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16주간의 복합운동이 제2형 당뇨병 노인 여성의 인슐린 저항성, 염증 지표, 산화 스트레스 및 백혈구 텔로미어 길이에 미치는 영향

Effects of 16 weeks’ combined exercise on insulin resistance, inflammatory markers, oxidative stress, and leukocyte telomere length in elderly women with type 2 DM

조현석|정원상|이만균|이태희
국민체육진흥공단 한국스포츠과학원 (Korea Institute of Sport Science)|2019.09|체육과학연구 (Korean Journal of Sport Science)|제30권 제3호|pp. 470-485|DOI 10.24985/kjss.2019.30.3.470

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참고문헌

키워드

당뇨병diabetes mellitus체력insulin resistance복합운동combined exercise인슐린 저항성텔로미어 길이telomere lengthphysical fitness.
주제분류체육

초록

[목적] 이 연구에서는 16주간의 복합운동이 제2형 당뇨병 노인 여성의 인슐린 저항성 지표, 염증 지표, 산화 스트레스 지표, 백혈구 텔로미어 길이, 그리고 신체구성과 일상생활체력에 미치는 영향을 규명하고자 하였다. [방법] 이 연구의 대상자는 제2형 당뇨병 노인 여성 28명으로서, 운동집단의 대상자 14명은 16주간, 주 3회, 회당 60분간 복합운동 프로그램에 참여한 반면, 통제집단의 대상자 14명은 동일한 처치 기간 동안 특별한 처치 없이 평소의 생활습관을 유지하도록 하였다. 처치 전과 후에 인슐린 저항성 지표, 염증 지표, 산화 스트레스 지표, 백혈구 텔로미어 길이, 그리고 신체구성과 일상생활체력을 측정한 다음, 반복 이원변량분석을 이용하여 두 집단 간, 그리고 두 검사 간에 비교하였다. [결과] 이 연구에서 얻은 주요결과는 다음과 같다. 1) 인슐린 저항성과 관련하여, 공복 인슐린과 HOMA-IR에서 집단과 검사의 상호작용이 유의하게 나타났다. 공복 인슐린과 HOMA-IR이 운동집단에서 감소되는 경향을 보인 반면, 통제집단에서 유의하게 증가되었다. 2) 염증 지표와 관련하여, IL-6, TNF-α, 그리고 hs-CRP가 운동집단에서 감소되었으나 통계적으로 유의한 변화는 나타나지 않았다. 3) 산화 스트레스와 관련하여, 운동집단과 통제집단 모두에서 MDA가 유의하게 증가되고 GPx가 유의하게 감소되어 운동 트레이닝의 효과가 없었다고 해석된다. 4) 백혈구 텔로미어 길이가 운동집단에서 유의하게 증가되었다. 5) 신체구성과 관련하여, 제지방량, 체지방량, 그리고 체지방률에서 집단과 검사의 상호작용이 유의하게 나타났다. 제지방량은 운동집단에서 증가되었고, 체지방량과 체지방률은 운동집단에서 유의하게 감소되었다. 6) 일상생활체력과 관련하여, 상완굴신력, 앉았다일어서기, 앉아윗몸앞으로굽히기, tandem test, 10m 빠르게걷기, 그리고 up & go에서 집단과 검사의 상호작용이 유의하게 나타났다. 상완굴신력, 앉았다일어서기, 눈뜨고외발서기, 기능적뻗기, tandem test, 그리고 10m 빠르게걷기가 운동집단에서 유의하게 향상되었다. [결론] 이 연구에서 실시한 16주간의 복합운동에 따라 제2형 당뇨병 노인 여성의 인슐린 저항성이 개선되었고, 백혈구 텔로미어 길이가 증가되었으며, 신체구성이 개선되고 일상생활체력이 향상되었다고 결론지을 수 있다. 규칙적인 운동이 당뇨병 환자의 당뇨 증상과 비만도를 개선시키고 체력을 향상시키는 것은 물론 수명의 연장에도 기여할 가능성이 있다는 것을 확인하였다. 당뇨병 환자를 대상으로 운동 트레이닝을 통하여 백혈구 텔로미어 길이가 증가되는 기전을 규명하는 후속 연구가 요청된다.

