تأثير دو شيوه تمرين درماني بر سلامت قلبي متابوليكي زنان ميان‌سال داراي اضافه وزن مبتلا به ديابت شيرين

The Effect of Two Exercise Therapy Methods on Cardiometabolic Health of Overweight MiddleAged Females With Diabetes Mellitus

مقدمه: اثرات سودمند ورزش در ديابت نوع 2 در ارتباط با كنترل گلوكز و چندين عامل خطرزاي بيماري قلبي عروقي بخوبي ثابت شده است. هدف از پژوهش حاضر بررسي تأثير دو شيوه تمرين درماني بر سلامت قلبي متابوليكي زنان ميان‌سال داراي اضافه وزن مبتلا به ديابت شيرين بوده است. روش كار: اين تحقيق به لحاظ هدف كاربردي و به لحاظ شيوه گردآوري داده‌ها نيمه تجربي است. 52 نفر از زنان مبتلا به ديابت نوع 2 (سن 45 تا 60 سال) شهرستان شهركرد در سال 1394 به‌طور داوطلبانه در تحقيق حاضر شدند و بر اساس مقادير هموگلوبين گليكوزيله (HbA1c) به سه گروه تمرين تركيبي قدرتي-استقامتي (17 نفر) و تمرين سرعتي تناوبي شديد (17 نفر) و شاهد (18 نفر) تقسيم شدند. متغيرهاي گلوكز ناشتا، انسولين، مقاومت به انسولين، hs-CRP، IL-6، فشارخون سيستوليك و دياستوليك، درصدچربي بدن، محيط كمر (WC)، نسبت محيط كمر به باسن (WHR)، شاخص توده بدن (BMI) مورد ارزيابي قرار گرفتند. نتايج با استفاده از نسخه 21 نرم افزار SPSS و با آزمون‌هاي تي زوجي و تحليل كوواريانس و درصورت معني‌داري از آزمون LSD براي تعيين اختلاف بين گروه‌ها استفاده گرديد. يافته‌ها: نتايج نشان داد كه در گروه تمرينات شديد تناوبي و تمرينات تركيبي قدرتي-استقامتي متغيرهاي انسولين و مقاومت به انسولين نسبت به گروه شاهد كاهش معني داري داشته است (0/05>p) ولي تفاوت معني داري در سي آر پي فوق حساس (hs-CRP) مشاهده نگرديده است (0/05p). به طوري در گروه‌هاي مداخله دور كمر و فشار خون دياستوليك كاهش معني دار و حداكثر اكسيژن مصرفي افزايش معني داري داشته است. نتيجه گيري: تمرين سرعتي تناوبي نسبت به تمرينات تركيبي قدرتي-استقامتي اثرات بهتري بر فاكتورهاي مرتبط با سلامت قلبي-متابوليكي و مقاومت به انسولين زنان ميانسال مبتلا به ديابت شيرين دارد.

Introduction: The beneficial effect of exercise on glucose control in type 2 diabetes is associated with several risk factors for cardiovascular disease. The purpose of this study was to study the effect of two exercise therapy methods on cardiometabolic health of overweight middleaged females with diabetes mellitus. Methods: Overall, 52 overweight female type 2 diabetic patients (age; 4560 years old and fasting blood glucose &ge; 126 mg/dL (7.0 mmol/L)) were assessed for eligibility. Participants were assigned to sprint interval training group (n = 17), concurrent resistanceendurance training group (n = 17) and control group (n = 18). The combined strengthendurance group did 12 weeks, three sessions per week of endurance training at 60% of maximal heart rate and two sessions resistance training at 70% 1RM. Intense interval training group did three sessions/week of four to ten repetitions during 30 seconds. Wingate on ergometer included 10 weeks of concurrent resistanceendurance training and intense interval training. Fasting glucose, insulin, insulin resistance, high sensitivityCReactive protein (hsCRP), interleukin6 (IL6), systolic blood pressure, diastolic blood pressure, body fat, waist circumference (WC), waist to hip ratio (WHR) and body mass index (BMI) were measured before and after 12 weeks of intensive training and combined resistanceendurance training. Results: The results showed that following sprint interval training, there were significant changes in hsCRP (P < 0.001), yet this wasn&rsquo;t significant following concurrent training (P = 0.062). The results showed that following combined training and sprint interval training, there were no significant changes in body mass index and fat percentage (P > 0.05). In addition, it was shown that following combined training there were significant differences in body mass (P = 0.032) and waist circumference in the combined training (P = 0.000); sprint interval training (P = 0.001) and resting heart rate in the intense training group (P = 0.01); systolic blood pressure in the combined training (P = 0.005); sprint interval training (P = 0.009) and diastole pressure in combined (P = 0.001) and sprint interval training (P = 0.001). Differences were not significant for fasting blood glucose in the sprint interval training groups (P = 0.000). Serum insulin levels showed significant increases in the SIT (P = 0.000) and Com (P = 0.000), significantly. The data showed significant differences in insulin resistance index (HOMAIR) in sprint interval training group (P = 0.000) and concurrent resistanceendurance training (P = 0.008). The data showed no significant difference in fasting blood glucose concentrations (P = 0.171). Conclusions: Sprint interval training has more effect than combined resistance endurance training for improving cardiometabolic health and insulin resistance of overweight middleaged females with diabetes mellitus.