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Tee CCL, Chong MC, Cooke MB, Rahmat N, Yeo WK, Camera DM. Effects of exercise modality combined with moderate hypoxia on blood glucose regulation in adults with overweight. Front Physiol 2024; 15:1396108. [PMID: 38903909 PMCID: PMC11188384 DOI: 10.3389/fphys.2024.1396108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 05/15/2024] [Indexed: 06/22/2024] Open
Abstract
Purpose: This study aimed to investigate the combined effects of moderate hypoxia with three different exercise modes on glucose regulation in healthy overweight adults. Methods: Thirteen overweight males (age: 31 ± 4 years; body fat 26.3 ± 3.2%) completed three exercise trials in a randomized crossover design involving 60 min cycling exercise at 90% lactate threshold (LOW), sprint interval training (20 × 4 s all-out; SIT) and lower limb functional bodyweight exercises (8 sets of 4 × 20 s; FEX) under moderate hypoxia (FiO2 = 16.5%). Post-exercise oral glucose tolerance test (OGTT) was performed following each trial. Heart rate, oxygen saturation (SpO2), physical activity enjoyment scale (PACES), and perceptual measures were recorded during each exercise session. Venous blood was collected pre-, immediately post-, and 24 h post-exercise and analysed for plasma glucose and insulin, incremental area under curve (iAUC), and circulating microRNA expression (c-miRs-486-5p, -126-5p, and -21-5p). Interstitial glucose concentrations were measured using continuous glucose monitoring (CGM). Results: Post-exercise OGTT iAUC for plasma glucose and insulin concentration were lower in SIT and LOW vs. control (p < 0.05) while post-exercise interstitial glucose iAUC and c-miRs were not different between exercise modes. Heart rate was greater in SIT vs. LOW and FEX, and FEX vs. LOW (p < 0.05), SpO2 was lower in SIT, while PACES was not different between exercise modes. Perceptual measures were greater in SIT vs. LOW and FEX. Conclusion: Acute SIT and LOW under moderate hypoxia improved post-exercise plasma insulin compared to FEX exercises. Considering SIT was also time-efficient, well tolerated, and enjoyable for participants, this may be the preferred exercise modality for improving glucose regulation in adult males with overweight when combined with moderate hypoxia.
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Affiliation(s)
- Chris Chow Li Tee
- Division of Research and Innovation, National Sports Institute of Malaysia, Kuala Lumpur, Malaysia
- Sport and Exercise Medicine Group, Swinburne University of Technology Melbourne, Hawthorn, Australia
| | - Mee Chee Chong
- Sport and Exercise Medicine Group, Swinburne University of Technology Melbourne, Hawthorn, Australia
| | - Matthew B. Cooke
- Sport, Performance and Nutrition Research Group, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Nurhamizah Rahmat
- Division of Research and Innovation, National Sports Institute of Malaysia, Kuala Lumpur, Malaysia
| | - Wee Kian Yeo
- Division of Research and Innovation, National Sports Institute of Malaysia, Kuala Lumpur, Malaysia
| | - Donny M. Camera
- Sport and Exercise Medicine Group, Swinburne University of Technology Melbourne, Hawthorn, Australia
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Shepherd AI, James TJ, Gould AAM, Mayes H, Neal R, Shute J, Tipton MJ, Massey H, Saynor ZL, Perissiou M, Montgomery H, Sturgess C, Makaronidis J, Murray AJ, Grocott MPW, Cummings M, Young-Min S, Rennell-Smyth J, McNarry MA, Mackintosh KA, Dent H, Robson SC, Corbett J. Impact of nocturnal hypoxia on glycaemic control, appetite, gut microbiota and inflammation in adults with type 2 diabetes mellitus: A single-blind cross-over trial. J Physiol 2024. [PMID: 38769692 DOI: 10.1113/jp285322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 04/22/2024] [Indexed: 05/22/2024] Open
Abstract
High altitude residents have a lower incidence of type 2 diabetes mellitus (T2DM). Therefore, we examined the effect of repeated overnight normobaric hypoxic exposure on glycaemic control, appetite, gut microbiota and inflammation in adults with T2DM. Thirteen adults with T2DM [glycated haemoglobin (HbA1c): 61.1 ± 14.1 mmol mol-1; aged 64.2 ± 9.4 years; four female] completed a single-blind, randomised, sham-controlled, cross-over study for 10 nights, sleeping when exposed to hypoxia (fractional inspired O2 [F I O 2 ${{F}_{{\mathrm{I}}{{{\mathrm{O}}}_{\mathrm{2}}}}}$ ] = 0.155; ∼2500 m simulated altitude) or normoxic conditions (F I O 2 ${{F}_{{\mathrm{I}}{{{\mathrm{O}}}_{\mathrm{2}}}}}$ = 0.209) in a randomised order. Outcome measures included: fasted plasma [glucose]; [hypoxia inducible factor-1α]; [interleukin-6]; [tumour necrosis factor-α]; [interleukin-10]; [heat shock protein 70]; [butyric acid]; peak plasma [glucose] and insulin sensitivity following a 2 h oral glucose tolerance test; body composition; appetite indices ([leptin], [acyl ghrelin], [peptide YY], [glucagon-like peptide-1]); and gut microbiota diversity and abundance [16S rRNA amplicon sequencing]. During intervention periods, accelerometers measured physical activity, sleep duration and efficiency, whereas continuous glucose monitors were used to assess estimated HbA1c and glucose management indicator and time in target range. Overnight hypoxia was not associated with changes in any outcome measure (P > 0.05 with small effect sizes) except fasting insulin sensitivity and gut microbiota alpha diversity, which exhibited trends (P = 0.10; P = 0.08 respectively) for a medium beneficial effect (d = 0.49; d = 0.59 respectively). Ten nights of overnight moderate hypoxic exposure did not significantly affect glycaemic control, gut microbiome, appetite, or inflammation in adults with T2DM. However, the intervention was well tolerated and a medium effect-size for improved insulin sensitivity and reduced alpha diversity warrants further investigation. KEY POINTS: Living at altitude lowers the incidence of type 2 diabetes mellitus (T2DM). Animal studies suggest that exposure to hypoxia may lead to weight loss and suppressed appetite. In a single-blind, randomised sham-controlled, cross-over trial, we assessed the effects of 10 nights of hypoxia (fractional inspired O2 ∼0.155) on glucose homeostasis, appetite, gut microbiota, inflammatory stress ([interleukin-6]; [tumour necrosis factor-α]; [interleukin-10]) and hypoxic stress ([hypoxia inducible factor 1α]; heat shock protein 70]) in 13 adults with T2DM. Appetite and inflammatory markers were unchanged following hypoxic exposure, but an increased insulin sensitivity and reduced gut microbiota alpha diversity were associated with a medium effect-size and statistical trends, which warrant further investigation using a definitive large randomised controlled trial. Hypoxic exposure may represent a viable therapeutic intervention in people with T2DM and particularly those unable or unwilling to exercise because barriers to uptake and adherence may be lower than for other lifestyle interventions (e.g. diet and exercise).
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Affiliation(s)
- Anthony I Shepherd
- Extreme Environments Laboratory, School of Sport, Health and Exercise Science, Faculty of Science and Health, University of Portsmouth, Portsmouth, UK
- Clinical Health and Rehabilitation Team, School of Sport, Health and Exercise Science, Faculty of Science and Health, University of Portsmouth, Portsmouth, UK
- Diabetes and Endocrinology Department, Portsmouth Hospitals University NHS Trust, Portsmouth, UK
| | - Thomas J James
- Extreme Environments Laboratory, School of Sport, Health and Exercise Science, Faculty of Science and Health, University of Portsmouth, Portsmouth, UK
- Clinical Health and Rehabilitation Team, School of Sport, Health and Exercise Science, Faculty of Science and Health, University of Portsmouth, Portsmouth, UK
| | - Alex A M Gould
- Extreme Environments Laboratory, School of Sport, Health and Exercise Science, Faculty of Science and Health, University of Portsmouth, Portsmouth, UK
| | - Harry Mayes
- Extreme Environments Laboratory, School of Sport, Health and Exercise Science, Faculty of Science and Health, University of Portsmouth, Portsmouth, UK
| | - Rebecca Neal
- Department of Rehabilitation and Sport Sciences, Bournemouth University, Poole, UK
| | - Janis Shute
- School of Pharmacy and Biomedical Sciences, Faculty of Science and Health, University of Portsmouth, Portsmouth, UK
| | - Michael J Tipton
- Extreme Environments Laboratory, School of Sport, Health and Exercise Science, Faculty of Science and Health, University of Portsmouth, Portsmouth, UK
| | - Heather Massey
- Extreme Environments Laboratory, School of Sport, Health and Exercise Science, Faculty of Science and Health, University of Portsmouth, Portsmouth, UK
| | - Zoe L Saynor
- Clinical Health and Rehabilitation Team, School of Sport, Health and Exercise Science, Faculty of Science and Health, University of Portsmouth, Portsmouth, UK
| | - Maria Perissiou
- Clinical Health and Rehabilitation Team, School of Sport, Health and Exercise Science, Faculty of Science and Health, University of Portsmouth, Portsmouth, UK
| | - Hugh Montgomery
- Centre for Human Health and Performance, Dept Medicine, University College London, London, UK
| | - Connie Sturgess
- Centre for Human Health and Performance, Dept Medicine, University College London, London, UK
| | - Janine Makaronidis
- Centre for Obesity Research, University College London, London, UK
- National Institute for Health and Care Research, University College London Hospitals Biomedical Research Centre, London, UK
| | - Andrew J Murray
- Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK
| | - Michael P W Grocott
- Perioperative and Critical Care Theme, NIHR Southampton Biomedical Research Centre, University Hospital Southampton & University of Southampton, Southampton, UK
| | - Michael Cummings
- Diabetes and Endocrinology Department, Portsmouth Hospitals University NHS Trust, Portsmouth, UK
| | - Steven Young-Min
- Rheumatology Department, Portsmouth Hospitals University NHS Trust, Portsmouth, UK
| | - Janet Rennell-Smyth
- Clinical Health and Rehabilitation Team, School of Sport, Health and Exercise Science, Faculty of Science and Health, University of Portsmouth, Portsmouth, UK
- Patient and public involvement member
| | - Melitta A McNarry
- School of Biological Science, Faculty of Science and Health, University of Portsmouth, Portsmouth, UK
| | - Kelly A Mackintosh
- School of Biological Science, Faculty of Science and Health, University of Portsmouth, Portsmouth, UK
| | - Hannah Dent
- School of Pharmacy and Biomedical Sciences, Faculty of Science and Health, University of Portsmouth, Portsmouth, UK
- Institute of Life Sciences and Healthcare, Faculty of Science and Health, University of Portsmouth, Portsmouth, UK
| | - Samuel C Robson
- School of Pharmacy and Biomedical Sciences, Faculty of Science and Health, University of Portsmouth, Portsmouth, UK
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, School of Sport and Exercise Sciences, Swansea University, Swansea, UK
- Institute of Life Sciences and Healthcare, Faculty of Science and Health, University of Portsmouth, Portsmouth, UK
| | - Jo Corbett
- Extreme Environments Laboratory, School of Sport, Health and Exercise Science, Faculty of Science and Health, University of Portsmouth, Portsmouth, UK
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Peifer-Weiß L, Al-Hasani H, Chadt A. AMPK and Beyond: The Signaling Network Controlling RabGAPs and Contraction-Mediated Glucose Uptake in Skeletal Muscle. Int J Mol Sci 2024; 25:1910. [PMID: 38339185 PMCID: PMC10855711 DOI: 10.3390/ijms25031910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 01/26/2024] [Accepted: 01/27/2024] [Indexed: 02/12/2024] Open
Abstract
Impaired skeletal muscle glucose uptake is a key feature in the development of insulin resistance and type 2 diabetes. Skeletal muscle glucose uptake can be enhanced by a variety of different stimuli, including insulin and contraction as the most prominent. In contrast to the clearance of glucose from the bloodstream in response to insulin stimulation, exercise-induced glucose uptake into skeletal muscle is unaffected during the progression of insulin resistance, placing physical activity at the center of prevention and treatment of metabolic diseases. The two Rab GTPase-activating proteins (RabGAPs), TBC1D1 and TBC1D4, represent critical nodes at the convergence of insulin- and exercise-stimulated signaling pathways, as phosphorylation of the two closely related signaling factors leads to enhanced translocation of glucose transporter 4 (GLUT4) to the plasma membrane, resulting in increased cellular glucose uptake. However, the full network of intracellular signaling pathways that control exercise-induced glucose uptake and that overlap with the insulin-stimulated pathway upstream of the RabGAPs is not fully understood. In this review, we discuss the current state of knowledge on exercise- and insulin-regulated kinases as well as hypoxia as stimulus that may be involved in the regulation of skeletal muscle glucose uptake.
