背景:糖尿病前期是一种介于血糖正常和糖尿病之间的中间代谢状态。如果没有干预,前驱糖尿病通常进展为糖尿病,前驱糖尿病与心血管疾病的风险增加有关,癌症,肾脏疾病,和痴呆症。生活方式的改变在控制糖尿病前期中起着重要作用。但是生活方式干预通常依从性差,药物的副作用通常不被人们喜欢。作为一种无副作用的非侵入性疗法,腹部按摩(AM),在中国也被称为内脏按摩,已被用于治疗糖尿病前期和肥胖相关疾病。肠道菌群已被认为是代谢性疾病发展的重要因素。患有前驱糖尿病的个体具有异常的肠道微生物群特征。结肠运输时间和粪便稠度与肠道微生物群密切相关。内脏按摩可以通过减少结肠运输时间和促进肠道运动来缓解便秘。我们可以推断,内脏按摩可以调节肠道微生物群的组成,影响人体新陈代谢。所以,在这次审判中,我们将从肠道菌群的角度探讨脏腑按摩对糖尿病前期的作用机制。
方法:本研究将招募80名糖尿病前期个体。将80例糖尿病前期患者按简单随机方法分为生活方式干预组和脏腑按摩+生活方式干预组。每个小组将有40个人。内脏按摩+生活方式干预组的手法将主要通过揉腹部进行,揉腹部,振动腹部,按压腹部,每次30分钟,一天一次,每5天休息2天。生活方式干预将通过微信应用推送健康生活方式指导信息,并每天一起提供面对面的建议。生活方式干预组仅接受健康生活方式干预。所有的干预将进行4周。重量,体重指数(BMI),腰围,腰臀比,腰围与身高的比率将在每周的最后一天测量。甘油三酯,总胆固醇,低密度脂蛋白胆固醇,高密度脂蛋白胆固醇,空腹血糖,餐后2小时血糖(2hPG)和糖化血红蛋白,空腹胰岛素和胰岛素抵抗指数将在干预课程的第一天和最后一天进行测试。受试者的粪便样品将在干预课程的第一天和最后一天收集,并进行16SrRNA基因测序和宏基因组检测。最后,将结合所有结果讨论内脏按摩对糖尿病前期的作用和潜在机制。
结论:本研究结果将用于验证AM对糖尿病前期的作用,并从肠道菌群的角度探讨AM对糖尿病前期的作用机制。
BACKGROUND: Prediabetes is an intermediate metabolic state between normoglycemia and diabetes. Without intervention, prediabetes often progresses to diabetes and prediabetes is associated with increased risk of cardiovascular disease, cancer, renal disease, and dementia. Lifestyle modification play a major role in controlling prediabetes. But lifestyle interventions are often with poor compliance and side effects of drugs are often be dislike by people. As a non-invasive therapy with no side effects, abdominal massage (AM), also called
viscera massage in China, has been used to treat prediabetes and obesity-associated diseases. The gut microbiota has been recognized as an important factor in the development of metabolic diseases. Individuals with prediabetes have aberrant intestinal microbiota character. Colonic transport time and stool consistency are strongly associated with gut microbiota. Viscera massage can ease constipation by reducing colonic transport time and promoting intestinal motility. We can infer that
viscera massage can modulate composition of gut microbiota affects human metabolism. So, in this
trial, we will explore the mechanism of
viscera massage on prediabetes from the perspective of intestinal microbiota.
METHODS: Eighty prediabetes individuals will be recruited for this
study. Eighty prediabetes individuals will be divided into lifestyle intervention group and viscera massage + lifestyle intervention group by a simple random method. Each group will have 40 individuals. The manipulation of the viscera massage + lifestyle intervention group will be mainly carried out through rubbing the abdomen, kneading abdomen, vibrating abdomen, and pressing the abdomen, 30 minutes per time, once a day, with 2 days off every 5 days. Lifestyle interventions will be performed by combining pushing healthy lifestyle guidance information through Wechat application and giving face-to-face advice together daily. The lifestyle intervention group will receive healthy lifestyle intervention only. All the intervention will be conducted for 4 weeks. Weight, body mass index (BMI), waist circumference, waist-to-hip ratio, and waist-to-height ratio will be measured at the last day of every week. Triglycerides, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, fasting blood-glucose, 2-hour post-meal blood glucose (2hPG) and glycosylated hemoglobin, fasting insulin and insulin resistance index will be tested at the first day and last day of the intervention course. The fecal samples of subjects will be gathered at the first day and last day of the intervention course and will be performed 16S rRNA gene sequencing and metagenomic detection. Finally, the effect and potential mechanism of viscera massage on prediabetes will be discussed in combination with all the results.
CONCLUSIONS: The results of this
study will be used to verify the effect of AM on prediabetes and explore the mechanism of AM on prediabetes from the perspective of gut microbiota.