期刊
DIABETES
卷 52, 期 9, 页码 2191-2197出版社
AMER DIABETES ASSOC
DOI: 10.2337/diabetes.52.9.2191
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资金
- NCRR NIH HHS [5 M01RR00056] Funding Source: Medline
- NIA NIH HHS [K01-AG-00851] Funding Source: Medline
- NIDDK NIH HHS [K24 DK02782, R01DK-49200-04, 1P30DK46204] Funding Source: Medline
Skeletal muscle insulin resistance entails dysregulation of both glucose and fatty acid metabolism. This study examined whether a combined intervention of physical activity and weight loss influences fasting rates of fat oxidation and insulin-stimulated glucose disposal. Obese (BMI >30 kg/m(2)) volunteers (9 men and 16 women) without diabetes, aged 39+/-4 years, completed 16 weeks of moderate-intensity physical activity combined with caloric reduction. Body composition was determined by dual-energy X-ray absorptiometry and computed tomography. Glucose disposal rates (R-d) were measured during euglycemic hyperinsulinemia (40 mU. m(-2) . min(-1)), and substrate oxidation was determined via indirect calorimetry. Fat mass and regional fat depots were reduced and Vo(2max) improved by 19%, from 38.8+/-1.2 to 46.0+/-1.0 ml . kg fat-free mass (FFM)(-1) . min(-1) (P < 0.05). Insulin sensitivity improved 49+/-10% (6.70+/-0.40 to 9.51+/-0.51 mg . min(-1) . kg FFM-1; P < 0.05). Rates of fat oxidation following an overnight fast increased (1.16+/-0.06 to 1.36+/-0.05 mg . min(-1) . kg FFM-1; P < 0.05), and the proportion of energy derived from fat increased from 38 to 52%. The strongest predictor of the improved insulin sensitivity was enhanced fasting rates of fat oxidation, accounting for 52% of the variance. In conclusion, exercise combined with weight loss enhances postabsorptive fat oxidation, which appears to be a key aspect of the improvement in insulin sensitivity in obesity.
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