有氧運動計畫對肥胖症合併葡萄糖不耐症青少年身體組成及胰臟β細胞功能之影響:隨機試驗

Efficacy of aerobic exercise program on anthropometric measurements and glucose metabolism in obese adolescents with impaired glucose tolerance : A randomized

緒論:儘管身體活動能改善身體組成並降低罹患代謝症候群的風險，然而，不同的有氧運動計劃對身體組成的影響是否相似及目前有氧運動對胰臟β細胞功能的改善仍不明確。故本研究的目的是比較居家式與中心式有氧運動計畫在身體組成改變和胰臟β細胞功能改善上是否具相同的影響。方法：招募肥胖症且合併葡萄糖不耐症之青少年共33位，採隨機分派為三組，每組11位，分別進行8週有氧運動介入，分別為中心式運動計畫（CP），每週三次，每次30分鐘達中等強度的跑步機運動；居家式運動計畫（HP），每週三日，每日配戴計步器且達日累計萬步的走路運動；控制組，維持目前生活型態。受試者在介入前一週及8週介入結束後一週內，分別接受身體組成測量和胰臟β細胞功能評估。結果：兩組運動（CP vs. HP）組在體脂肪 （-1.58 vs. -1.80）（F=9.95, p < .001）、腰圍（-3.78 vs. -4.88）（F=12.24, p < .001）、臀圍（-1.55 vs. -2.25）及腰臀比（-0.02 vs. -0.03）（F=4.28, p = .025）變項上達顯著減少，胰臟β細胞功能之胰島素敏感性（BIGTT-SI）（0.60 vs.0.63）（F=6.89, p = .004）和葡萄糖代謝率（DI）（5.54 vs. 5.66）（F=7.51, p < .001） 顯著改善，且兩組運動組之改變量無差異。結論：本研究顯示，居家式與中心式有氧運動計畫在身體組成及胰臟β細胞功能上具相似的影響。

Introduction: Although physical activity improves the body composition and minimizes risks of metabolic diseases, whether different exercise programs result in similar effects on anthropometric measurements and pancreatic β-cell function is not clear. The purpose of this study was to verify whether a home-based walking program has the same effects in anthropometric measurements and pancreatic β-cell function as a center-based aerobic exercise program. Methods: Obese adolescents with impaired glucose tolerance (n=33) were recruited and randomly assigned to a center-based program (CP) group (exercise on a treadmill with moderate intensity for 30 min, 3 times per week for 8 weeks; n=11), a home-based program (HP) group (walk with a pedometer to accumulate 10,000 steps per day for at least 3 days per week for 8 weeks; n=11), or a control (CG) group (maintain ones normal daily activities; n=11). Anthropometric parameters and pancreatic β-cell function were measured at the baseline and after 8 weeks of exercise programs. An analysis of covariance (ANCOVA) was conducted to test the overall effects. Results: Both exercise groups showed significant improvements in the fat mass (-1.58 vs. -1.80)(F=9.95, p < .001), waist circumference (-3.78 vs. -4.88)(F=12.24, p < .001), hip circumference (-1.55 vs. -2.25) (F=17.90, p < .001), and waist-hip ratio (-0.02 vs. -0.03)(F=4.28, p = .025) compared to the control group. Pancreatic β-cell function in both exercise groups significantly improved, which was reflected by the insulin action by insulin sensitivity (BIGTT-SI)(0.60 vs.0.63) (F=6.89, p = .004) and deposition index (DI) (5.54 vs. 5.66) (F=7.51, p < .001). Differences in all measurements between two groups were not observed. Conclusion : The findings suggested that a home-based walking program has similar effects as center-based aerobic exercise program on anthropometric measurements and pancreatic β-cell function.