تأثیر تمرینات آکوا و مقاومتی بر نیمرخ لیپیدی، آدیپونکتین، انسولین و گلوکز خون مبتلایان به دیابت بارداری

نوع مقاله: اصیل پژوهشی

نویسندگان

1 دانشیار گروه فیزیولوژی ورزشی، واحد مرودشت، دانشگاه آزاد اسلامی، مرودشت، ایران.

2 استادیار گروه فیزیولوژی ورزشی، واحد مرودشت، دانشگاه آزاد اسلامی، مرودشت، ایران.

3 استادیار گروه تربیت بدنی و علوم ورزشی، پردیس بین‌الملل کیش، دانشگاه تهران، کیش، ایران.

4 دانشیار گروه فیزیولوژی ورزشی، دانشکده تربیت بدنی، دانشگاه تهران، ایران.

5 دانشیار گروه زنان و مامایی، مرکز تحقیقات بیماری‌های مادر و جنین، دانشگاه علوم پزشکی شیراز، شیراز، ایران.

چکیده

مقدمه: فعالیت­ بدنی، یکی از راهکارهای اساسی در کنترل و درمان دیابت می­باشد، با این وجود هر نوع فعالیت بدنی دارای سازوکارهای متفاوتی در بیماران مبتلا به دیابت می‌باشد، لذا مطالعه حاضر با هدف مقایسه اثر تمرینات آکوا و مقاومتی بر آدیپونکتین، نیمرخ لیپیدی، انسولین و گلوکز خون مبتلایان به دیابت بارداری انجام شد.
روش‌کار: این مطالعه کارآزمایی بالینی تصادفی شده در دی ماه سال 1394 بر روی 34 مادر مبتلا به دیابت بارداری مراجعه کننده به درمانگاه پریناتولوژی بیمارستان آموزشی- درمانی حافظ و درمانگاه مطهری انجام شد.افراد در سه ﮔﺮوه ﺗﻤﺮﻳﻦ آکوا، تمرین مقاومتی و کنترل قرار گرفتند. گروه تمرینات آکوا و مقاومتی، به مدت 6 هفته، 3 جلسه در هفته و هر جلسه 45-30 دقیقه تمرین کردند. ﮔﺮوه ﻛﻨﺘﺮل در این مدت فقط فعالیت­های روزانه خود را داشتند. جهت اندازه‌گیری متغیرهای تحقیق شامل آدیپونکتین، کلسترول تام، لیپوپروتئین پرچگال، تری‌گلیسرید، گلوکز ناشتا و انسولین مورد نیاز؛ نمونه خون در وضعیت ناشتا در پیش آزمون و پس آزمون به عمل آمد. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماری SPSS (نسخه 21) و آزمون­های تیوابسته، تحلیل کواریانس، آنالیز واریانس یک‌طرفه به همراه آزمون تعقیبی بنفرونی انجام گرفت. میزان p کمتر از 05/0 معنادار در نظر گرفته شد.
ﻳﺎﻓﺘﻪ‌ﻫﺎ: تمرین آکوا تأثیر معنی‌داری بر افزایش آدیپونکتین و کاهش کلسترول تام، تری‌گلیسرید و انسولین مورد نیاز داشت(05/0≥p). تمرین مقاومتی تأثیر معنی‌داری بر کاهش لیپوپروتئین پرچگال، انسولین مورد نیاز و گلوکز ناشتا داشت (05/0≥p). همچنین تمرین آکوا نسبت به تمرین مقاومتی اثر بیشتری بر کاهش تری‌گلیسیرید داشت(05/0≥p).
ﻧﺘﻴﺠﻪﮔﻴﺮی: ﺑﻪ ﻧﻈﺮ ﻣﻲرﺳﺪ، تمرینات آکوا نسبت به تمرینات مقاومتی تأثیرات مثبت بیشتری بر آدیپونکتین و نیمرخ لیپیدی زﻧﺎن ﻣﺒﺘﻼ ﺑﻪ دﻳﺎﺑﺖ ﺑﺎرداری دارند.