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Affiliation(s)
- Leon Peifer-Weiß
- Institute for Clinical Biochemistry and Pathobiochemistry, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University, Medical Faculty, 40225 Düsseldorf, Germany; (L.P.-W.); (H.A.-H.)
- German Center for Diabetes Research (DZD e.V.), Partner Düsseldorf, 85764 Neuherberg, Germany
| | - Hadi Al-Hasani
- Institute for Clinical Biochemistry and Pathobiochemistry, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University, Medical Faculty, 40225 Düsseldorf, Germany; (L.P.-W.); (H.A.-H.)
- German Center for Diabetes Research (DZD e.V.), Partner Düsseldorf, 85764 Neuherberg, Germany
| | - Alexandra Chadt
- Institute for Clinical Biochemistry and Pathobiochemistry, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University, Medical Faculty, 40225 Düsseldorf, Germany; (L.P.-W.); (H.A.-H.)
- German Center for Diabetes Research (DZD e.V.), Partner Düsseldorf, 85764 Neuherberg, Germany
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4
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Costalat G, Lemaitre F, Ramos S, Renshaw GMC. Intermittent normobaric hypoxia alters substrate partitioning and muscle oxygenation in individuals with obesity: implications for fat burning. Am J Physiol Regul Integr Comp Physiol 2024; 326:R147-R159. [PMID: 38047315 DOI: 10.1152/ajpregu.00153.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 11/28/2023] [Accepted: 11/29/2023] [Indexed: 12/05/2023]
Abstract
This single-blind, crossover study aimed to measure and evaluate the short-term metabolic responses to continuous and intermittent hypoxic patterns in individuals with obesity. Indirect calorimetry was used to quantify changes in resting metabolic rate (RMR), carbohydrate (CHOox, %CHO), and fat oxidation (FATox, %FAT) in nine individuals with obesity pre and post: 1) breathing normoxic air [normoxic sham control (NS-control)], 2) breathing continuous hypoxia (CH), or 3) breathing intermittent hypoxia (IH). A mean peripheral oxygen saturation ([Formula: see text]) of 80-85% was achieved over a total of 45 min of hypoxia. Throughout each intervention, pulmonary gas exchanges, oxygen consumption (V̇o2) carbon dioxide production (V̇co2), and deoxyhemoglobin concentration (Δ[HHb]) in the vastus lateralis were measured. Both RMR and CHOox measured pre- and postinterventions were unchanged following each treatment: NS-control, CH, or IH (all P > 0.05). Conversely, a significant increase in FATox was evident between pre- and post-IH (+44%, P = 0.048). Although the mean Δ[HHb] values significantly increased during both IH and CH (P < 0.05), the greatest zenith of Δ[HHb] was achieved in IH compared with CH (P = 0.002). Furthermore, there was a positive correlation between Δ[HHb] and the shift in FATox measured pre- and postintervention. It is suggested that during IH, the increased bouts of muscle hypoxia, revealed by elevated Δ[HHb], coupled with cyclic periods of excess posthypoxia oxygen consumption (EPHOC, inherent to the intermittent pattern) played a significant role in driving the increase in FATox post-IH.
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Affiliation(s)
- Guillaume Costalat
- Adaptations Physiologiques à l'Exercice et Réadaptation à l'Effort Laboratory, Faculty of Sport Sciences, University of Picardie Jules Verne, Amiens, France
| | - Frederic Lemaitre
- Centre d'Etude des Transformations des Activités Physiques et Sportives Laboratory, Faculty of Sport Sciences, Normandy University, Rouen, France
- Centre de Recherche Insulaire et Observatoire de l'Environnement, Centre National de la Recherche Scientifique-Ecole Pratique des Hautes Etudes-Université de Perpignan Via Domitia, Moorea, French Polynesia
| | - Sandra Ramos
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - Gillian M C Renshaw
- Hypoxia and Ischemia Research Unit, School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
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5
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Burtscher J, Citherlet T, Camacho-Cardenosa A, Camacho-Cardenosa M, Raberin A, Krumm B, Hohenauer E, Egg M, Lichtblau M, Müller J, Rybnikova EA, Gatterer H, Debevec T, Baillieul S, Manferdelli G, Behrendt T, Schega L, Ehrenreich H, Millet GP, Gassmann M, Schwarzer C, Glazachev O, Girard O, Lalande S, Hamlin M, Samaja M, Hüfner K, Burtscher M, Panza G, Mallet RT. Mechanisms underlying the health benefits of intermittent hypoxia conditioning. J Physiol 2023. [PMID: 37860950 DOI: 10.1113/jp285230] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 10/11/2023] [Indexed: 10/21/2023] Open
Abstract
Intermittent hypoxia (IH) is commonly associated with pathological conditions, particularly obstructive sleep apnoea. However, IH is also increasingly used to enhance health and performance and is emerging as a potent non-pharmacological intervention against numerous diseases. Whether IH is detrimental or beneficial for health is largely determined by the intensity, duration, number and frequency of the hypoxic exposures and by the specific responses they engender. Adaptive responses to hypoxia protect from future hypoxic or ischaemic insults, improve cellular resilience and functions, and boost mental and physical performance. The cellular and systemic mechanisms producing these benefits are highly complex, and the failure of different components can shift long-term adaptation to maladaptation and the development of pathologies. Rather than discussing in detail the well-characterized individual responses and adaptations to IH, we here aim to summarize and integrate hypoxia-activated mechanisms into a holistic picture of the body's adaptive responses to hypoxia and specifically IH, and demonstrate how these mechanisms might be mobilized for their health benefits while minimizing the risks of hypoxia exposure.
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Affiliation(s)
- Johannes Burtscher
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Tom Citherlet
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Alba Camacho-Cardenosa
- Department of Physical Education and Sports, Faculty of Sports Science, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Marta Camacho-Cardenosa
- Clinical Management Unit of Endocrinology and Nutrition - GC17, Maimónides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofía University Hospital, Córdoba, Spain
| | - Antoine Raberin
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Bastien Krumm
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Erich Hohenauer
- Rehabilitation and Exercise Science Laboratory (RES lab), Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Landquart, Switzerland
- International University of Applied Sciences THIM, Landquart, Switzerland
- Department of Neurosciences and Movement Science, University of Fribourg, Fribourg, Switzerland
| | - Margit Egg
- Institute of Zoology, University of Innsbruck, Innsbruck, Austria
| | - Mona Lichtblau
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Julian Müller
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Elena A Rybnikova
- Pavlov Institute of Physiology, Russian Academy of Sciences, St Petersburg, Russia
| | - Hannes Gatterer
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
- Institute for Sports Medicine, Alpine Medicine and Health Tourism (ISAG), UMIT TIROL-Private University for Health Sciences and Health Technology, Hall in Tirol, Austria
| | - Tadej Debevec
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
- Department of Automatics, Biocybernetics and Robotics, Jožef Stefan Institute, Ljubljana, Slovenia
| | - Sebastien Baillieul
- Service Universitaire de Pneumologie Physiologie, University of Grenoble Alpes, Inserm, Grenoble, France
| | | | - Tom Behrendt
- Chair Health and Physical Activity, Department of Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Lutz Schega
- Chair Health and Physical Activity, Department of Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Hannelore Ehrenreich
- Clinical Neuroscience, University Medical Center and Max Planck Institute for Multidisciplinary Sciences, Göttingen, Germany
| | - Grégoire P Millet
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Max Gassmann
- Institute of Veterinary Physiology, Vetsuisse Faculty, University of Zürich, Zurich, Switzerland
- Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich, Switzerland
- Universidad Peruana Cayetano Heredia (UPCH), Lima, Peru
| | - Christoph Schwarzer
- Institute of Pharmacology, Medical University of Innsbruck, Innsbruck, Austria
| | - Oleg Glazachev
- Department of Normal Physiology, N.V. Sklifosovsky Institute of Clinical Medicine, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Olivier Girard
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Crawley, Western Australia, Australia
| | - Sophie Lalande
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX, USA
| | - Michael Hamlin
- Department of Tourism, Sport and Society, Lincoln University, Christchurch, New Zealand
| | - Michele Samaja
- Department of Health Science, University of Milan, Milan, Italy
| | - Katharina Hüfner
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Hospital for Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria
| | - Martin Burtscher
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Gino Panza
- The Department of Health Care Sciences, Program of Occupational Therapy, Wayne State University, Detroit, MI, USA
- John D. Dingell VA Medical Center Detroit, Detroit, MI, USA
| | - Robert T Mallet
- Department of Physiology & Anatomy, University of North Texas Health Science Center, Fort Worth, TX, USA
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Corbett J, Tipton MJ, Perissiou M, James T, Young JS, Newman A, Cummings M, Montgomery H, Grocott MPW, Shepherd AI. Effect of different levels of acute hypoxia on subsequent oral glucose tolerance in males with overweight: A balanced cross-over pilot feasibility study. Physiol Rep 2023; 11:e15623. [PMID: 37144546 PMCID: PMC10161207 DOI: 10.14814/phy2.15623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/06/2023] [Accepted: 02/07/2023] [Indexed: 05/06/2023] Open
Abstract
Previous research has shown that ≤60 min hypoxic exposure improves subsequent glycaemic control, but the optimal level of hypoxia is unknown and data are lacking from individuals with overweight. We undertook a cross-over pilot feasibility study investigating the effect of 60-min prior resting exposure to different inspired oxygen fractions (CON FI O2 = 0.209; HIGH FI O2 = 0.155; VHIGH FI O2 = 0.125) on glycaemic control, insulin sensitivity, and oxidative stress during a subsequent oral glucose tolerance test (OGTT) in males with overweight (mean (SD) BMI = 27.6 (1.3) kg/m2 ; n = 12). Feasibility was defined by exceeding predefined withdrawal criteria for peripheral blood oxygen saturation (SpO2 ), partial pressure of end-tidal oxygen or carbon dioxide and acute mountain sickness (AMS), and dyspnoea symptomology. Hypoxia reduced SpO2 in a stepwise manner (CON = 97(1)%; HIGH = 91(1)%; VHIGH = 81(3)%, p < 0.001), but did not affect peak plasma glucose concentration (CON = 7.5(1.8) mmol∙L-1 ; HIGH = 7.7(1.1) mmol∙L-1 ; VHIGH = 7.7(1.1) mmol∙L-1 ; p = 0.777; η2 = 0.013), plasma glucose area under the curve, insulin sensitivity, or metabolic clearance rate of glucose (p > 0.05). We observed no between-conditions differences in oxidative stress (p > 0.05), but dyspnoea and AMS symptoms increased in VHIGH (p < 0.05), with one participant meeting the withdrawal criteria. Acute HIGH or VHIGH exposure prior to an OGTT does not influence glucose homeostasis in males with overweight, but VHIGH is associated with adverse symptomology and reduced feasibility.
