12주간의 유산소운동과 저항성운동이 여성 노인 당뇨병환자의 복부지방, 체력, 아디포카인 및 염증지표에 미치는 영향 = Effects of 12 Weeks of Aerobic and Resistance Training on Abdominal Fat, Physical Fitness, Adipokines, and Inflammatory Markers in Female Elderly Patients with Type 2 Diabetes

다국어 초록 (Multilingual Abstract)

The study was designed to investigate the effects of 12 weeks of aerobic training and resistance training on abdominal fat, physical fitness, adipokines, and inflammatory markers. Thirty-three female type 2 diabetes mellitus (T2D) patients, aged 60-78 yrs, in three groups, i.e., aerobic exercise training group (AT; n=12), resistance exercise training group (RT; n=12), and control group (CON; n=10), participated in the study. AT participants peformed at 60-70% of HRmax, 20-40 min/session, 3 sessions/wk for 12 weeks, and RT participants performed at 60-65% of 1-RM, 2-3 sets 3 sessions/wk for 12 weeks. Variables regarding abdominal fat, physical fitness, adipokines, and inflammatory markers were measured in pre- and post-test, and were compared among three groups and between two tests. Main results were as follows:1) Body weight and BMI decreased significantly in the AT, and percent body fat (%BF) decreased significantly in both AT and RT. %BF in the AT (p<.001) decreased more significantly than the RT (p<.01). 2) Abdominal fat area including total abdominal fat area, visceral fat area, and subcutaneous fat area decreased significantly in the AT, whereas total abdominal fat area and subcutaneous fat area decreased significantly in the RT. Total abdominal fat area in the AT (p<.001) decreased more significantly than the RT (p<.01). 3) VO2max increased significantly in the AT and RT. 4) One-RM of bench press and leg press increased significantly in the RT. 5) Although leptin showed a trend to decrease in the AT and RT, the changes failed to reach statistical significant level. Adiponectin showed no significant change in all groups. 6) C-reactive protein (CRP) decreased significantly in the AT. Interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) showed no significant change in all groups. It was concluded that 12 weeks of both aerobic and resistance training improved body composition, especially abdominal fat, aerobic capacity, and muscular strength in female elderly T2D patients. No significant effects of either aerobic or resistance training on adipokines and inflammatory makers were found, except positive effect of aerobic exercise training on CRP.

참고문헌 (Reference)

1 박경수, "혈중 아디포카인 농도와 대사지표와의 상관관계" 대한내분비학회 20 (20): 441-443, 2005

2 유민, "한국인에서의 아디포넥틴의 유전자다형성과 제2형 당뇨병과의 연관성" 한국생명과학회 19 (19): 1495-1498, 2009

3 이상엽, "한국 성인에서 대사증후군의 복부비만 적정기준과 의의" 23 (23): 206-210, 2010

4 이규성, "탄력밴드운동시 NIDDM 환자의 혈장내 Leptin 수준과 Insulin, Glucose 신체구성성분과의 관련성 분석" 한국운동생리학회 11 (11): 131-143, 2002

5 정의달, "제2형 당뇨병환자에서 초음파로 측정한 내장지방 길이와 컴퓨터 단층촬영으로 측정한 내장지방 면적과의 상관관계" 대한당뇨병학회 32 (32): 418-427, 2008

6 강현식, "유산소 걷기 운동이 중년여성의 복부피하지방조직의 싸이토카인 유전자 발현에 미치는 영향" 한국운동생리학회 20 (20): 11-26, 2011

7 김명수, "운동 프로그램에 따른 비만 노인여성의 혈중지질, 렙틴 및 코티졸 변화" 한국사회체육학회 (36) : 663-671, 2009

8 국제당뇨연맹, "세계 당뇨인구통계"

9 최경묵, "새로운 아디포카인" 대한내분비학회 23 (23): 219-222, 2008

10 임승준, "비만중년여성의 8주간 복합운동이 대사증후군 위험인자와 Leptin, Adiponetin 및 CRP에 미치는 영향" 한국체육과학회 20 (20): 1139-1150, 2011

11 권영우, "비만여성의 운동형태가 신체구성과 염증지표에 미치는 영향" 한국체육과학회 20 (20): 1479-1489, 2011

12 김종엽, "비만도에 따른 Adiponectin, Leptin, Ghrelin과 인슐린 저항성, 심혈관 위험인자의 상호 연관성" 대한내과학회 69 (69): 631-641, 2005

13 소위영, "미용덤벨 운동이 노인의 근감소증 예방을 위한 신체조성, 체력 및 혈중지질에 미치는 영향" 한국노년학회 29 (29): 837-850, 2009

14 김태영, "당뇨병의 유형과 운동에 관한 문헌 연구" 한국체육과학회 20 (20): 783-796, 2011

15 미국스포츠의학협회, "당뇨병 환자의 운동지침"

16 경제협력개발기구, "당뇨 사망률 통계"

17 대한당뇨학회, "국내 당뇨인구통계"

18 Ibanez, J., "Twice weekly progressive resistance training decreases abdominal fat and improves insulin sensitivity in older man with type 2 diabetes" 28 (28): 662-667, 2005

19 Dandona, P., "Tumor necrosis factor-alpha in sera of obese patients : fall with weight loss" 83 (83): 2907-2910, 1998

20 Hamer, M., "The accumulative effects of modifiable risk factors on inflammation and haemostasis" 22 (22): 1041-1043, 2008

