysis. Cardiovasc Diabetol. 2017;16(1):1–10.
  4. Tarnopolsky MA, Rennie CD, Robertshaw HA, Fedak-Tarnopolsky SN, Devries MC, Hamadeh MJ. Influence of endurance exercise training and sex on intramyocellular lipid and mitochondrial ultrastructure, substrate use, and mitochondrial enzyme activity. Am J Physiol - Regul Integr Comp Physiol. 2007;292(3):R1271–8.
  5. Asadi Gandomani M, Shekarchizadeh P, Ghafari M. The effect of intensive interval training and combined training on apolipoprotein A and B in women with type 2 diabetes. International Sports Science 195(1):1-15.
  6. Kessler HS, Sisson SB, Short KR. The potential for high-intensity interval training to reduce cardiometabolic disease risk. Sports Medicine. 2012. 1;42(6):489-509.
  7. Paoli A, Pacelli F, Bargossi AM, Marcolin G, Guzzinati S, Neri M, et al. Effects of three distinct protocols of fitness training on body composition, strength and blood lactate. J Sports Med Phys Fitness. 2010; 195(1):1-15.
  8. Mitranun W, Deerochanawong C, Tanaka H, Suksom D. Continuous vs interval training on glycemic control and macro- and microvascular reactivity in type 2 diabetic patients. Scand J Med Sci Sport. 2014;24(2):69–76.
  9. Torabi S, Asad MR, Tabrizi A. The effect of endurance training with cinnamon supplementation on plasma concentrations of liver enzymes (ALT, AST) in women with type II diabetes. Tehran Univ Med J. 2016;74(6):433–41.
  10. Banitalebi E, Ghahfarrokhi MM, Faramarzi M, Nasiri S. The effect of 10 weeks of sprint interval training on new non-alcoholic fatty liver markers in overweight middle-aged women with type 2 diabetes: a clinical trial. J Rafsanjan Univ Med Sci. 2018;17(6):495-510.
  11. Banitalebi E, Razavi T, Norian M, Bagheri L. The effect of combined aerobic exercise training and green tea extract on serum Tnf-Α And Il-6 levels in obese women with type 2 diabetes. 2016;
  12. Jafari Ghaleh No SA, Fathi M, Hejazi K, Ziayi M. The effects of eight weeks of aerobic interval exercise on omentin-1, resistin, and adiponectin in elderly men with type 2 diabetes %J Pathobiology Research. 2017;20(3):17-32
  13. Motahari-Tabari N, Shirvani MA, Shirzad-e-Ahoodashty M, Yousefi-Abdolmaleki E, Teimourzadeh MJGjohs. The effect of 8 weeks aerobic exercise on insulin resistance in type 2 diabetes: a randomized clinical trial. 2015;7(1):115-125.
  14. Parsian H, Eizadi M, Khorshidi D, Khanali F. The effect of long-term aerobic exercise on serum adiponectin and insulin sensitivity in type 2 diabetic patients %J Pars of Jahrom University of Medical Sciences. 2013;11(1):41-8.