کلیدواژه‌ها


عنوان مقاله [English]

The Effect of Aqua and Resistance Trainings on Lipid Profile, Adiponectin, Insulin, and Glucose in Women with Gestational Diabetes Mellitus

نویسندگان [English]

  • Seyed Ali Hosseini 1
  • Nasibeh Kazemi 2
  • Reza Nouri 3
  • Mohammad Reza kordi 4
  • Maryam Kasraian 5
1 Associate Professor, Department of Sport Physiology, Marvdasht Branch, Islamic Azad University, Marvdasht, Iran.
2 Assistant Professor, Department of Sport Physiology, Marvdasht Branch, Islamic Azad University, Marvdasht, Iran.
3 Assistant Professor, Department of Physical Education and Sport Science, Kish International Paradise, Tehran University, Kish, Iran.
4 Associate Professor, Department of Sport Physiology, School of Physical Education, Tehran University, Tehran, Iran
5 Associate Professor, Department of Obstetrics and Gynecology, Maternal-Fetal Medicine Research Center, Shiraz University of Medical Science, Shiraz, Iran.
چکیده [English]

Introduction: Physical activity is one of basic solutions in the control and treatment of diabetes. Nevertheless, any kind of physical activity has different mechanisms in diabetic patients. Therefore, the aim of the present study was to compare the effect of aqua and resistance trainings on blood adiponectin, lipid profile, insulin, and glucose in patients with gestational diabetes mellitus (GDM).
Methods: This randomized clinical trial was conducted in January, 2015 on 34 women with gestational diabetes referred to Motahari Clinic and Primatology Clinic of Hafez Hospital. The subjects were divided in three groups of aqua and resistance trainings and control. During 6 weeks, aqua and resistance training groups trained three 30-45-min sessions per week. The participants in the control group had just their daily activity. The levels of adiponectin, total cholesterol,high-density lipoprotein, triglyceride, fasting blood sugar, and insulin requirement were measured. The blood samples were collected in fasting status at the pre- and post-intervention phases. Data analysis was performed using t-test, analysis of covariance, one-way analysis of variance, and Bonferroni post-hoc test. P≤0.05 was considered statistically significant.
Results: Aqua training had significant effect on increasing adiponectin and decreasing total cholesterol, triglyceride, and insulin requirement (P≤0.05). Resistance training had significant effect on the reduction of high-density lipoprotein, insulin requirement, and fasting blood sugar (P≤0.05). Additionally, aqua training rather had more effect on reduction of triglycerides in comparison to resistance training (P≤0.05).
Conclusion: Aqua training had more positive effect on adiponectin and lipid profile in women with gestational diabetes in comparison to resistance training.

کلیدواژه‌ها [English]

  • Training
  • Adiponectin
  • Glycemic indices
  • lipid profile
  • Gestational diabete
 
 

