اثر تمرین ترکیبی (مقاومتی-هوازی) بر هموگلوبین گلیکوزیله، کلسترول‌تام، تری‌گلیسرید، و مقاومت به انسولین در زنان یائسه مبتلا به نوروپاتی محیطی دیابتی

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشجوی دکتری فیزیولوژی ورزشی، بیوشیمی و متابولیسم ورزشی، دانشکده علوم ورزشی، دانشگاه فردوسی مشهد، مشهد، ایران

2 استاد گروه فیزیولوژی ورزشی، دانشکده علوم ورزشی دانشگاه فردوسی مشهد، مشهد، ایران

3 استاد گروه فیزیولوژی ورزشی، دانشکده علوم ورزشی دانشگاه حکیم سبزواری، سبزوار، ایران

چکیده

زمینه و هدف  شایع‌ترین علت بروز پلی‌نوروپاتی، بیماری دیابت می‌باشد. تاکنون مطالعات بسیار کمی در زمینه اثر تمرین ترکیبی بر عوارض بیماری دیابت و نوروپاتی محیطی دیابتی انجام شده است. هدف این پژوهش، بررسی تأثیر چهار ماه تمرین ترکیبی (مقاومتی- هوازی) بر هموگلوبین گلیکوزیله، کلسترول تام، تری‌گلیسرید و مقاومت به انسولین در زنان یائسه مبتلا به نوروپاتی محیطی دیابتی بود.
مواد و روش‌ها بدین منظور 21 بیمار مبتلا به نوروپاتی محیطی در دو گروه کنترل و تجربی قرار گرفتند. گروه تجربی به مدت چهار ماه تمرینات ترکیبی مقاومتی- هوازی سه جلسه در هفته انجام دادند. نمونه سرم آزمودنی‌ها قبل و پس از ماه اول، دوم، سوم و چهارم تمرین، در حالت ناشتایی به‌دست آمد. داده‌ها با استفاده از روش آماری ANOVA یک‌طرفه و ANOVA با اندازه‌گیری مکرر تحلیل شد.
یافته‌ها سطوح کلسترول تام، تری‌گلیسرید، هموگلوبین گلیکوزیله، مقاومت به انسولین، وزن و درصد چربی در گروه تجربی نسبت به گروه کنترل تغییر معنی‌داری نداشت (0/05>P).
نتیجه‌گیری تثبیت قند و هموگلوبین گلیکوزیله بیماران نوروپاتی دیابتی و افزایش نیافتن سطوح کلسترول تام، تری‌گلیسرید و مقاومت به انسولین طی چهار ماه به لحاظ بالینی اهمیت زیادی دارد و نشان می‌دهد تمرین مقاومتی- هوازی منظم می‌تواند پیشرفت و عوارض بیماری را به تأخیر اندازد.

کلیدواژه‌ها

موضوعات


عنوان مقاله [English]

The Effect of Combined Training (Resistance-Aerobic) on glycosylated Haemoglobin, cholesterol, triglyceride, Insulin Resistance in Postmenopausal Women with Diabetic-Peripheral-Neuropathy

نویسندگان [English]

  • tayebe Amiri Parsa 1
  • Seyyed Reza Attarzadeh hosseini 2
  • Nahid Bijeh 2
  • Mohammadreza Hamedinia 3
1 Ph.D Student in Exercise Physiology, Biochemistry and Sport Metabolism, , Faculty of Sport Sciences, Ferdowsi University of Mashhad, Mashhad, IR Iran
2 Professor of Sport Physiology, Faculty of Sport Sciences, Ferdowsi University of Mashhad, Mashhad, IR Iran
3 Professor of Sport Physiology, Faculty of Sport Sciences, Hakim Sabzevari University, Sabzevar, IR Iran
چکیده [English]

Introduction: The most common cause of polyneuropathy is diabetes. Very few studies have investigated the effects of combined training on diabetes and diabetic-peripheral neuropathy complications. The purpose of this study was to investigate the effect of four months aerobicresistance training on glycosylated haemoglobin, total cholesterol, triglyceride and insulin resistance in postmenopausal women with diabetic-peripheral neuropathy .
Materials and methods: For this purpose, 21 patients with diabetic neuropathy, were divided into two groups of control (n =10) and experimental (n =11). The experimental group performed resistance - aerobic training three sessions per week for four months. Subjects’ fasting serum samples were obtained before the start of the study and after the first, second, third and fourth months of training. Data were analyzed by one-way ANOVA and repeated measures ANOVA .
Results: Total cholesterol, triglyceride, insulin resistance and glycosylated hemoglobin levels, as well as weight and fat percentage in the experimental group did not change significantly (P> 0.05) .
Conclusion: Stabilized glucose and glycosylated hemoglobin in diabetic-neuropathy patients and no increase in total cholesterol, insulin resistance and triglyceride levels within four months is clinically important and indicate that regular resistance - aerobic training can delay progression and complications of the disease. 

