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目的:探讨2年的抗阻运动和有氧运动对糖尿病前期患者心血管疾病风险的影响。方法:选取2014年1—4月在南京中医药大学附属中西医结合医院以及2014年5—12月在丹阳市人民医院和广西医科大学第一附属医院就诊的糖尿病前期患者共248例，随机数字表法将248例患者随机分为3组：抗阻运动组（RT组）82例，有氧运动组（AT组）83例和对照组 83例。AT组、RT组干预24个月后，比较各组患者在基线以及第12个月和第24个月时的血糖、血脂等指标。结果:随着干预时间的延长，RT组和AT组患者糖化血红蛋白（HbA1c）、低密度脂蛋白胆固醇（LDL-C）、血压和稳态模型2胰岛素抵抗指数（HOMA2-IR）趋于降低，稳态模型2β细胞功能指数（HOMA2-β）趋于增高。24个月时，RT组和AT组患者HbA1c ［5.80 （5.43， 6.20）%、5.70 （5.50， 6.00）% 比6.20 （5.70， 6.60）%，n P值均≤0.01］，LDL-C ［3.07（2.69， 3.58）mmol/L、2.97（2.62， 3.95）mmol/L比3.21（2.54， 3.78） mmol/L，n P值均<0.05］ 和 HOMA2-IR ［0.96（0.82， 1.47）、1.20（0.99， 1.43）比1.34.（1.09， 1.51），n P值均0.05）。校正年龄、性别、血压后，干预后RT组（n P=0.017）和AT组（n P=0.018）的糖尿病前期心血管风险显著降低。校正年龄、性别、他汀类药物治疗、体重指数、腰臀围比后，Cox回归显示抗阻运动（n HR=0.419， 95n %CI =0.415~0.942， n P=0.037）和有氧运动（n HR=0.310， 95n %CI=0.447~0.866， n P=0.026）为糖尿病前期心血管疾病保护因子，分别降低了糖尿病前期患者58.1%和69.0%的心血管疾病风险。n 结论:24个月有氧和抗阻运动可改善血糖控制和糖尿病前期患者HOMA2-IR。抗阻运动能够降低心血管疾病风险，对于没有明显运动禁忌证的糖尿病前期患者，抗阻运动是值得推荐的运动方式。“,”Objective:To investigate the effect of a 2-year resistance and aerobic training on reducing the risk of cardiovascular disease in patients with prediabetes.Methods:A total of 248 patients with prediabetes were enrolled from Chinese and Western Medicine Hospital Affiliated to Nanjing University of Chinese Medicine from January to April 2014, and Danyang People′s Hospital and The First Affiliated Hospital of Guangxi Medical University from May to December 2014.Based on random number table method, the patients were divided into 3 groups: the resistance training group (RT group, 82 cases), the aerobic training group (AT group, 83 cases) and control group (83 cases). Participants in the RT group and the AT group underwent a total of 24 months of exercise training. Changes in indicators (blood glucose,blood lipid, etc.) at baseline and the end of 12 and 24 months among the groups were compared.Results:After intervention, glycosylated hemoglobin (HbA1c), low density lipoprotein cholesterol (LDL-C), blood pressure and homeostasis model 2 insulin resistance index (HOMA2-IR) in the RT and AT groups tended to decrease, and the steady state model 2 β cell function index (HOMA2-β) tended to increase. At the end of 24 months, HbA1c [5.80 (5.43, 6.20) %, 5.70 (5.50, 6.00)% vs. 6.20 (5.70, 6.60) %, all n P≤ 0.01], LDL-C [3.07 (2.69, 3.58) mmol/L, 2.97 (2.62, 3.95) mmol/L vs. 3.21(2.54, 3.78) mmol/L, all n P<0.05] and HOMA2-IR [0.96 (0.82, 1.47), 1.20 (0.99, 1.43) vs. 1.34 (1.09, 1.51), all n P0.05). After adjusting for age, sex and blood pressure, the cardiovascular risk of prediabetes was significantly reduced in RT (n P =0.017) and AT groups (n P =0.018). The Cox regression analyses showed that both the resistance training (HR=0.419, 95n %CI =0.415-0.942, n P=0.037) and the aerobic training (n HR=0.310, 95n %CI=0.447-0.866, n P=0.026) were protective factors for cardiovascular disease in prediabetic patients after adjustment of age, sex, statins, body mass index and waist-to-hip ratio, which reduced the risks of cardiovascular disease in prediabetic patients by 58.1% and 69.0%, respectively.n Conclusions:Two years of aerobic and resistance training interventions have obvious advantages on glycemic and insulin resistance control in prediabetes patients. The resistance training can reduce the risk of cardiovascular disease, and it is, thus, recommended for prediabetic patients without obvious exercise contraindications.