Abstract

[Purpose] The purpose of this study was to examine the effects of 16 weeks’ combined exercise training on insulin resistance, inflammatory markers, oxidative stress, leukocyte telomere length, body composition, and daily living fitness in elderly women with type 2 diabetes mellitus (DM). [Methods] Twenty-eight participants were randomly assigned into one of two groups, i.e., exercise training group (EX: n=14) and control group (CON: n=14). Subjects in EX participated in 3 sessions of 60 min-combined exercise for 16 weeks, whereas subjects in CON were asked to maintain their normal life pattern during the same period. The variables regarding insulin resistance, inflammatory markers, oxidative stress, leukocyte telomere length, body composition, and daily living fitness were measured and compared between two groups as well as between pre-post test utilizing a repeated two-way ANOVA. [Results] Main results were as follows: 1) Fasting plasma insulin and HOMA-IR tended to decrease in EX, whereas increased significantly in CON. 2) IL-6, TNF-α, hs-CRP decreased in EX, but the changes were not statistically significant. 3) MDA increased significantly and GPx decreased significantly in both EX and CON. 4) Leukocyte telomere length increased significantly in EX. 5) Fat-free mass increased in EX, whereas fat mass and percent body fat decreased significantly in EX. 6) Arm curl, chair stand, sit & reach, tandem test, 10m walking speed, and up & go improved significantly in EX. [Conclusion] It was concluded that the combined exercise for 16 weeks had a positive effect on improving insulin resistance, increasing leukocyte telomere length, as well as enhancing body composition and daily living fitness in elderly women with type 2 diabetes.

참고문헌 (65)

