Chinese General Practice ›› 2023, Vol. 26 ›› Issue (24): 2997-3004.DOI: 10.12114/j.issn.1007-9572.2023.0029

Special Issue: 男性健康最新文章合集 运动相关研究最新文章合集

• Original Research • Previous Articles     Next Articles

Immediate Effects of Aerobic Exercise on Arterial Stiffness in a Male Population with Different Blood Glucose Levels

  

  1. 1. Department of Emergency, North China University of Science and Technology Affiliated Hospital, Tangshan 063000, China
    2. Graduate School of North China University of Science and Technology, Tangshan 063200, China
    3. Department of Cardiology, Kailuan General Hospital, Tangshan 063000, China
  • Received:2022-12-19 Revised:2023-03-16 Published:2023-08-20 Online:2023-04-03
  • Contact: SUN Lixia

有氧运动对不同血糖水平男性人群动脉僵硬度的即时影响研究

  

  1. 1.063000 河北省唐山市,华北理工大学附属医院急诊科
    2.063200 河北省唐山市,华北理工大学研究生学院
    3.063000 河北省唐山市,开滦总医院心血管内科
  • 通讯作者: 孙丽霞
  • 作者简介:
    作者贡献:何荣负责设计研究方案,选取调查对象,开展调查,数据收集、采集、清洗和统计学分析、绘制图表,撰写论文以及最终版本修订;张丽负责研究调查和数据清洗;张丽、李鹏、张晓玲、张国、臧懿然负责数据收集、采集;吴寿岭负责研究思路和提出研究命题;孙丽霞负责文章的质量控制与审查,对文章整体负责,监督管理。
  • 基金资助:
    河北省重点研发计划项目(19277791D)

Abstract:

Background

Previous studies on the benefits of aerobic exercise mainly focus on the impact of aerobic exercise on long-term cardiovascular health and outcomes, namely regular aerobic exercise can improve arterial stiffness, while some studies point out that high blood sugar increases arterial stiffness.

Objective

To investigate the immediate effect of aerobic exercise on arterial stiffness in people with different blood glucose levels.

Methods

This study selected individuals who had participated in the 6th follow-up physical examination of the Kailuan Study during 2018—2020 and participated in the 5th national physical fitness surveillance in 2020 and completed their brachial-ankle pulse wave conduction velocity (baPWV) measured before and after the secondary load test of the power vehicle bicycle in four subordinate enterprises of Kailuan Group. Epidemiological survey result were collected: general information (age, hypertension, hyperlipidemia, history of antihypertensive drugs, etc.) , anthropometric indicators〔systolic blood pressure (SBP) , diastolic blood pressure (DBP) , etc.〕and biochemical indicators (fasting blood glucose, etc.) . baPWV measured in the secondary load test of the power vehicle bicycle (used as the aerobic exercise) was used as an indicator of upper and lower limb arterial stiffness. baPWV-related indicators〔SBP, DBP, mean arterial pressure (MAP) , heart rate (HR) , baPWV, metabolic equivalent (MET) , maximal oxygen uptake (VO2max) , etc.〕before and after the test were expressed using a unified form, for example, pre- and post-test baPWV were recorded as baPWV1 and baPWV2, respectively, and its pre- and post-test difference was denoted as ?baPWV. The epidemiological survey result and BAPWV-related data were compared between fasting blood glucose (FBG) quartile groups〔Q1 (n=220) : <5.00 mmol/L; Q2 (n=240) : 5.00-<5.40 mmol/L; Q3 (n=230) : 5.40-<5.81 mmol/L; Q4 (n=234) : ≥5.81 mmol/L〕. Generalized linear regression model was used to evaluate the association of FBG with pre- and post-test baPWV.

