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تاثیر تمرینات هوازی و مکمل 25 هیدروکسی ویتامین "د" بر شاخص‌های گلایسمیک و مقاومت انسولین در مردان مبتلا به دیابت نوع 2

نوع مقاله : مقاله پژوهشی

نویسندگان

چکیده

مقدمه: دﯾﺎﺑﺖ ﯾﮑﯽ از ﻣﻌﻀﻼت ﺳﻼﻣﺘﯽ در ﺗﻤﺎﻣﯽ ﺟﻮاﻣﻊ ﻣﺤﺴﻮب ﻣﯽشود. مداخلات ورزﺷﯽ و مکمل از ﺟﻤﻠﻪ روﯾﮑﺮدﻫﺎی ﺑﻬﺒﻮد وﺿﻌﯿﺖ اﻓﺮاد دﯾﺎﺑﺘﯽ ﺗﻠﻘﯽ ﻣﯽﮔﺮدد. لذا هدف از پژوهش حاضر بررسی اثرات 8 هفته تمرین هوازی با و بدون مکمل 25هیدروکسی ویتامین Dبر قند خون ناشتا، میزان انسولین پلاسما و شاخص مقاومت انسولین بود .مواد و روش: در این تحقیق از نوع نیمه تجربی، با طرح پیش آزمون- پس آزمون از بین مردان 40 تا60 سال مبتلا به دیابت نوع 2 مراجعه‌کننده به مرکز دیابت بیمارستان عیسی بن مریم اصفهان، تعداد 48نفر به صورت داوطلبانه و در دسترس انتخاب و در 4 گروه تمرینات هوازی (12بیمار)، گروه تمرینات هوازی و مصرف مکمل 25هیدروکسی ویتامین D (12بیمار)، گروه مصرف مکمل 25 هیدروکسی ویتامین D  (12بیمار) و گروه کنترل (12بیمار) قرار گرفتند. برنامه تمرینات هوازی به مدت 8 هفته (3جلسه در هفته، هر جلسه 60 تا 75 دقیقه با شدت 85-60 درصد حداکثر ضربان قلب) اعمال شد. گروه‌های دریافت کننده مکمل نیز مکمل 25هیدروکسی ویتامینD  را به مدت 8 هفته با 50000 واحد خوراکی مصرف کردند. میزان قند خون ناشتا، انسولین پلاسما و شاخص مقاومت انسولین قبل و بعد از مداخله در چهار گروه اندازه‌گیری شد. در نهایت داده‌ها با استفاده از آزمون تحلیل کواریانس و آزمون تعقیبی LSD مورد تجزیه و تحلیل آماری قرار گرفت.یافته‌ها: نتایج تحقیق بیانگر تفاوت معنی‌داری بین میانگین سطح انسولین پلاسما، قند خون ناشتا و شاخص مقاومت انسولین گروه تمرینات هوازی، گروه تمرینات هوازی و مصرف مکمل، گروه مصرف مکمل و گروه کنترل بود (05/0 > P).بحث و نتیجه‌گیری: مکمل‌سازی ویتامین D به همراه تمرینات هوازی منجر به بهبود میزان قند خون ناشتا، سطح انسولین پلاسما و مقاومت انسولین گردید. بنظر می‌رسد انجام فعالیت‌های ورزشی و مکمل ویتامین D، می‌تواند به عنوان یک روش درمانی مکمل در بهبود وضعیت بیماران دیابتی مد نظر قرار گیرد.

کلیدواژه‌ها

عنوان مقاله [English]

The Effect of Aerobic Exercises and 25-Hydroxy Vitamin D Supplements on Glycemic Indexes and Insulin Resistant in Males with Type 2 Diabetes

نویسندگان [English]

  • N Rahimi
  • M A amavati Sharif
  • A R Goharian
  • A Heidarian Pour

چکیده [English]

