제2형 당뇨병 환자들의 최대운동이 적혈구생성호르몬과 지방세포분비 단백질에 미치는 영향 = The Effects of Maximal Exercise on EPO(Erythropoietin) and Adipokine in Type 2 Diabetes Patient

국문 초록 (Abstract)

본 연구는 제2형 당뇨병 환자들의 최대운동이 적혈구생성호르몬과 지방세포분비 단백질에 미치는 영향을 알아보고자 실시하였다. 연구대상자들은 인슐린저항성을 보이는 제2형 당뇨병 환자들로서 스스로 연구에 참어를 동의한 사람들로서 무작위추출에 의해 실험A군(정상체중그룹, n=7), 실험B군(과체중그룹, n=8)으로 나누어 실시하였다. 측정내용은 체성분 분석기(Venus 5.5)를 통한 신체조성검사를 실시하였으며, 최대운동부하 검사는 Quark b2를 통해서 실시하였으며, 혈장과 혈청을 통해 HbA1c, EPO, IL-6, RBP4, Adiponectin을 검사하여 다음과 같은 결과를 얻었다. HbA1c는 유의한 감소가 나타났으며, EPO는 감소하였지만 통계적으로 유의성은 나타나지 않았다. 또한 RBP4는 최대운동전보다 운동후에 두그룹 모두 유의한 감소가 나타났으며, Adiponectin은 유의한 증가가 나타났다. 하지만 IL-6는 통계적으로 유의성이 나타나지 않았다. 따라서 인슐린저항성을 나타내는 제2형 당뇨병 환자들 중 특히 과체중환자들은 최대운동과 같은 탈진적운동이 당수송을 촉진하여 지방세포에서 분비되는 단백질에 영향을 주는 것으로 사료된다.

다국어 초록 (Multilingual Abstract)

The purpose of this study was to investigate the effects of maximal exercise on EPO and adipokine in type 2 diabetes patient. Subjects were recruited and divided into 2 groups. One group of subjects was experiment A(n=7, normal weight group) and other group was experiment B(n=8, over weight group). Maximal exercise test used to Quark b2 that HbA1c, EPO, RBP4, IL-6, Adiponectin was measured from blood plasma and serum. The results showed that HbA1c was decreased significant and EPO was not significant. Serum RBP4 was decreased and adiponectin was increased significant after maximal exercise. But IL-6 was not changed. Therefore, in subjects type 2 diabetes insulin sensitivity in overweight group maximal exercise was positive on adipokine through glucose transport palpation.

참고문헌 (Reference)

1 "당뇨병학 3판" 대한당뇨병학회 2005

2 "the enigma of the metabolic fate of circulation erythropoietin(EPO) in view of the pharmacokinetics of the recombinant drugs r-hEPO and NESP" 69 : 265-274, 2002

3 "in vitro interaction with retinol-binding protein and influence on plasma retinol. FASEB. J. 7" . reti (. reti): 1179-1184, 1993

4 "cDNA cloning and expression of a novel adipose specific collagen-like factor, apM1(Adipose most abundant gene transcript 1)" 221 : 286-289, 1996

5 "What is a normal red blood cell mass for professional cyclists?" 352 : 1758-, 1998

6 "Vitamin A(retinol) status of first nation adults with non-insulin- dependent diabetes mellitus" 16 (16): 39-45, 1997

7 "The transthyretin-retinol-binding protein complex" 1482 (1482): 65-72, 2000

8 "The role of the novel adipocyte-derived hormone adiponectin in human disease" 148 : 293-300, 2003

9 "The insulin resistance syndrome: definition and dietary approaches to treatment" 25 : 391-406, 2005

10 "The effect of exercise training on leptin levels in obese males" 274 : 280-286, 1998

11 "Serum retionl binding protein 4 contributes to insulin resistance in obesity and type 2 diabetes" 436 (436): 356-362, 2005

12 "Searching for the exercise factor: is IL6 a candidate" 24 : 113-119, 2003

13 "Retinol-binding protein 4 and insulin resistance in lean, obese, and diabetic subjects" 354 (354): 1 2552-2563, 2006

14 "Retinol, alpha-tocopherol and carotenoids in diabetes" 53 (53): 630-635, 1999

15 "Relationship between exercise training-induced increase in insulin sensitivity and adiponectinemia in healthy men" 50 : 233-238, 2003

16 "RBP4, an unexpected adipokine" 12 (12): 30-31, 2006

17 "Plasma leptin concentrations in obese children: changes during 4-mo periods with and without physical training" 69 : 388-394, 1999

18 "Physical performance and associated electrolyte changes after hemoglobin normalization: a comparative study in haemodialysis patients" 14 : 1182-1187, 1999

19 "Muscle-derived interleukin-6: possible biological effects" 536 : 329-337, 2001

20 "Muscle-derived interleukin-6: mechanisms for activation and possible biological roles" 16 : 1335-1347, 2002

21 "Moderate-intensity regular exercise decrease serum tumor necrosis factor-α and HbA1c levels in healthy women" 24 : 1207-1211, 2000

22 "Issues related to blood sampling in athletes for doping control" 28 : 25-30, 1999

23 "Isolation and characterization of GBP28, a novel gelatin-binding protein purified from human plasma" 120 : 803-812, 1996

24 "Increasing the hematocrit has a beneficial effect on quality of life and is safe in selected hemodialysis patients" 11 : 335-342, 2000

25 "Impaired retinal function and vitamin A availability in mice lacking retinol-binding protein" 18 (18): 4633-4644, 1999