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Affiliation(s)
- Jo Corbett
- Extreme Environments Laboratory, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Michael J Tipton
- Extreme Environments Laboratory, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Maria Perissiou
- Clinical, Health and Rehabilitation Team, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Thomas James
- Extreme Environments Laboratory, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
- Clinical, Health and Rehabilitation Team, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - John S Young
- National Horizons Centre, Teesside University, Middlesbrough, UK
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | - Alexander Newman
- National Horizons Centre, Teesside University, Middlesbrough, UK
| | - Michael Cummings
- Diabetes and Endocrinology Department, Portsmouth Hospitals University NHS Trust, Portsmouth, UK
| | - Hugh Montgomery
- Centre for Sport Exercise and Health, Dept Medicine, University College London, London, UK
| | - Michael P W Grocott
- Perioperative and Critical Care Theme, NIHR Southampton Biomedical Research Centre, University Hospital Southampton/University of Southampton, Southampton, UK
| | - Anthony I Shepherd
- Clinical, Health and Rehabilitation Team, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
- Diabetes and Endocrinology Department, Portsmouth Hospitals University NHS Trust, Portsmouth, UK
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7
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Msg RR. Would Intermittent Hypoxia Add Significant Benefits to Simple Breathing Pranayama? Complement Med Res 2023; 30:362-364. [PMID: 37121231 DOI: 10.1159/000530874] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 04/26/2023] [Indexed: 05/02/2023]
Affiliation(s)
- Ram Rahim Msg
- PMAJ Integrated Medicine Hospital, Nejia Khera, India
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8
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van Meijel RLJ, Blaak EE, Goossens GH. Effects of hypoxic exercise on 24-hour glucose profile and substrate metabolism in overweight and obese men with impaired glucose metabolism. Am J Physiol Endocrinol Metab 2023; 324:E135-E143. [PMID: 36542847 DOI: 10.1152/ajpendo.00230.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Hypoxic exercise (HE) may have more pronounced effects on glucose homeostasis than exercise under normoxic conditions (NE), but effects on 24-h glucose profile and substrate utilization remain unclear. We investigated the effects of moderate-intensity HE compared with NE on 24-h glucose profile and substrate metabolism in overweight/obese individuals. Ten overweight/obese men with impaired glucose homeostasis participated in a randomized, single-blind, crossover trial. Participants performed moderate-intensity cycling exercise for 4 consecutive days under mild normobaric hypoxic ([Formula: see text]: 15%) or normoxic ([Formula: see text]: 21%) conditions at similar relative exercise intensity (2 × 30 min/day at 50% of maximal heart rate, with a ∼4-wk washout period. Twenty-four-hour glucose levels and systemic oxygen saturation ([Formula: see text]) were monitored throughout the study. At day 5, plasma metabolites and substrate oxidation were determined during a mixed-meal test under normoxic conditions. [Formula: see text] and absolute workload were lower (both P < 0.001), whereas heart rate was comparable during HE compared with NE. HE did not alter mean 24-h, daytime, and nighttime glucose concentrations, and measures of glycemic variability. However, the HE-induced decrease in [Formula: see text] was positively correlated with HE-induced improvements in mean 24-h (rs = 0.683, P = 0.042) and daytime (rs = 0.783, P = 0.013) glucose concentrations. HE at similar relative exercise intensity reduces [Formula: see text] and has comparable effects on mean 24-h glucose concentration and glycemic variability than NE in overweight/obese men with impaired glucose metabolism. Nevertheless, a more pronounced reduction in [Formula: see text] during HE was associated with lower 24-h glucose concentrations, suggesting that a marked hypoxic stimulus is needed to improve glucose homeostasis.NEW & NOTEWORTHY We demonstrate that hypoxic exercise at similar relative exercise intensity (i.e. lower absolute workload) reduces systemic oxygen saturation ([Formula: see text]) and has comparable effects on mean 24-h glucose concentrations and glycemic variability than normoxic exercise in men with overweight/obesity and impaired glucose metabolism. A more pronounced reduction in [Formula: see text] during hypoxic exercise, however, was associated with lower 24-h and daytime glucose concentrations. Our findings suggest that a marked hypoxic stimulus may improve glucose homeostasis.
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Affiliation(s)
- Rens L J van Meijel
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Ellen E Blaak
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Gijs H Goossens
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands
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The role of exercise and hypoxia on glucose transport and regulation. Eur J Appl Physiol 2023; 123:1147-1165. [PMID: 36690907 DOI: 10.1007/s00421-023-05135-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 01/06/2023] [Indexed: 01/25/2023]
Abstract
Muscle glucose transport activity increases with an acute bout of exercise, a process that is accomplished by the translocation of glucose transporters to the plasma membrane. This process remains intact in the skeletal muscle of individuals with insulin resistance and type 2 diabetes mellitus (T2DM). Exercise training is, therefore, an important cornerstone in the management of individuals with T2DM. However, the acute systemic glucose responses to carbohydrate ingestion are often augmented during the early recovery period from exercise, despite increased glucose uptake into skeletal muscle. Accordingly, the first aim of this review is to summarize the knowledge associated with insulin action and glucose uptake in skeletal muscle and apply these to explain the disparate responses between systemic and localized glucose responses post-exercise. Herein, the importance of muscle glycogen depletion and the key glucoregulatory hormones will be discussed. Glucose uptake can also be stimulated independently by hypoxia; therefore, hypoxic training presents as an emerging method for enhancing the effects of exercise on glucose regulation. Thus, the second aim of this review is to discuss the potential for systemic hypoxia to enhance the effects of exercise on glucose regulation.
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10
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Tee CCL, Cooke MB, Chong MC, Yeo WK, Camera DM. Mechanisms for Combined Hypoxic Conditioning and Divergent Exercise Modes to Regulate Inflammation, Body Composition, Appetite, and Blood Glucose Homeostasis in Overweight and Obese Adults: A Narrative Review. Sports Med 2023; 53:327-348. [PMID: 36441492 PMCID: PMC9877079 DOI: 10.1007/s40279-022-01782-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2022] [Indexed: 11/29/2022]
Abstract
Obesity is a major global health issue and a primary risk factor for metabolic-related disorders. While physical inactivity is one of the main contributors to obesity, it is a modifiable risk factor with exercise training as an established non-pharmacological treatment to prevent the onset of metabolic-related disorders, including obesity. Exposure to hypoxia via normobaric hypoxia (simulated altitude via reduced inspired oxygen fraction), termed hypoxic conditioning, in combination with exercise has been increasingly shown in the last decade to enhance blood glucose regulation and decrease the body mass index, providing a feasible strategy to treat obesity. However, there is no current consensus in the literature regarding the optimal combination of exercise variables such as the mode, duration, and intensity of exercise, as well as the level of hypoxia to maximize fat loss and overall body compositional changes with hypoxic conditioning. In this narrative review, we discuss the effects of such diverse exercise and hypoxic variables on the systematic and myocellular mechanisms, along with physiological responses, implicated in the development of obesity. These include markers of appetite regulation and inflammation, body conformational changes, and blood glucose regulation. As such, we consolidate findings from human studies to provide greater clarity for implementing hypoxic conditioning with exercise as a safe, practical, and effective treatment strategy for obesity.
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Affiliation(s)
- Chris Chow Li Tee
- Division of Research and Innovation, National Sports Institute of Malaysia, Kuala Lumpur, Malaysia
- Sport and Exercise Medicine Group, Swinburne University, Room SPW224, Mail H21, PO Box 218, Hawthorn, VIC, 3122, Australia
| | - Matthew B Cooke
- Sport and Exercise Medicine Group, Swinburne University, Room SPW224, Mail H21, PO Box 218, Hawthorn, VIC, 3122, Australia
| | - Mee Chee Chong
- Sport and Exercise Medicine Group, Swinburne University, Room SPW224, Mail H21, PO Box 218, Hawthorn, VIC, 3122, Australia
| | - Wee Kian Yeo
- Division of Research and Innovation, National Sports Institute of Malaysia, Kuala Lumpur, Malaysia
| | - Donny M Camera
- Sport and Exercise Medicine Group, Swinburne University, Room SPW224, Mail H21, PO Box 218, Hawthorn, VIC, 3122, Australia.
