16주간 복합운동이 제 2형 당뇨병 척수장애인의 아디포사이토카인 및 인슐린 저항성에 미치는 영향

국문 초록 (Abstract)

본 연구의 목적은 1과제와 2과제로 구분할 수 있다. 첫째, 성인 남성 척수장애인을 대상으로 제2형 당뇨병 유⋅무에 따른 체중, 복부지방, 체력, 아디포사이토카인, 그리고 대사증후군 위험인자의 차이를 규명하는 것이었다. 성인 남성 척수장애인 중 제2형 당뇨집단 10명, 비당뇨집단 10명으로 구성하여, 두 집단의 측정값을 비교⋅분석하였다. 제2과제는, 당뇨병이 있는 척수장애인 중 운동 트레이닝 집단 8명, 통제 집단 7명을 대상으로 구성하였으며, 운동 트레이닝 집단은 일일 60분, 주 3회, 16주간 thera-band를 이용하여 스트레칭, 저항성운동 및 유산소운동으로 구성된 복합운동 트레이닝을 실시하였고, 통제 집단은 평상시 생활을 그대로 16주간 유지하도록 하였다. 두 집단의 운동 실시 전⋅후에서 얻은 측정값을 비교⋅분석하였으며, 제1과제의 경우 두 집단의 측정값을 비교하기 위해 독립t검증을 실시하였으며, 제2과제의 경우 반복이 있는 이원변량분석을 통해 비교⋅분석 하였다.본 연구 결과를 종합해 보면, 제2형 당뇨병의 성인 남성 척수장애인의 경우 비당뇨집단 보다 높은 총지방면적, 내장지방면적, 피하지방면적, 공복 시 혈당, 공복 시 인슐린, 그리고 인슐린저항성과 낮은 아디포넥틴이 나타났다. 또한 제2형 당뇨병을 갖고 있는 성인 남성 척수장애인의 16주간 운동 트레이닝이 피하지방면적, 좌악력, 최고산소섭취량, TNF-α, 그리고 LDL-C 개선에 효과적인 것으로 나타났다. 당뇨가 있는 척수장애인이 당뇨가 없는 집단보다 복부지방이 높게 나타났으나, 당뇨병이 있는 척수장애인을 대상으로 운동 트레이닝을 시킨 결과 체력과 TNF-α의 유의한 변화가 나타났음에도 불구하고 피하지방을 제외한 내장지방과 총지방면적에는 유의한 변화가 나타나지 않았다. 따라서 향후 연구는 대상자의 수를 증가시키고, 대상자의 특성을 제한하여, 다양한 운동 프로그램을 적용시켜 척수장애인의 당뇨와 관련된 변인에 미치는 그 효과를 검증하는 것이 이루어져야 할 것으로 생각된다.

다국어 초록 (Multilingual Abstract)

The purpose of this study is divided into subjectⅠand subjectⅡ. The subjectⅠwas to examine the difference of male diabetic spinal cord individuals' weight, abdominal fat, physical strength, adipocytokine, according to the having typeⅡ diabetes, and risk factors of metabolic symptom. The value of measurement of this research was compared and analyzed from male diabetic spinal cord individuals' two group 20persons: typeⅡ diabetes group 10persons and none diabetes group 10persons. The subjectⅡ was composed to exercise group 8persons whose were trained complex exercise which was consisted of stretching, resistance and aerobic training using thera-band for 60 minutes in everyday, 3 times a week and 16 weeks, and control group 7persons whose were maintained their daily lives for 16 weeks. The measured value between two group was compared and analyzed before and after exercise. In case of subjectⅠ, it was operated independent t prove in order to compare the value of measurement between two group, while subjectⅡ was operated the value using Two-Way Anova. The followings are the summery from this research.
1. The difference of weight of spinal cord injuries, according to the diabetes existence, was not apparent, but the diabetes group's TFA and VFA were high clearly, and diabetes group's SFA and VSR were higher than none diabetes group.
2. There was no difference of right and left grasping power, O2peak, HRpeak, and HRrest of spinal cord injuries, according to the diabetes existence.
3. There was no apparent difference of leptin and TNF-α of spinal cord injuries, according to the diabetes existence, but diabets group's adiponetin was higher than none diabetes group.
There was no apparent difference of TG, HDL, TG, SBP and DBP of spinal cord injured individuals, according to the diabetes existence, but the diabetes group's LDL-C, an empty stomach blood sugar and insulin, and HOMAIR were higher than none diabetes group.
4. There was no apparent statistical difference of weight, TFA, VFA between two groups after exercise for 16 weeks, but the trained group's VSR(19.23%) was increased comparatively, while SFA(13.48%) was decreased.
5. The trained group shown an apparent increase of right grasping power(10.57%), O2peak(15.69%), but there was no clear difference of HRpeak and HRrest among two groups.
6. Two all groups were not shown apparent difference of leptin, adiponetin after during 16 weeks, but the trained group's TNF-α(97.53%) was decreased comparatively.
There was no clear statistical difference of TC, HDL-C, TG, an empty blood and insulin, HOMAIR, SBP, and DBP from both of two groups, but the trained group's LDL-C(16.68%), an empty blood(26.78%) were shown apparent decrease.
From these conclusions, TFA, VFA, LDL-C, an empty blood and insulin, HOMAIR, low adiponetin of male diabetic spinal cord injured person, having typeⅡ diabetes, were higher than none diabetes group. Also, 16 weeks exercise was effective to improve SFA, left grasping power, O2peak, TNF-α, and LDL-C. The adult male' abdominal fat, having diabetes, was measured highly. It means that there was no apparent difference of abdominal fat, excepting fat under the skin, though being clear difference of TNF-a of diabetic spinal cord injured persons after exercise. In sum, it would advance this research in the future: increase the number of subject, restrain the trait of subject, and improve the effect to variables which related diabetes of spinal cord injured persons, adapting varies exercise programs.