članak: 1 od 1  
Vojnosanitetski pregled
2003, vol. 60, br. 6, str. 683-690
jezik rada: srpski
stručni članak
doi:10.2298/VSP0306683C

Efekti dvonedeljnog programa individualno dozirane fizičke aktivnosti na insulinsku rezistenciju kod gojaznih insulin-nezavisnih dijabetičara
Vojnomedicinska akademija

Sažetak

Poznato je da se pod uticajem redovne, individualno dozirane aerobne fizičke aktivnosti može povećati biološka efikasnost insulina povećanjem broja insulinskih receptora, njihove senzitivnosti i efikasnosti, povećanjem koncentracije glukoznog transportera GLUT-4 na nivou ćelijske membrane. Cilj istraživanja je da se utvrdi da li se primenom programa individualno dozirane fizičke aktivnosti u periodu od 14 dana kod gojaznih insulin-nezavisnih dijabetičara (tip 2 dijabetesa) uz povećanje maksimalne potrošnje kiseonika - (VO2)max ostvaruje i smanjenje insulinske rezistencije (M/I). Kod 10 tip 2 dijabetičara životnog doba 47,6 ± 4,6 god. (grupa E) u periodu od 14 dana primenjen je program aerobnog treninga, 10 sesija od po 35 min hodanja na pokretnoj traci, intenziteta 60,8% (VO2)max, učestalosti pet puta nedeljno uz dijetu od 1 600 kcal. U isto vreme drugih 10 tip 2 dijabetičara životnog doba 45,9 ± 5,6 god. (grupa K) bili su samo na dijeti od 1 600 kcal. Pre i nakon ovog perioda u obe grupe određena je: insulinska senzitivnost (M/I) metodom hiperinsulinskog euglikemijskog klampa i (VO2)max Astrandovim testom opterećenja na ergobiciklu. Za razliku od K grupe u drugom testiranju kod E grupe dobijeno je značajno povećanje M/I (1,23 ± 0,78 prema 2,42 ± 0,95 (mg/kg/min)(mU) p<0,001, 96,75%) i povećanje (VO2)max (26,34 ± 4,26 prema 29,16 ± 5,01 ml/kg/min p<0,05, 10,71%). Rezultati ukazuju da je kod naših ispitanika primenjeni dvonedeljni program aerobnog treninga značajno uticao na povećanje aerobne sposobnosti i insulinske senzitivnosti.