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11
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Tee CCL, Parr EB, Cooke MB, Chong MC, Rahmat N, Md Razali MR, Yeo WK, Camera DM. Combined effects of exercise and different levels of acute hypoxic severity: A randomized crossover study on glucose regulation in adults with overweight. Front Physiol 2023; 14:1174926. [PMID: 37123278 PMCID: PMC10133678 DOI: 10.3389/fphys.2023.1174926] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 04/05/2023] [Indexed: 05/02/2023] Open
Abstract
Purpose: The aim of this study was to investigate the influence of manipulating hypoxic severity with low-intensity exercise on glucose regulation in healthy overweight adults. Methods: In a randomized crossover design, 14 males with overweight (age: 27 ± 5 years; body mass index (BMI) 27.1 ± 1.8 kg⋅m2) completed three exercise trials involving 60 min aerobic exercise cycling at 90% lactate threshold in normoxia (NM, FiO2 = 20.9%), moderate hypoxia (MH, FiO2 = 16.5%) and high hypoxia (HH, FiO2 = 14.8%). A post-exercise oral glucose tolerance test (OGTT) was performed. Venous blood samples were analyzed for incremental area under the curve (iAUC), plasma glucose and insulin, as well as exerkine concentrations (plasma apelin and fibroblast growth factor 21 [FGF-21]) pre- and post-exercise. A 24-h continuous glucose monitoring (CGM) was used to determine interstitial glucose concentrations. Heart rate, oxygen saturation (SpO2) and perceptual measures were recorded during exercise. Results: Post-exercise OGTT iAUC for plasma glucose and insulin concentrations were lower in MH vs. control (p = 0.02). Post-exercise interstitial glucose iAUC, plasma apelin and FGF-21 were not different between conditions. Heart rate was higher in HH vs. NM and MH, and MH vs. NM (p < 0.001), while SpO2 was lower in HH vs. NM and MH, and MH vs. NM (p < 0.001). Overall perceived discomfort and leg discomfort were higher in HH vs. NM and MH (p < 0.05), while perceived breathing difficulty was higher in HH vs. NM only (p = 0.003). Conclusion: Compared to higher hypoxic conditions, performing acute aerobic-based exercise under moderate hypoxia provided a more effective stimulus for improving post-exercise glucose regulation while concomitantly preventing excessive physiological and perceptual stress in healthy overweight adults.
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Affiliation(s)
- Chris Chow Li Tee
- Division of Research and Innovation, National Sports Institute of Malaysia, Kuala Lumpur, Malaysia
- Sport and Exercise Medicine Group, Swinburne University of Technology Melbourne, Hawthorn, VI, Australia
- *Correspondence: Chris Chow Li Tee,
| | - Evelyn B. Parr
- Exercise and Nutrition Research Program, Mary Mackillop Institute for Health Research, Australia Catholic University, Melbourne, VI, Australia
| | - Matthew B. Cooke
- Sport and Exercise Medicine Group, Swinburne University of Technology Melbourne, Hawthorn, VI, Australia
| | - Mee Chee Chong
- Sport and Exercise Medicine Group, Swinburne University of Technology Melbourne, Hawthorn, VI, Australia
| | - Nurhamizah Rahmat
- Division of Research and Innovation, National Sports Institute of Malaysia, Kuala Lumpur, Malaysia
| | - Mohd Rizal Md Razali
- Division of Research and Innovation, National Sports Institute of Malaysia, Kuala Lumpur, Malaysia
| | - Wee Kian Yeo
- Division of Research and Innovation, National Sports Institute of Malaysia, Kuala Lumpur, Malaysia
| | - Donny M. Camera
- Sport and Exercise Medicine Group, Swinburne University of Technology Melbourne, Hawthorn, VI, Australia
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12
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Kindlovits R, Pereira AMDS, Sousa AC, Viana JL, Teixeira VH. Effects of Acute and Chronic Exercise in Hypoxia on Cardiovascular and Glycemic Parameters in Patients with Type 2 Diabetes: A Systematic Review. High Alt Med Biol 2022; 23:301-312. [PMID: 36036723 DOI: 10.1089/ham.2022.0029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Kindlovits, Raquel, Alberto Mello da Silva Pereira, Ana Catarina Sousa, João Luís Viana,and Vitor Hugo Teixeira. Effects of acute and chronic exercise in hypoxia on cardiovascular and glycemic parameters in patients with type 2 diabetes: a systematic review. High Alt Med Biol. 23:301-312, 2022. Background: Exercise in hypoxia (EH, decreased oxygen availability) has been proposed as a potential therapeutic intervention to promote angiogenesis and improve glucose metabolism to a greater extent than exercise under normoxia (normal ambient air) in patients with type 2 diabetes (T2D). Currently, there are no studies that systematize the existent evidence. This study aims to systematically review the literature and qualitatively evaluate the effects of acute and chronic EH on cardiovascular and glycemic parameters in T2D patients. Methods: A structured search was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines until March 2021, in the MEDLINE/PubMed, Scopus, and Web of Science databases. The inclusion criteria were as follows: (1) randomized and nonrandomized trials, (2) in complication-free patients with T2D, (3) in which EH was compared with exercise in normoxia or with baseline data, and (4) published in English. Results: Six articles (64 subjects) met the inclusion criteria and were reviewed to data extraction. Four articles investigated the acute effect of EH (33 subjects), and two articles investigated the chronic effect of EH (31 subjects), ranging from 6 to 8 weeks. All studies used a cycle ergometer as exercise. Acute EH benefits insulin sensitivity, blood glucose, vascular endothelial growth factor, and metalloproteinase-9, while chronic EH benefits nitric oxide synthase in erythrocytes, but not brachial artery flow-mediated dilation. Conclusion: Acute EH improves glucose homeostasis in T2D patients, which was not seen with chronic EH. Both acute EH and chronic EH improve angiogenesis regulators, but not vascular function. Despite the putative benefits of EH in patients with T2D, the evidence is still scarce and further research is needed before recommendations can be provided.
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Affiliation(s)
- Raquel Kindlovits
- Faculty of Nutrition and Food Sciences, University of Porto (FCNAUP), Porto, Portugal
| | | | - Ana Catarina Sousa
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), University of Maia, Maia, Portugal
| | - João Luís Viana
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), University of Maia, Maia, Portugal
| | - Vitor Hugo Teixeira
- Faculty of Nutrition and Food Sciences, University of Porto (FCNAUP), Porto, Portugal.,Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sports, University of Porto (FADEUP), Portugal.,Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
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13
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Hypoxia as a Double-Edged Sword to Combat Obesity and Comorbidities. Cells 2022; 11:cells11233735. [PMID: 36496995 PMCID: PMC9736735 DOI: 10.3390/cells11233735] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/14/2022] [Accepted: 11/17/2022] [Indexed: 11/24/2022] Open
Abstract
The global epidemic of obesity is tightly associated with numerous comorbidities, such as type II diabetes, cardiovascular diseases and the metabolic syndrome. Among the key features of obesity, some studies have suggested the abnormal expansion of adipose-tissue-induced local endogenous hypoxic, while other studies indicated endogenous hyperoxia as the opposite trend. Endogenous hypoxic aggravates dysfunction in adipose tissue and stimulates secretion of inflammatory molecules, which contribute to obesity. In contrast, hypoxic exposure combined with training effectively generate exogenous hypoxic to reduce body weight and downregulate metabolic risks. The (patho)physiological effects in adipose tissue are distinct from those of endogenous hypoxic. We critically assess the latest advances on the molecular mediators of endogenous hypoxic that regulate the dysfunction in adipose tissue. Subsequently we propose potential therapeutic targets in adipose tissues and the small molecules that may reverse the detrimental effect of local endogenous hypoxic. More importantly, we discuss alterations of metabolic pathways in adipose tissue and the metabolic benefits brought by hypoxic exercise. In terms of therapeutic intervention, numerous approaches have been developed to treat obesity, nevertheless durability and safety remain the major concern. Thus, a combination of the therapies that suppress endogenous hypoxic with exercise plans that augment exogenous hypoxic may accelerate the development of more effective and durable medications to treat obesity and comorbidities.
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14
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Effects of Six Weeks of Hypoxia Exposure on Hepatic Fatty Acid Metabolism in ApoE Knockout Mice Fed a High-Fat Diet. LIFE (BASEL, SWITZERLAND) 2022; 12:life12101535. [PMID: 36294970 PMCID: PMC9605121 DOI: 10.3390/life12101535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/08/2022] [Accepted: 09/28/2022] [Indexed: 11/05/2022]
Abstract
Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease with a characteristic of abnormal lipid metabolism. In the present study, we employed apolipoprotein E knockout (ApoE KO) mice to investigate the effects of hypoxia exposure on hepatic fatty acid metabolism and to test whether a high-fat diet (HFD) would suppress the beneficial effect caused by hypoxia treatment. ApoE KO mice were fed a HFD for 12 weeks, and then were forwarded into a six-week experiment with four groups: HFD + normoxia, normal diet (ND) + normoxia, HFD + hypoxia exposure (HE), and ND + HE. The C57BL/6J wild type (WT) mice were fed a ND for 18 weeks as the baseline control. The hypoxia exposure was performed in daytime with normobaric hypoxia (11.2% oxygen, 1 h per time, three times per week). Body weight, food and energy intake, plasma lipid profiles, hepatic lipid contents, plasma alanine aminotransferase (ALT) and aspartate aminotransferase (AST), and molecular/biochemical makers and regulators of the fatty acid synthesis and oxidation in the liver were measured at the end of interventions. Six weeks of hypoxia exposure decreased plasma triglycerides (TG), total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-C) contents but did not change hepatic TG and non-esterified fatty acid (NEFA) levels in ApoE KO mice fed a HFD or ND. Furthermore, hypoxia exposure decreased the mRNA expression of Fasn, Scd1, and Srebp-1c significantly in the HFD + HE group compared with those in the HFD + normoxia group; after replacing a HFD with a ND, hypoxia treatment achieved more significant changes in the measured variables. In addition, the protein expression of HIF-1α was increased only in the ND + HE group but not in the HFD + HE group. Even though hypoxia exposure did not affect hepatic TG and NEFA levels, at the genetic level, the intervention had significant effects on hepatic metabolic indices of fatty acid synthesis, especially in the ND + HE group, while HFD suppressed the beneficial effect of hypoxia on hepatic lipid metabolism in male ApoE KO mice. The dietary intervention of shifting HFD to ND could be more effective in reducing hepatic lipid accumulation than hypoxia intervention.
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15
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Sprint Interval Exercise Improves Cognitive Performance Unrelated to Postprandial Glucose Fluctuations at Different Levels of Normobaric Hypoxia. J Clin Med 2022; 11:jcm11113159. [PMID: 35683546 PMCID: PMC9181000 DOI: 10.3390/jcm11113159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/30/2022] [Accepted: 05/30/2022] [Indexed: 12/10/2022] Open
Abstract
Objective: The aim of our study was to examine cognition response to sprint interval exercise (SIE) against different levels of hypoxia. Research design and methods: 26 recreational active males performed SIE (20 × 6 s of all-out cycling bouts, 15 s of passive recovery) under normoxia (FIO2: 0.209), moderate hypoxia (FIO2: 0.154), and severe hypoxia (FIO2: 0.112) in a single-blinded crossover design. Cognitive function and blood glucose were assessed before and after 0, 10, 30, and 60 min of the SIE. Heart rate (HR), peripheral oxygen saturation (SpO2), and ratings of perceived exertion (RPE, the Borg 6−20-point scale) during each SIE trial were recorded before and immediately after every five cycling bouts, and after 0, 10, 30, and 60 min of the SIE. Results: All the three SIE trials had a significantly faster overall reaction time in the Stroop test at 10 min after exercise as compared to that of the baseline value (p = 0.003, ƞ2 = 0.606), and returned to normal after 60 min. The congruent RT at 10 min after SIE was significantly shorter than that of the baseline (p < 0.05, ƞ2 = 0.633), while the incongruent RT at both 10 min and 30 min were significantly shorter than that measured at baseline (p < 0.05, ƞ2 = 0.633). No significant differences in terms of accuracy were found across the three trials at any time points (p = 0.446, ƞ2 = 0.415). Blood glucose was significantly reduced at 10 min and was sustained for at least 60 min after SIE when compared to pre-exercise in all trials (p < 0.05). Conclusions: Acute SIE improved cognitive function regardless of oxygen conditions, and the sustained improvement following SIE could last for at least 10−30 min and was unaffected by the altered blood glucose level.
