Effect of Hypoxic Training on carbohydrate metabolism, bone, and oxidative stress in Elderly Patients
Creators: name: Li, Ning
Publisher: name: The Health & Fitness Journal of Canada
Year: 2022

description: Purpose: From normal people to diabetes mellitus (DM) patients, it is not overnight, but a long course of disease. Between normal people and patients with DM, there is a stage of impaired glucose regulation, which is also called pre-diabetes (PD). People with PD are more likely to develop DM without effective intervention. PD does not reach the disease level, and after effective intervention, the development of PD can be delayed or not developed into DM and may even return to the normal state. Studies have found that altitude training can improve the ability of glucose transport in DM patients and help patients control their blood glucose. However, previous studies have found that high altitude hypoxia can lead to increased bone resorption, so hypoxia is one of the risk factors for osteoporosis (OP). Therefore, hypoxic training as a treatment for hypoglycemia may have the side effect of accelerating bone loss. At present, the intervention effect and potential risk of hypoxic training in PD population still need to be further explored. Based on this, this study aims to explore the effects of hypoxic training on bone mineral density (BMD), bone metabolism, glucose metabolism, antioxidant capacity and other factors in the elderly with PD, to further determine the improvement effect of hypoxic training on glucose metabolism in the PD population and to evaluate the potential risks of bone loss and oxidative stress proposed by previous studies. Methods: In this study, 12 healthy elderly men were recruited from community resident service centers（age:63.41±3.03years; body mass index (BMI): 25.34±4.76kg/m3; maximal oxygen consumption (VO2max): 38.87±4.76ml/kg/min; fasting plasma glucose (FPG): 5.71±3.82 mmol/l; oral glucose tolerance test (OGTT): 7.21±1.19 mmol/l; femoral neck bone mineral density (FN-BMD): 0.96±0.08g/cm2; L1-L4BMD: 1.02±0.06g/cm2) . Thirty-six elderly men with PD and osteopenia (OST) were recruited from community hospitals (age: 62.23±1.58years; BMI: 26.92±6.98kg/m3; VO2max: 36.22±5.98ml/kg/min; FPG: 6.53±3.26 mmol/l; OGTT: 9.55±1.58 mmol/l; FN-BMD: 0.82±0.12g/cm2; L1-L4BMD: 0.90±0.12g/cm2). 36 elderly PD patients with OST were divided into hypoxic training group (HT group, n=12), normoxia training group (NT group, n=12), and model control group (MC group, n=12). Twelve healthy elderly people were classified as normal control group (NC group n=12), and were tested for VO2max, BMD and glucose metabolism indexes. Then each group was interfered for 36 weeks according to the intervention plan (Table 1). After the intervention, blood and urine were collected, BMD, bone metabolism, glucose metabolism and insulin sensitivity were detected by bone scanning (post-test). At an interval of 48 hours after blood collection, exhaustive uphill running was conducted. Blood collection was conducted at 24 hours after the end of running to detect oxidative stress indicators. SPSS22.0 was used for paired samples T-test and one-way ANOVA, values were provided as the mean±standard deviation (SD) significant was set at p＜0.05. Results: After 36 weeks of training, in terms of glucose metabolism, FPG, OGTT-2HPG, HOMA-IR indexes, the post-measured values of HT group and NT group were significantly decreased compared with the pre-measured values (P &lt; 0.05), and HT group was significantly lower than NT group and MC group (P &lt; 0.05). BMD of HT group, NT group, post-test and pre-test were significantly increased (P &lt; 0.05), but there was no significant difference between HT group and NT group (P &gt; 0.05), and they were significantly higher than MC group (P &lt; 0.05). In bone metabolism, the indexes of the indexes of parathyroid hormone (PTH), deoxypyridinoline (D-PYR), tartar-resistant acidphosphatase-5b (TRACP-5b), bone alkaline phosphatase (BALP), and the post-test values of HT and NT groups were significantly decreased compared with the pre-test values (P &lt; 0.05). The insulin-like growth factor-1 (IGF-1) and osteocalcin (OC) indexes in HT and NT, which the corresponding post-test values were significantly increased compared with the pre-test values (P &lt; 0.05). The indexes of nitric oxide (NO) and malonaldehyde (MDA) in oxidative stress in HT and NT groups were significantly lower than those in MC group, and the post-test results in HT group were significantly lower than those in NT group and PC group (P &lt;0.05). Superoxide dismutase (SOD) index, NT group and HT group were significantly higher than MC group (P &lt; 0.05), HT group was significantly higher than NT group (P &lt; 0.05). Conclusion: 1) Hypoxic training can control blood glucose, relieve insulin resistance, reduce bone resorption conversion rate, and improve bone density and antioxidant capacity of the body in the elderly with PD. 2) Training in hypoxic conditions simulating an altitude of 2,400 m did not pose a risk of BMD loss, bone resorption, and increased metabolic stress in PD patients.
description: The Health &amp; Fitness Journal of Canada, Vol. 14 No. 3 (2021): Proceedings from the 8th International Society for Physical Activity and Health Congress