12주간의 비타민D 섭취와 순환운동이 비타민D 결핍제2형 당뇨병 노인 여성의 골격근량에 미치는 영향
The Effects of 12-Weeks of Vitamin D Supplementation and Circuit Training on Skeletal Muscle Mass in Elderly Women with Type-2 Diabetes Mellitus and Vitamin D Deficiency
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초록
이 연구에서는 12주간의 비타민D 섭취와 순환운동이 비타민D 결핍 제2형 당뇨병 노인 여성의 골격근량에 미치는 영향을 구명하고자 하였다. 아울러 이 변인들과 밀접한 관계가 있는 신체구성, 인슐린 저항성 및 비타민D에 대한 영향도 함께 구명하고자 하였다. 연구 대상자로 비타민D 결핍 제2형 당뇨병 노인 여성 48명을 통제집단, 비타민D 섭취집단, 순환운동집단, 복합처치집단으로 무선할당하였다. 비타민D는 12주간 매일 하루 1,200 IU 섭취하였으며, 순환운동프로그램은 주 3회 실시하였다. 사전검사와 사후검사에서 신체구성을 측정하였고, 혈액을 통해 25(OH)D, 공복혈당, 그리고 인슐린 농도를 분석하였다. 12주간의 비타민D 섭취와 순환운동 트레이닝 후 순환운동집단과 복합처치집단의 체지방률이 유의하게 감소하였고, 비타민D 섭취집단, 순환운동집단, 복합처치집단의 25(OH)D 수준이 유의하게 증가하였다. 또한 공복혈당, 인슐린, 그리고 HOMA-IR의 경우 모든 집단에서 유의한 차이가 나타나지 않았으며, 제지방량은 복합처치집단에서만 유의하게 증가하였다. 이상의 결과를 종합해보면, 12주간의 비타민D 섭취와 순환운동은 제지방량의 증가에 있어 단일처치보다 복합처치 시 긍정적인 영향을 주는 것으로 결론지을 수 있다.
Abstract
The objective of this study was to investigate the effects of 12-weeks of vitamin D supplementation and circuit training on skeletal muscle mass in elderly women with type 2 diabetes mellitus and vitamin D deficiency. Forty eight elderly women with type-2 diabetes mellitus and vitamin D deficiency were randomly assigned to control(n=10), vitamin D supplement(n=11), exercise(n=12), and vitamin D supplement+exercise(n=15) groups. Dependent variables were measured before and after the 12-week interventions. Major outcomes included body composition, fasting glucose, insulin, and 25(OH)D concentration. ASM(apeendicular skeletal muscle mass), SMI(skeletal muscle mass), and HOMA-IR (homeostasis model for insulin resistance) were calculated. Women assigned to the vitamin D supplement consumed 1,200 IU of vitamin D orally per week for 12 weeks. Women assigned to the exercise intervention performed a circuit training at an intensity of 60%~80% of HRmax with a frequency of 3 days per week for 12 weeks. Compared to control group, all groups had significant loss of body weight and increases in serum 25(OH)D after the 12-week intervention. ASM and SMI increased significantly in only vitamin D+exercise group. Regardless of treatments, no significant group differences were found in changed scores of fasting glucose, insulin, and HOMA-IR. In conclusion, vitamin D + exercise would improve the loss of ASM and SMI compared with vitamin D or exercise alone.
