摘要
目的探讨中等强度有氧运动对初发未用药2型糖尿病(T2DM)患者循环生长分化因子15(GDF15)水平的影响,并分析运动诱导的GDF15变化与体成分指标的相关性。方法纳入2020年5月至2023年5月于中国康复研究中心内分泌科门诊就诊的15例初发未用药的T2DM患者为研究对象。所有受试者完成30 min中等强度(60%最大摄氧量)踏车有氧运动,分别于运动前、运动结束后即刻及运动结束后30 min恢复期采集静脉血样,采用酶联免疫吸附测定法检测血浆GDF15水平,同时测定指尖血糖。应用生物电阻抗法评估体成分(腰臀比、体质指数、体脂肪量、体脂率、骨骼肌质量、身体水分、无机盐、蛋白质)。比较运动前、运动后、恢复期GDF15和血糖水平,分析运动诱导的GDF15变化值(ΔGDF15=运动后值-运动前值)与年龄、体成分指标的相关性。结果运动前、运动后、恢复期的GDF15、血糖水平比较差异有统计学意义(P<0.05)。两两比较显示,运动后GDF15水平较运动前显著升高(P<0.05),恢复期回落至基线水平(P>0.05)。运动后和恢复期血糖水平较运动前显著下降,差异有统计学意义(P<0.05)。ΔGDF15与年龄呈负相关(P<0.05);与骨骼肌质量、身体水分、蛋白质含量、无机盐含量均呈显著正相关(P<0.05);与腰臀比、身体质量指数、体脂肪含量、体脂率无相关性(P>0.05)。结论单次中等强度有氧运动可诱导初发未用药T2DM患者循环GDF15快速、短暂升高,该效应与骨骼肌质量等瘦体重成分呈正相关,老年T2DM患者的GDF15运动应答存在衰减。GDF15可能作为肌肉源性因子介导运动的代谢改善作用,维持或增加骨骼肌质量有助于增强运动获益。
Objective To investigate the effect of moderate-intensity aerobic exercise on circulating growth differentiation factor 15(GDF15)levels in drug-naive patients with newly diagnosed type 2 diabetes mellitus(T2DM),and to analyze the correlation between exercise-induced GDF15 changes and body composition parameters.Methods A selfcontrolled before-after study design was employed.Fifteen drug-naive patients with newly diagnosed T2DM were enrolled.All participants completed a 30-minute moderate-intensity(60%VO2max)cycling exercise.Venous blood samples were collected at three time points:pre-exercise,immediately post-exercise,and 30 minutes into recovery.Plasma GDF15 levels were measured by enzyme-linked immunosorbent assay,and fingertip blood glucose was simultaneously measured.Body composition parameters(waist-to-hip ratio,body mass index,fat mass,body fat percentage,skeletal muscle mass,body water,minerals,protein)were assessed using bioelectrical impedance analysis.The change of GDF15(ΔGDF15=post-exercise value-pre-exercise value)induced by exercise was compared with age and body composition indexes.Results There were statistically significant differences in GDF15 and blood glucose levels before exercise,after exercise and during the recovery period(P<0.05).Pairwise comparisons after the fact showed that the level of GDF15 after exercise was significantly higher than that before exercise(P<0.05),and it dropped back to the baseline level during the recovery period(P>0.05).The blood glucose levels after exercise and during the recovery period decreased significantly compared with those before exercise,and the difference was statistically significant(P<0.05).ΔGDF15 was negatively correlated with age(r=-0.379,P=0.164).It was significantly positively correlated with skeletal muscle mass(r=0.587,P=0.027),body water content(r=0.557,P=0.039),protein content(r=0.580,P=0.030),and inorganic salt content(r=0.545,P=0.044)(all P<0.05).There was no significant correlation with waist-hip ratio(r=-0.177,P=0.545),body mass index(r=0.190,P=0.555),body fat content(r=0.193,P=0.508),and body fat percentage(r=-0.048,P=0.870)(all P>0.05).Conclusion A single bout of moderateintensity aerobic exercise induces a rapid and transient increase in circulating GDF15 in drug-naive patients with newly diagnosed T2DM.This effect is positively correlated with lean mass components such as skeletal muscle mass and negatively correlated with age.GDF15 may serve as a muscle-derived factor mediating the metabolic benefits of exercise,and maintaining or increasing skeletal muscle mass may help enhance exercise-induced benefits.
作者
张燕
郑欣
史文丽
胡苏
毕丽娜
Zhang Yan;Zheng Xin;Shi Wenli;Hu Su;Bi Lina(Department of Endocrinology,China Rehabilitation Research Center,Beijing 100068,China)
基金
中国康复研究中心青年基金(编号:2020-Q14)。
