تأثیر دو شیوه زندگی فعال و غیر فعال همراه با رژیم غذایی کنترل شده بر مقاومت انسولینی و سطوح سرمی آنزیم‌های AST و ALT کبد زنان باردار

نوع مقاله : اصیل پژوهشی

نویسندگان

1 کارشناس ارشد فیزیولوژی، دانشگاه آزاد اسلامی واحد نجف آباد، نجف آباد، ایران.

2 دانشیار گروه تربیت بدنی و علوم ورزشی، دانشگاه آزاد اسلامی واحد نجف آباد، نجف آباد، ایران.

چکیده

مقدمه: با توجه به اثرات مفید تأیید شده فعالیت بدنی در دوران بارداری، مطالعه حاضر با هدف بررسی زندگی فعال و غیرفعال بر سطوح مقاومت به انسولین و آنزیم‌های AST و ALT کبدی زنان باردار سه ماهه دوم بارداری انجام شد.
روش‌کار: این مطالعه مقطعی در سال 1394 بر روی80 زن باردار سه ماهه دوم شهرستان اصفهان انجام شد. افراد پس از تکمیل فرم رضایت نامه و پرسشنامه فعالیت بدنی دوران بارداری PPAQ بر اساس سبک زندگی و انجام و عدم انجام پیاده‌روی روزانه به دو گروه فعال و غیرفعال تقسیم و از نظر سطوح سرمی آنزیمهای AST و ALT کبدی و میزان مقاومت به انسولین مقایسه شدند. تجزیه و تحلیل داده ها با استفاده از نرم‌افزار آماری SPSS (نسخه 18) و آزمون کولموگروف اسمیرنوف و تی مستقل انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته‌ها: نتایج مطالعه نشان داد که سطح سرمی آنزیم AST کبدی در زنان باردار فعال که پیاده‌روی روزانه داشتند به طور معنی‌داری کمتر از زنان غیرفعال بود (018/0=p). ولی در میزان سطح ALT (079/0=p) و مقاومت به انسولین (146/0=p) تفاوت معناداری مشاهده نشد.
نتیجه‌گیری: فعالیت بدنی در دوران بارداری بر سطح سرمی آنزیم AST کبدی تأثیر دارد، ولی دلیل عدم معناداری سطوح آنزیم ALT کبدی و مقاومت به انسولین را با توجه به بررسی متغیرهای کنترل می‌توان پیاده‌روی با سرعت آهسته، ساعات بی‌تحرکی طولانی مدت (5/2±8/11) و خواب طولانی‌تر از استاندارد (00/2±9/9) بیان نمود.

کلیدواژه‌ها


عنوان مقاله [English]

Effect of two passive and active lifestyle along with controlled diet on insulin resistance and serum levels of AST and ALT liver enzyme in pregnant women

نویسندگان [English]

  • Somayeh Sheikhi dehchenari 1
  • Jamshid Banaee Boroujeni 2
1 MSc of Physiology, Islamic Azad University, Najaf Abad Branch, Najaf Abad, Iran.
2 Associate professor, Department of Physical Education and Sports Sciences, Islamic Azad University, Najaf Abad Branch, Najaf Abad, Iran
چکیده [English]

Abstract
Introduction: According to confirmed beneficial effects of physical activity during pregnancy, this study was performed with aim to investigate active and passive lifestyle on insulin resistance and the levels of AST and ALT liver enzymes in pregnant women at second trimester of pregnancy.
Methods: This cross-sectional study was performed on 80 pregnant women at second trimester in Isfahan at 2015. After completing the consent form and Pregnancy Physical Activity Questionnaire (PPAQ) based on lifestyle and doing and not doing daily walking were divided to two groups of active and passive lifestyle and were compared in terms of insulin resistance and the levels of AST and ALT liver enzymes. Data was analyzed using SPSS software (version 18) and Kolmogorov-Smirnov test and t-test. PResults: Serum levels of AST liver enzymes in active pregnant women who had daily walk were significantly lower than inactive women (P=0.018), but there was no significant difference between two groups in terms of ALT levels (P=0.079) and insulin resistance (P=0.146).
Conclusion: Physical activity during pregnancy is effective on serum levels of AST liver enzymes, but according to the evaluation of control variables, ALT liver enzyme levels and insulin resistance were not significantly different due to walking with slow speed, long hours of immobility (11.8 ± 2.5)  and sleep longer than the standard (9.9 ± 2.00).

کلیدواژه‌ها [English]

