نوع مقاله : مقاله پژوهشی

نویسندگان

1 رازی

2 استاد/دانشگاه رازی

3 استاد/ دانشگاه علوم پزشکی رازی

چکیده

هدف این پژوهش مقایسۀ تأثیر تمرین ترکیبی بر سطوح گلوکز خون ناشتا، هموگلوبین گلیکوزیله، پروتئین واکنش‌گر C با حساسیت بالا و مقاومت به انسولین در افراد مبتلا به دیابت نوع 2 بوده‌است. در این مطالعه 33 نفر زن مبتلا به دیابت نوع 2 با دامنۀ سنی 40 تا 60 سال به سه گروه تجربی1) تمرین ترکیبی (مقاومتی- هوازی) با فاصله 20 دقیقه استراحت، تجربی2) اجرای تمرین ترکیبی بدون استراحت و 3) گروه کنترل تقسیم شدند. برنامه تمرین به صورت هشت هفته و سه جلسه در هفته اجرا شد .نتایج نشان‌داد پروتئین واکنش‌گر C و هموگلوبین گلیکوزیله در دو گروه تمرینی کاهش و مقاومت به انسولین افزایش یافت، اما این تغییرات معنادار نبودند (P>0.05). غلظت گلوکز خون ناشتا در دو گروه تمرینی کاهش معناداری یافت (P<0.05). با این حال بین کاهش گلوکز خون ناشتا در دو گروه تمرینی تفاوت معناداری وجود نداشت. در گروه گواه هیچ‌­یک از متغیرها تغییر معنادار نداشتند. در نتیجه با توجه به آثار سودمند مشابه دو نوع تمرین ترکیبی و احتمال افت قند خون و پرهیز از خستگی بیش از حد این افراد در یک جلسه تمرین ترکیبی می­توان اجرای تمرین ترکیبی مقاومتی- هوازی را با 20 دقیقه فاصله استراحتی پیشنهاد کرد.