참고문헌 (66)
- 권영섭, "Brief review of muscle hypertrophy mechanism", 스포츠건강의학 학술지, 9(2), pp.13~20 (2007)
- 김상훈, "12주간의 순환운동이 노인비만여성의 비만, 체력 및 대사증후군 지표에 미치는 영향", 한국노년학, 29(3), pp.823~835 (2009), 한국노년학회
- 김인경, "비타민 D 섭취와 운동프로그램 적용이 여성 노인의 생리적 지표, 근육량 및 신체 기능에 미치는 영향", 박사, 간호과학과, pp.2012
- 대한당뇨학회, "Diabetes fact sheet in Korea 2012", ~ (2012)
- 대한비만학회, "Fact sheet", ~ (2010)
- 박상갑, "복합운동프로그램이 Sarcopenia 여성노인을 위한 건강체력과 항노화호르몬 및 근감소증예방에 미치는 영향", 한국사회체육학회지, 40(40), pp.435~442 (2010), 한국사회체육학회
- 소위영, "미용덤벨 운동이 노인의 근감소증 예방을 위한 신체조성, 체력 및 혈중지질에 미치는 영향", 한국노년학, 29(3), pp.837~850 (2009), 한국노년학회
- 오수일, "복합운동프로그램이 중년 여성의 신체구성, 건강관련체력 및 대사증후군 위험인자에 미치는 영향", 운동학 학술지, 15(3), pp.91~100 (2013), 대한운동학회
- 유민주, "단거리 육상선수와 일반여대생의 신체구성, 골밀도와 골밀도 관련 요인 분석", 한국여성체육학회지, 25(3), pp.121~134 (2011), 한국여성체육학회
- 정성림, "순환운동과 유산소운동이 비만 중년여성의 대사성증후군 위험인자 및 동맥경화 지수 변화에 미치는 영향", 한국체육과학회지, 18(1), pp.1019~1030 (2009), 한국체육과학회
- 최영미, "당뇨병환자에서 칼슘과 비타민 D 섭취가 인슐린저항성에 미치는 영향", Diabetes and Metabolism Journal, 33(4), pp.324~334 (2009), 대한당뇨병학회
- 홍상모, "Sarcopenia의 최신지견: 근감소증", 대한내과학회지, 83(4), pp.444~454 (2012), 대한내과학회[DOI]
- Baker, S., "Effects and clinical potential of very-low-calorie diets(VLCDs)in type 2 diabetes", Diabetes Research and Clinical Practice, 85(3), pp.235~242 (2009)
- Bassil, M. S., "Muscle protein anabolism in type 2 diabetes", Current Opinion in Clinical Nutrition & Metabolic Care, 16(1), pp.83~88 (2013)
- Baumgartner, R. N., "Epidemiology of sarcopenia among the elderly in New Mexico", American Journal of Epidemiology, 147(8), pp.755~763 (1998)
- Bischoff-Ferrari, H. A., "Estimation of optimal serum concentrations of 25-hydroxy vitamin D for multiple health outcomes", The American Journal of Clinical Nutrition, 84(1), pp.18~28 (2006)
- Borissova, A. M., "The effect of vitamin D3 on insulin secretion and peripheral insulin sensitivity in type 2diabetic patients", International Journal of Clinical Practice, 57(4), pp.258~261 (2003)
- Choi, H. S., "Vitamin D insufficiency in Korea—a greater threat to younger generation : the Korea National Health and Nutrition Examination Survey(KNHANES)2008", Journal of Clinical Endocrinology & Metabolism, 96(3), pp.643~651 (2011)
- Christ-Roberts, C. Y., "Exercise training increases glycogen synthase activity and GLUT4 expression but not insulin signaling in overweight nondiabetic and type 2 diabetic subjects", Metabolism, 53(9), pp.1233~1242 (2004)
- Colberg, S. R., "Exercise and Type 2 Diabetes The American College of Sports Medicine and the American Diabetes Association : joint position statement executive summary", Diabetes Care, 33(12), pp.2692~2696 (2010)
- Cuff, D. J., "Effective exercise modality to reduce insulin resistance in women with type 2 diabetes", Diabetes Care, 26(11), pp.2977~2982 (2003)
- Dalgård, C., "Vitamin D status in relation to glucose metabolism and type 2 diabetes in septuagenarians", Diabetes Care, 34(6), pp.1284~1288 (2011)
- Davidson, L. E., "Effects of exercise modality on insulin resistance and functional limitation in older adults : a randomized controlled trial", Archives of Internal Medicine, 169(2), pp.122~131 (2009)
- Delmonico, M. J., "Alternative definitions of sarcopenia, lower extremity performance, and functional impairment with aging in older men and women", Journal of the American Geriatrics Society, 55(5), pp.769~774 (2007)
- Doherty, T. J., "Invited review : aging and sarcopenia", Journal of Applied Physiology, 95(4), pp.1717~1727 (2003)
- Duncan, G. E., "Exercise training, without weight loss, increases insulin sensitivity and post heparin plasma lipase activity in previously sedentary adults", Diabetes Care, 26(3), pp.557~562 (2003)
