有氧运动对不同血糖水平男性人群动脉僵硬度的即时影响
Immediate effects of aerobic exercise on arterial stiffness in a male population with different blood glucose levels
背景 以往有氧运动获益的研究主要关注的是有氧运动对长期心血管健康及结局的影响,即规律有氧运动可以改善动脉僵硬度,而有研究指出高血糖是增加动脉僵硬度的因素,因此推测高血糖可能削弱了有氧运动改善动脉硬化的作用。为了验证这一假设,本研究对有氧运动后人群立即进行动脉僵硬度检测以反映即时影响,利用开滦研究数据,分析有氧运动对不同血糖水平人群动脉僵硬度的即时影响。目的 探究有氧运动对不同血糖水平人群动脉僵硬度的即时影响。方法 本研究以既参加开滦研究 2018—2020 年第 6 次随访体检又于开滦集团旗下四家企业完成功率车二级负荷试验前、后臂踝脉搏波传导速度(baPWV)测量者为研究对象。对研究对象开展流行病学调查,包括一般情况(年龄、高血压、高脂血症、降压药史等)、人体测量学指标〔收缩压(SBP)、舒张压(DBP)等〕和生化检测指标(空腹血糖等),根据空腹血糖水平将研究对象按照四分位分组:Q1 组(n=220):<5.00 mmol/L、Q2 组(n=240):5.00~<5.40 mmol/L、Q3 组(n=230):5.40~<5.81 mmol/L、Q4 组(n=234):≥ 5.81 mmol/L。以功率车二级负荷试验作为有氧运动的形式,以 baPWV 水平作为反映四肢动脉僵硬度的指标,收集研究对象功率车二级负荷试验前、后baPWV 相关资料〔SBP、DBP、平均动脉压(MAP)、心率(HR)和 baPWV 水平、代谢当量(MET)、最大摄氧量(VO2max)等〕,试验前记作 1,试验后记作 2;并计算前、后两次测量结果的差值(记作△ baPWV 等)。比较 Q1 组、Q2 组、Q3 组、Q4 组流行病学调查资料和 baPWV 相关资料的差异;采用广义线性回归模型评估不同血糖水平对功率车二级负荷试验前、后 baPWV 水平的影响。结果 符合纳入标准的研究对象 924 例,平均年龄为(36.93±7.72)岁。各组流行病学调查资料比较结果显示,四组的年龄、高脂血症、高血压、降压药史、收缩压、舒张压、空腹血糖、高敏 C 反应蛋白、三酰甘油、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇情况比较,差异具有统计学意义(P<0.01);各组功率车二级负荷试验前、后的 baPWV 相关资料比较结果显示,Q1 组、Q2 组、Q3 组 HR2 高于 HR1(P<0.01);Q1 组、Q2 组、Q3 组、Q4 组 的 baPWV2 高 于 baPWV1(P<0.01); 四 组 间 的 SBP1、SBP2、DBP1、DBP2、MAP1、MAP2、baPWV1、baPWV2 比较,差异具有统计学意义(P<0.01);与 baPWV1 相比,不同血糖水平人群 baPWV2 平均下降 36.0 cm/s。广义线性回归模型分析结果显示,在校正混杂因素后,与 Q4 组相比,Q1 组的△ baPWV 水平降低〔b(95%CI)=-18.96(-36.96,-0.96),P=0.04〕。结论 有氧运动能即时改善动脉僵硬的程度,但高血糖减弱了有氧运动改善动脉僵硬度的作用,临床医生要针对不同人群设计不同的有氧运动方案,以改善动脉硬化延缓血管老化。
Background Previous studies on the benefits of aerobic exercise mainly focus on the impact of aerobic exercise on long-term cardiovascular health and outcomesnamely regular aerobic exercise can improve arterial stiffnesswhile some studies point out that high blood sugar increases arterial stiffness. Thereforeit is supposed that hyperglycaemia may weaken the effect of aerobic exercise on improving arterial stiffness. To verify thiswe used the Kailuan study data to analyze the immediate effect of aerobic exercise on arterial stiffness in people with different blood glucose levels. Objective To investigate the immediate effect of aerobic exercise on arterial stiffness in people with different blood glucose levels. Methods This study selected individuals who had participated in the 6th follow-up physical examination of the Kailuan Study during 2018—2020 and had their brachial-ankle pulse wave conduction velocitybaPWVmeasured before and after the secondary load test of the power vehicle bicycle in four subordinate enterprises of Kailuan Group. Epidemiological survey result were collectedgeneral informationagehypertensionhyperlipidemiahistory of antihypertensive drugsetc.anthropometric indicatorssystolic blood pressureSBPdiastolic blood pressureDBPetc.and biochemical indicatorsfasting blood glucoseetc.. baPWV measured in the secondary load test of the power vehicle bicycleused as the aerobic exercise was used as an indicator of upper and lower limb arterial stiffness. baPWV-related indicatorsSBPDBPmean arterial pressureMAPheart rateHRbaPWVmetabolic equivalentMETmaximal oxygen uptakeVO2maxetc. before and after the test were expressed using a unified formfor examplepre- and post-test baPWV were recorded as baPWV 1 and baPWV 2respectivelyand its pre- and post-test difference was denoted as baPWV. The epidemiological survey result and BAPWV-related data were compared between fasting blood glucoseFBG quartile groupsQ1n=220<5.00 mmol/LQ2n=2405.00-<5.40 mmol/LQ3n=2305.40-<5.81 mmol/LQ4n=234≥ 5.81 mmol/L. Generalized linear regression model was used to evaluate the association of FBG with pre- and post-test baPWV. Results A total of 924 eligible cases were enrolledwith an average age of36.93±7.72years. FBG quartile groups had statistically significant differences in mean agehyperlipidemia and hypertensionhistory of using antihypertensive drugsmean SBPDBPFBGhigh sensitivity C-reactive proteintriglyceridetotal cholesterolhigh-density lipoprotein cholesterol and low-density lipoprotein cholesterolP<0.01. HR2 was found to be statistically significant higher than HR1 in groups Q1Q2 and Q3P<0.01. baPWV2 was found to be statistically significant higher than baPWV1 in Q1Q2Q3 and Q4 groupsP<0.01. SBP1DBP1MAP1 and baPWV1 significantly differed across the groupsand so did SBP2DBP2MAP2 and baPWV2P<0.01. Compared with baPWV1baPWV2 decreased by an average of 36.0 cm/s in people with different blood glucose levels. The generalized linear regression model showed that after adjusting for confounding factorsthe baPWV level in group Q1 was lower than that in group Q4b95%CI=-18.96-36.96-0.96P=0.04. Conclusion Aerobic exercise can immediately improve the degree of arterial stiffnessbut the effect can be weakened by high blood sugar. Clinicians should design aerobic exercise programs according to the personal features of populations to improve arteriosclerosis and delay vascular aging.
李鹏、张国、何荣、吴寿岭、张晓玲、张丽、孙丽霞、臧懿然
10.12114/j.issn.1007-9572.2023.0029
医药卫生理论医学研究方法内科学
运动糖尿病血管硬化程度有氧运动血糖动脉僵硬度脉搏波传导速度心血管疾病
Exerciseiabetes mellitusVascular stiffnessaerobic exerciseFasting blood glucosePulse wave velocityrterial stiffnessardiovascular disease
李鹏,张国,何荣,吴寿岭,张晓玲,张丽,孙丽霞,臧懿然.有氧运动对不同血糖水平男性人群动脉僵硬度的即时影响[EB/OL].(2023-04-10)[2025-08-25].https://chinaxiv.org/abs/202304.00986.点此复制
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