El ejercicio de intensidad moderada y alta mejora la glucemia, la presión arterial y la composición corporal en mujeres menopáusicas con diabetes tipo 2
DOI:
https://doi.org/10.33448/rsd-v10i8.17571Palabras clave:
Calidad de Vida; Ejercicio físico; Factores de riesgo cardiometabólicoResumen
Las mujeres posmenopáusicas tienen un alto riesgo de desarrollar diabetes mellitus tipo 2 (DM2) y enfermedades cardiovasculares. Se recomienda la actividad física regular para el tratamiento de enfermedades crónicas. Sin embargo, todavía no hay consenso sobre la intensidad y el tipo de ejercicio. Este estudio tuvo como objetivo evaluar los efectos de la intensidad del entrenamiento funcional combinado sobre los parámetros cardiometabólicos de mujeres posmenopáusicas con DM2. Se invitó a participar en este estudio a 98 mujeres posmenopáusicas con DM2 inscritas en el servicio de salud pública de un municipio brasileño. Dieciséis voluntarios se dividieron en grupos de intensidad moderada (MI) y alta (HI). El entrenamiento funcional se realizó 3 veces por semana. Se midieron datos antropométricos, presión arterial, frecuencia cardíaca (FC) y concentración plasmática de glucosa, hemoglobina glucosilada, colesterol total, HDL-C, LDL-C y triacilglicéridos (TG). El entrenamiento funcional redujo la hemoglobina glucosilada y los niveles de presión arterial y mejoró la composición corporal en ambos grupos. El entrenamiento de HI mejoró los niveles de HDL-C y TG, aunque se observó una reducción en el LDL-C en el grupo MI. El entrenamiento físico no modificó el resto de parámetros evaluados. Los datos mostraron que 8 semanas de entrenamiento funcional, independientemente de la intensidad, es una estrategia eficaz para mejorar el control de la glucosa y promover beneficios para la salud en mujeres posmenopáusicas con DM2.
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ADA, A. D. A. (2019). Introduction: Standards of Medical Care in Diabetes—2019. Diabetes Care, 42(Supplement 1), S1–S2. https://doi.org/10.2337/dc19-Sint01
Albu, J. B., Heilbronn, L. K., Kelley, D. E., Smith, S. R., Azuma, K., Berk, E. S., Xavier Pi-Sunyer, F., & Ravussin, E. (2010). Metabolic changes following a 1-year diet and exercise intervention in patients with type 2 diabetes. Diabetes, 59(3), 627–633. https://doi.org/10.2337/db09-1239
Alvarez, C., Ramirez-Campillo, R., Martinez-Salazar, C., Castillo, A., Gallardo, F., & Ciolac, E. (2018). High-Intensity Interval Training as a Tool for Counteracting Dyslipidemia in Women. International Journal of Sports Medicine, 39(05), 397–406. https://doi.org/10.1055/s-0044-100387
Bacchi, E., Negri, C., Zanolin, M. E., Milanese, C., Faccioli, N., Trombetta, M., Zoppini, G., Cevese, A., Bonadonna, R. C., Schena, F., Bonora, E., Lanza, M., & Moghetti, P. (2012). Metabolic effects of aerobic training and resistance training in type 2 diabetic subjects: A randomized controlled trial (the RAED2 study). Diabetes Care, 35(4), 676–682. https://doi.org/10.2337/dc11-1655
Balducci, S., D’Errico, V., Haxhi, J., Sacchetti, M., Orlando, G., Cardelli, P., Vitale, M., Bollanti, L., Conti, F., Zanuso, S., Lucisano, G., Nicolucci, A., & Pugliese, G. (2019). Effect of a Behavioral Intervention Strategy on Sustained Change in Physical Activity and Sedentary Behavior in Patients with Type 2 Diabetes: The IDES-2 Randomized Clinical Trial. JAMA - Journal of the American Medical Association, 321(9), 880–890. https://doi.org/10.1001/jama.2019.0922
Boyle, M. (2011). Advances in functional training (1st ed.). On Target Publications.