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16
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Luo Y, Chen Q, Zou J, Fan J, Li Y, Luo Z. Chronic Intermittent Hypoxia Exposure Alternative to Exercise Alleviates High-Fat-Diet-Induced Obesity and Fatty Liver. Int J Mol Sci 2022; 23:ijms23095209. [PMID: 35563600 PMCID: PMC9104027 DOI: 10.3390/ijms23095209] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 05/01/2022] [Accepted: 05/04/2022] [Indexed: 01/27/2023] Open
Abstract
Obesity often concurs with nonalcoholic fatty liver disease (NAFLD), both of which are detrimental to human health. Thus far, exercise appears to be an effective treatment approach. However, its effects cannot last long and, moreover, it is difficult to achieve for many obese people. Thus, it is necessary to look into alternative remedies. The present study explored a noninvasive, easy, tolerable physical alternative. In our experiment, C57BL/6 mice were fed with a high-fat diet (HFD) to induce overweight/obesity and were exposed to 10% oxygen for one hour every day. We found that hypoxia exerted protective effects. First, it offset HFD-induced bodyweight gain and insulin resistance. Secondly, hypoxia reversed the HFD-induced enlargement of white and brown adipocytes and fatty liver, and protected liver function. Thirdly, HFD downregulated the expression of genes required for lipolysis and thermogenesis, such as UCP1, ADR3(beta3-adrenergic receptor), CPT1A, ATGL, PPARα, and PGC1α, M2 macrophage markers arginase and CD206 in the liver, and UCP1 and PPARγ in brown fat, while these molecules were upregulated by hypoxia. Furthermore, hypoxia induced the activation of AMPK, an energy sensing enzyme. Fourthly, our results showed that hypoxia increased serum levels of epinephrine. Indeed, the effects of hypoxia on bodyweight, fatty liver, and associated changes in gene expression ever tested were reproduced by injection of epinephrine and prevented by propranolol at varying degrees. Altogether, our data suggest that hypoxia triggers stress responses where epinephrine plays important roles. Therefore, our study sheds light on the hope to use hypoxia to treat the daunting disorders, obesity and NAFLD.
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Affiliation(s)
- Yunfei Luo
- Jiangxi Provincial Key Laboratory of Tumor Pathogens and Molecular Pathology, Department of Pathophysiology, Schools of Basic Sciences, Nanchang University, Nanchang 330031, China; (Y.L.); (Q.C.); (J.Z.); (J.F.); (Y.L.)
| | - Qiongfeng Chen
- Jiangxi Provincial Key Laboratory of Tumor Pathogens and Molecular Pathology, Department of Pathophysiology, Schools of Basic Sciences, Nanchang University, Nanchang 330031, China; (Y.L.); (Q.C.); (J.Z.); (J.F.); (Y.L.)
| | - Junrong Zou
- Jiangxi Provincial Key Laboratory of Tumor Pathogens and Molecular Pathology, Department of Pathophysiology, Schools of Basic Sciences, Nanchang University, Nanchang 330031, China; (Y.L.); (Q.C.); (J.Z.); (J.F.); (Y.L.)
| | - Jingjing Fan
- Jiangxi Provincial Key Laboratory of Tumor Pathogens and Molecular Pathology, Department of Pathophysiology, Schools of Basic Sciences, Nanchang University, Nanchang 330031, China; (Y.L.); (Q.C.); (J.Z.); (J.F.); (Y.L.)
| | - Yuanjun Li
- Jiangxi Provincial Key Laboratory of Tumor Pathogens and Molecular Pathology, Department of Pathophysiology, Schools of Basic Sciences, Nanchang University, Nanchang 330031, China; (Y.L.); (Q.C.); (J.Z.); (J.F.); (Y.L.)
| | - Zhijun Luo
- Jiangxi Provincial Key Laboratory of Tumor Pathogens and Molecular Pathology, Department of Pathophysiology, Schools of Basic Sciences, Nanchang University, Nanchang 330031, China; (Y.L.); (Q.C.); (J.Z.); (J.F.); (Y.L.)
- Queen Mary School, Nanchang University, Nanchang 330031, China
- Correspondence: ; Tel.: +86-158-7917-7010
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Dugan CW, Maloney SK, Abramoff KJ, Panag SS, Davis EA, Jones TW, Fournier PA. Effects of Simulated High Altitude on Blood Glucose Levels During Exercise in Individuals With Type 1 Diabetes. J Clin Endocrinol Metab 2022; 107:1375-1382. [PMID: 34935935 DOI: 10.1210/clinem/dgab881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT Current exercise guidelines for individuals with type 1 diabetes (T1D) do not consider the impact that high altitude may have on blood glucose levels (BGL) during exercise. OBJECTIVE To investigate the effect of acute hypoxia (simulated high altitude) on BGL and carbohydrate oxidation rates during moderate intensity exercise in individuals with T1D. METHODS Using a counterbalanced, repeated measures study design, 7 individuals with T1D completed 2 exercise sessions; normoxia and hypoxia (~4200 m simulated altitude). Participants cycled for 60 min on an ergometer at 45% of their sea-level V̇O2peak, and then recovered for 60 min. Before, during, and after exercise, blood samples were taken to measure glucose, lactate, and insulin levels. Respiratory gases were collected to measure carbohydrate oxidation rates. RESULTS Early during exercise (<30 min), there was no fall in BGL in either condition. After 1 h of exercise and during recovery, BGL were significantly lower under the hypoxic condition compared to both pre-exercise levels (P = 0.008) and the normoxic condition (P = 0.027). Exercise in both conditions resulted in a significant rise in carbohydrate oxidation rates, which returned to baseline levels postexercise. Before, during, and after exercise, carbohydrate oxidation rates were higher under the hypoxic compared with the normoxic condition (P < 0.001). CONCLUSIONS The greater decline in BGL during and after exercise performed under acute hypoxia suggests that exercise during acute exposure to high altitude may increase the risk of hypoglycemia in individuals with T1D. Future guidelines may have to consider the impact altitude has on exercise-mediated hypoglycemia.
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Affiliation(s)
- Cory W Dugan
- Department of Sport Science, Exercise and Health, School of Human Sciences, The University of Western Australia, Crawley, Australia
| | - Shane K Maloney
- Department of Sport Science, Exercise and Health, School of Human Sciences, The University of Western Australia, Crawley, Australia
| | - Kristina J Abramoff
- Department of Sport Science, Exercise and Health, School of Human Sciences, The University of Western Australia, Crawley, Australia
| | - Sohan S Panag
- Department of Sport Science, Exercise and Health, School of Human Sciences, The University of Western Australia, Crawley, Australia
| | - Elizabeth A Davis
- Childrens Diabetes Centre, Telethon Kids Institute, Nedlands, Australia
| | - Timothy W Jones
- Childrens Diabetes Centre, Telethon Kids Institute, Nedlands, Australia
| | - Paul A Fournier
- Department of Sport Science, Exercise and Health, School of Human Sciences, The University of Western Australia, Crawley, Australia
- Childrens Diabetes Centre, Telethon Kids Institute, Nedlands, Australia
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18
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Warnier G, De Groote E, Britto FA, Delcorte O, Nederveen JP, Nilsson MI, Pierreux CE, Tarnopolsky MA, Deldicque L. Effects of an acute exercise bout in hypoxia on extracellular vesicle release in healthy and prediabetic subjects. Am J Physiol Regul Integr Comp Physiol 2021; 322:R112-R122. [PMID: 34907783 DOI: 10.1152/ajpregu.00220.2021] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE To investigate exosome-like vesicle (ELV) plasma concentrations and markers of multivesicular body (MVB) biogenesis in skeletal muscle in response to acute exercise. METHODS Seventeen healthy (BMI: 23.5±0.5kg·m-2) and fifteen prediabetic (BMI: 27.3±1.2kg·m-2) men were randomly assigned to two groups performing an acute cycling bout in normoxia or hypoxia (FiO2 14.0%). Venous blood samples were taken before (T0), during (T30) and after (T60) exercise and biopsies from m. vastus lateralis were collected before and after exercise. Plasma ELVs were isolated by size exclusion chromatography, counted by nanoparticle tracking analysis (NTA), and characterized according to international standards, followed by expression analyses of canonical ELV markers in skeletal muscle. RESULTS In the healthy normoxic group, the total number of particles in the plasma increased during exercise from T0 to T30 (+313%) followed by a decrease from T30 to T60 (-53%). In the same group, an increase in TSG101, CD81 and HSP60 protein expression was measured after exercise in plasma ELVs; however, in the prediabetic group, the total number of particles in the plasma was not affected by exercise. The mRNA content of TSG101, ALIX and CD9 were upregulated in skeletal muscle after exercise in normoxia; whereas, CD9 and CD81 were downregulated in hypoxia. CONCLUSIONS ELV plasma abundance increased in response to acute aerobic exercise in healthy subjects in normoxia, but not in prediabetic subjects, nor in hypoxia. Skeletal muscle analyses suggested that this tissue did not likely play a major role of the exercise-induced increase in circulating ELVs.
