Influencia del ejercicio físico moderado sobre el metabolismo lipídico posprandial en pacientes diabéticos tipo 2 no obesos

Laburpena

Background Coronary heart disease is the leading cause of death in type 2 diabetic patients. The abnormalities observed in the triglycerides rich lipoproteins (TRL) could justify the high prevalence of atherosclerosis in type 2 diabetes. Most studies in diabetes have assessed lipid metabolism in the fasting state; however, recently it has been suggested that high triglycerides levels in the postprandial state are potentially atherogenic by way of induced alterations of lipoprotein metabolism. Physical exercise influences lipid concentrations, but there are few studies of its potentially beneficial effects on postprandial lipemia in type 2 diabetes. The objective of this study was to assess the influence of moderate physical exercise on postprandial lipemia in type 2 diabetic subjects. Methods We compared 20 type 2 diabetic subjects, with good metabolic control, sedentary and not obese, with 10 control subjects. The 30 subjects were submitted to an oral fat test to determine the magnitude of postprandial lipemia. The 20 diabetic subjects were divided into two groups; the first group (n = 10) followed a moderate physical exercise program during 3 months, while the second group (n = 10) remained sedentary. After 3 months, postprandial lipemia was assessed again. Results Diabetic patients had increased fasting triglyceride levels and reduced HDL cholesterol levels in comparison with the control group. Postprandial lipemia and the maximum TG peak after the oral fat test were higher in the diabetic group. An increase in VLDL triglyceride and VLDL cholesterol and a decreased HDL cholesterol in both states (fasting and postprandial) were observed in the diabetic subjects. After the physical exercise program, postprandial triglyceride levels were lower than at baseline and in diabetics who remained sedentary, but the areas under the curve were not significantly different. No changes in fasting or postprandial HDL cholesterol levels were observed after the physical exercise program. Conclusion In type 2 diabetic subjects, moderate physical exercise produces favorable changes in the composition of postprandial lipoproteins which probably decrease their atherogenic capacity.