Cadore, E. (2014). Strength and Endurance Training Prescription in Healthy and Frail Elderly. Aging and Disease, 5(3), 183. https://doi.org/10.14336/AD.2014.0500183
Choudhury, R. P., Rong, J. X., Trogan, E., Elmalem, V. I., Dansky, H. M., Breslow, J. L., Witztum, J. L., Fallon, J. T., & Fisher, E. A. (2004). High-density lipoproteins retard the progression of atherosclerosis and favorably remodel lesions without suppressing indices of inflammation or oxidation. Arteriosclerosis, Thrombosis, and Vascular Biology, 24(10), 1904–1909. https://doi.org/10.1161/01.ATV.0000142808.34602.25
Christos, Z. E., Tokmakidis, S. P., Volaklis, K. A., Kotsa, K., Touvra, A. M., Douda, E., & Yovos, I. G. (2009). Lipoprotein profile, glycemic control and physical fitness after strength and aerobic training in post-menopausal women with type 2 diabetes. European Journal of Applied Physiology, 106(6), 901–907. https://doi.org/10.1007/s00421-009-1078-6
Clegg, D., Hevener, A. L., Moreau, K. L., Morselli, E., Criollo, A., Van Pelt, R. E., & Vieira-Potter, V. J. (2017). Sex Hormones and Cardiometabolic Health: Role of Estrogen and Estrogen Receptors. Endocrinology, 158(5), 1095–1105. https://doi.org/10.1210/en.2016-1677
Conceição, M., Bonganha, Vechin, Berton, LixandrÃo, Damas Nogueira, F. R., Souza, Chacon-mikahil, & Libardi. (2013). Sixteen weeks of resistance training can decrease the risk of metabolic syndrome in healthy postmenopausal women. Clinical Interventions in Aging, 8, 1221. https://doi.org/10.2147/CIA.S44245
Cooper, A. R., Sebire, S., Montgomery, A. A., Peters, T. J., Sharp, D. J., Jackson, N., Fitzsimons, K., Dayan, C. M., & Andrews, R. C. (2012). Sedentary time, breaks in sedentary time and metabolic variables in people with newly diagnosed type 2 diabetes. Diabetologia, 55(3), 589–599. https://doi.org/10.1007/s00125-011-2408-x
Cuff, D. J., Meneilly, G. S., Martin, A., Ignaszewski, A., Tildesley, H. D., & Frohlich, J. J. (2003). Effective Exercise Modality to Reduce Insulin Resistance in Women With Type 2 Diabetes. Diabetes Care, 26(11), 2977–2982. https://doi.org/10.2337/diacare.26.11.2977
Diniz, T. A., Rossi, F. E., Fortaleza, A. C. S., Neves, L. M., Christofaro, D. G. D., Buonani, C., Lira, F. S., Campos, E. Z., Prado, W. L. do, & Freitas Jr, I. F. (2018). Changes in HDL-c concentrations after 16 weeks of combined training in postmenopausal women: characteristics of positive and negative responders. Applied Physiology, Nutrition, and Metabolism, 43(1), 38–44. https://doi.org/10.1139/apnm-2017-0294
Escosteguy, C. C. (1999). Tópicos Metodológicos e Estatísticos em Ensaios Clínicos Controlados Randomizados. Arq Bras Cardiol, 72(no 2), 139–143.