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Affiliation(s)
- Geoffrey Warnier
- Institute of Neuroscience, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Estelle De Groote
- Institute of Neuroscience, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Florian A Britto
- Institute of Neuroscience, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Ophélie Delcorte
- CELL Unit, de Duve Institute, Université Catholique de Louvain, Brussels, Belgium
| | - Joshua P Nederveen
- Department of Pediatrics, McMaster University Medical Centre (MUMC), Hamilton, ON, Canada
| | - Mats I Nilsson
- Exerkine Corporation, McMaster University Medical Centre (MUMC), Hamilton, ON, Canada
| | | | - Mark A Tarnopolsky
- Department of Pediatrics, McMaster University Medical Centre (MUMC), Hamilton, ON, Canada
| | - Louise Deldicque
- Institute of Neuroscience, Université catholique de Louvain, Louvain-la-Neuve, Belgium
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19
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Kelly LP, Basset FA, McCarthy J, Ploughman M. Normobaric Hypoxia Exposure During Treadmill Aerobic Exercise After Stroke: A Safety and Feasibility Study. Front Physiol 2021; 12:702439. [PMID: 34483958 PMCID: PMC8415265 DOI: 10.3389/fphys.2021.702439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 07/30/2021] [Indexed: 11/23/2022] Open
Abstract
Objective To evaluate the safety and feasibility of performing treadmill aerobic exercise in moderate normobaric hypoxia among chronic hemiparetic stroke survivors. Design Observational study using convenience sampling. Setting Research laboratory in a tertiary rehabilitation hospital. Participants Chronic hemiparetic stroke survivors who could walk at least 10-m with or without assistance and had no absolute contraindications to exercise testing. Intervention Participants (three male and four female) were asked to complete three normobaric hypoxia exposure protocols within a single session. First, they were passively exposed to normobaric hypoxia through gradual reductions in the fraction of inspired oxygen (FIO2 = 20.9, 17.0, and 15.0%) while seated (5-min at each level of FIO2). Participants were then exposed to the same reductions in FIO2 during constant-load exercise performed on a treadmill at 40% of heart rate reserve. Finally, participants completed 20-min of exercise while intermittently exposed to moderate normobaric hypoxia (5 × 2-min at FIO2 = 15.0%) interspaced with 2-min normoxia intervals (FIO2 = 20.9%). Outcome Measures The primary outcome was occurrence of adverse events, which included standardized criteria for terminating exercise testing, blood oxygen saturation (SpO2) <80%, or acute mountain sickness score >2. The increased cardiovascular strain imposed by normobaric hypoxia exposure at rest and during exercise was evaluated by changes in SpO2, heart rate (HR), blood pressure, and rating of perceived exertion (RPE). Results One participant reported mild symptoms of nausea during exercise in normobaric hypoxia and discontinued participation. No other adverse events were recorded. Intermittent normobaric hypoxia exposure was associated with reduced SpO2 (MD = −7.4%, CI: −9.8 to −5.0) and increased HR (MD = 8.2, CI: 4.6 to 11.7) compared to intervals while breathing typical room air throughout the 20-min constant-load exercise period. The increase in HR was associated with a 10% increase in relative effort. However, reducing FIO2 had little effect on blood pressure and RPE measurements. Conclusion Moderate normobaric hypoxia appeared to be a safe and feasible method to increase the cardiovascular strain of submaximal exercise in chronic hemiparetic stroke survivors. Future studies evaluating the effects of pairing normobaric hypoxia exposure with existing therapies on secondary prevention and functional recovery are warranted.
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Affiliation(s)
- Liam P Kelly
- Recovery and Performance Laboratory, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada.,School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Fabien Andre Basset
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Jason McCarthy
- Recovery and Performance Laboratory, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Michelle Ploughman
- Recovery and Performance Laboratory, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
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20
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Lopez-Pascual A, Trayhurn P, Martínez JA, González-Muniesa P. Oxygen in Metabolic Dysfunction and Its Therapeutic Relevance. Antioxid Redox Signal 2021; 35:642-687. [PMID: 34036800 DOI: 10.1089/ars.2019.7901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Significance: In recent years, a number of studies have shown altered oxygen partial pressure at a tissue level in metabolic disorders, and some researchers have considered oxygen to be a (macro) nutrient. Oxygen availability may be compromised in obesity and several other metabolism-related pathological conditions, including sleep apnea-hypopnea syndrome, the metabolic syndrome (which is a set of conditions), type 2 diabetes, cardiovascular disease, and cancer. Recent Advances: Strategies designed to reduce adiposity and its accompanying disorders have been mainly centered on nutritional interventions and physical activity programs. However, novel therapies are needed since these approaches have not been sufficient to counteract the worldwide increasing rates of metabolic disorders. In this regard, intermittent hypoxia training and hyperoxia could be potential treatments through oxygen-related adaptations. Moreover, living at a high altitude may have a protective effect against the development of abnormal metabolic conditions. In addition, oxygen delivery systems may be of therapeutic value for supplying the tissue-specific oxygen requirements. Critical Issues: Precise in vivo methods to measure oxygenation are vital to disentangle some of the controversies related to this research area. Further, it is evident that there is a growing need for novel in vitro models to study the potential pathways involved in metabolic dysfunction to find appropriate therapeutic targets. Future Directions: Based on the existing evidence, it is suggested that oxygen availability has a key role in obesity and its related comorbidities. Oxygen should be considered in relation to potential therapeutic strategies in the treatment and prevention of metabolic disorders. Antioxid. Redox Signal. 35, 642-687.
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Affiliation(s)
- Amaya Lopez-Pascual
- Department of Nutrition, Food Science and Physiology, School of Pharmacy and Nutrition, Centre for Nutrition Research, University of Navarra, Pamplona, Spain.,Neuroendocrine Cell Biology, Lund University Diabetes Centre, Lund University, Malmö, Sweden
| | - Paul Trayhurn
- Obesity Biology Unit, University of Liverpool, Liverpool, United Kingdom.,Clore Laboratory, The University of Buckingham, Buckingham, United Kingdom
| | - J Alfredo Martínez
- Department of Nutrition, Food Science and Physiology, School of Pharmacy and Nutrition, Centre for Nutrition Research, University of Navarra, Pamplona, Spain.,IdiSNA, Navarra Institute for Health Research, Pamplona, Spain.,CIBERobn Physiopathology of Obesity and Nutrition, Centre of Biomedical Research Network, ISCIII, Madrid, Spain.,Precision Nutrition and Cardiometabolic Health, IMDEA Food, Madrid Institute for Advanced Studies, Madrid, Spain
| | - Pedro González-Muniesa
- Department of Nutrition, Food Science and Physiology, School of Pharmacy and Nutrition, Centre for Nutrition Research, University of Navarra, Pamplona, Spain.,IdiSNA, Navarra Institute for Health Research, Pamplona, Spain.,CIBERobn Physiopathology of Obesity and Nutrition, Centre of Biomedical Research Network, ISCIII, Madrid, Spain
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21
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Morin R, Mauger JF, Amaratunga R, Imbeault P. The effect of acute intermittent hypoxia on postprandial triglyceride levels in humans: a randomized crossover trial. J Transl Med 2021; 19:268. [PMID: 34158069 PMCID: PMC8220832 DOI: 10.1186/s12967-021-02933-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 06/09/2021] [Indexed: 12/18/2022] Open
Abstract
Background Obstructive sleep apnea (OSA), a sleep disorder frequently observed in individuals living with obesity, consists of repeated involuntary breathing obstructions during sleep, leading to intermittent hypoxia (IH). In humans, acute continuous hypoxia slightly increases plasma triglycerides (TG). However, no study yet compared the postprandial TG response of individuals with or without OSA under intermittent hypoxia. Methods Using a randomized crossover design, seven individuals diagnosed with moderate OSA and eight healthy individuals without OSA were given a meal after which they were exposed for 6 h to normoxia or intermittent hypoxia (e.g., 15 hypoxic events per hour). Blood lipid levels were measured hourly during each session. Results Peak postprandial TG concentrations tended to be 22% higher under IH irrespective of group (IH × time interaction, p = 0.068). This trend toward higher total plasma TG was attributable to increased levels of denser TG-rich lipoproteins such as very low-density lipoproteins (VLDL) and chylomicrons (CM) remnants. Irrespective of group, the postprandial TG concentrations in denser TG-rich lipoproteins was 20% higher under IH (IH × time interaction, p = 0.036), although IH had virtually no impact on denser TG-rich lipoprotein concentrations in the OSA group. Conclusion Acute intermittent hypoxia tends to negatively affect postprandial TG levels in healthy individuals, which is attributable to an increase in denser TG-carrying lipoprotein levels such as VLDL and CM remnants. This altered postprandial TG response to acute intermittent hypoxia was not observed in individuals with OSA.
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Affiliation(s)
- Renée Morin
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Jean-François Mauger
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Ruwan Amaratunga
- Institut du Savoir Montfort, Hôpital Montfort, Ottawa, ON, Canada
| | - Pascal Imbeault
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada. .,Institut du Savoir Montfort, Hôpital Montfort, Ottawa, ON, Canada. .,Behavioural and Metabolic Research Unit, School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, 200 Lees, Ottawa, ON, K1N 6N5, Canada.
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22
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van Hulten V, van Meijel RLJ, Goossens GH. The impact of hypoxia exposure on glucose homeostasis in metabolically compromised humans: A systematic review. Rev Endocr Metab Disord 2021; 22:471-483. [PMID: 33851320 PMCID: PMC8087568 DOI: 10.1007/s11154-021-09654-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/06/2021] [Indexed: 02/06/2023]
Abstract
Humans living at a higher altitude are less prone to suffer from impaired glucose homeostasis and type 2 diabetes mellitus (T2DM), which might at least partly be explained by lower oxygen availability at higher altitudes. The present systematic review aimed to provide an overview of the current literature on the effects of hypoxia exposure on glucose homeostasis in metabolically compromised humans. Several databases were searched up to August 10th, 2020. The search strategy identified 368 unique records. Following assessment for eligibility based on the selection criteria, 16 studies were included in this review. Six studies (2 controlled studies; 4 uncontrolled studies) demonstrated beneficial effects of hypoxia exposure on glucose homeostasis, while 10 studies (8 controlled studies; 2 uncontrolled studies) reported no improvement in glucose homeostasis following hypoxia exposure. Notably, passive hypoxia exposure seemed to improve glucose homeostasis, whereas hypoxic exercise training (2-8 weeks) appeared to have no additional/synergistic effects on glucose homeostasis compared to normoxia exposure. Due to the heterogeneity in study populations and intervention duration (acute studies / 2-8 wks training), it is difficult to indicate which factors may explain conflicting study outcomes. Moreover, these results should be interpreted with some caution, as several studies did not include a control group. Taken together, hypoxia exposure under resting and exercise conditions might provide a novel therapeutic strategy to improve glucose homeostasis in metabolically compromised individuals, but more randomized controlled trials are warranted before strong conclusions on the effects of hypoxia exposure on glucose homeostasis can be drawn.
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Affiliation(s)
- Veerle van Hulten
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Clinical Pharmacology and Toxicology, CARIM School for Cardiovascular Diseases, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Rens L J van Meijel
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Gijs H Goossens
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands.
