Analisi cronobiologica dell’attività fisica in soggetti con ridotta tolleranza ai carboidrati (RTC)

Abstract

Impaired glucose tolerance (IGT) is a disorder of glucose metabolism, associated with a significant risk for chronic complications, especially affecting the cardiovascular system. Several studies showed that although IGT can persist in a stable form for many years, up to 30% of cases, if not treated with lifestyle modification (caloric restriction and physical exercise), can progress to overt DM2. In this study we examined a cohort of adult IGT patients (12 men and 8 women; mean age 58.6 ± 7.5 years) with overweight/obesity (BMI = 32.2 ± 3.6 kg/m2) treated during twelve months with moderate caloric restriction (aimed to a 2-8% body weight reduction in 6 months) and with moderate physical activity (3-6 METs or 1500 kcal/week). We evaluated the effect of the duration and intensity of physical activity on glucose and lipid metabolism at the end of the time interval. Physical activity was measured by using questionnaire as well as with the metabolic holter Sensweare™ Armband (BodyMedia Inc.) worn for three consecutive days. With the help of the Cronolife® software we constructed a “motion polygon” which represent the lifestyle of the subject. After 12 months of treatment plasma glucose values at the second hour of OGTT showed a correlation with total energy expenditure (TEE) (r = –0.44; p = 0.022) and especially with the intensity of physical activity > 3 METs (r = –0.64 p = 0.003). A significant correlation between TEE and reduction of LDL cholesterol levels (r = 0.56; p = 0.011) but not with body weight reduction, was found. Based on these results we suggest to treat IGT subjects, other than with caloric restriction, also with a program of physical reconditioning which includes physical activity levels between 10 and 20 METs/h/week. The subject’s compliance to the prescribed physical activity may be accurately determined with the Armband/Cronolife® system

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