- Fujita, S., "Aerobic exercise overcomes the age-related insulin resistance of muscle protein metabolism by improving endothelial function and Akt", mammalian target of rapamycin signaling, 2007, pp.56(6), 1615~1622
- George, P. S., "Effect of vitamin D supplementation on glycemic control and insulin resistance", Diabetic Medicine, 29(8), pp.142~150 (2012)
- Goodpaster, B. H., "Enhanced fat oxidation through physical activity is associated with improvements in insulin sensitivity in obesity", Diabetes, 52(9), pp.2191~2197 (2003)
- Holick, M. F., "Vitamin D : photobiology, metabolism, mechanism of action, and clinical applications. In : Favus M, ed. Primer on the metabolic bone diseases and disorders of mineral metabolism", American Society for Bone and Mineral Research, 5, pp.129~137 (2003)
- Holick, M. F., "Vitamin D deficiency", New England Journal of Medicine, 357(3), pp.266~281 (2007)
- Hurskainen, A. R., "Association of serum 25‐hydroxy vitamin D with type 2 diabetes and markers of insulin resistance in a general older population in Finland", Diabetes, 2012, pp.28(5), 418~423
- Iannuzzi-Sucich, M., "Prevalence of sarcopenia and predictors of skeletal muscle mass in healthy, older men and women", The Journals of Gerontology Series A : Biological Sciences and Medical Sciences, 57(12), pp.772~777 (2002)
- Ibañez, J., "Twice-weekly progressive resistance training decreases abdominal fat and improves insulin sensitivity in older men with type 2 diabetes", Diabetes Care, 28(3), pp.662~667 (2005)
- Kelley, G. A., "Effects of aerobic exercise on lipids and lipoproteins in adults with type 2diabetes : a meta-analysis of randomized-controlled trials", Public Health, 121(9), pp.643~655 (2007)
- 김경수, "Management of Type 2 Diabetes Mellitus in Older Adults", Diabetes and Metabolism Journal, 36(5), pp.336~344 (2012), 대한당뇨병학회[DOI]
- Kim, T. N., "Prevalence and determinant factors of sarcopenia in patients with type 2diabetes: the Korean Sarcopenic Obesity Study (KSOS)", Diabetes Care, 33(7), pp.1497~1499 (2010)
- Koopman, R., "Aging, exercise, and muscle protein metabolism", Journal of Applied Physiology, 106(6), pp.2040~2048 (2009)
- Krentz, A. J., "Insulin resistance : a risk marker for disease and disability in the older person", Diabetic Medicine, 30(5), pp.535~548 (2013)
- Landi, F., "Sarcopenia and Diabetes : Two Sides of the Same Coin", Journal of the American Medical Directors Association, 14(8), pp.540~541 (2013)
- Lee, J. H., "Vitamin D Deficiency; An Important, Common, and Easily Treatable Cardiovascular Risk Factor?", Journal of the American College of Cardiology, 52(24), pp.1949~1956 (2008)
- Additive association of vitamin D insufficiency and sarcopenia with low femoral bone mineral density in non-institutionalized elderly population:the Korea National Health and Nutrition Examination Surveys 2009-2010, "Lee, S. G.", Osteoporosis International, 1~11 (2013)
- Lim, S., "Vitamin D inadequacy is associated with significant coronary artery stenosis in a community-based elderly cohort : the Korean Longitudinal Study on Health and Aging", Journal of Clinical Endocrinology & Metabolism, 97(1), pp.169~178 (2012)
- Malabanan, A., "Redefining vitamin D insufficiency", The Lancet, 351(9105), pp.805~806 (1998)
- Marcus, R. L., "Comparison of combined aerobic and high-force eccentric resistance exercise with aerobic exercise only for people with type 2diabetes mellitus", Physical Therapy, 88(11), pp.1345~1354 (2008)
- Mason, C., "Influence of diet, exercise, and serum vitamin D on sarcopenia in postmenopausal women", Medicine and Science in Sports and Exercise, 45(4), pp.607~614 (2012)