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23
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Kim SW, Jung WS, Chung S, Park HY. Exercise intervention under hypoxic condition as a new therapeutic paradigm for type 2 diabetes mellitus: A narrative review. World J Diabetes 2021; 12:331-343. [PMID: 33889283 PMCID: PMC8040082 DOI: 10.4239/wjd.v12.i4.331] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 01/25/2021] [Accepted: 03/08/2021] [Indexed: 02/06/2023] Open
Abstract
This review aims to summarize the health benefits of exposure to hypoxic conditions during exercise in patients with type 2 diabetes mellitus (T2DM). Exposure to hypoxic conditions during exercise training positively changes the physiological response in healthy subjects. Exposure to hypoxic conditions during exercise could markedly increase skeletal muscle glucose uptake compared to that in normoxic conditions. Furthermore, post-exercise insulin sensitivity of T2DM patients increases more when exercising under hypoxic than under normoxic conditions. Regular exercise under short-term hypoxic conditions can improve blood glucose control at lower workloads than in normoxic conditions. Additionally, exercise training under short-term hypoxic conditions can maximize weight loss in overweight and obese patients. Previous studies on healthy subjects have reported that regular exercise under hypoxic conditions had a more positive effect on vascular health than exercising under normoxic conditions. However, currently, evidence indicating that exposure to hypoxic conditions could positively affect T2DM patients in the long-term is lacking. Therefore, further evaluations of the beneficial effects of exercise under hypoxic conditions on the human body, considering different cycle lengths, duration of exposures, sessions per day, and the number of days, are necessary. In this review, we conclude that there is evidence that exercise under hypoxic conditions can yield health benefits, which is potentially valuable in terms of clinical care as a new intervention for T2DM patients.
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Affiliation(s)
- Sung-Woo Kim
- Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul 05029, South Korea
| | - Won-Sang Jung
- Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul 05029, South Korea
| | - Sochung Chung
- Department of Pediatrics, Konkuk University Medical Center, Research Institute of Medical Science, Konkuk University, School of Medicine, Seoul 05029, South Korea
| | - Hun-Young Park
- Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul 05029, South Korea
- Department of Sports Science and Medicine, Konkuk University, Seoul 05029, South Korea
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24
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[Into thin air - Altitude training and hypoxic conditioning: From athlete to patient]. Rev Mal Respir 2021; 38:404-417. [PMID: 33722445 DOI: 10.1016/j.rmr.2021.02.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 10/15/2020] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Hypoxic exposure should be considered as a continuum, the effects of which depend on the dose and individual response to hypoxia. Hypoxic conditioning (HC) represents an innovative and promising strategy, ranging from improved human performance to therapeutic applications. STATE OF THE ART With the aim of improving sports performance, the effectiveness of hypoxic exposure, whether natural or simulated, is difficult to demonstrate because of the large variability of the protocols used. In therapeutics, the benefits of HC are described in many pathological conditions such as obesity or cardiovascular pathologies. If the HC benefits from a strong preclinical rationale, its application to humans remains limited. PERSPECTIVES Advances in training and acclimation will require greater personalization and precise periodization of hypoxic exposures. For patients, the harmonization of HC protocols, the identification of biomarkers and the development and subsequent validation of devices allowing a precise control of the hypoxic stimulus are necessary steps for the development of HC. CONCLUSIONS From the athlete to the patient, HC represents an innovative and promising field of research, ranging from the improvement of human performance to the prevention and treatment of certain pathologies.
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25
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Kayser B, Verges S. Hypoxia, energy balance, and obesity: An update. Obes Rev 2021; 22 Suppl 2:e13192. [PMID: 33470528 DOI: 10.1111/obr.13192] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 12/07/2020] [Indexed: 02/06/2023]
Abstract
Because of the enduring rise in the prevalence of obesity worldwide, there is continued interest in hypoxia as a mechanism underlying the pathophysiology of obesity and its comorbidities and as a potential therapeutic adjunct for the management of the disease. Lifelong exposure to altitude is accompanied by a lower risk for obesity, whereas altitude sojourns are generally associated with a loss of body mass. A negative energy balance upon exposure to hypoxia can be due to a combination of changes in determinants of energy expenditure (resting metabolic rate and physical activity energy expenditure) and energy intake (appetite). Over the past 15 years, the potential therapeutic interest of hypobaric or normobaric hypoxic exposure in individuals with obesity-to lower body mass and improve health status-has become an active field of research. Various protocols have been implemented, using actual altitude sojourns or intermittent normobaric hypoxic exposures, at rest or in association with physical activity. Although several studies suggest benefits on body mass and cardiovascular and metabolic variables, further investigations are required before recommending hypoxic exposure in obesity management programs. Future studies should also better clarify the effects of hypoxia on appetite, the intestinal microbiota, and finally on overall energy balance.
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Affiliation(s)
- Bengt Kayser
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Samuel Verges
- HP2 Laboratory, INSERM, Grenoble Alpes University Hospital, Université Grenoble Alpes, Grenoble, France
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26
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De Groote E, Deldicque L. Is Physical Exercise in Hypoxia an Interesting Strategy to Prevent the Development of Type 2 Diabetes? A Narrative Review. Diabetes Metab Syndr Obes 2021; 14:3603-3616. [PMID: 34413663 PMCID: PMC8370110 DOI: 10.2147/dmso.s322249] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 07/10/2021] [Indexed: 12/13/2022] Open
Abstract
Impaired metabolism is becoming one of the main causes of mortality and the identification of strategies to cure those diseases is a major public health concern. A number of therapies are being developed to treat type 2 diabetes mellitus (T2DM), but few of them focus on situations prior to diabetes. Obesity, aging and insulin resistance are all risk factors, which fortunately can be reversed to some extent. Non-drug interventions, such as exercise, are interesting strategies to prevent the onset of diabetes, but it remains to determine the optimal dose and conditions. In the search of optimizing the effects of physical exercise to prevent T2DM, hypoxic training has emerged as an interesting and original strategy. Several recent studies have chosen to look at the effects of hypoxic training in people at risk of developing T2DM. Therefore, the purpose of this narrative review is to give an overview of all original articles having tested the effects of a single exercise or exercise training in hypoxia on glucose metabolism and other health-related parameters in people at risk of developing T2DM. Taken together, the data on the effects of hypoxic training on glucose metabolism, insulin sensitivity and the health status of people at risk of T2DM are inconclusive. Some studies show that hypoxic training can improve glucose metabolism and the health status to a greater extent than normoxic training, while others do not corroborate the latter. When an additional benefit of hypoxic vs normoxic training is found, it still remains to determine which signaling pathways and molecular mechanisms are involved.
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Affiliation(s)
- Estelle De Groote
- Institute of Neuroscience, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Louise Deldicque
- Institute of Neuroscience, Université catholique de Louvain, Louvain-la-Neuve, Belgium
- Correspondence: Louise Deldicque Institute of Neuroscience, Université catholique de Louvain, Place Pierre de Coubertin, 1 Box L08.10.01, Louvain-la-Neuve, 1348, BelgiumTel +32 10 47 44 43 Email
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27
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De Groote E, Britto FA, Balan E, Warnier G, Thissen JP, Nielens H, Sylow L, Deldicque L. Effect of hypoxic exercise on glucose tolerance in healthy and prediabetic adults. Am J Physiol Endocrinol Metab 2021; 320:E43-E54. [PMID: 33103453 DOI: 10.1152/ajpendo.00263.2020] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This study aimed to investigate the mechanisms known to regulate glucose homeostasis in human skeletal muscle of healthy and prediabetic subjects exercising in normobaric hypoxia. Seventeen healthy (H; 28.8 ± 2.4 yr; maximal oxygen consumption (V̇O2max): 45.1 ± 1.8 mL·kg-1·min-1) and 15 prediabetic (P; 44.6 ± 3.9 yr; V̇O2max: 30.8 ± 2.5 mL·kg-1·min-1) men were randomly assigned to two groups performing an acute exercise bout (heart rate corresponding to 55% V̇O2max) either in normoxic (NE) or in hypoxic (HE; fraction of inspired oxygen [Formula: see text] 14.0%) conditions. An oral glucose tolerance test (OGTT) was performed in a basal state and after an acute exercise bout. Muscle biopsies from m. vastus lateralis were taken before and after exercise. Venous blood samples were taken at regular intervals before, during, and after exercise. The two groups exercising in hypoxia had a larger area under the curve of blood glucose levels during the OGTT after exercise compared with baseline (H: +11%; P: +4%). Compared with pre-exercise, an increase in p-TBC1D1 Ser237 and in p-AMPK Thr172 was observed postexercise in P NE (+95%; +55%, respectively) and H HE (+91%; +43%, respectively). An increase in p-ACC Ser212 was measured after exercise in all groups (H NE: +228%; P NE: +252%; H HE: +252%; P HE: +208%). Our results show that an acute bout of exercise in hypoxia reduces glucose tolerance in healthy and prediabetic subjects. At a molecular level, some adaptations regulating glucose transport in muscle were found in all groups without associations with glucose tolerance after exercise. The results suggest that hypoxia negatively affects glucose tolerance postexercise through unidentified mechanisms.NEW & NOTEWORTHY The molecular mechanisms involved in glucose tolerance after acute exercise in hypoxia have not yet been elucidated in human. Due to the reversible character of their status, prediabetic individuals are of particular interest for preventing the development of type 2 diabetes. The present study is the first to investigate muscle molecular mechanisms during exercise and glucose metabolism after exercise in prediabetic and healthy subjects exercising in normoxia and normobaric hypoxia.
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Affiliation(s)
- Estelle De Groote
- Institute of Neuroscience, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Florian A Britto
- Institute of Neuroscience, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Estelle Balan
- Institute of Neuroscience, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Geoffrey Warnier
- Institute of Neuroscience, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Jean-Paul Thissen
- Departement of Diabetology and Nutrition, Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, Brussels, Belgium
| | - Henri Nielens
- Institute of Neuroscience, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Lykke Sylow
- Molecular Physiology Group, Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Louise Deldicque
- Institute of Neuroscience, Université catholique de Louvain, Louvain-la-Neuve, Belgium
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Hein M, Chobanyan-Jürgens K, Tegtbur U, Engeli S, Jordan J, Haufe S. Effect of normobaric hypoxic exercise on blood pressure in old individuals. Eur J Appl Physiol 2020; 121:817-825. [PMID: 33355713 PMCID: PMC7892684 DOI: 10.1007/s00421-020-04572-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 11/25/2020] [Indexed: 12/28/2022]
Abstract
Purpose To test the hypothesis that the combination of endurance training and hypoxia leads to greater improvements in resting and exercise blood pressure in old sedentary individuals compared to endurance training only. Methods We randomly assigned 29 old overweight participants (age: 62 ± 6 years, body mass index (BMI): 28.5 ± 0.5 kg/m2, 52% men) to single blind 8-week bicycle exercise in hypoxia (fraction of inspired oxygen (FIO2) = 0.15) or normoxia (FIO2 = 0.21). Brachial blood pressure was measured at rest, during maximal incremental exercise testing, and during a 30 min constant work rate test, at baseline and after the training period. Results Work rate, heart rate and perceived exertion during training were similar in both groups, with lower oxygen saturation for participants exercising under hypoxia (88.7 ± 1.5 vs. 96.2 ± 1.2%, t(27) = − 13.04, p < 0.001, |g|= 4.85). Office blood pressure and blood pressure during incremental exercise tests did not change significantly in either group after the training program. Systolic blood pressure during the constant work rate test was reduced after training in hypoxia (160 ± 18 vs. 151 ± 14 mmHg, t(13) = 2.44 p < 0.05, |d|= 0.55) but not normoxia (154 ± 22 vs. 150 ± 16 mmHg, t(14) = 0.75, p = 0.46, |d|= 0.18) with no difference between groups over time (F = 0.08, p = 0.77, η2 = 0.01). Conclusion In old individuals hypoxia in addition to exercise does not have superior effects on office or exercise blood pressure compared to training in normoxia. Trial registration number ClinicalTrials.gov No. NCT02196623 (registered 22 July 2014).