26 "Health Fitness Instructor's Handbook" Human Kinetics 1998

27 "Haemoglobin, blood volume, cardiac function, and aerobic power" 24 : 54-65, 1999

28 "Guidelines for exercise testing and prescription" Baltimore, Williams & Wilkins 2005

29 "Faster oxygen uptake kinetics at the onset of submaximal cycling exercise following 4 weeks recombinant human erythropoietin(r-HuEPO) treatment" 447 : 231-238, 2003

30 "Exercising skeletal muscle blood flow in humans responds to reduction in arterial oxyhaemoglobin, but not to altered free oxygen" 530 : 331-341, 2001

31 "Exercise increases adiponectin levels and insulin sensitivity in humans" 27 : 629-630, 2004

32 "Exercise and the immune system: regulation, integration and adaptation" 80 : 1055-1081, 2000

33 "Evidence for an essential role of megalin in transepithelial transport of retinol" 10 (10): 685-695, 1999

34 "Erythropoietin prevents neuronal apoptosis after cerebral ischemia and metabolic stress" 98 (98): 4044-4049, 2001

35 "Erythropoietin prevents motor neuron apoptosis and neurologic disability in experimental spinal cord ischemic injury" 99 (99): 2258-2263, 2002

36 "Erythropoietin attenuated high glucose-induced apoptosis in cultured human aortic endothelial cells" 334 (334): 218-222, 2005

37 "Effects of porlonged low doses of recombinant human erythropoietin during submaximal and maximal exercise" 86 : 442-449, 2002

38 "Effects of erythropoietin admini- stration in training athletes and possible indirect detection in doping control" 5 : 639-645, 1999

39 "Effect of erythropoietin on muscle O2 transport during exercise in patients with chronic renal failure" 97 : 2092-2100, 1996

40 "Effect of erythropoietin on exercise capacity in patients with moderate to severe chronic heart failure" 107 (107): 294-299, 2003

41 "Effect of aerobic exercise on plasma adiponectin levels and insulin resistance in type 2 diabetes" 27 : 1756-1758, 2004

42 "EPO, red cells, and serum transferrin receptor in continuous and intermittent hypoxia" 32 (32): 800-804, 2000

43 "Disruption of adiponectin cause insulin resistance and neointimal formation" 277 : 25863-25866, 2002

44 "Comparison of the release of adipokines by adipose tissue, adipose tissue matrix, and adipocytes from visceral and subcutaneous abdominal adipose tissues of obese humans" 145 : 2273-2282, 2004

45 "Cloning of adiponectin receptors that mediate antidiabetic metabolic effects" 423 : 762-769, 2003

46 "Clinical practice guidelines: final guideline summaries from the work groups of the national kidney foundation-dialysis outcomes quality initiative" New York : National Kidney Foundation 1997

47 "Circulation concentrations of the adipocyte protein adiponectin are decreased in parallel with reduced insulin sensitivity during the progression to type 2 diabetes in rhesus monkeys" 50 : 1126-1133, 2001

48 "Body composition is related to increase in plasma adiponectin levels rather than trining in young obese men" 94 : 520-526, 2005

49 "Adipose-selective targeting of the GLUT4 gene impairs insulin action in muscle and liver" 409 (409): 729-733, 2001

50 "Adipose tissue as an endocrine organ" 89 : 2548-2556, 2004

51 "Adipose tissue as an endocrine organ" 11 (11): 327-332, 2000

52 "Adiponectin: more than just another fat cell hormone?" 26 : 2442-2450, 2003

53 "Adiponectin levels do not change with moderate dietary induced weight loss and exercise in obese postmenopausal women" 279 : 1066-1071, 2003

54 "Adiponectin is not altered with exercise training despite enhanced insulin action" 283 : E861-E865, 2002

55 "Adiponectin and HIV- lipodystrophy: taking HAART" 145 : 484-486, 2004

56 "AdipoQ is novel adipose-specific gene dysregulated in obesity" 271 : 10697-10703, 1996

57 "A transgenic mouse with a deletion in the collagenous domain of adiponectin displays elevated circulating adiponectin and improved insulin sensitivity" 145 : 367-383, 2004

58 "A novel serum protein similar to C1q, produced exclusively in adipocytes" 270 : 26746-26749, 1995

59 "A novel protective effect of erythropoietin in the infarcted heart" 112 (112): 999-1007, 2003

60 ". The interaction of retinol-binding protein with its plasma-membrane receptor. Biochem. J. 255" 561-569, 1988

61 ". Specific uptake of retinol-binding protein by variant F9 cell lines. J. Biol. Chem. 268" 18859-18865, 1993

62 ". Rate of erythropoietin formation in response to acute hypobaric hypoxia. J. Appl. Physiol. 66" 1785-1788, 1989

63 ". In vitro production of erythropoietin by kidneys perfused with a serum free solution. Blood. 44" 77-85, 1974

64 ". Erythropoietin retards DNA breakdown and prevents programmed death in erythroid progenitor cells. Science. 248" 378-381, 1990

65 ". Erythropoietin response to acute normobaric hypoxia in humans. J. Appl. Physiol." 837-840, 1992

66 ". Effect of erythropoietin administration on maximal aerobic power. Scand. J. Med. Sci. Sports. 1" 88-93, 1991

67 ". Apoptosis of human erythroid colony-forming cells is decreased by stem cell factor and insulin-like growth factor I as well as erythropoietin. J. Cell Physiol." 264-271, 1993