Faludi, A., Izar, M., Saraiva, J., Chacra, A., Bianco, H., Afiune Neto, A., Bertolami, A., Pereira, A., Lottenberg, A., Sposito, A., Chagas, A., Casella-Filho, A., Simão, A., Alencar Filho, A., Caramelli, B., Magalhães, C., Magnoni, D., Negrão, C., Ferreira, C., … Salgado Filho, W. (2017). Atualização da diretriz brasileira de dislipidemias e prevenção da aterosclerose - 2017. Arquivos Brasileiros de Cardiologia, 109(1), 1–92. https://doi.org/10.5935/abc.20170121
Farias, T. Y., Santos-Lozano, A., Urra, P. S., & Cristi-Montero, C. (2015). Efectos del entrenamiento y el desentrenamiento físico sobre la hemoglobina glucosilada, la glucemia y el perfil lipídico en diabéticos tipo II. Nutricion Hospitalaria, 32(4), 1729–1734. https://doi.org/10.3305/nh.2015.32.4.9341
Friedewald, W. T., Levy, R. I., & Fredrickson, D. S. (1972). Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clinical Chemistry, 18(6), 499–502. http://www.ncbi.nlm.nih.gov/pubmed/4337382
Giannopoulou, I., Ploutz-Snyder, L. L., Carhart, R., Weinstock, R. S., Fernhall, B., Goulopoulou, S., & Kanaley, J. A. (2005). Exercise Is Required for Visceral Fat Loss in Postmenopausal Women with Type 2 Diabetes. The Journal of Clinical Endocrinology & Metabolism, 90(3), 1511–1518. https://doi.org/10.1210/jc.2004-1782
Grundy, S. M., Stone, N. J., Bailey, A. L., Beam, C., Birtcher, K. K., Blumenthal, R. S., Braun, L. T., de Ferranti, S., Faiella-Tommasino, J., Forman, D. E., Goldberg, R., Heidenreich, P. A., Hlatky, M. A., Jones, D. W., Lloyd-Jones, D., Lopez-Pajares, N., Ndumele, C. E., Orringer, C. E., Peralta, C. A., & Yeboah, J. (2019). 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal of the American College of Cardiology, 73(24), e285–e350. https://doi.org/10.1016/j.jacc.2018.11.003
Haddad, M., Stylianides, G., Djaoui, L., Dellal, A., & Chamari, K. (2017). Session-RPE Method for Training Load Monitoring: Validity, Ecological Usefulness, and Influencing Factors. Frontiers in Neuroscience, 11(NOV). https://doi.org/10.3389/fnins.2017.00612
Hansen, D., Dendale, P., Jonkers, R. A. M., Beelen, M., Manders, R. J. F., Corluy, L., Mullens, A., Berger, J., Meeusen, R., & van Loon, L. J. C. (2009). Continuous low- to moderate-intensity exercise training is as effective as moderate- to high-intensity exercise training at lowering blood HbA1c in obese type 2 diabetes patients. Diabetologia, 52(9), 1789–1797. https://doi.org/10.1007/s00125-009-1354-3
Ho, S. S., Dhaliwal, S. S., Hills, A. P., & Pal, S. (2012). The effect of 12 weeks of aerobic, resistance or combination exercise training on cardiovascular risk factors in the overweight and obese in a randomized trial. BMC Public Health, 12(1), 704. https://doi.org/10.1186/1471-2458-12-704
IDF, I. D. F. (2020). IDF Diabetes Atlas. 2020. https://www.idf.org/e-library/epidemiology-research/diabetes-atlas
Irving, B. A., Davis, C. K., Brock, D. W., Weltman, J. Y., Swift, D., Barrett, E. J., Gaesser, G. A., & Weltman, A. (2008). Effect of Exercise Training Intensity on Abdominal Visceral Fat and Body Composition. Medicine & Science in Sports & Exercise, 40(11), 1863–1872. https://doi.org/10.1249/MSS.0b013e3181801d40
Jiang, H., Yan, W.-H., Li, C.-J., Wang, A.-P., Dou, J.-T., & Mu, Y.-M. (2014). Elevated White Blood Cell Count Is Associated with Higher Risk of Glucose Metabolism Disorders in Middle-Aged and Elderly Chinese People. International Journal of Environmental Research and Public Health, 11(5), 5497–5509. https://doi.org/10.3390/ijerph110505497