21 Holten, M. K., "Strength training increases insulin-mediated glucose uptake, GLUT4 content, and insulin signalling in skeletal muscle in patients with type 2 diabetes" 53 (53): 294-305, 2004

22 Brooks, N., "Strength training improves muscle quality and insulin sensitivity in Hispanic older adults with type 2 diabetes" 4 (4): 19-27, 2007

23 Kacerovsky-Bielesz, G., "Short-term exercise training does not stimulate skeletal muscle ATP synthesis in relatives of humans with type 2 diabetes" 58 (58): 1333-1341, 2009

24 Eves, N. D., "Resistance training and type 2 diabetes : Considerations for implementation at the population level" 29 (29): 1933-1941, 2006

25 McConnell, T. R., "Prediction of maximal oxygen consumption during handrail-supported treadmill exercise" 7 (7): 324-331, 1987

26 Kuramoto, A. K., "Predicting muscular strength in women : A preliminary study" 66 (66): 168-172, 1995

27 최혜진, "Power walking 프로그램이 인체의 면역 반응에 미치는 영향" 한국운동생리학회 17 (17): 1-10, 2008

28 Hu, G., "Physical activity, body mass index, and risk of type 2 diabetes in patients with normal or impaired glucose regulation" 164 (164): 892-896, 2004

29 Bruunsgaard, H., "Physical activity and modulation of systemic low-level inflammation" 78 (78): 819-835, 2005

30 Bruunsgaard, H., "Muscle strength after resistance training is inversely correlated with baseline levels of soluble tumor necrosis factor receptors in the oldest old" 52 (52): 237-241, 2004

31 Mourier, A., "Mobilization of visceral adipose tissue related to the improvement in insulin sensitivity in response to physical training in NIDDM : Affects of branched-chain amino acid supplements" 20 (20): 385-391, 1997

32 Bruce, R. A., "Maximal oxygen intake and nomographic assessment of functional aerobic impairment in cardiovascular disease" 85 (85): 546-562, 1973

33 Juhan-Vague, I., "Involvement of the hemostatic system in the insulin resistance syndrome : A study of 1500 patients with angina pectoris. The ECAT Angina Pectoris Study Group" 13 (13): 1865-1873, 1993

34 Weyer, C., "Hypoadiponectinemia in obesity and type 2 diabetes : Close association with insulin resistance and hyperinsulinemia" 86 (86): 1930-1935, 2001

35 Kongsgaard, M., "Heavy resistance training increases muscle size, strength and physical function in elderly male COPD patients : A pilot study" 98 (98): 1000-1007, 2004

36 Plotnikoff, R. C., "Factors associated with physical activity in Canadian adults with diabetes" 38 (38): 1526-1534, 2006

37 Lee, S. J., "Exercise without weight loss is an effective strategy for obesity reduction in obese individuals with and without type 2 diabetes" 99 (99): 1220-1225, 2005

38 Marcell, T. J., "Exercise training is not associated with improved levels of C-reactive protein or adiponectin" 54 (54): 533-541, 2005

39 Nicklas, B. J., "Exercise training and plasma C-reactive protein and interleukin-6 in elderly people" 56 (56): 2045-2052, 2008

40 Figueroa, A., "Endurance training improves post-excercise cardiac autonomic modulation in obese women with and without type 2 diabetes" 100 (100): 437-444, 2007

41 Sigal, R. J., "Effects of aerobic training, resistance training, or both on glycemic control in type 2 diabetes : A randomized trial" 147 (147): 357-369, 2007

42 Tessier, D., "Effects of aerobic physical exercise in the elderly with type 2 diabetes mellitus" 31 (31): 121-132, 2000

43 권휘련, "Effects of Aerobic Exercise vs. Resistance Training on Endothelial Function in Women with Type 2 Diabetes Mellitus" 대한당뇨병학회 35 (35): 364-373, 2011

44 Baker, S., "Effects and clinical potential of very-low-calorie diets(VLCDs)in type 2 diabetes" 85 (85): 235-242, 2009

45 Cuff, D. J., "Effective exercise modality to reduce insulin resistance in women with type 2 diabetes" 26 (26): 2977-2982, 2003

46 Misra, A., "Effect of supervised progressive resistance-exercise training protocol on insulin sensitivity, glycemia, lipids, and body composition in asian indians with type 2 diabetes" 31 (31): 1282-1287, 2008

47 Donges, C. E., "Effect of resistance or aerobic exercise training on interleukin-6, C-reactive protein, and body composition" 42 (42): 304-313, 2010

48 Irving, B. A., "Effect of exercise training intensity on abdominal visceral fat and body composition" 40 (40): 1863-1872, 2008

49 Nicklas, B. J., "Diet induced weight loss, exercise, and chronic inflammation in older, obese adults : A randomized controlled clinical trial" 79 (79): 544-551, 2004

50 Havel, P. J., "Control of energy homeostasis and insulin action by adipocyte hormones : Leptin, acylation stimulating protein, and adiponectin" 13 (13): 51-59, 2002

51 Geffken, D. F., "Association between physical activity and markers of inflammation in a healthy elderly population" 153 (153): 242-250, 2001

52 Galic, S., "Adipose tissue as an endocrine organ" 316 (316): 129-139, 2010

53 Spiegelman, B. M., "Adipogenesis and obesity : Rounding out the big picture" 87 (87): 377-389, 1996

54 Wycherley, T. P., "A high-protein diet with resistance exercise training improves weight loss and body composition in overweight and obese patients with type 2 diabetes" 33 (33): 969-976, 2010