کلیدواژه‌ها [English]

  • insulin resistance
  • Glycated Hemoglobin
  • CHOLESTEROL
  • Diabetic Neuropathie
[1]. Jameson JL, Fauci AS, Kasper DL,Hauser SL, Longo DL et al. Harrison's principles of internal medicine 20e: McGraw-Hill Professional Publishing; 2018.
[2]. Boulton AJM, Vinik AI, Arezzo JC, Bril V, Feldman EL, Freeman R, et al. Diabetic neuropathies: a statement by the American Diabetes Association. Diabetes care. 2005;28(4):956-62.
[3]. Fioretto P, Dodson PM, Ziegler D, Rosenson RS. Residual microvascular risk in diabetes: unmet needs and future directions. Nat Rev Endocrinol. 2010;6(1):19-25.
[4]. Toth C, Brussee V, Martinez J, McDonald D, Cunningham F, Zochodne D. Rescue and regeneration of injured peripheral nerve axons by intrathecal insulin. Neuroscience. 2006;139(2):429-49.
[5]. Kim B FE. Insulin resistance in the nervous system. Trends Endocrinol Metab. 2012;1(3):133-41.
[6]. Praet SF, Van Loon LJ. Optimizing the therapeutic benefits of exercise in type 2 diabetes. J Appl Physiol. 2007;103(4):1113-20.
[7]. Wolf G, Gabay E, Tal M, Yirmiya R, Shavit Y. Genetic impairment of interleukin-1 signaling attenuates neuropathic pain, autotomy, and spontaneous ectopic neuronal activity, following nerve injury in mice. Pain. 2006;120(3):315-24.
[8]. 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-e67.
[9]. de Oliveira VN, Bessa A, Jorge MLMP, Oliveira RJdS, de Mello MT, De Agostini GG, et al. The effect of different training programs on antioxidant status, oxidative stress, and metabolic control in type 2 diabetes. Appl Physiol Nutr Metab. 2012;37(2):334-44.
[10]. Jorge ML, de Oliveira VN, Resende NM, Paraiso LF, Calixto A, Diniz AL 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;60(9):1244-52.
[11]. Kadoglou NPE, Fotiadis G, Kapelouzou A, Kostakis A, Liapis CD, Vrabas IS. The differential anti-inflammatory effects of exercise modalities and their association with early carotid atherosclerosis progression in patients with type 2 diabetes. Diabet Med. 2013;30(2):e41-e50.
[12]. Sigal RJ, Kenny GP, Boulé NG, Wells GA, Prud'homme D, Fortier M, et al. Effects of aerobic training, resistance training, or both on glycemic control in type 2 diabetes: a randomized trial. Ann. Intern. Med. 2007;147(6):357-69.
[13]. Annibalini G, Lucertini F, Agostini D, Vallorani L, Gioacchini A, Barbieri E, et al. Concurrent Aerobic and Resistance Training Has Anti-Inflammatory Effects and Increases Both Plasma and Leukocyte Levels of IGF-1 in Late Middle-Aged Type 2 Diabetic Patients. Oxidative Med Cell Longevity 2017; 18(12): 42-56 [14]. Kluding PM, Pasnoor M, Singh R, Jernigan S, Farmer K, Rucker J, et al. The effect of exercise on neuropathic symptoms, nerve function, and cutaneous innervation in people with diabetic peripheral neuropathy. J Diabetes Complications. 2012;26(5):424-9.
[15]. Escott-Stump S, Mahan L. Dietary reference intakes (DRIs): recommended intakes for individuals, vitamin/mineral. Krause’s Food & Nutrition Therapy, 12th Edition, Saunders Elsevier, Philadelphia. 2008. [16]. Fernandes DD, Barbosa JS, de Aguiar VF, de Carvalho DD. Use of Assistance Protocols for the Screening of Diabetic Neuropathy in Primary Care: An Integrative Review. International Journal of Advanced Engineering Research and Science (IJAERS).2020;7(5).
[17]. Moghtaderi A, Bakhshipour A, Rashidi H. Validation of Michigan neuropathy screening instrument for diabetic peripheral neuropathy. Clin Neurol Neurosurg 2006;108(5):477-8.