Background and Objectives: Diabetes is considered to be one of the health problems in all societies. Exercise training and supplements are approaches for improving diabetes. This study aimed to investigate the effect of 8 weeks of aerobic training with and without 25-hydroxy vitamin D supplementation on fasting blood sugar, serum insulin, and insulin resistance.
Methods: This semi-experimental research with pretest-posttest design was conducted on 48 men aging 40 to 60 years with type 2 diabetes admitted to Jesus, son of Mary Hospital in Isfahan. Volunteers were selected through convenience sampling and were divided into four groups as follows: aerobic exercise group (n=12), aerobic exercise with
25-hydroxy vitamin D supplementation group (n=12), 25-hydroxy vitamin D supplementation group (n=12), and control group (n=12). The aerobic exercise program was performed for 8 weeks (3 sessions a week, each session lasting for 60-75 minutes, with the intensity of 60-80% of maximum heart rate). The supplement groups also received 50000 units of oral vitamin D weekly for 8 weeks. Fasting blood sugar, serum insulin, and insulin resistance were measured in the 4 groups before and after the intervention. The data were analyzed by ANCOVA and LSD post-hoc test.   
 Results: The findings showed a significant difference among the four groups regarding the mean of fasting blood sugar, serum insulin, and insulin resistance (P<0.05).
Conclusion: The results indicated that vitamin D supplementation combined with aerobic exercises improved fasting blood sugar, plasma insulin level, and insulin resistance. Thus, aerobic training together with the use of vitamin D supplements can be considered as a complementary therapy in improvement of diabetes.

کلیدواژه‌ها [English]