  1. Akash, M. S. H., "Biochemical investigation of gender-specific association between insulin resistance and inflammatory biomarkers in types 2 diabetic patients", Biomedicine and Pharmacotherapy, 106, pp.285~291 (2018)
  2. American Diabetes Association, "Standards of medical care in diabetes—2016 abridged for primary care providers", Clinical Diabetes, 34(1), pp.3~21 (2016)
  3. Andreazza, A. C., "Oxidative stress markers in bipolar disorder : A meta-analysis", Journal of Affective Disorders, 111(2), pp.135~144 (2008)
  4. Balducci, S., "Anti-inflammatory effect of exercise training in subjects with type 2 diabetes and the metabolic syndrome is dependent on exercise modalities and independent of weight loss. Nutrition", Metabolism and Cardiovascular Diseases, 20(8), pp.608~617 (2010)
  5. Beavers, K. M., "Change in bone mineral density during weight loss with resistance versus aerobic exercise training in older adults", Journals of Gerontology Series A : Biomedical Sciences and Medical Sciences, 72(11), pp.1582~1585 (2017)
  6. Bekaert, S., "Telomere length versus hormonal and bone mineral status in healthy elderly men", Mechanisms of Ageing and Development, 126(10), pp.1115~1122 (2005)
  7. Bessa, A. L., "Exercise intensity and recovery : Biomarkers of injury, inflammation, and oxidative stress", The Journal of Strength and Conditioning Research, 30(2), pp.311~319 (2016)
  8. Blackburn, E. H., "Telomeres and telomerase : Their mechanisms of action and the effects of altering their functions", Federation of European Biochemical Societies Letters, 579(4), pp.859~862 (2005)
  9. Blackburn, E. H., "Human telomere biology : a contributory and interactive factor in aging, disease risks, and protection", Science, 350(6265), pp.1193~1198 (2015)
  10. Bloomer, R. J., "Effect of resistance training on blood oxidative stress in Parkinson disease", Medicine and Science in Sports and Exercise, 40(8), pp.1385~1389 (2008)
  11. Bonomini, F., "Metabolic syndrome, aging and involvement of oxidative stress", Aging and Disease, 6(2), pp.109~120 (2015)
  12. Bruun-sgaard, H., "Physical activity and modulation of systemic low-level inflammation", Journal of Leukocyte Biology, 78(4), pp.819~835 (2005)
  13. Carlsson, M., "Effects of high-intensity exercise and protein supplement on muscle mass in ADL dependent older people with and without malnutrition—A randomized controlled trial", The Journal of Nutrition, Health and Aging, 15(7), pp.554~560 (2011)
  14. Cartee, G. D., "Exercise promotes healthy aging of skeletal muscle", Cell Metabolism, 23(6), pp.1034~1047 (2016)
  15. Cawthon, R. M., "Telomere length measurement by a novel monochrome multiplex quantitative PCR method", Nucleic Acids Research, 37(3), pp.e21~ (2009)[DOI]
  16. Cherkas, L. F., "The association between physical activity in leisure time and leukocyte telomere length", Archives of Internal Medicine, 168(2), pp.154~158 (2008)
  17. Cochran, A. J., "Intermittent and continuous high‐intensity exercise training induce similar acute but different chronic muscle adaptations", Experimental Physiology, 99(5), pp.782~791 (2014)
  18. Cohen, J., "Statistical Power Analysis for the Behavioral Sciences" (1977)
  19. Colberg, S. R., "Exercise and type 2 diabetes : the american college of sports medicine and the american diabetes association : Joint position statement", Diabetes Care, 33(12), pp.147~167 (2010)
  20. Colberg, S. R., "Physical activity", exercise and diabetes : a position statement of the American Diabetes Association, 2016, pp.39(11), 2065~2079
  21. Dean, W., "Biological Aging Measurement: Clinical Applications" (1988), Center for Bio-Gerontology
  22. Demissie, S., "Insulin resistance, oxidative stress, hypertension, and leukocyte telomere length in men from the Framingham Heart Study", Aging Cell, 5(4), pp.325~330 (2006)
  23. Dick, S. A., "Chronic heart failure and inflammation", Circulation Research, 119(1), pp.159~176 (2016)
  24. Dimauro, I., "Regular exercise participation improves genomic stability in diabetic patients : an exploratory study to analyse telomere length and DNA damage", Scientific Reports, 7(1), pp.4137~4148 (2017)
  25. García-López, D., "Effects of strength and endurance training on antioxidant enzyme gene expression and activity in middle aged men", Scandinavian Journal of Medicine and Science in Sports, 17(5), pp.595~604 (2007)
  26. Gomes, M. J., "Skeletal muscle aging : Influence of oxidative stress and physical exercise", Oncotarget, 8(12), pp.20428~20440 (2017)
  27. Gordon, L. A., "Effect of exercise therapy on lipid profile and oxidative stress indicators in patients with type 2 diabetes", BMC Complementary and Alternative Medicine, 8(1), pp.21~30 (2008)
  28. Greider, C. W., "Identification of a specific telomere terminal transferase activity in tetrahymena extracts", Cell, 43(2), pp.405~413 (1985)
  29. Hayashino, Y., "Effects of exercise on C-reactive protein, inflammatory cytokine and adipokine in patients with type 2 diabetes : A meta-analysis of randomized controlled trials", Metabolism, 63(3), pp.431~440 (2014)
  30. Irving, B. A., "Combined training enhances skeletal muscle mitochondrial oxidative capacity independent of age", The Journal of Clinical Endocrinology and Metabolism, 100(4), pp.1654~1663 (2015)
  31. Jorge, M. L. M. P., "The effects of aerobic, resistance, and combined exercise on metabolic control, inflammatory markers, adipocytokines, and muscle insulin signaling in patients with type 2 diabetes mellitus", Metabolism, 60(9), pp.1244~1252 (2011)