Joy, E. A., & Pescatello, L. S. (2016). Pre-exercise screening: role of the primary care physician. Israel Journal of Health Policy Research, 5(1), 29. https://doi.org/10.1186/s13584-016-0089-0
Lesser, I. A., Guenette, J. A., Hoogbruin, A., Mackey, D. C., Singer, J., Gasevic, D., & Lear, S. A. (2016). Association between exercise-induced change in body composition and change in cardiometabolic risk factors in postmenopausal South Asian women. Applied Physiology, Nutrition, and Metabolism = Physiologie Appliquee, Nutrition et Metabolisme, 41(9), 931–937. https://doi.org/10.1139/apnm-2016-0082
Liu, S., Hempe, J. M., McCarter, R. J., Li, S., & Fonseca, V. A. (2015). Association between Inflammation and Biological Variation in Hemoglobin A1c in U.S. Nondiabetic Adults. The Journal of Clinical Endocrinology & Metabolism, 100(6), 2364–2371. https://doi.org/10.1210/jc.2014-4454
Maillard, F., Rousset, S., Pereira, B., Traore, A., de Pradel Del Amaze, P., Boirie, Y., Duclos, M., & Boisseau, N. (2016). High-intensity interval training reduces abdominal fat mass in postmenopausal women with type 2 diabetes. Diabetes and Metabolism, 42(6), 433–441. https://doi.org/10.1016/j.diabet.2016.07.031
Mauvais-Jarvis, F. (2017). Menopause, estrogens, and glucose homeostasis in women. Advances in Experimental Medicine and Biology, 1043, 217–225. https://doi.org/10.1007/978-3-319-70178-3_11
McEniery, C. M. (2020). Transitioning the Menopause. Arteriosclerosis, Thrombosis, and Vascular Biology, 40(4), 850–852. https://doi.org/10.1161/ATVBAHA.120.313980
McGarrah, R. W., Slentz, C. A., & Kraus, W. E. (2016). The Effect of Vigorous- Versus Moderate-Intensity Aerobic Exercise on Insulin Action. Current Cardiology Reports, 18(12), 117. https://doi.org/10.1007/s11886-016-0797-7
Millán, J., Pintó, X., Muñoz, A., Zúñiga, M., Rubiés-Prat, J., Pallardo, L. F., Masana, L., Mangas, A., Hernández-Mijares, A., González-Santos, P., Ascaso, J. F., & Pedro-Botet, J. (2009). Lipoprotein ratios: Physiological significance and clinical usefulness in cardiovascular prevention. Vascular Health and Risk Management, 5, 757. https://doi.org/10.2147/VHRM.S6269
Monteleone, P., Mascagni, G., Giannini, A., Genazzani, A. R., & Simoncini, T. (2018). Symptoms of menopause — global prevalence, physiology and implications. Nature Reviews Endocrinology, 14(4), 199–215. https://doi.org/10.1038/nrendo.2017.180
Myers, V. H., McVay, M. A., Brashear, M. M., Johannsen, N. M., Swift, D. L., Kramer, K., Harris, M. N., Johnson, W. D., Earnest, C. P., & Church, T. S. (2013). Exercise training and quality of life in individuals with type 2 diabetes. Diabetes Care, 36(7), 1884–1890. https://doi.org/10.2337/dc12-1153
Nascimento, L. S., Santos, A. C., Lucena, J. M. S., Silva, L. G. O., Almeida, A. E. M., & Brasileiro-Santos, M. S. (2017). Acute and chronic effects of aerobic exercise on blood pressure in resistant hypertension: Study protocol for a randomized controlled trial. Trials, 18(1). https://doi.org/10.1186/s13063-017-1985-5
Nathan, D. M., Turgeon, H., & Regan, S. (2007). Relationship between glycated haemoglobin levels and mean glucose levels over time. Diabetologia, 50(11), 2239–2244. https://doi.org/10.1007/s00125-007-0803-0
Puciato, D., Borysiuk, Z., & Rozpara, M. (2017). Quality of life and physical activity in an older working-age population. Clinical Interventions in Aging, 12, 1627–1634. https://doi.org/10.2147/CIA.S144045