  • Diabetes mellitus
  • Aerobic exercises
  • Vitamin D
  • Insulin resistance
مراجع
  1. Lambers S, Van Laethem C, Van Acker Sint K, Calder P, Calders B. Influence of combined exercise training on indices of obesity, diabetes and cardiovascular risk in type 2 diabetes patients. Clinical Rehabilitation 2008; 22(6): 483- 92.
  2. John BB, Kenneth SP. Type 2 diabetes mellitus. In: Larsen PR, Kronenberg HM, Melmed Sh, Polonsky KS, editors. Williams Textbook of endocrinology. 11th ed. Philadelphia: Saunders; 2007. P: 1329-54.
  3. Harati H, Hadaegh F, Saadat N, Azizi F. Population-based incidence of Type 2 diabetes and its associated risk factors: results from a sixyear cohort study in Iran. BMC Public Health 2009; 9: 186-197. (Persian)
  4. Kowalska I. Role of adipose tissue in the development of vascular complications in type 2 diabetes mellitus. Diabetes Res Clin Pract 2007; 78: 14-22.
  5. Ersoy C, Imamoglu S, Budak F, Tuncel E, Ertürk E and Oral B. Effect of amlodipine on insulin resistance & tumor necrosis factoralpha levels in hypertensive obese type 2 diabetic patients. Indian J Med Res 2004; 120 (5):481-488.
  6. Ceriello A. New insights on oxidative stress and diabetic complicationsmay lead to a "causal" antioxidant therapy. Diabetes Care 2003; 26(5):1589- 1596.
  7. Maestro B, Campion J, Davila N, Calle C. Stimulation by 1, 25-dihydroxyvitamin D3 of insulin receptor expression and insulin responsiveness for glucose transport in U-937 human promonocytic cells. Endocr J 2000;47(4):383-91.
  8. Tarcin O, Yavuz DG, Ozben B, Telli A, Ogunc AV, Yuksel M, et al. Effect of Vitamin D Deficiency and Replacement on Endothelial Function in Asymptomatic Subjects. J Clin Endocrinol Metab. 2009; 94(10):4023-30.
  9. Mathieu C, Gysemans C, Giulietti A, Bouillon R. Vitamin D and diabetes. Diabetologia 2005; 48: 1247-1257.
  10. Brouwer-Brolsma EM, Feskens EJ, Steegenga WT, de Groot LC. Associations of 25 hydroxyvitamin D with fasting glucose, fasting insulin, dementia and depression in European elderly: the SENECA study. Eur J Nutr. 2013; 52(3):917-25.
  11. von Hurst PR, Stonehouse W, Coad J. Vitamin D supplementation reduces insulin resistance in South Asian women living in New Zealand who are insulin resistant and vitamin D deficient–a randomised, placebo-controlled trial. British Journal of Nutrition. 2010; 103(04): 549-555.
  12. Bourlon PM, Billaudel B, Faure-Dussert A. Influence of vitamin D3 deficiency and 1, 25 dihydroxyvitamin D3 on de novo insulin biosynthesis in the islets of the rat endocrine pancreas. J Endocrinol 1999; 160(1):87-95.
  13. Kayaniyil S, Vieth R, Retnakaran R, Knight JA, Qi Y, Gerstein HC, et al. Association of vitamin D with insulin resistance and beta-cell dysfunction in subjects at risk for type 2 diabetes. Diabetes Care 2010;33(6):1379-81
  14. Gulseth HL, Gjelstad IM, Tierney AC, Lovegrove JA, Defoort C, Blaak EE, et al. Serum vitamin D concentration does not predict insulin action or secretion in European subjects with the metabolic syndrome. Diabetes Care 2010; 33(4):923-5.
  15. Mackawy AM, Badawi ME. Association of vitamin D and vitamin D receptor gene polymorphisms with chronic inflammation, insulin resistance and metabolic syndrome components in type 2 diabetic Egyptian patients. Meta Gene. 2014; 2: 540-65.
  16. Song Y, Wang L, Pittas AG, Del Gobbo LC, Zhang C, Manson JE, Hu FB. Blood 25- hydroxyl vitamin D levels and incident type 2 diabetes: A meta-analysis of prospective studies. Diabetes Care 2013; 36(5):1422-8.
  17. Misra A, Alappan NK, Vikram NK, Goel K, Gupta N, Mittal K, et al. Effect of supervised progressive resistanceexercise training protocol on insulin sensitivity, glycemia, lipids, and body composition in Asian Indians with type 2. Indian population. Int J Diabetes & Metabolism. 2009; 17:27-30.
  18. Kim HJ, Lee JS, Kim CK. Effect of exercise training on muscle glucose transporter 4 protein and intramuscular lipid content in elderly men with impaired glucose tolerance. Eur J Appl Physiol 2004; 93(3): 353-58.
  19. Tokmakidis SP, Zois CE, Volaklis KA, Kotsa K, Touvra AM. The effects of a combined strength and aerobic exercise program on glucose control and insulin action in women with type 2 diabetes. Eur J Appl Physiol 2004; 92(4-5): 437-42.
  20. American Diabetes Association. Standards of Medical Care in Diabetes-2013. Diabetes Care 2013; 36(1): 10-14.
  21. Talaei A, Mohamadi M, Adgi Z. The effect of vitamin D on insulin resistance in patients with type 2 diabetesDiabetology & Metabolic Syndrome  2013: 26(5): 5-8. (Persian)
  22. Nezamdoust Z, Saghebjoo M, Barzgar A. Effect of twelve weeks of aerobic training on serum levels of vaspin, fasting blood suger, and insulin resistant index in women patients with type 2 diabets. Iranian Journal of Diabetes and Metabolism 2014; 14(2): 1-11.
  23. Saremi A, Shavandi N, Shahrjerdi Sh, Mahmoudi Z. The Effect of Aerobic Training with Vitamin D Supplementation on Cardiovascular Risk Factors in Obese Women. Journal of Cell & Tissue 2014; 4(4): 388-9. (Persian)
  24. Kim H-J, Kang CK, Park H and Lee MG. Effects of vitamin D supplementation and circuit training on indices of obesity and insulin resistance in T2D and vitamin D deficient elderly women. J Exerc Nutr Biochem 2014; 18(3):249-257.
