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目的 :探讨运动能量代谢测定指导2型糖尿病患者个体化最佳运动量的临床意义。方法 :采用Cosmed K4b2间接热量计,测定56例2型糖尿病患者在不同运动强度下的脂肪消耗。测定患者的腰臀围、体重指数(BMI),计算胰岛素抵抗指数(HOMA-IR)。并采用双能X线骨密度检测仪测定其肌肉、脂肪分布,同时分析最大脂肪消耗量与腰臀围、胰岛素抵抗、肌肉脂肪分布之间的相关性。结果:随着运动强度的增加,2型糖尿病患者脂肪耗能先增加后降低,但最大脂肪消耗量的运动强度不同;随着脂肪耗能增加,BMI、胰岛素抵抗指数显著下降,呈明显负相关(r=-0.372,P=0.005;r=-0.558,P<0.001)。结论:脂肪能量消耗增加可降低BMI,改善胰岛素抵抗,运动能量代谢仪可检测2型糖尿病患者最大脂肪耗能的运动强度,制定个体化的运动处方。
Objective: To investigate the clinical significance of motor energy metabolism measurement to guide individualized optimal exercise in patients with type 2 diabetes mellitus. Methods: Cosmed K4b2 indirect calorimeter was used to determine the fat consumption of 56 patients with type 2 diabetes under different exercise intensity. The patient’s waist-hip circumference, body mass index (BMI), and insulin resistance index (HOMA-IR) were calculated. The distribution of muscle and fat was measured by dual-energy X-ray absorptiometry, and the correlation between maximum fat consumption and waist-hip circumference, insulin resistance and muscle fat distribution was also analyzed. Results: With the increase of exercise intensity, the type 2 diabetes patients first increased and then decreased in fat consumption, but the maximum exercise intensity of different fat consumption was different. With the increase of fat consumption, BMI and insulin resistance index decreased significantly, showing a significant negative correlation (r = -0.372, P = 0.005; r = -0.558, P <0.001). Conclusion: The increase of fat energy consumption can reduce BMI and improve insulin resistance. The exercise energy metabolism meter can detect the exercise intensity of maximal fat consumption in patients with type 2 diabetes and formulate individual exercise prescriptions.