Results

A total of 924 eligible cases were enrolled, with an average age of (36.9±7.7) years. FBG quartile groups had statistically significant differences in mean age, hyperlipidemia and hypertension, history of using antihypertensive drugs, mean SBP, DBP, FBG, high sensitivity C-reactive protein, triglyceride, total cholesterol, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol (P<0.01) . HR2 was found to be statistically significant higher than HR1 in groups Q1, Q2 and Q3 (P<0.01) . The baPWV2 was found to be statistically significant higher than baPWV1 in Q1, Q2, Q3 and Q4 groups (P<0.01) . SBP1, DBP1, MAP1 and baPWV1 significantly differed across the groups, and so did SBP2, DBP2, MAP2 and baPWV2 (P<0.01) . Compared with baPWV1, baPWV2 decreased by an average of 36.0 cm/s in people with different blood glucose levels. The generalized linear regression model showed that after adjusting for confounding factors, the ?baPWV level in group Q1 was lower than that in group Q4〔B (95%CI) =-18.96 (-36.96, -0.96) , P=0.04) 〕.

Conclusion

Aerobic exercise can immediately improve the degree of arterial stiffness, but the effect can be weakened by high blood sugar. Clinicians should design aerobic exercise programs according to the personal features of populations to improve arteriosclerosis and delay vascular aging.

Key words: Exercise, Diabetes mellitus, Vascular stiffness, Aerobic exercise, Fasting blood glucose, Arterial stiffness, Pulse wave velocity, Cardiovascular disease

摘要:

背景

以往有氧运动获益的研究主要关注有氧运动对长期心血管健康及结局的影响,即规律有氧运动可以改善动脉僵硬度,而有研究指出高血糖是增加动脉僵硬度的因素,因此推测高血糖可能削弱了有氧运动改善动脉硬化的作用。

目的

探究有氧运动对不同血糖水平人群动脉僵硬度的即时影响。

方法

本研究以既往参加开滦研究2018—2020年第6次随访体检且被抽取参加2020年第5次国民体质监测并于开滦集团旗下四家企业完成功率车二级负荷试验前、后臂踝脉搏波传导速度(baPWV)测量者为研究对象。对研究对象开展流行病学调查,包括一般情况(年龄、高血压、高脂血症、降压药史等)、人体测量学指标〔收缩压(SBP)、舒张压(DBP)等〕和生化检测指标(空腹血糖等),根据空腹血糖四分位数将研究对象分为4组,Q1组(n=220):<5.00 mmol/L、Q2组(n=240):5.00~<5.40 mmol/L、Q3组(n=230):5.40~<5.81 mmol/L、Q4组(n=234):≥5.81 mmol/L。以功率车二级负荷试验作为有氧运动的形式,以baPWV水平作为反映四肢动脉僵硬度的指标,收集研究对象功率车二级负荷试验前、后baPWV相关资料〔SBP、DBP、平均动脉压(MAP)、心率(HR)和baPWV水平、代谢当量(MET)、最大摄氧量(VO2max)等〕,试验前记作1,试验后记作2;并计算前、后两次测量结果的差值(记作?baPWV等)。比较Q1组、Q2组、Q3组、Q4组流行病学调查资料和baPWV相关资料的差异;采用广义线性回归模型评估不同血糖水平对功率车二级负荷试验前、后baPWV水平的影响。

结果

符合纳入标准的研究对象924例,平均年龄为(36.9±7.7)岁。各组流行病学调查资料比较结果显示,四组的年龄、高脂血症、高血压、降压药史、SBP、DBP、空腹血糖、超敏C反应蛋白、三酰甘油、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇情况比较,差异有统计学意义(P<0.01);各组功率车二级负荷试验前、后的baPWV相关资料比较结果显示,Q1组、Q2组、Q3组HR2高于HR1(P<0.01);Q1组、Q2组、Q3组、Q4组的baPWV2高于baPWV1(P<0.01);四组间的SBP1、SBP2、DBP1、DBP2、MAP1、MAP2、baPWV1、baPWV2比较,差异有统计学意义(P<0.01);与baPWV1相比,不同血糖水平人群baPWV2平均下降36.0 cm/s。广义线性回归模型分析结果显示,在校正混杂因素后,与Q4组相比,Q1组的?baPWV水平降低〔B(95%CI)=-18.96(-36.96,-0.96),P=0.04〕。

结论

有氧运动能即时改善动脉僵硬的程度,但高血糖减弱了有氧运动改善动脉僵硬度的作用,临床医生要针对不同人群设计不同的有氧运动方案,以改善动脉硬化延缓血管老化。

关键词: 运动, 糖尿病, 血管硬化程度, 有氧运动, 血糖, 动脉僵硬度, 脉搏波传导速度, 心血管疾病