- Mattila, C., "Serum 25-hydroxy vitamin D concentration and subsequent risk of type 2 diabetes", Diabetes Care, 30(10), pp.2569~2570 (2007)
- Meneilly, G. S., "Diabetes in elderly adults", The Journals of Gerontology Series A : Biological Sciences and Medical Sciences, 56(1), pp.5~13 (2001)
- Need, A. G., "Relationship between fasting serum glucose, age, body mass index and serum 25 hydroxy vitamin D in postmenopausal women", Clinical Endocrinology, 62(6), pp.738~741 (2005)
- Newman, A. B., "Sarcopenia : alternative definitions and associations with lower extremity function", Journal of the American Geriatrics Society, 51(11), pp.1602~1609 (2003)
- Pan, X. R., "Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance : the Da Qing IGT and Diabetes Study", Diabetes Care, 20(4), pp.537~544 (1997)
- Park, S. W., "Excessive loss of skeletal muscle mass in older adults with type 2 diabetes", Diabetes Care, 32(11), pp.1993~1997 (2009)
- Patel, P., "Lack of effect of subtherapeutic vitamin D treatment on glycemic and lipid parameters in Type 2 diabetes : A pilot prospective randomized trial", Journal of Diabetes, 2(1), pp.36~40 (2010)
- Pittas, A. G., "The role of vitamin D and calcium in type 2 diabetes. A systematic review and meta-analysis", Journal of Clinical Endocrinology & Metabolism, 92(6), pp.2017~2029 (2007)
- Rejeski, W. J., "Lifestyle change and mobility in obese adults with type 2 diabetes", New England Journal of Medicine, 366(13), pp.1209~1217 (2012)
- Scragg, R., "Serum 25-hydroxy vitamin D, diabetes, and ethnicity in the Third National Health and Nutrition Examination Survey", Diabetes Care, 27(12), pp.2813~2818 (2004)
- Sigal, R. J., "Effects of aerobic training, resistance training, or both on glycemic control in type 2 diabetes; A randomized trial", Annals of Internal Medicine, 147(6), pp.357~369 (2007)
- Singh, M. A. F., "Insulin-like growth factor I in skeletal muscle after weight-lifting exercise in frail elders", American Journal of Physiology-Endocrinology and Metabolism, 277(1), pp.135~143 (1999)
- Snowling, N. J., "Effects of Different Modes of Exercise Training on Glucose Control and Risk Factors for Complications in Type 2 Diabetic Patients A meta-analysis", Diabetes Care, 29(11), pp.2518~2527 (2006)
- Verschueren, S. M., "The effects of whole‐body vibration training and vitamin D supplementation on muscle strength, muscle mass, and bone density in institutionalized elderly women : A 6‐month randomized, controlled trial", Journal of Bone and Mineral Research, 26(1), pp.42~49 (2011)
- Volpi, E., "Muscle tissue changes with aging", Current Opinion in Clinical Nutrition and Metabolic Care, 7(4), pp.405~410 (2004)
- Von Hurst, P. R., "Vitamin D supplementation reduces insulin resistance in South Asian women living in New Zealand who are insulin resistant and vitamin D deficient–a randomized, placebocontrolled trial", British Journal of Nutrition, 103(4), pp.549~ (2010)
- Wang, T. J., "Vitamin D deficiency and risk of cardiovascular disease", Circulation, 117(4), pp.503~511 (2008)
- Yarasheski, K. E., "Resistance exercise training increases mixed muscle protein synthesis rate in frail women and men≥ 76 yr old", American Journal of Physiology-Endocrinology and Metabolism, 277(1), pp.118~125 (1999)
- Zhou, Q. G., "1, 25-Dihydroxy vitamin D improved the free fatty‐acid‐induced insulin resistance in cultured C2C12 cells", Diabetes, 2008, pp.24(6), 459~464
- Ziambaras, K., "Reversible muscle weakness in patients with vitamin D deficiency", Western Journal of Medicine, 167(6), pp.435~439 (1997)