Rader, D. J., & Hovingh, G. K. (2014). HDL and cardiovascular disease. The Lancet, 384(9943), 618–625. https://doi.org/10.1016/S0140-6736(14)61217-4
Rochlani, Y., Pothineni, N. V., Kovelamudi, S., & Mehta, J. L. (2017). Metabolic syndrome: pathophysiology, management, and modulation by natural compounds. Therapeutic Advances in Cardiovascular Disease, 11(8), 215–225. https://doi.org/10.1177/1753944717711379
Rossi, F. E., Fortaleza, A. C. S., Neves, L. M., Buonani, C., Picolo, M. R., Diniz, T. A., Kalva-Filho, C. A., Papoti, M., Lira, F. S., & Freitas, I. F. (2016). Combined Training (Aerobic Plus Strength) Potentiates a Reduction in Body Fat but Demonstrates No Difference on the Lipid Profile in Postmenopausal Women When Compared With Aerobic Training With a Similar Training Load. Journal of Strength and Conditioning Research, 30(1), 226–234. https://doi.org/10.1519/JSC.0000000000001020
Schroeder, E. C., Franke, W. D., Sharp, R. L., & Lee, D. (2019). Comparative effectiveness of aerobic, resistance, and combined training on cardiovascular disease risk factors: A randomized controlled trial. PLOS ONE, 14(1), e0210292. https://doi.org/10.1371/journal.pone.0210292
Schwingshackl, L., Missbach, B., Dias, S., König, J., & Hoffmann, G. (2014). Impact of different training modalities on glycaemic control and blood lipids in patients with type 2 diabetes: a systematic review and network meta-analysis. Diabetologia, 57(9), 1789–1797. https://doi.org/10.1007/s00125-014-3303-z
Shimojo, G. L., Silva Dias, D. da, Malfitano, C., Sanches, I. C., Llesuy, S., Ulloa, L., Irigoyen, M.-C., & De Angelis, K. (2018). Combined Aerobic and Resistance Exercise Training Improve Hypertension Associated With Menopause. Frontiers in Physiology, 9(OCT). https://doi.org/10.3389/fphys.2018.01471
Son, W. M., Sung, K. D., Cho, J. M., & Park, S. Y. (2016). Combined exercise reduces arterial stiffness, blood pressure, and blood markers for cardiovascular risk in Postmenopausal women with hypertension. Menopause, 24(3), 262–268. https://doi.org/10.1097/GME.0000000000000765
Srivastava, R. A. K. (2018). Dysfunctional HDL in diabetes mellitus and its role in the pathogenesis of cardiovascular disease. Molecular and Cellular Biochemistry, 440(1–2), 167–187. https://doi.org/10.1007/s11010-017-3165-z
Stefanska, A., Bergmann, K., & Sypniewska, G. (2015). Metabolic Syndrome and Menopause. Advances in Clinical Chemistry, 72, 1–75. https://doi.org/10.1016/bs.acc.2015.07.001
Stratton, I. M., Adler, A. I., Neil, H. A. W., Matthews, D. R., Manley, S. E., Cull, C. A., Hadden, D., Turner, R. C., & Holman, R. R. (2000). Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): Prospective observational study. British Medical Journal, 321(7258), 405–412. https://doi.org/10.1136/bmj.321.7258.405
Vistisen, D., Witte, D. R., Brunner, E. J., Kivimäki, M., Tabák, A., Jørgensen, M. E., & Færch, K. (2018). Risk of Cardiovascular Disease and Death in Individuals With Prediabetes Defined by Different Criteria: The Whitehall II Study. Diabetes Care, 41(4), 899–906. https://doi.org/10.2337/dc17-2530
Zaw, J. J. T., Howe, P. R. C., & Wong, R. H. X. (2018). Postmenopausal health interventions: Time to move on from the Women’s Health Initiative? Ageing Research Reviews, 48(October), 79–86. https://doi.org/10.1016/j.arr.2018.10.005
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