2542-1298 2687-1491 Журнал медико-биологических исследований Journal of Medical and Biological Research Северный (Арктический) федеральный университет 10.37482/2687-1491-Z271 https://journals.narfu.ru/index.php/med/article/view/2258 Влияние различных типов физической нагрузки на функциональное состояние печени мышей при диабете 2-го типа (обзор) Effects of Different Types of Exercise on Liver Function in Type 2 Diabetes in Mice (Review) Юнь Юйфэнь Юнь Юйфэнь Yun Yuyfeng q634920875@163.com 0009-0005-8495-207X Дьякова Елена Юрьевна Дьякова Елена Юрьевна Dyakova Elena Yu. 0000-0001-7653-2386 Цюй Сяньбо Цюй Сяньбо Qu Xianbo 0000-0002-0237-7915 Национальный исследовательский Томский государственный университет (Томск, Россия) Tomsk State University (Tomsk, Russia) 11 03 2026 14 1 73 89 27 06 2025 31 10 2025 28 10 2025 © Юнь Ю., Дьякова Е.Ю., Цюй С., 2026 2026 Юнь Ю., Дьякова Е.Ю., Цюй С. Yun Y., Dyakova E.Yu., Qu X. CC BY 4.0 https://journals.narfu.ru/index.php/med/article/view/2258

Сахарный диабет 2-го типа вызывает комплексные системные нарушения, при этом печень, будучи центральным органом углеводного и липидного обмена, является одной из основных мишеней хронических диабетических осложнений. Регулярная физическая активность рассматривается как эффективное немедикаментозное средство коррекции метаболических расстройств, связанных с указанным заболеванием. Цель настоящего обзора – сравнительный анализ влияния различных форм физической активности на показатели функционального состояния печени у животных с экспериментальной моделью сахарного диабета 2-го типа. Материалы и методы. Выполнен сетевой метаанализ, охватывающий 38 рандомизированных контролируемых исследований (суммарно – с участием 601 мыши). Данные были собраны из баз Web of Science, PubMed, Scopus, CNKI и EBSCO. Рассматривались следующие виды нагрузок: аэробные и силовые тренировки, плавание, высокоинтенсивные интервальные тренировки, тренировки средней интенсивности, а также спонтанная двигательная активность. В качестве исходных критериев оценки учитывались уровни аланинаминотрансферазы (ALT), аспартатаминотрансферазы (AST), триглицеридов, липопротеинов высокой (ЛПВП) и низкой (ЛПНП) плотности, а также активность фосфоенолпируваткарбоксикиназы (PEPCK). Результаты. Анализ выявил, что высокоинтенсивные интервальные тренировки оказывали наиболее выраженное воздействие на функциональное состояние печени мышей с сахарным диабетом 2-го типа, обеспечивая значительное снижение уровней ALT и триглицеридов при одновременном повышении концентрации ЛПВП. Силовые тренировки продемонстрировали преимущество в снижении уровней AST, ЛПНП и активности PEPCK. Плавание и тренировки средней интенсивности также положительно влияли на ряд биомаркеров, однако их эффект был менее выраженным. На основании полученных данных можно сделать вывод, что высокоинтенсивные интервальные тренировки и силовые тренировки могут быть более эффективными стратегиями для регуляции метаболизма печени у мышей с сахарным диабетом 2-го типа. Эти результаты подчеркивают потенциал физической активности как безопасного и доступного метода коррекции диабетических нарушений печени, действенность которого требует дальнейшего подтверждения в клинических исследованиях.

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder that affects multiple organ systems. The liver serves as a central regulator of carbohydrate and lipid homeostasis and represents a major target of diabetic complications. Regular physical activity is acknowledged as an effective non-pharmacological intervention for improving metabolic control in diabetes. The purpose of this review was a comparative analysis of the effects of different exercise modalities on liver-related biomarkers in animals with T2DM. Materials and methods. A network meta-analysis of 38 randomized controlled trials with a total of 601 animals involved was conducted. The following databases were searched: Web of Science, PubMed, Scopus, CNKI and EBSCO. Six categories of exercise interventions were analysed: aerobic training, resistance training, swimming, high-intensity interval training, moderate-intensity continuous training, and voluntary wheel running. The initial assessment criteria included alanine aminotransferase (ALT), aspartate aminotransferase (AST), hepatic triglyceride, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) levels as well as phosphoenolpyruvate carboxykinase (PEPCK) enzymatic activity. Results. High-intensity interval training showed the greatest effectiveness in reducing ALT and hepatic triglyceride levels as well as increasing HDL concentrations in mice with T2DM. Resistance training was most effective in lowering AST and LDL as well as in PEPCK activity. Swimming and moderate-intensity continuous training had a positive, albeit less pronounced, influence on certain biomarkers. The findings indicate that high-intensity interval training and resistance training can be more effective strategies for modulating hepatic metabolism in mice with T2DM. These results underscore the potential of physical exercise as a safe and accessible adjunct to the management of diabetes-induced liver dysfunction. However, additional clinical studies in human populations are needed to substantiate these effects.