Ključne reči

Reference

*** (1993) Position stand of the American College of Sports Medicine. The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness in healthy adults. Schweiz Sportmed, 41(3), str. 127-37
Allenberg, K., Johansen, K., Saltin, B. (1988) Skeletal muscle adaptations to physical training in type II (non-insulin-dependent) diabetes mellitus. Acta Med Scand, 223(4): 365-73
Anderson, K.L., Rutenfranz, J., Masironi, R., Selinger, V. (1978) Habitual physical activity and health. Geneva, itd: World Health Organization / WHO
Astrand, P.O. (1972) Ergometry with bicycle ergometer. Varberg: MonarkCrescent AB
Block, W.D. (1987) The influence of physical training on glucose tolerance, insulin sensitivity, and lipid and lipoprotein concentrations in middle-aged hypertriglyceridaemic, carbohydrate intolerant men. Diabetologia, 30(6): 380-5
Burleigh, K.M., Storlien, L.H., Bennett, S.P., Kraegen, E.W. (1986) Heterogeneity of insulin action in muscle: Influence of blood flow. Am J Physiol, 251(4 Pt 1): E422-30
Burstein, R., Epstein, Y., Shapiro, Y., Charuzi, I., Karnieli, E. (1990) Effect of an acute bout of exercise on glucose disposal in human obesity. J Appl Physiol, 69(1): 299-304
Cavalot, F., Vitali, S., Banaudi, C., Lucchina, P.G., Fiocchi, F., Emanuelli, G., Lenti, G. (1984) Influence of physical training on blood glucose control, glucose tolerance, insulin secretion, and insulin action in non-insulin-dependent diabetic patients. Diabetes Care, 7(5): 416-20
Dalsky, G.P., Ehsani, A.A., Holloszy, J.O. (1984) Glucose tolerance in young and older athletes and sedentary men. J Appl Physiol, 56(6): 1521-5
DeFronzo, R.A. (1988) Lilly lecture 1987. The triumvirate: Beta-cell, muscle, liver. A collusion responsible for NIDDM. Diabetes, 37(6): 667-87
DeFronzo, R.A., Tobin, J.D., Andres, R. (1979) Glucose clamp technique: A method for quantifying insulin secretion and resistance. Am J Physiol, 237(3): E214-23
DeFronzo, R.A., Ferrannini, E., Sato, Y., Felig, P., Wahren, J. (1981) Synergistic interaction between exercise and insulin on peripheral glucose uptake. J Clin Invest, 68(6): 1468-74
Dragojević, R. (1992) Influence of controlled moderate-intensity exercise on some atherogenic factors in non-insulin-dependent diabetic patients. Beograd: Vojnomedicinska akademija / VMA, dissertation
Eriksson, J., Taimela, S., Koivisto, V.A. (1997) Exercise and the metabolic syndrome. Diabetologia, 40(2): 125-35
Eriksson, J.G. (1999) Exercise and the treatment of type 2 diabetes mellitus. An update. Sports Med, 27(6): 381-91
Eriksson, J.G., Groop, L.C. (1994) Resistance training improves insulin sensitivity in children of type 2 diabetic patients. Diabetologia, 37, str. 623-4
Henriksson, J., Reitman, J.S. (1977) Time course of changes in human skeletal muscle succinate dehydrogenase and cytochrome oxidase activities and maximal oxygen uptake with physical activity and inactivity. Acta Physiol Scand, 99(1): 91-7
Hurley, B.F., Hagberg, J.M., Goldberg, A.P., Seals, D.R., Ehsani, A.A., Brennan, R.E., Holloszy, J.O. (1988) Resistive training can reduce coronary risk factors without altering VO2max or percent body fat. Med Sci Sports Exerc, 20(2): 150-4
Kallio, V. (1986) A controlled randomized study on the effect of long-term physical exercise on the metabolic control in type 2 diabetic patients. Acta Med Scand, 220(3): 219-24
Katz, M.S., Lowenthal, D.T. (1994) Influences of age and exercise on glucose metabolism: Implications for management of older diabetics. South Med J, 87(5): S70-3
King, D.S., Dalsky, G.P., Clutter, W.E., Young, D.A., Staten, M.A., Cryer, P.E., Holloszy, J.O. (1988) Effects of lack of exercise on insulin secretion and action in trained subjects. Am J Physiol, 254(5 Pt 1): E537-42
Koivisto, V.A., de Fronzo, R.A. (1984) Exercise in the treatment of type II diabetes. Acta Endocrinol (Copenh), 262:: 107-11
Krotkiewski, M., Lonnroth, P., Mandroukas, K., Wroblewski, Z., Rebuffe-Scrive, M., Holm, G., Smith, U., Bjorntorp, P. (1985) The effects of physical training on insulin secretion and effectiveness and on glucose metabolism in obesity and type 2 (non-insulin-dependent) diabetes mellitus. Diabetologia, 28(12): 881-90
Lampman, M.R., Santiga, J.T., Savega, P.J., Bassett, D.R., Hydrick, C.R., Flora, J., i dr. (1985) Effects of exercise training on glucose tolerance in vivo insulin sensitivity, lipid lipoprotein concentrations in middle-aged men with mild hypertrygliceridemia. Metabolism, 34(3):
Moller, D.E., ur. (1993) Insulin resistance. New York, itd: Wiley
Nyholm, B., Mengel, A., Nielsen, S., Skjaerbaek, C., Moller, N., Alberti, K.G., Schmitz, O. (1996) Insulin resistance in relatives of NIDDM patients: The role of physical fitness and muscle metabolism. Diabetologia, 39(7): 813-22
Olefsky, J., Reaven, G.M., Farquhar, J.W. (1974) Effects of weight reduction on obesity: Studies of lipid and carbohydrate metabolism in normal and hyperlipoproteinemic subjects. J Clin Invest, 53(1): 64-76
Pedersen, O. (1999) Genetics of insulin resistance. Exp Clin Endocrinol Diabetes, 107(2): 113-8
Pedersen, O., Beck-Nielsen, H., Heding, L. (1980) Increased insulin receptors after exercise in patients with insulin-dependent diabetes mellitus. N Engl J Med, 302(16): 886-92
Perseghin, G., Price, T.B., Petersen, K.F., Roden, M., Cline, G.W., Gerow, K., Rothman, D.L., Shulman, G.I. (1996) Increased glucose transport-phosphorylation and muscle glycogen synthesis after exercise training in insulin-resistant subjects. N Engl J Med, 335(18): 1357-62
Segal, K.R., Blando, L., Ginsberg-Fellner, F., Edano, A. (1992) Postprandial thermogenesis at rest and postexercise before and after physical training in lean, obese, and mildly diabetic men. Metabolism, 41(8): 868-78
Tonino, R.P. (1989) Effect of physical training on the insulin resistance of aging. Am J Physiol, 256(3 Pt 1): E352-6
Vallerand, A.L., Lupien, J., Deshaies, Y., Bukowiecki, L.J. (1986) Intensive exercise training does not improve intravenous glucose tolerance in severely diabetic rats. Horm Metab Res, 18(2): 79-81
Wardzala, L.J., Crettaz, M., Horton, E.D., Jeanrenaud, B., Horton, E.S. (1982) Physical training of lean and genetically obese Zucker rats: Effect on fat cell metabolism. Am J Physiol, 243(5): E418-26
Weiner, J.S., Lourie, J.A. (1981) Practical human biology. New York-San Diego, itd: Academic Press
Zorzano, A., Munoz, P., Camps, M., Mora, C., Testar, X., Palacin, M. (1996) Insulin-induced redistribution of GLUT4 glucose carriers in the muscle fiber. In search of GLUT4 trafficking pathways. Diabetes, 45 Suppl 1: S70-81
Živanić, S., Životić-Vanović, M., Mijić, R., Dragojević, R. (1999) Aerobic capacity and its evaluation by Astrand loading test on ergocycle. Beograd: Udruženje za medicinu sporta Srbije