  25. Gordan L, Morrison EY, McGrowder D, Penas YF, Zamoraz EM, Garwood D, et al. Effect of yoga and traditional physical exercise on hormones and percentage insulin binding receptor in patients with type 2 diabetes. Am J Biotechnol Biochem 2088; 4(1):35-42.
  26. Tokmakidis SP, Zois CE, Volaklis KA, Kotsa K, Touvra AM. The effects of a combined strength and aerobic exercise program on glucose control and insulin action in women with type 2 diabetes. Eur J Appl Physiol 2004; 92(4):437-42.
  27. Azarbayejani M, Abedi B, Piri M, Rasaie M. The Effects of a Single Session of Combined Aerobic and Resistance Exercise on Leptin Levels and Insulin Resistance Index in Sedentary Men. Qom Univ Med Sci J 2012; 6(1):46-54. (Persian)
  28. Dunstan DW, Daly RM, Owen N, Jolley D, Courten MD, Shaw J, Zimmet P. High-Intensity Resistance Training Improves Glycemic Control in Older Patients With Type 2 Diabetes. Diabetes Care 2002; 25 (10):1729-36.
  29. Robertson RP, Harmon J, Tran PO, Tanaka Y, Takahashi H. Glucose toxicityin beta-cells: type 2 diabetes, good radicals gone badly, and the glutathione connection. Diabetes. 2003; 52 (3):581-587.
  30. Sigal RJ, Kenny GP, Boule NG, Wells GA, Prud’homme D, Fortier M, et al. Effects of aerobic training, resistance training, or both on glycaemic control in type 2 diabetes: a randomized trial. Ann Intern Med 2007; 147(6):357-369.
  31. Teixeira-Lemos E, Nunes S, Teixeira F, Reis F. Regular physical exercise training assists in preventing type 2 diabetes development: focus on its antioxdidant and anti-inflammatory properties. Cardiovasc Diabetol 2011; 10(12):1-15.
  32. Taguchi T, Kishikawa H, Motoshima H, Sakai K, Nishiyama T, Yoshizato K. Involvement of Bradykinin in Acute Exercise-Induced Increase of Glucose Uptake and GLUT-4Translocation in Skeletal Muscle: Studies in Normal and Diabetic Humans and Rats. Metabolism 2000; 49 (7):920-930.
  33. Ersoy C, Imamoglu S, Budak F, Tuncel E, Erturk E, Oral B. Effect of amlodipine on insulin resistance & tumor necrosis factoralpha levels in hypertensive obese type 2 diabetic patients. Indian J Med Res 2004; 120: 481-88.
  34. Shenoy S, Arora E, Jaspal S. Effects of progressive resistance training and aerobic exercise on type 2 diabetics in Indian population. Int J Diabetes & Metabolism 2009; 17:27-30.
  35. Moosavi J, Habibian M, Farzanegi P. The effect of regular aerobic exercise on plasma levels of 25- hydroxy vitamin D and insulin resistance in hypertensive postmenopausal women with type 2 diabetes. Razi Journal of Medical Sciences 2016; 22 (141):80-90. (Persian)
  36. Baziar N, DJafarian K, Shadman Z, Qorbani M, Khoshniat Nikoo M, Razi F. Effect Of Vitamin D Supplementation On Improving Vitamin D Level And Insulin Resistance In Vitamin D Insufficient Or Defficient Type 2Diabetics. Iranian Journal of Diabetes and Metabolism (ijdld) 2014; 13 (5):425-433. (Persian)
  37. Jorde R, Figenschau Y. Supplementation with cholecalciferol does not improve glycaemic control in diabetic subjects with normal serum 25-hydroxyvitamin D levels. Eur J Nutr 2009; 48(6):349-54.
  38. Breslavsky A, Frand J, Matas Z, Boaz M, Barnea Z, Shargorodsky M. Effect of high doses of vitamin D on arterial properties, adiponectin, leptin and glucose homeostasis in type 2 diabetic patients. Clin Nutr 2013; 32(6):970-75.
  39. HoseiniR, Damirchi A, Babaei P. The Interaction Effect of Aerobic Training and Different Doses of Intramuscular Vitamin D on Body Weight, Visceral Fat and Food Intake in Female Wistar Rats. Arak Medical University Journal (AMUJ).  2015; 18(100): 24-33. (Persian)
  40. Maestro B, Molero S, Bajo S, Dávila N, Calle C. Transcriptional activation of the human insulin receptor gene by 1, 25 dihydroxyvitamin D3. Cell biochemistry and function. 2002; 20(3):227-32.
  41. Sertznig P, Seifert M, Tilgen W, Reichrath J. Peroxisome proliferator-activated receptor (PPAR) and vitamin D receptor (VDR) signaling pathways in melanoma cells: Promising new therapeutic targets? The Journal of steroid biochemistry and molecular biology 2010; 121(1):383-6.
  42. Nadi M, Marandi SM, Esfarjani F,  Mohammadi M, Ahmadi F. Effects of 12-Weeks Combined Trainings with Vitamin D Supplement on the Sensory-Motor Neuropathy in Women with Type 2 Diabetes. Journal of Isfahan Medical School 2015; 332(33):622-630. (Persian)
  43. Reis JP, von Mühlen D, Kritz-Silverstein D, Wingard DL, Barrett-Connor E. Vitamin D, parathyroid hormone levels, and the prevalence of metabolic syndrome in community-dwelling older adults. Diabetes Care. 2007;30(6):1549-55
  44. Gao Y, Wu X, Fu Q, Li Y, Yang T, Tang W. The Relationship between Serum 25-Hydroxy Vitamin D and Insulin Sensitivity and 𝛽-Cell Function in Newly Diagnosed Type 2 Diabetes. Journal of Diabetes Research 2015; Article ID 636891, 5 pages. http://dx.doi.org/10.1155/2015/636891.
  45. Bonakdaran S, Varasteh A, Khaajeh-Dalouie M. Serum 25 Hydroxy Vitamin D3 and Laboratory Risk Markers of Cardiovascular Diseases in Type 2 Diabetic Patients. Iranian Journal of Endocrinology and Metabolism 2010; 11 (5):504-509. (Persian)
  46. Yosria E. Alya, Azza S. Abdoua, Mona M. Rashadb, Menatallah M. Nassef. Effect of exercise on serum vitamin D and tissue vitamin D receptors in experimentally induced type 2 Diabetes Mellitus. Journal of Advanced Research 2016; 7(5):671-679.
مجله علوم پزشکی صدرا
دوره 5، شماره 1
14
دی 1395
صفحه 45-56
فایل ها
هم رسانی
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