  32. Kadoglou, N. P., "The anti-inflammatory effects of exercise training in patients with type 2 diabetes mellitus", European Journal of Cardiovascular Prevention & Rehabilitation, 14(6), pp.837~843 (2007)
  33. Kadoglou, N. P., "The impact of aerobic exercise training on novel adipokines, apelin and ghrelin, in patients with type 2 diabetes. Medical Science Monitor", International Medical Journal of Experimental and Clinical Research, 18(5), pp.290~295 (2012)
  34. Kim, J. H., "Habitual physical exercise has beneficial effects on telomere length in postmenopausal women", Menopause, 19(10), pp.1109~1115 (2012)
  35. 김경렬, "규칙적인 복합 운동 프로그램이 폐경 이후 중년여성의 골밀도, 혈중 오스테오칼신 농도 및 건강관련체력에 미치는 영향", 한국사회체육학회지, (64), pp.887~896 (2016), 한국사회체육학회[DOI]
  36. Kohut, M. L., "Aerobic exercise, but not flexibility", resistance exercise, reduces serum IL-18, CRP, and IL-6 independent of β-blockers, BMI, and psychosocial factors in older adults, 2006, pp.20(3), 201~209
  37. Laakso, M., "Insulin resistance and hyperglycaemia in cardiovascular disease development", Nature Reviews Endocrinology, 10(5), pp.293~302 (2014)
  38. Lavie, C. J., "Exercise and the cardiovascular system : Clinical science and cardiovascular outcomes", Circulation Research, 117(2), pp.207~219 (2015)
  39. Liu, F., "The efficacy and safety of different simvastatin doses on hyperlipidemia in the elderly", Chongqing Medicine, 2014(9), pp.1088~1089 (2014)
  40. Mann, S., "Changes in insulin sensitivity in response to different modalities of exercise : A review of the evidence", Diabetes, 2014, pp.30(4), 257~268
  41. Martins, R. A., "The effect of aerobic versus strength-based training on high-sensitivity C-reactive protein in older adults", European Journal of Applied Physiology, 110(1), pp.161~169 (2010)
  42. Mason, C., "Independent and combined effects of dietary weight loss and exercise on leukocyte telomere length in postmenopausal women", Obesity, 21(12), pp.549~554 (2013)
  43. Matthews, D. R., "Homeostasis model assessment : insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man", Diabetologia, 28(7), pp.412~419 (1985)
  44. Mozaffarian, D., "Does excessive sitting age you?", Tufts University Health and Nutrition Letter, 35(2), pp.2~3 (2017)
  45. Nadrowski, P., "Associations between cardiovascular disease risk factors and IL-6 and hsCRP levels in the elderly", Experimental gerontology, 85, pp.112~117 (2016)
  46. Ornish, D., "Increased telomerase activity and comprehensive lifestyle changes : A pilot study", The Lancet Oncology, 9(11), pp.1048~1057 (2008)
  47. Pittaluga, M., "Physical exercise and redox balance in type 2 diabetics : Effects of moderate training on biomarkers of oxidative stress and DNA damage evaluated through comet assay", Oxidative Medicine and Cellular Longevity, 2015, pp.7~14 (2015)
  48. Rexrode, K. M., "Relationship of total and abdominal adiposity with CRP and IL-6 in women", Annals of Epidemiology, 13(10), pp.674~682 (2003)
  49. Rikli, R. E., "Senior Fitness Test Manual" (2013), Human Kinetics
  50. Robergs, R. A., "The surprising history of the"HRmax= 220-age"equation", Journal of Exercise Physiology Online, 5(2), pp.1~10 (2002)
  51. Roh, H. T., "Obesity promotes oxidative stress and exacerbates blood-brain barrier disruption after high-intensity exercise", Journal of Sport and Health Science, 6(2), pp.225~230 (2017)
  52. Rosas-Villegas, A., "Differential effect of sucrose and fructose in combination with a high fat diet on intestinal microbiota and kidney oxidative stress", Nutrients, 9(4), pp.393~405 (2017)
  53. Schrauwen, P., "Oxidative capacity, lipotoxicity, and mitochondrial damage in type 2 diabetes", Diabetes, 53(6), pp.1412~1417 (2004)
  54. Shahar, S., "Effectiveness of exercise and protein supplementation intervention on body composition, functional fitness, and oxidative stress among elderly Malays with sarcopenia", Clinical Interventions in Aging, 8, pp.1365~1375 (2013)
  55. 신윤아, "신체활동, 운동 및 체력수준이 세포노화 지표인 텔로미어 길이에 미치는 효과", 운동과학, 27(2), pp.96~108 (2018), 한국운동생리학회[DOI]
  56. Singh, R., "Role of free radical in atherosclerosis, diabetes and dyslipidaemia : Larger than life", Diabetes, 2015, pp.31(2), 113~126
  57. Stefani, G. P., "Metabolic syndrome and dna damage : The interplay of environmental and lifestyle factors in the development of metabolic dysfunction", Open Journal of Endocrine and Metabolic Diseases, 5(7), pp.65~76 (2015)
  58. Stephens, N. A., "A transcriptional signature of"exercise resistance"in skeletal muscle of individuals with type 2 diabetes mellitus", Metabolism, 64(9), pp.999~1004 (2015)
  59. Tessier, D., "Effects of aerobic physical exercise in the elderly with type 2 diabetes mellitus", Archives of Gerontology and Geriatrics, 31(2), pp.121~132 (2000)
  60. Verney, J., "Combined lower body endurance and upper body resistance training improves performance and health parameters in healthy active elderly", European Journal of Applied Physiology, 97(3), pp.288~297 (2006)
  61. Vincent, H. K., "Resistance training lowers exercise induced oxidative stress and homocysteine levels in overweight and obese older adults", Obesity, 14(11), pp.1921~1930 (2006)
  62. Wang, Q., "AMPK", pp.507~517 (2018), Humana Press
  63. Xie, Z., "Early telomerase inactivation accelerates aging independently of telomere length", Cell, 160(5), pp.928~939 (2015)
  64. Zhao, J., "Association between telomere length and type 2 diabetes", PLoS One, 8(11), pp.e79993~e79999 (2013)
  65. Zhou, Y., "Shortened leukocyte telomere length in type 2 diabetes mellitus : Genetic polymorphisms in mitochondrial uncoupling proteins and telomeric pathways", Clinical and Translational Medicine, 5(1), pp.8~13 (2016)

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