[18]. Lambers S, Van Laethem C, Van Acker K, Calders P. Influence of combined exercise training on indices of obesity, diabetes and cardiovascular risk in type 2 diabetes patients. Clin Rehabil. 2008;22(6):483-92.
[19]. Schwingshackl L, Missbach B, Dias S, König J, Hoffmann G. Impact of different training modalities on glycaemic control and blood lipids in patients with type 2 diabetes: a systematic review and network meta-analysis. Diabetologia. 2014;57(9):1789-97.
[20]. Banaei P TV, Rahimi MA. Comparison of the effect of two types of aerobic exercise protocols on fasting blood glucose, glycosylated hemoglobin, High-sensitivity Creactive Protein and insulin resistance on Diabetic women. Sport Physiology. 2015(25):99-108.
[21]. Chudyk A, Petrella RJ. Effects of exercise on cardiovascular risk factors in type 2 diabetes: a metaanalysis. Diabetes care. 2011;34(5):1228-37.
[22]. Colberg SR, Sigal RJ, Fernhall B, Regensteiner JG, Blissmer BJ, Rubin RR, Chasan-Taber L, Albright AL, Braun B. Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement. Diabetes care. 2010; 33(12):e14767.
[23]. Badri N HnM, Hosseini Kakhk SA. The effect of two types of combined training with a different volume on some of the indicators of neuropathic and functional in women of type 2 diabetic patients with peripheral neuropathy. Thesis Hakim Sabzevari University. 2018.
[24]. Rezaei M, HamediNia MR, Haghighi AH. The effect of 8 weeks combined resistance- aerobic training on functional fitness, Nerve growth factor and insulin resistance of diabetic women with peripheral neuropathy. Thesis Hakim Sabzevari University. 2018.
[25]. Tan S, Li W, Wang J. Effects of six months of combined aerobic and resistance training for elderly patients with a long history of type 2 diabetes. J Sports Sci Med. 2012;11(3):495-501
[26]. Balducci S, Iacobellis G, Parisi L, Di Biase N, Calandriello E, Leonetti F, et al. Exercise training can modify the natural history of diabetic peripheral neuropathy. J Diabetes Complications. 2006;20(4):216-23.
[27]. Kim SH, Lee SJ, Kang ES, Kang S, Hur KY, Lee HJ, et al. Effects of lifestyle modification on metabolic parameters and carotid intima-media thickness in patients with type 2 diabetes mellitus. Metabolism. 2006;55(8):1053-9.
[28]. Kelly AS, Steinberger J, Olson TP, Dengel DR. In the absence of weight loss, exercise training does not improve adipokines or oxidative stress in overweight children. Metabolism. 2007;56(7):1005-9.
[29]. Kluding PM, Pasnoor M, Singh R, D'Silva LJ, Yoo M, Billinger SA, et al. Safety of aerobic exercise in people with diabetic peripheral neuropathy: single-group clinical trial. Physical therapy. 2015;95(2):223-34.
[30]. Millet GP, Vleck VE, Bentley DJ. Physiological differences between cycling and running. Sports Medicine. 2009;39(3):179-206.
[31]. Umpierre D, Ribeiro PAB, Kramer CK, Leitão CB, Zucatti ATN, Azevedo MJ, et al. Physical activity advice only or structured exercise training and association with HbA1c levels in type 2 diabetes: a systematic review and metaanalysis. JAMA. 2011;305(17):1790-9.
[32]. Church TS, Blair SN, 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: a randomized controlled trial. Jama. 2010;304(20):2253-62.
[33]. Loprinzi PD, Hager KK, Ramulu PY. Physical activity, glycemic control, and diabetic peripheral neuropathy: a national sample. J diabetes complications. 2014;28(1):1721.
[34]. Davis WA, Norman PE, Bruce DG, Davis TME. Predictors, consequences and costs of diabetes-related lower extremity amputation complicating type 2 diabetes: the Fremantle Diabetes Study. Diabetologia. 2006;49(11):263441.