太極運動對肥胖的第二型糖尿病患者體重、 代謝、氧化壓力指標及生活品質的影響

Abstract

Objective: This study aimed to validate the effects of a simplified, gentle form of Tai Chi Chuan in obese type 2 diabetic patients.Design: Randomized, controlled trial. Setting: Department of Metabolism and Endocrinology at Cheng Ching Hospital, Taichung, Taiwan.Subjects: Hospital-based obese type 2 diabetic patients (aged 40-70, BMI 30-35 kgw/m2) were randomly selected and grouped into Tai Chi exercise and conventional exercise groups. Interventions: After receiving instruction in Tai Chi, the Tai Chi group and the conventional exercise group practiced three times a week, including one practice session lasting up to 1 hour, for 12 weeks. Outcome measures: Hemoglobin A1C, serum lipid profile, serum malondialdehyde, and C-reactive protein were measured. Physical parameters of body weight and body mass index were also measured. Diet and medications of participants were monitored carefully as biochemical and physical conditions were analyzed. Results: After 12 weeks, hemoglobin A1C values of the experimental group did not decrease (8.9±2.7%: 8.3±2.2%, P=0.064). Body weight (83.9±4.2 : 82.4±3.2, P=0.022 )and body mass index (33.5±4.8: 31.3±4.2, P=0.038) and serum lipids, including triglyceride (214±47 mg/dL: 171±34 mg/dL, P=0.012) and high density lipoprotein cholesterol (38±16 mg/dL: 45±18 mg/dL, P=0.023) showed significant improvements. Serum malondialdehyde tended to decrease from baseline (2.66±0.78 μmol/L: 2.31±0.55 μmol/L, P=0.035), and C-reactive protein also decreased (0.39±0.19 mg/dL: 0.22±0.15 mg/dL, P=0.014). No improvements were seen in BMI, lipid and oxidative stress profiles in the conventional exercise group. The life quality scores showed some improvements of physiological functions (1.56±0.17 : 1.62±0.20, P=0.038 ) and consensuses of health (1.39±0.35:1.57±0.52,P=0.033)in Tai Chi group. There were also some improvements of consensuses of health(1.39±0.35:1.57±0.52, P=0.033) in the conventional exercise group. Conclusion: Tai Chi exercise practiced by obese diabetic patients is efficient and safe when supervised by professionals and helps to improve parameters such as body mass index, lipid profiles, C-reactive protein, oxidative stress indicators such as malondialdehyde and life quality. Periodic monitoring of blood glucose, blood pressure; heart rate, breathing, physical fitness and symptoms of discomfort of patients who exercise helps to prevent injury. Simple, gentle “Tai Chi exercise” can be applied as regular daily exercise for type 2 diabetic patients even when obese.