활동적 생활습관과 복합운동이 인슐린 저항성에 미치는 영향

다국어 초록 (Multilingual Abstract)

The aim of the current study was to examine the changes of body composition, insulin resistance, blood lipid profiles and inflammatory markers following to spontaneous or controlled exercise participation in Korean adults selected from the general population. Subjects with previous diagnosis of diabetes were divided into 2 groups based upon spontaneous exercise participation for using a cross-sectional approach as active group (n=16) and non-active group (n=16). Additionally, we analyzed the effects of a 12 week exercise intervention program by the comparison of between exercise group (n=12) and control group (n=12). We measured anthropometric factors (BMI, percent body fat, WHR, and abdominal fat area by CT scanning), BP, blood levels of glucose, lipid profiles, fibrinogen, CRP, leptin, HbA1c, PAI-1, HOMA, OGTT and physical fitness. Independent t-tests were used to assess differences between active and non-active groups. Additionally, 2-way repeated ANOVA for group and time was used to compare the changes after a 12 week exercise intervention program. Significance was accepted at p<0.05. In cross sectional comparison, active group showed significantly (p<0.05) lower in WHR, visceral fat area, VSR, blood levels of TG, HbA1c and CRP than non-active group. Active group had a lower trend for HOMA-IR than non-active group, and showed significantly (p<0.05) lower in glucose response area of OGTT than non-active group. Exercise group showed a significant (p<0.05) decrease in WHR and HOMA-IR whereas control group showed no changes. In these results, we confirmed that continuous and regular exercise participation has a positive effect on insulin resistance with the decrease of WHR, visceral fat area and blood level of TG. We think that the more long-term exercise intervention may be effective improvement on insulin resistance.

참고문헌 (Reference)

1 "장기간의 운동이 허리-엉덩이 둘레 비, 체질량지수, 당화혈색소에 미치는 영향" 29 (29): 526-532, 2005

2 "Will older sedentary people with non-insulin-dependent dia- betes mellitus start exercising? A health promotion model" 37 (37): 121-128, 1997

3 "Two formulas for computation of the area under the curve represent measures of total hormone concentration versus time-dependent chang" 28 : 916-931, 2002

4 Alam, S, "The effect of a six-month exercise program on very low-density lipoprotein apolipoprotein B secretion in type 2 diabetes" 89 (89): 688-694, 2004

5 Rippe, J. M, "The Rationale for Intervention to Reduce the Risk of Coronary Heart Disease" 1 (1): 10-19, 2007

6 Gavella, M, "Serum sialic acid in subjects with impaired glucose tolerance and in newly diagnosed type 2 diabetic patients" 40 (40): 95-100, 2003

7 Yki-Jarvinen, H, "Role of insulin resistance in the pathogenesis of NIDDM" 38 (38): 1378-1388, 1995

8 Bastard, J. P, "Relationship between plasma plasminogen activator inhibitor 1 and insulin resistance" 16 (16): 192-201, 2000

9 "Paradoxical decrease of an adipose-specific protein, adiponectin, in obesity" 257 (257): 79-83, 1999

10 "Obesity, regional body fat distribution, and the metabolic syndrome in older men and women" 165 (165): 777-783, 2005

11 Grundy, S. M, "Obesity, metabolic syndrome, and cardiovascular disease" 89 (89): 2595-2600, 2004

12 Pickup, J. C, "Is type II diabetes mellitus a disease of the innate immune system?" 41 (41): 1241-1248, 1998

13 "Effects of aerobic or resistance exercise and/or diet on glucose tolerance and plasma insulin levels in obese men" 22 (22): 684-691, 1999

14 "Effect of aerobic exercise on plasma adiponectin levels and insulin resistance in type 2 diabetes" 27 (27): 1756-1758, 2004

15 "C-reactive protein in healthy subjects: associations with obesity, insulin resistance, and endothelial dysfunction, a potential role for cytokines originating from adipose tissue?" 19 (19): 972-978, 1999

16 "C-Reactive protein, a sensitive marker of inflammation, predicts future risk of coronary heart disease in initially healthy middle-aged men: results from the MONICA (Monitoring Trends and Determinants in Cardiovascular Disease) Augsburg Cohort Study, 1984 to 1992" 99 (99): 237-242, 1999

17 "American Diabetes Association；North American Association for the Study of Obesity；American Society for Clinical Nutrition. Weight management through lifestyle modification for the prevention and management of type 2 diabetes: rationale and strategies. A statement of the American Diabetes Association, the North American Association for the Study of Obesity, and the American Society for Clinical Nutrition" 80 (80): 257-263, 2004

18 Lonnqvist, F, "A pathogenic role of visceral fat beta 3-adrenoceptors in obesity" 95 (95): 1109-1116, 1995

19 ". The glucose fatty-acid cycle. Its role in insulin sensitivity and the metabolic disturbances of diabetes mellitus. Lancet. 13" 785-9, 1963

20 ". Lipoprotein metabolism in diabetes mellitus. J Lipid Res. 28" 613-28, 1987

21 ". Enhanced muscle glucose metabolism after exercise in the rat" 6-5, 1984

22 B, ". Effects of insulin and exercise on muscle lipoprotein lipase activity in man and its relation to insulin action. J Clin Invest. 84" 1124-9, 1989

23 E, ". Effect of fatty acids on glucose production and utilization in man. J Clin Invest. 72" 1737-47, 1983

24 ". Contractile activity increases glucose uptake by muscle in severely diabetic rats. J Appl Physiol. 57" (4) : 1045-9, 1984