  • Alanine transaminase
  • Aspartate Aminotransferase
  • insulin resistance
  • pregnancy
  1. Fazel NF. The impact of an exercise program on the type of delivery, quality of life and muscle fitness pregnant women. [Master Thesis]. Esfahan, Iran: University of Esfahan; 2010. (Persian).
  2. Holmes VA, Wallace JM. Haemostasis in normal pregnancy: a balancing act? Biochem Soc Trans 2005; 33(Pt 2):428-32.
  3. Kramer MS, McDonald SW. Aerobic exercise for women during pregnancy. Cochrane Database Syst Rev 2006; 3:180.
  4. Rudra CB, Sorensen TK, Luthy DA, Williams MA. A prospective analysis of recreational physical activity and preeclampsia risk. Med Sci Sports Exerc 2006; 40(9):1581–8.
  5. Rahman TM, Wendon J. Severe hepatic dysfunction in pregnancy. Q J Med 2002; 95(6):343–57.
  6. Hay JE. Liver disease in pregnancy. Hepatology 2008; 47(3):1067-76.
  7. Yates T, Khunti K, Wilmot EG, Brady E, Webb D, Srinivasan B, et al. Self-reported sitting time and markers of inflammation, insulin resistance, and adiposity. Am J Prev Med 2012; 42(1):1-7.
  8. Chasan-Taber L, Schmidt MD, Pekow P, Sternfeld B, Manson J, Markenson G. Correlates of physical activity in pregnancy among Latina women. Matern Child Health J 2007; 11(4):353-63.
  9. Lawlor DA, Sattar N, Smith GD, Ebrahim SH. The associations of physical activity and adiposity with alanine aminotransferase and gamma glutamyltransferase. Am J Epidemiol 2005; 161(11):1081-8.
  10.  Ramírez-Vélez R, Aguilar AC, Mosquera M, Garcia RG, Reyes LM, López-Jaramillo P. Clinical trial to assess the effect of physical exercise on endothelial function and insulin resistance in pregnant women. Trials 2009; 10:104.
  11. Hickman IJ, Jonsson JR, Prins JB, Ash S, Purdie DM, Clouston AD, et al. Modest weight loss and physical activity in overweight patients with chronic liver disease results in sustained improvements in alanine aminotransferase, fasting insulin, and quality of life. Gut 2004; 53(3):413–9.
  12. Khan MY, Naqvi SH, Dahot MU. Relation of maternal serum electrolyte, traces elements and other biochemical parameters in third trimester of pregnancy. Sindh Univ Res J 2011; 43(2):245-8.
  13. Torabi P, Shaykhal-Islam R, Minaei M. Country guide to nutrition during pregnancy and lactation. 1st ed. Tehran: Tandis; 2008. P. 11-3. (Persian).
  14. Dada LT. Maternal and child health nursing. Ibadan: School of Midwifery. University College Hospital; 2008. P. 99-113.
  15. Bansil P, Kuklina EV, Whiteman MK, Kourtis AP, Posner SF, Johnson CH, et al. Eating disorders among delivery hospitalizations, prevalence and outcomes. J Womens Health 2008; 17(9):1523-8.
  16. Adleshoar M. Factors predictive of underweight neonates in mothers that referred to hospital in Rasht. [Master Thesis]. Rasht, Iran: Rasht University of Shahid Beheshti Nursing and Midwifery; 2005.
  17. Baksua B, Davasa I, Baksua A, Akyola A, Gulbaba G. Plasma nitric oxide, endothelin-1 and urinary nitric oxide and cyclic guanosine monophosphate levels in hypertensive pregnant women. Intl J Gynecol Obstet 2005; 90(2):112–7.
  18. Cioffi FJ, Amorosa LF, Vintzileos AM, Lai YL, Lake MF, Gregori PM, et al. Relationship of insulin resistance and hyperinsulinemia to blood pressure during pregnancy. J Matern Fetal Med 1997; 6(3):174-9.
  19. Magann EF, Evans SF, Weitz B, Newnham J. Antepartum, intrapartum, and neonatal significance of exercise on healthy low-risk pregnant working women. Obstet Gynecol 2002; 99(3):466–72.
  20. Hopkins SA, Baldi JC, Cutfield WS, McCowan L, Hofman PL. Exercise training in pregnancy reduces offspring size without changes in maternal insulin sensitivity. J Clin Endocrinol Metab 2010; 95(5):2080-8.
  21. Dempsey JC, Sorensen TK, Williams MA, Lee IM, Miller RS, Dashow EE, et al. Prospective study of gestational diabetes mellitus in relation to maternal recreational physical activity before and during pregnancy. Am J Epidemiol 2004; 159(7):663-70.
  22. Oostdam N, van Poppel MN, Eekhoff EM, Wouters MG, van Mechelen W. Design of FitFor2 study: the effects of an exercise program on insulin sensitivity and plasma glucose levels in pregnant women at high risk for gestational diabetes. BMC Pregnancy Childbirth 2009; 9:1.
  23. Liu J, Laditka JN, Mayer-Davis E, Pate RR. Does physical activity during pregnancy reduce risk of gestational diabetes among previously inactive women? Birth 2008; 35(3):189–95.
  24. Buchanan TA, Xiang A, Kjos SL, Watanabe R. What is gestational diabetes? Diabetes Care 2007; 30(2):S105-11.
  25. Meigs JB, D'Agostino RB Sr, Wilson PW, Cupples LA, Nathan DM, Singer DE. Risk variable clustering in the insulin resistance syndrome. The Framingham offspring study. Diabetes 1997; 46(10):1594-600.
  26. Chasan-Taber L, Silveira M, Pekow P, Braun B, Manson JE, Solomon CG, et al. Physical activity, sedentary behavior and risk of hypertensive disorders of pregnancy in Hispanic women. Hypertens Pregnancy 2015; 34(1):1-16.
  27. Bashiri J, Gaeini A, Nikbakht H, Hadi H, Bashiri M. Effect of concurrent creatine monohydrate ingestion and resistance training on hepatic enzymes activity levels in non-athlete males. Iran J Endoerinol Metab 2010; 12(1):42-7. (Persian).
  28. Masoodsinki M, Nazarali P, Hanachi P. Evaluation and impact of omega-3 supplementation with a period of selective aerobic exercise on liver enzymes (AST-ALT) of active student girls. Bio J Hormozgan Univ Med Sci 2014; 18(3):247-55. (Persian).
  29. Nassis GP, Papantakou K, Skenderi K, Triandafillopoulou M, Kavouras SA, Yannakoulia M, et al. Aerobic exercise training improves insulin sensitivity without change in body weight, body fat, adiponectin, and inflammatory markers in overweight and obese girls. Metabolism 2005; 54(11):1472-9.
  30. Abbasi S, Moazami M, Bijeh N, Mirmajidi SR. Investigation of the relationship between physical activity levels, maternal weight (before delivery) and serum cortisol level (during labor) in nulliparous women. Iran J Obstet Gynecol Infertil 2015; 18(151):12-9. (Persian).
  31. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985; 28(7):412-9.