Study On The Changes Of Metabolic Parameters And Inflammation-related Factors In Female Patients With T2DM And Sarcopenia Before And After High-intensity Interval Exercise

Objective:Through high-intensity intermittent exercise(HIIE)to observe the immune and metabolic related factors(blood lactate,blood sugar,cortisol,leptin,irisin,IGF-1,IL-6,TNF-α,IL-15)of sarcopenia in women with type 2 diabetes(T2DM),provide a certain research basis for exercise therapy in patients with type 2 diabetic sarcopenia.Methods:Eleven female patients with T2DM sarcopenia who had a physical examination from September 2020 to November 2020 in the Health Management Center of Linyi People’s Hospital were randomly selected as the observation group(T2DM with sarcopenia group),12 T2DM with normal skeletal muscle levels in who underwent body fat composition examination during the same period were randomly selected as the control group 1(Diabetes group).To choose10 female subjects with primary sarcopenia served as the control group 2(Sarcopenia group),and 12 healthy subjects served as the control group 3(Healthy group).The diagnostic criteria refer to the Chinese Type 2Diabetes Prevention and Control Guidelines(2017)and the Asian Sarcopenia Consensus(2019)to determine whether the subject have T2DM and sarcopenia.Collect baseline data of all subjects,including height,weight,age,blood pressure,etc.All subjects were collected venous blood before the test,and then warmed up for 5 minutes.After warming up,rest for 5 minutes and perform high-intensity intermittent exercises.Each Wingate exercise test was performed for 30 s,followed by a 5 min rest,exercise and rest were alternated,a total of 3 Wingate exercise tests were performed,and the maximum power and average power of each Wingate test exercise were recorded.After 3 times,venous blood was drawn immediately,and the blood glucose was measured with a portable blood glucose meter before and after exercise.Then at 30 minutes and 60 minutes after the exercise,venous blood was drawn twice,a total of 4 times before and after exercise.The subjects’blood lactic acid,cortisol,leptin,irisin,IGF-1,IL-6,TNF-α,IL-15 were detected by enzyme-linked immunosorbent assay(ELISA)method,and use SPSS22.0and Stata16.0 statistical software to process the data to analyze the differences between the observation indicators of the four groups of subjects,and P<0.05 is statistically significant significance.Results:There were differences in the maximum power and average power of the three Wingate exercise tests between the four groups of patients,the two blood glucose before and after exercise,and the changes in the blood lactic acid,IL-6,and TNF-αlevels of the four before and after exercise(P<0.05),while The levels of IL-15,cortisol,leptin,irisin and IGF-1 had no significant changes(P>0.05).Further analysis found that,comparing the diabetes with sarcopenia group and the simple diabetes group,before and after HIIE the maximum power(F=66.671,P<0.001,η~2=0.760),the average power(F=72.393,P<0.001,η~2=0.775),the changes of blood lactate(F=7.360,P=0.013,η~2=0.260)and IL-6(F=4.382,P=0.049,η~2=0.173)levels were all significantly different.Conclusion:Sarcopenia will have a certain impact on the metabolism and immunity of female T2DM patients.These effects may further affect the patient’s disease progression and deserve further study.At the same time,studies have shown that the exercise effect of T2DM patients with sarcopenia will have an adverse effect,especially after exercise,the level of anti-inflammatory IL-6 produced after exercise is lower than that of patients with normal muscle levels,which may lead to a lower effect of exercise therapy.Therefore,the formulation of exercise therapy for T2MD patients with sarcopenia should be further evaluated and a more reasonable exercise intensity should be selected.