تأثیر تمرین هوازی فزآینده و مکمل سین بیوتیک بر سختی شریانی و پروتئین واکنشی C در زنان یائسه مبتلا به دیابت نوع دو (مقاله علمی وزارت علوم)
درجه علمی: نشریه علمی (وزارت علوم)
آرشیو
چکیده
مقدمه و هدف: استفاده از مکمل ها و تمرینات ورزشی جهت رفع اختلالات متابولیک و درمان بیماری ها رواج یافته است؛ هدف از مطالعه حاضر بررسی تأثیر تمرین هوازی فزآینده و مکمل سین بیوتیک بر سختی شریانی و پروتئین واکنشی C (PRC) در زنان یائسه مبتلا به دیابت نوع دو بود. روش تحقیق: در این پژوهش نیمه تجربی، 39 زن مبتلا به دیابت نوع دو به طور تصادفی به سه گروه تمرین هوازی + دارونما، تمرین هوازی + مکمل سین بیوتیک و مکمل سین بیوتیک تقسیم شدند. برنامه تمرینی با شدت 40 تا 70 ضربان قلب ذخیره به صورت فزاینده در 12 هفته اجرا شد. آزمودنی های گروه مکمل، یک ساعت پس از صرف ناهار، یک عدد کپسول سین بیوتیک باکانت (109×1 CFU) را مصرف کردند. برای سنجش CRP، قندخون ناشتا، سطح انسولین پلاسما پس از حداقل ۱۰ ساعت ناشتایی، به میزان پنج سی سی خون از سیاهرگ بازویی اخذ گردید و به روش الایزا و با کیت های مخصوص اندازه گیری شد. از آزمون t زوجی برای مقایسه درون گروهی و از روش تحلیل واریانس یک راهه برای مقایسه تغییرات بین گروهی در سطح معنی داری 05/0>p استفاده شد. یافته ها: پس از مداخله شاخص پایی بازویی (ABI) در گروه تمرین هوازی+دارونما (03/0=p) و تمرین هوازی+مکمل سین بیوتیک (0/02=p) به طور معنی داری نسبت به پیش آزمون افزایش یافت. همچنین شاخص قلبی- عروقی مچ پایی (CAVI) در گروه تمرین هوازی+دارونما (0/002=p) و تمرین هوازی+مکمل سین بیوتیک (02/0=p)؛ و PRC در هر سه گروه تمرین هوازی+دارونما (001/0=p)، تمرین هوازی+مکمل سین بیوتیک (0001/0=p)، و گروه مکمل سین بیوتیک (002/0=p)؛ کاهش معنی داری را نشان داد. با این حال، سطوح سرمی گلوکز ناشتا، انسولین، شاخص مقاومت به انسولین، شاخص توده بدن و درصد چربی بدن در سه گروه تغییر معنی داری نکرد (05/0<p). همچنین، شاخص های ABI (0/29=p)، CAVI (0/30=p)، PRC (0/48=p)، و انسولین (0/73=p)؛ تفاوت معنی داری بین گروه ها نداشت. نتیجه گیری: به نظر می رسد تمرین هوازی و مصرف سین بیوتیک در زنان یائسه مبتلا به دیابت نوع دو، می تواند بر روند بهبود شاخص های سختی شریانی و PRC مؤثر باشد.The effect of progressive aerobic exercise and synbiotic supplementation on arterial stiffness and C-reactive protein in postmenopausal women with type ॥ diabetes
Background and Aim: Type ॥ diabetes is characterized by several pathophysiological components, including insulin resistance, defective insulin secretion, obesity, increased glucagon secretion, and dyslipidemia (2). Multiple complications of diabetes, especially peripheral and central arterial stiffness, are concerning for diabetic patients (4). Various methods are used to measure arterial stiffness the cardio-ankle vascular index (CAVI) is a new metric that estimates the stiffness of the entire artery from the aortic origin to the ankle and is able to indicate the risk of atherosclerosis (9). Research has shown that CAVI increases linearly with aging in healthy individuals, and this index has been reported to be higher in diabetic patients compared to healthy counterparts (11). The ankle-brachial index (ABI) is another index used to assess peripheral arterial stiffness. C-reactive protein (CRP), as an inflammatory marker, can directly affect the pathogenesis of atherosclerosis. This protein is recognized as the most sensitive and strongest inflammatory indicator and predictor of cardiovascular disease in diabetics. Since the use of supplements and exercise training to improve arterial stiffness, eliminate metabolic disorders, and treat diabetes has become widespread, the aim of the present study was to investigate the effect of aerobic exercise and synbiotic supplementation on arterial stiffness and CRP levels in postmenopausal women with type ॥ diabetes.Materials and Methods: The present study was a semi-experimental, single-blind study with a pre-test and post-test design. In this semi-experimental study, 39 women with type ॥ diabetes were randomly divided into three groups: aerobic exercise + placebo, aerobic exercise + synbiotic supplement, and synbiotic supplement. The exercise program was performed with an intensity of 40 to 70 heart rate reserve, progressively increasing over 12 weeks (23). The subjects in the supplement group consumed one capsule of the synbiotic Bacant (1×109 CFU) one hour after lunch (22). The research indicators including CAVI, ABI, CRP, fasting blood sugar, plasma insulin level, insulin resistance index (HOMA-IR), body mass index (BMI), and body fat percentage were measured 48 hours before and after the intervention. For anthropometric measurements and body composition (weight, BMI, body fat percentage), the In Body 230 body composition measuring device made in Korea was used. The height of the subjects was measured in centimeters using a height gauge. Blood samples for measuring CRP, fasting blood sugar, and plasma insulin levels were collected after at least 10 hours of fasting. A five cc blood sample was drawn from the brachial vein while the subjects were seated, by a laboratory expert. Then, the samples were placed at room temperature for 20 minutes allow clotting. Subsequently, the tubes containing the samples were centrifuged for 20 minutes at 3000 rpm, and the separated serum was stored in a separate microtube at a temperature of -80 degrees celsius. CRP levels were measured using an ELISA method with a special kit from Monobind company, made in China, with a sensitivity of 0.2 μg/ml. Plasma insulin levels were measured by sandwich ELISA using an ELISA reader manufactured in the United States. Blood sugar levels were calculated using an enzymatic-calorimetric method, employing the glucose oxidase enzyme method using a kit from Pars Azmoun company and using a biochemistry autoanalyzer. Additionally, the arterial stiffness test was performed under standard conditions (room temperature 22°C with minimizing stimuli) using the Vasera-VS-2000 system (Fukuda Denshi Company, Japan) between 9 am and 12 AM. A paired t-test was used for intragroup comparison, whileone-way analysis of variance was used to compare changes between-group at a significance level of p<0.05.Findings: After the intervention, ABI significantly increased in both the aerobic exercise + placebo group (p=0.03) and the aerobic exercise + synbiotic supplement group (p=0.02) compared to the pre-test. Additionally, the CAVI showed significant decrease in the aerobic exercise + placebo group (p=0.002) and the aerobic exercise + synbiotic supplement group (p=0.02). CRP levels decreased significantly in all three groups: aerobic exercise + placebo (p=0.001), aerobic exercise + synbiotic supplement (p=0.0001), and the synbiotic supplement group (p=0.002). However, the levels of fasting serum glucose, insulin, insulin resistance index, body mass index and body fat percentage did not change significantly among the three groups (p<0.05). Furthermore, ABI (p=0.29), CAVI (p=0.30), CRP (p=0.48), and insulin (p=0.73) indices did not differ significantly between the groups.Conclusion: The most important findings of the present study are the lack of significant differences in CRP index between the groups in the between-group comparison, alongside a significant decrease in: aerobic exercise + placebo, aerobic exercise + synbiotic supplement, and synbiotic supplement groups in the within-group comparison. According to the results of this study, 12 weeks of aerobic exercise combined with synbiotic supplement consumption can improve arterial stiffness indices such as ABI and CAVI, as well as the inflammatory index CRP. Given these findings, it is recommended that patients with type ॥ diabetes engage in aerobic exercise combined with synbiotic supplement consumption. Considering the known effects of these two interventions separately, their simultaneous effectiveness on the inflammatory status of patients with type ॥ diabetes can be important from a therapeutic and medical perspective, highlighting the need for further future research in these fields. Additionally, it appears that aerobic exercise and synbiotic consumption may effectively improve arterial stiffness and CRP indices in postmenopausal women with type ॥ diabetes.Keywords: Aerobic exercise, Synbiotic supplement, Type ॥ diabetes, Arterial stiffness and C-reactive protein.Ethical ConsiderationsAll ethical principles in this research were meticulously adhered to by the researchers .Compliance with ethical guidelineTo conduct the research, the consent form was completed by the participants after they were fully informed about the research process, including its risks and benefits.FundingThe authors of this article declare that they have not received any financial support from any organization.Conflicts of interestThe authors report no conflicts of interest in relation to this manuscript.
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