  1. Ramezani S, Ahmadi M, Saghafi H, Alipoor M. Association of pregnancy-associated plasma protein A (PAPP-A) and gestational diabetes. Iran J Obstet Gynecol Infertility 2017; 20(1):61-9. (Persian).
  2. Larejani B, Hossein-nezhad A. Diabetes mellitus and pregnancy. J Diabetes Metab Disord 2001; 1(1):9-22.
  3. Rahimi M, Karami Moghadam F. The prevalence of gestational diabetes mellitus and its related risk factors using one-step method in Kermanshah, 2016. Iran J Obstet Gynecol Infertil 2017; 20(4):1-4. (Persian).
  4. Buchanan TA. Pancreatic B-cell defects in gestational diabetes: implications for the pathogenesis and prevention of type 2 diabetes. J Clin Endo Metab 2001; 86(3):989-93.
  5. Farsi S, Azarbayjan MA, Hosseini SA, Peeri M. The effects of endurance training with Genistein on ICAM-1, VCAM-1, and CRP of diabetic rats. Iran J Diabetes Obes 2016; 8(3):121-8.
  6. Briana DD, Malamitsi-Puchner A. Reviews: adipocytokines in normal and complicated pregnancies. Reprod Sci 2009; 16(10):921-37.
  7. Henry BA, Clarke IJ. Adipose tissue hormones and the regulation of food intake. J Neuroendocrinol 2008; 20(6):842-9.
  8. Rashidlamir A, Javaheri AH, Jafari M. The effect of regular aerobic training with weight loss on concentrations of fibrinogen and resistin in healthy and overweight men. Tehran Univ Med Sci J 2011; 68(12):710-7.
  9. Mansouri Z, Rahimi E, Hosseini SA, Tabatabaeian A. The effect of eight weeks resistance training on serum levels of adiponectin and total cholesterol of 16- 18 years old boys. Quart J Sport Bio Res 2014; 3(4):37-47. (Persian).
  10. Dehghan F, Hajiaghaalipour F, Yusof A, Muniandy S, Hosseini SA, Heydari S, et al. Saffron with resistance exercise improves diabetic parameters through the GLUT4/AMPK pathway in-vitro and in-vivo. Sci Rep 2016; 28(6):25139.
  11. Chen J, Tan B, Karteris E, Zervou S, Digby J, Hillhouse EW, et al. Secretion of adiponectin by human placenta: differential modulation of adiponectin and its receptors by cytokines. Diabetologia 2006; 49(6):1292-302.
  12. Bhograj A, Suryanarayana KM, Nayak A, Murthy NS, Dharmalingam M, Kalra P. Serum adiponectin levels in gestational diabetes mellitus. Indian J Endorin Metab 2016; 20(6):752-5.
  13. Pala HG, Ozalp Y, Yener AS, Gerceklioglu G, Uysal S, Onvural A. Adiponectin levels in gestational diabetes mellitus and in pregnant women without glucose intolerance. Adv Clin Exp Med 2015; 24(1):85-92.
  14. Elbalshy MM, Mohamed ME, Rahma AF. Effect of aerobic exercise on serum adiponectin and serum malondialdehyde (MDA) in type 1 diabetic patients. Eur J Prev Med 2017; 5(5):71-6.
  15. Bruun JM, Lihn AS, Verdich C. Regulation of adiponectin by adipose tissue derived cytokines: in vivo and in vitro investigations in humans. Am J Physiol Endocrinol Metab 2003; 285(3):E527-33.
  16. Ryckman KK, Spracklen CN, Smith CJ, Robinson JG, Saftlas AF. Maternal lipid levels during pregnancy and gestational diabetes: a systematic review and meta-analysis. BJOG 2015; 122(5):643-51.
  17. Fanshawe AE, Ibrahim M. The current status of lipoprotein (a) in pregnancy: a literature review. J Cardiol 2013; 61(2):99-106.
  18. Marks BL, Ward A, Morris DH, Castellani J, Rippe JM. Fat-free mass is maintained in women following a moderate diet and exercise program. Med Sci Sorts Exerc 1995; 27(9):1243-51.
  19. Golbidi S, Laher I. Potential mechanisms of exercise in gestational diabetes. J Nutr Metab 2013; 2013:285948
  20. Tabatabaie O, Ranjbar SH, Mohammad Amoli M, Heshmat R, Sajadi M, Balaie P, et al. Review the relationship of adiponectin gen polymorphism with anthropometric variables and blood pressure regard to gender in Iranian population. Iran J Diabetes Metab 2010; 9(2):116-22. (Persian).
  21. Winnick JJ, Gaillard T, Schuster DP. Resistance training differentially affects weight loss and glucose metabolism of White and African American patients with type 2 diabetes mellitus. Ethn Dis 2008; 18(2):152-6.
  22. Eves ND, Plotnikoff RC. Resistance training and type 2 diabetes considerations for implementation at the population level. Diabetes Care 2006; 29(8):1933-41.
  23. Oteng-Ntim E, Varma R, Croker H, Poston L, Doyle P. Lifestyle interventions for overweight and obese pregnant women to improve pregnancy outcome: systematic review and meta-analysis. BMC Med 2012; 10:47.
  24. Zhang C, Solomon CG, Manson JE, Hu FB. A prospective study of pregravid physical activity and sedentary behaviors in relation to the risk for gestational diabetes mellitus. Arch Intern Med 2006;166: 543 548.
  25. Dempsey JC, Butler CL, Williams MA. No need for a pregnant pause: physical activity may reduce the occurrence of gestational diabetes mellitus and preeclampsia. Exer Sport Sci Rev 2005; 33(3):141-9.
  26. Meredith-Jones K, Waters D, Legge M, Jones L. Upright water-based exercise to improve cardiovascular and metabolic health: a qualitative review. Complement Ther Med 2011; 19(2):93-103.