 Ключевые слова сахарный диабет 2-го типа функциональное состояние печени липидный обмен силовые тренировки высокоинтенсивные интервальные тренировки сетевой метаанализ Keywords type 2 diabetes mellitus liver function lipid metabolism resistance training high-intensity interval training network meta-analysis 1. Tomic D., Shaw J.E., Magliano D.J. The Burden and Risks of Emerging Complications of Diabetes Mellitus // Nat. Rev. Endocrinol. 2022. Vol. 18, No 9. P. 525–539. https://doi.org/10.1038/s41574-022-00690-7 2. Lee C.-H., Lui D.T.W., Lam K.S.L. Non-Alcoholic Fatty Liver Disease and Type 2 Diabetes: An Update // J. Diabetes Investig. 2022. Vol. 13, No 6. P. 930–940. https://doi.org/10.1111/jdi.13756 3. Bergman R.N., Piccinini F., Kabir M., Kolka C.M., Ader M. Hypothesis: Role of Reduced Hepatic Insulin Clearance in the Pathogenesis of Type 2 Diabetes // Diabetes. 2019. Vol. 68, No 9. P. 1709–1716. https://doi.org/10.2337/db19-0098 4. Ciardullo S., Perseghin G. Prevalence of Elevated Liver Stiffness in Patients with Type 1 and Type 2 Diabetes: A Systematic Review and Meta-Analysis // Diabetes Res. Clin. Pract. 2022. Vol. 190. Art. No 109981. https://doi.org/10.1016/j.diabres.2022.109981Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов. Conflict of interest. The authors declare no conflict of interest. AST и ALT используются как биохимические маркеры повреждения печени и потенциальные индикаторы инсулинорезистентности [65]. У пациентов с СД2 уровни этих ферментов значительно повышены [66]. Начальная стадия СД2 сопровождается накоплением жира в печени, что также приводит к увеличению уровней этих ферментов. Силовые тренировки регулируют липидный обмен и уменьшают образование жира в печени [67]. Независимо от изменений массы тела, физическая активность снижает уровни AST и ALT, вероятно благодаря ослаблению инсулинорезистентности. Аэробные, силовые и высокоинтенсивные интервальные тренировки способствуют уменьшению уровней AST и ALT [68], что согласуется с нашими результатами. Нами также было обнаружено, что среди различных режимов физических нагрузок высокоинтенсивные интервальные тренировки наиболее эффективно снижают уровень ALT, в то время как силовые тренировки – уровень AST. Ограничения исследования: 1. Включенные в обзор эксперименты были выполнены на животных с использованием двух моделей СД2, которые различаются по патогенетическим механизмам и могут оказывать влияние на полученные результаты. 2. Данный метаанализ был сфокусирован на сопоставлении эффективности типов физических нагрузок, в то время как детальное сравнение влияния различных уровней интенсивности и продолжительности упражнений не входило в задачи работы. В связи с этим в дальнейшем целесообразно проведение исследований, направленных на систематическую оценку воздействия именно интенсивности физических нагрузок на метаболические показатели при СД2. Наш метаанализ установил, что различные типы физических упражнений оказывают неодинаковое влияние на функциональные показатели печени у мышей с СД2. Наибольший положительный эффект выявлен при высокоинтенсивных интервальных тренировках, которые способствовали выраженному снижению уровней ALT и триглицеридов, а также увеличению концентрации ЛПВП. Силовые тренировки обеспечивали преимущественное уменьшение уровней AST, ЛПНП и активности РЕРСK, что отражает улучшение глюконеогенеза и липидного обмена в печени. Таким образом, физическая активность, особенно высокоинтенсивные интервальные тренировки и силовые упражнения, представляет собой наиболее эффективную немедикаментозную стратегию для коррекции нарушений печеночного метаболизма при СД2. 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