有氧運動後攝取不同劑量葡萄糖對高血壓前期男性氧化壓力、心臟交感神經活動與中心脈波傳導速度之影響

Effects of Glucose Intake Doses after Acute Aerobic Exercise on Oxide Stress, Cardiac Sympathetic Nervous Activity and Central Pulse Wave Velocity in Male Prehypertensives

薛智元(Chih-Yuan Hsueh)

指導教授 ： 林信甫

國立臺灣大學/共同教育中心/運動設施與健康管理碩士學位學程/碩士(2021年)

https://doi.org/10.6342/NTU202103097

摘要

背景: 高糖飲食可能會造成氧化壓力提高、動脈硬化，與提升罹患心血管疾病的風險; 單次有氧運動則有助於改善動脈硬化。然而，單次有氧運動對於攝取不同劑量葡萄糖後血管功能之改善效益，以及其他相關心血管因子變化尚不清楚，並且研究對象也僅限於健康成人。目的: 探討執行單次有氧運動後攝取不同劑量葡萄糖補充液，對於高血壓前期男性餐後動脈硬化、氧化壓力、骨鈣素 (osteocalcin, OC) 及交感神經之影響。方法: 12名高血壓前期男性 (28 ± 4歲) 為研究對象，隨機交叉分配為控制組 (安慰劑, Con)、低糖組 (25克葡萄糖, 25g) 與高糖組 (75克葡萄糖, 75g)，每組實驗中間至少間隔一週。運動前測量血管硬化指標 (心跳、血壓、心-肱脈波傳導速度、收縮間隔) 與抽血取樣 (血糖、胰島素) 後，執行30分鐘65%保留心跳率 (heart rate reserve, HRR) 之跑步機慢跑，運動結束立即飲用250克葡萄糖補充液。接著，分別在運動後30、60、90與120分鐘測量血管硬化指標與抽血取樣。此外，在運動前與運動後30分鐘氧化壓力與骨鈣素也會進行採樣分析。結果: 75g組在運動後60分鐘之心-肱脈波傳導速度(heart-brachial pulse wave velocity, hbPWV) 顯著高於Con (75g: 3.35±0.48 m/s; Con: 3.14±0.40 m/s)。超氧化物歧化酶 (superoxide dismutase, SOD) 運動後些微上升，但無顯著差異。丙二醛 (malondialdehyde, MDA) 運動後僅25g組顯著上升 (Pre-test: 8.9±1.7 nmol/mL; 30min: 10.6±2.2 nmol/mL)，75g組接近顯著差異 (Pre-test: 9.0±2.4 nmol/mL; 30min: 11.5±3.1 nmol/mL, p=0.059)。25g與75g組左心室射血時間 (ejection time, ET)、射血前期 (pre-ejection period, PEP) 在運動後30分鐘皆顯著下降。結論: 單次有氧運動對中心動脈硬化改善效果不顯著，但攝取高劑量葡萄糖後60分鐘會導致中心動脈硬化程度保持較高水平，可能與高胰島素濃度造成的心臟交感神經興奮有關，而非MDA或SOD。

關鍵字

動脈功能 ； 收縮間隔 ； 氧化壓力 ； 心臟交感神經活動 ； 胰島素

並列摘要

Background: A diet with high glucose uptake may contribute to arterial stiffening and an increase on cardiovascular risks; a single bout of aerobic exercise may help to ameliorate arterial stiffness. However, it remains unknown whether glucose intake would attenuate the arterial de-stiffening effects induced by acute aerobic exercise in a dose-dependent manner. Purpose: To investigate the effects of different doses of glucose supplementation after a single session of aerobic exercise on postprandial arterial stiffening, oxidative stress, osteocalcin (OC) and cardiac sympathetic activity in prehypertensive men. Methods: Twelve prehypertensive men (28 ± 4 years) were randomly cross-assigned to a control group (placebo, Con), a low glucose group (25 g of glucose, 25 g), and a high glucose group (75 g of glucose, 75 g) at least one week apart. After measuring the vascular function index (heart rate, blood pressure, heart-brachial pulse wave velocity, systolic time intervals) and taking blood samples (blood glucose, insulin) before exercise, a 30-minute treadmill running at 65% heart rate reserve (HRR) was performed, and 250 g of glucose supplement was consumed immediately after exercise. The vascular function index and blood sampling were measured at 30, 60, 90 and 120 minutes after exercise. In addition, oxidative stress and osteocalcin were also sampled before and 30 minutes after exercise. Results: The heart-brachial pulse wave velocity (hbPWV) at 60 minutes post-exercise was significantly higher in the 75g group than in the Con group (75g: 3.35±0.48 m/s; Con: 3.14±0.40 m/s). Superoxide dismutase (SOD) increased slightly after the exercise, but there was no significant difference. Malondialdehyde (MDA) increased significantly after exercise only in the 25g group (Pre-test: 8.9±1.7 nmol/mL; 30min: 10.6±2.2 nmol/mL), with near significant differences in the 75g group (Pre-test: 9.0±2.4 nmol/mL; 30min: 11.5±3.1 nmol/mL, p=0.059). The left ventricular ejection time (ET) and pre-ejection period (PEP) decreased significantly 30 minutes after exercise. Conclusions: The reduction of central arterial stiffness by a single session of aerobic exercise was not significant in the present study, but a significantly higher level in central arterial stiffness was observed 60 minutes after high dose of glucose intake, which may be related to cardiac sympathetic excitation caused by induced high insulin concentration rather than MDA / SOD.

並列關鍵字

arterial function ； systole time intervals ； oxide stress ； cardiac sympathetic nervous activity ； insulin

參考文獻

1. Kaptoge S, Pennells L, De Bacquer D, Cooney MT, Kavousi M, Stevens G, Riley LM, Savin S, Khan T, and Altay S. World Health Organization cardiovascular disease risk charts: Revised models to estimate risk in 21 global regions. The Lancet Global Health 7: 1332-1345, 2019.

2. Cecelja M, and Chowienczyk P. Role of arterial stiffness in cardiovascular disease. JRSM Cardiovascular Disease 1: 1-10, 2012.

3. Mah E, and Bruno RS. Postprandial hyperglycemia on vascular endothelial function: Mechanisms and consequences. Nutrition Research 32: 727-740, 2012.

4. Kobayashi R, Yoshida S, and Okamoto T. Arterial stiffness after glucose ingestion in exercise-trained versus untrained men. Applied Physiology, Nutrition, and Metabolism 40: 1151-1156, 2015.

5. Monnier L, Mas E, Ginet C, Michel F, Villon L, Cristol J-P, and Colette C. Activation of oxidative stress by acute glucose fluctuations compared with sustained chronic hyperglycemia in patients with type 2 diabetes. Jama 295: 1681-1687, 2006.