  27. Hosseini KS, Attarzadeh Z, Haghighi A. A comparison of the effects of two aquatic exercise sessions with different duration on adiponectin and insulin resistance in women with type 2 diabetes. Sabzevar Med Sci Univ J 2014; 20(4):572-63.
  28. Khajei R, Soltani M, Hejazi SM, Noor Nematolahi S, Zendedel A, Ashkanifar M. The effect of aquatic aerobics exercises on some of cardiovascular risk factors in patients with multiple sclerosis. Evid Based Care 2012; 6(2):65-74.
  29. Buchanan TA, Metzger BE, Freinkel N, Bergman RN. Insulin sensitivity and B-cell responsiveness to glucose during late pregnancy in lean and moderately obese women with normal glucose tolerance or mild gestational diabetes. Am J Obstet Gynecol 1990; 162(4):1008-14.
  30. Akbari Z, Tol A, Shojaeizadeh D, Aazam K. Assessing of physical activity self-efficacy and knowledge about benefits and safety during pregnancy among women. Razi J Med Sci 2016; 22(139):76-87.
  31. Melton B, Marshall E, Bland H, Schmidt M, Guion WK. American rural women's exercise self- efficacy and awareness of exercise benefits and safety during pregnancy. Nurs Health Sci 2013; 15(4):468-73.
  32. Abedi B, Azarbayjani MA, Peeri M, Rasaee MJ. The effect of a single session of resistance training on serum adiponectin level and insulin resistance index in sedentary men. Arak Med Univ J 2011; 14(5):53-62. (Persian).
  33. Catalano PM, Tyzbir ED, Wolfe RR, Calles GE, Roman NM, Amini SB, et al. Carbohydrate metabolism during pregnancy in control subjects and women with gestational diabetes. Am J Physiol 1993; 264(1):E60-7.
  34. de Barros MC, Lopes MA, Francisco RP, Sapienza AD, Zugaib M. Resistance exercise and glycemic control in women with gestational diabetes mellitus. Am J Obstet Gynecol 2010; 203(6):556-61.
  35. Halse RE, Wallman KE, Newnham JP, Guelfi KJ. Pregnant women exercise at a higher intensity during 30min of self-paced cycling compared with walking during late gestation: implications for 2h postprandial glucose levels. Metabolism 2013; 62(6):801-7.
  36. Bhograj A, Suryanarayana KM, Nayak A, Murthy NS, Dharmalingam M, Kalra P. Serum adiponectin levels in gestational diabetes mellitus. Indian J Endocrinol Metab 2016; 20(6):752-5.
  37. Miehle K, Stepan H, Fasshauer M. Leptin, adiponectin and other adipokines in gestational diabetes mellitus and pre‐eclampsia. Clin Eendocrinol 2012; 76(1):2-11.
  38. López‐Bermejo A, Fernández‐Real JM, Garrido E, Rovira R, Brichs R, Genaro P, et al. Maternal soluble tumor necrosis factor receptor type 2 (sTNFR2) and adiponectin are both related to blood pressure during gestation and infant's birth weight. Clin Endocrinol 2004; 61(5):544-52.
  39. Worda C, Leipold H, Gruber C, Kautzky-Willer A, Knöfler M, Bancher-Todesca D. Decreased plasma adiponectin concentrations in women with gestational diabetes mellitus. Am J Obstet Gynecol 2004; 191(6):2120-4.
  40. Brankston GN, Mitchell BF, Ryan EA, Okun NB. Resistance exercise decreases the need for insulin in overweight women with gestational diabetes mellitus. Am J Obstet Gynecol 2004; 190(1):188-93.
  41. Padayachee C, Coombes JS. Exercise guidelines for gestational diabetes mellitus. World J Diabetes 2015; 6(8):1033-44.
  42. Barrett HL, Marloes Nitert D, Mclntyre HD, Callaway LK. Normalizing metabolism in diabetic pregnancy: is it time to target lipids? Diabetes Care 2014; 37(5):1484-93.
  43. Hadden DR, McLauglin C. Normal and abnormal maternal metabolism during pregnancy. Semin Fetal Neonatal Med 2009; 14(2):66-71.
  44. Wang C, Guelfi KJ, Yanga HX. Exercise and its role in gestational diabetes mellitus. Chronic Dis Transl Med 2016; 2(4):208-14.
  45. Oostdam N, Van Poppel MN, Wouters MG, Eekhoff EM, Bekedam DJ, Kuchenbecker WK, et al. No effect of the FitFor 2 exercise programed on blood glucose, insulin sensitivity, and birth weight in pregnant women who were overweight and at risk for gestational diabetes: results of a randomized controlled trial. BJOG 2012; 119(9):1098-107.
  46. Jovanovic-Peterson L, Durak EP, Peterson CM. Randomized trial of diet versus diet plus cardiovascular conditioning on glucose levels in gestational diabetes. Am J Obstet Gynecol 1989; 161(2):415-9.
  47. Barbour LA, McCurdy CE, Hernandez TL, Kirwan JP, Catalano PM, Friedman JE. Cellular mechanisms for insulin resistance in normal pregnancy and gestational diabetes. Diabetes Care 2009; 2:S112- 9.
  48. Strasser B, Pesta D. Resistance training for diabetes prevention and therapy: experimental findings and molecular mechanisms. Biomed Res Int 2013; 2013:805217.
  49. Weir GC, Bonner-Weir S. Five stages of evolving beta-cell dysfunction during progression to diabetes. Diabetes 2004; 53(Suppl 3):S16-21.
  50. Park S, Hong SM, Lee JE, Sung SR. Exercise improves glucose homeostasis that has been impaired by a high-fat diet by potentiating pancreatic β-cell function and mass through IRS2 in diabetic rats. J Appl Physiol 2007; 103(5):1764-71.