کلیدواژه‌ها

1) Bergman R N, Ader M. Free fatty acids and pathogenesis of type 2 diabetes mellitus. Trends Endocrin Met. 2000 Nov;11(9):351-6.
2) Mora S, Musunuru K, Blumenthal R S. The Clinical Utility of High-Sensitivity C-Reactive Protein in Cardiovascular Disease and the Potential Implication of JUPITER on Current Practice Guidelines. Clin Chem. 2009 Feb;55(2):219-28.
3) Pfutzner A, Schondorf T, Hanefeld M, Forst T. High-Sensitivity C-Reactive Protein Predicts Cardiovascular Risk in Diabetic and Nondiabetic Patients: Effects of Insulin-Sensitizing Treatment with Pioglitazone. J Diabetes Sci Technol. 2010 4(3);706–16.
4) Lee S, Park H, Kim Y, Kim H. High-sensitivity C-reactive Protein Can Predict Major Adverse Cardiovascular Events in Korean Patients with Type 2 Diabetes. J Korean Med Sci. Oct 2011; 26(10): 1322–7.
5) Vepsalainen T, Soinio M, Marniemi J, Lehto S, Juutilainen A, Laakso M & et al. Physical Activity, High-Sensitivity C-Reactive Protein, and Total and Cardiovascular Disease Mortality in Type 2 Diabetes. Diabetes Care. 2011 Jul;34(7):1492-6.
6) Leslie D G and Cohen R M. Biologic Variability in Plasma Glucose, Hemoglobin A1c, and Advanced Glycation End Products Associated with Diabetes Complications. J Diabetes Sci Technol. 2009 Jul1;3(4):635-43.
7) Hoelzel W, Weykamp C, Jeppsson J O, Miedema K, Barr J R, Goodall & et al. IFCC Reference System for Measurement of Hemoglobin A1c in Human Blood and the National Standardization Schemes in the United States, Japan, and Sweden: A Method-Comparison Study. Clini Chem. 2004 Jan;50(1):166-74.
8) Steele A M, Wensley K J, Ellard S, Murphy R, Shepherd M, Colclough K & et al. Use of HbA1c in the Identification of Patients with Hyperglycaemia Caused by a Glucokinase Mutation: Observational Case Control Studies. PLoS ONE. 2013 Jun14;8(6):65326.
9) Gillett M J. International Expert Committee Report on the Role of the A1C Assay in the Diagnosis of Diabetes. Diabetes Care. 2009 Jul;32(7):1327-34.
10) Harati H, Hadaegh F, Saadat N, Azizi F. Population-based incidence of Type 2 diabetes and its associated risk factors: results from a six-year cohort study in Iran. BMC Public Health 2009; 9:186. doi:10.1186/1471-2458-9-186.
11) Levy J, Atkinson A B, Bell P M, McCance D R, Hadden D R. Beta-cell deterioration determines the onest and rate of progression of secondary dietary failure in type 2 diabetes mellitus: the 10 year follow-up of the Belfast Diet study. Diabet Med. 1998 Apr;15(4):  290-6.
12) Church T S, Blair S, Cocreham S, Johannsen N, Johnson W, Kramer K & et al. Effects of Aerobic and Resistance Training on Hemoglobin A1c Levels in Patients With Type 2 Diabetes. JAMA. 2010 Nov;304(20):2253-62.
13) Jorge M, Oliveira V, Resende N, Paraiso L, Calixto A, Diniz A & et al .The effects of aerobic, resistance, and combined exercise on metabolic control, inflammatory markers, adipocytokines, and muscle insulin signaling in patients with type 2 diabetes mellitus. Metabolism. 2011 Sep;60(9):1244-52.
14) Umpierre D, Ribeiro P, Kramer C, Leita˜o C, Zucatti A, Azevedo M & et al. Physical Activity Advice Only or Structured Exercise Training and Association With HbA1c Levels in Type 2 Diabetes. JAMA. 2011 May 4;305(17):1790-9.
15) Yavari A, Najafipoor F, Aliasgarzadeh A, Niafar M, Mobasseri M, Nikookheslat S. Effect of Aerobic Exercise, Resistance Training or Combined. Biol Sport. 2012;29:135-43.
16) Assarzade Noushabadi M, Abedi B. Effects of combination training on insulin resistance index and some inflammatory markers in inactive men. Quarterly of Ofoghe Danesh. 2012;18(3): 95-101.
17) Tofighi A, samadian A. Comparison of 12 Weeks Aerobic with Resistance Exercise Training on Serum Levels of Resistin and Glycemic Indices in Obese Postmenopausal Women with Type 2 Diabetes (Comparison of Two Exercise Protocols). Jundishapur Sci Med J. 2013;12(6): 665-76.
18) Colberg S R, Sigal R, Ferenhall B, Blissemer B, Rubin R, Alberight A. Exercise and Type 2 Diabetes. ACSM & ADA. Diabetes Care. 2010;Dec 33(12): 147–67.
19) Goto K, Ishi N, Sugihara SH, Yoshioka T, Takamatsu K. Effect of resistance exercise on lipolysis during subsequent submaximal exercise. Med Sci Sports Exerc. 2007 Feb39(2):30815.
20) Pitavos C, Panagiotakos D B, Tambalis K, Chrysohoou C, Sidossis L S and Stefanadis C. Resistance exercise plus to aerobic activities is associated with better lipids’ profile among healthy individuals: the ATTICA study. Q J Med. 2009 Sep;102(9):609-16.
21) Kern M, Wells J A, Stephens J M, Elton C W, Friedman J E, Tapscott E B & et al. Insulin responsiveness in skeletal muscle is determined by glucose transporter (Glut4) protein level. Biochem J. 1990 Sep1;270(2):397–400.
22) Ford E S, Herman W H. Leisure-time physical activity patterns in the U.S. diabetic population: findings from the 1990 national health interview survey– health promotion and disease prevention supplement. Diabetes Care. 1995 Jan;18(1):27-33.
23) Genest J. C-reactive protein: risk factor, biomarker and/or therapeutic target? Can J cardio. 2010 Mar;26:41-4.
24) Holten M K, Zacho M, Gaster M, Juel C, Wojtaszewski J and Dela F. Strength training increases in insulin mediated glucose uptake, GLUT4, content, and insulin signaling in skeletal muscle in patients with type 2 diabetes. Diabetes. 2004 Feb;53(2):294-305.
25) Rice B, Janssen I, Hudson R, Ross R. Effects of aerobic or resistance exercise and or diet on glucose tolerance and plasma insulin levels in obese men. Diabetes Care. 1999 May;22(5):684-91.
26) Eriksson J, Taimela S, Eriksson K, Parviainen S, Peltonen J, Kujala U. Resistance training the treatment of non-insulin-dependent diabetes mellitus. J Sports Med. 1997 May;18(4):242-6.
27) Miller J P, Pratley R E, Glodberg A P, Gordon P, Rubin M, Treuth M S & et al. Strength training increases insulin action in healthy 50-to 65-year old men. J Appl Physiol. 1994 Sep;77(3):1122-7.
28) Poehlman E T, Dvorak R V, Denino W F, Brochu M, Ades P A. Effect of resistance training and endurance training on insulin sensitivity in nonobese, young women: A controlled randomized trial. J Clin Endocrino Metab. 2000 Jul;85(7):2463-8.
29) Greenberg A S and Obin M S. Obesity and the role of adipose tissue in inflammation and metabolism. Am J clin nutr. 2006 Feb;83(2):461-5.