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Affiliation(s)
- Markus Hein
- Institute of Sports Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Kristine Chobanyan-Jürgens
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany.,Department of Clinical Pharmacology and Pharmacoepidemiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Uwe Tegtbur
- Institute of Sports Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Stefan Engeli
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
| | - Jens Jordan
- Institute of Aerospace Medicine, German Aerospace Center and University of Cologne, Cologne, Germany
| | - Sven Haufe
- Institute of Sports Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
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Sumi D, Hayashi N, Yatsutani H, Goto K. Exogenous glucose oxidation during endurance exercise in hypoxia. Physiol Rep 2020; 8:e14457. [PMID: 32652803 PMCID: PMC7354086 DOI: 10.14814/phy2.14457] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 04/27/2020] [Accepted: 04/30/2020] [Indexed: 12/22/2022] Open
Abstract
Purpose Endurance exercise in hypoxia promotes carbohydrate (CHO) metabolism. However, detailed CHO metabolism remains unclear. The purpose of this study was to evaluate the effects of endurance exercise in moderate hypoxia on exogenous glucose oxidation at the same energy expenditure or relative exercise intensity. Methods Nine active healthy males completed three trials on different days, consisting of 30 min of running at each exercise intensity: (a) exercise at 65% of normoxic maximal oxygen uptake in normoxia [NOR, fraction of inspired oxygen (FiO2) = 20.9%, 10.6 ± 0.3 km/h], (b) exercise at the same relative exercise intensity with NOR in hypoxia (HYPR, FiO2 = 14.5%, 9.4 ± 0.3 km/h), and (c) exercise at the same absolute exercise intensity with NOR in hypoxia (HYPA, FiO2 = 14.5%, 10.6 ± 0.3 km/h). The subjects consumed 113C‐labeled glucose immediately before exercise, and expired gas samples were collected during exercise to determine 13C‐excretion (calculated by 13CO2/12CO2). Results The exercise‐induced increase in blood lactate was significantly augmented in the HYPA than in the NOR and HYPR (p = .001). HYPA involved a significantly higher respiratory exchange ratio (RER) during exercise compared with the other two trials (p < .0001). In contrast, exogenous glucose oxidation (13C‐excretion) during exercise was significantly lower in the HYPA than in the NOR (p = .03). No significant differences were observed in blood lactate elevation, RER, or exogenous glucose oxidation between NOR and HYPR. Conclusion Endurance exercise in moderate hypoxia caused a greater exercise‐induced blood lactate elevation and RER compared with the running exercise at same absolute exercise intensity in normoxia. However, exogenous glucose oxidation (13C‐excretion) during exercise was attenuated compared with the same exercise in normoxia.
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Affiliation(s)
- Daichi Sumi
- Graduate School of Sports and Health Science, Ritsumeikan University, Kusatsu, Shiga, Japan.,Research Fellow of Japan Society for the Promotion of Science, Chiyodaku, Japan
| | - Nanako Hayashi
- Graduate School of Sports and Health Science, Ritsumeikan University, Kusatsu, Shiga, Japan
| | - Haruka Yatsutani
- Graduate School of Sports and Health Science, Ritsumeikan University, Kusatsu, Shiga, Japan
| | - Kazushige Goto
- Graduate School of Sports and Health Science, Ritsumeikan University, Kusatsu, Shiga, Japan.,Faculty of Sports and Health Science, Ritsumeikan University, Kusatsu, Shiga, Japan
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Chacaroun S, Borowik A, Doutreleau S, Belaidi E, Wuyam B, Tamisier R, Pépin JL, Flore P, Verges S. Cardiovascular and metabolic responses to passive hypoxic conditioning in overweight and mildly obese individuals. Am J Physiol Regul Integr Comp Physiol 2020; 319:R211-R222. [PMID: 32609532 DOI: 10.1152/ajpregu.00311.2019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Although severe intermittent hypoxia (IH) is well known to induce deleterious cardiometabolic consequences, moderate IH may induce positive effects in obese individuals. The present study aimed to evaluate the effect of two hypoxic conditioning programs on cardiovascular and metabolic health status of overweight or obese individuals. In this randomized single-blind controlled study, 35 subjects (54 ± 9.3 yr, 31.7 ± 3.5 kg/m2) were randomized into three 8-wk interventions (three 1-h sessions per week): sustained hypoxia (SH), arterial oxygen saturation ([Formula: see text]) = 75%; IH, 5 min [Formula: see text] = 75% - 3 min normoxia; normoxia. Ventilation, heart rate, blood pressure, and tissue oxygenation were measured during the first and last hypoxic conditioning sessions. Vascular function, blood glucose and insulin, lipid profile, nitric oxide metabolites, and oxidative stress were evaluated before and after the interventions. Both SH and IH increased ventilation in hypoxia (+1.8 ± 2.1 and +2.3 ± 3.6 L/min, respectively; P < 0.05) and reduced normoxic diastolic blood pressure (-12 ± 15 and -13 ± 10 mmHg, respectively; P < 0.05), whereas changes in normoxic systolic blood pressure were not significant (+3 ± 9 and -6 ± 13 mmHg, respectively; P > 0.05). IH only reduced heart rate variability (e.g., root-mean-square difference of successive normal R-R intervals in normoxia -21 ± 35%; P < 0.05). Both SH and IH induced no significant change in body mass index, vascular function, blood glucose, insulin and lipid profile, nitric oxide metabolites, or oxidative stress, except for an increase in superoxide dismutase activity following SH. This study indicates that passive hypoxic conditioning in obese individuals induces some positive cardiovascular and respiratory improvements despite no change in anthropometric data and even a reduction in heart rate variability during IH exposure.
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Affiliation(s)
- Samarmar Chacaroun
- HP2 laboratory, Univiversité Grenoble Alpes, INSERM, CHU Grenoble Alpes, Grenoble, France
| | - Anna Borowik
- HP2 laboratory, Univiversité Grenoble Alpes, INSERM, CHU Grenoble Alpes, Grenoble, France
| | - Stephane Doutreleau
- HP2 laboratory, Univiversité Grenoble Alpes, INSERM, CHU Grenoble Alpes, Grenoble, France
| | - Elise Belaidi
- HP2 laboratory, Univiversité Grenoble Alpes, INSERM, CHU Grenoble Alpes, Grenoble, France
| | - Bernard Wuyam
- HP2 laboratory, Univiversité Grenoble Alpes, INSERM, CHU Grenoble Alpes, Grenoble, France
| | - Renaud Tamisier
- HP2 laboratory, Univiversité Grenoble Alpes, INSERM, CHU Grenoble Alpes, Grenoble, France
| | - Jean-Louis Pépin
- HP2 laboratory, Univiversité Grenoble Alpes, INSERM, CHU Grenoble Alpes, Grenoble, France
| | - Patrice Flore
- HP2 laboratory, Univiversité Grenoble Alpes, INSERM, CHU Grenoble Alpes, Grenoble, France
| | - Samuel Verges
- HP2 laboratory, Univiversité Grenoble Alpes, INSERM, CHU Grenoble Alpes, Grenoble, France
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Park Y, Jang I, Park HY, Kim J, Lim K. Hypoxic exposure can improve blood glycemic control in high-fat diet-induced obese mice. Phys Act Nutr 2020; 24:19-23. [PMID: 32408410 PMCID: PMC7451840 DOI: 10.20463/pan.2020.0004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 03/26/2020] [Accepted: 03/26/2020] [Indexed: 12/27/2022] Open
Abstract
PURPOSE Blood glucose and insulin resistance were lower following hypoxic exposure in previous studies. However, the effect of hypoxia as therapy in obese model has not been unknown. METHODS Six-week-old mice were randomly divided into chow diet (n=10) and high-fat diet (HFD) groups (n=20). The chow diet group received a non-purified commercial diet (65 % carbohydrate, 21 % protein, and 14 % fat) and water ad libitum. The HFD group was fed an HFD (Research Diet, #D12492; 60% kcal from fat, 5.24 kcal/g). Both groups consumed their respective diet for 7 weeks. Subsequently, HFD-induced mice (12-weeks-old) were randomly divided into two treatment groups : HFD-Normoxia (HFD; n=10) and HFD-Hypoxia (HYP; n=10, fraction of inspired=14.6%). After treatment for 4 weeks, serum glucose, insulin and oral glucose tolerance tests (OGTT) were performed. RESULTS Homeostatic model assessment values for insulin resistance (HOMA-IR) of the HYP group tended to be lower than the HFD group. Regarding the OGTT, the area under the curve was 13% lower for the HYP group than the HFD group. CONCLUSION Insulin resistance tended to be lower and glucose uptake capacity was significantly augmented under hypoxia. From a clinical perspective, exposure to hypoxia may be a practical method of treating obesity.
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Affiliation(s)
- Yeram Park
- Department of Physical Education in Graduated school, Konkuk University, SeoulRepublic of Korea
| | - Inkwon Jang
- Department of Sports Medicine and Science in Graduated School, Konkuk University, SeoulRepublic of Korea
| | - Hun-Young Park
- Department of Sports Medicine and Science in Graduated School, Konkuk University, SeoulRepublic of Korea
| | - Jisu Kim
- Department of Sports Medicine and Science in Graduated School, Konkuk University, SeoulRepublic of Korea
| | - Kiwon Lim
- Department of Physical Education in Graduated school, Konkuk University, SeoulRepublic of Korea
- Department of Sports Medicine and Science in Graduated School, Konkuk University, SeoulRepublic of Korea
- Physical Activity and Performance Institute (PAPI), Konkuk University, SeoulRepublic of Korea
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Tobin B, Costalat G, Renshaw GMC. Intermittent not continuous hypoxia provoked haematological adaptations in healthy seniors: hypoxic pattern may hold the key. Eur J Appl Physiol 2020; 120:707-718. [DOI: 10.1007/s00421-020-04310-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 01/27/2020] [Indexed: 02/04/2023]
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Britto FA, De Groote E, Aranda J, Bullock L, Nielens H, Deldicque L. Effects of a 30-week combined training program in normoxia and in hypoxia on exercise performance and health-related parameters in obese adolescents: a pilot study. J Sports Med Phys Fitness 2020; 60:601-609. [PMID: 32037783 DOI: 10.23736/s0022-4707.20.10190-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND A light but regular combined training program is sufficient to improve health in obese adolescents. Hypoxia is known to potentiate the effects of a high intensity period of combined training on exercise performance and glucose metabolism in this population. Here, we tested the effects of a less intensive hypoxic combined training program on exercise performance and health-related markers in obese adolescents. METHODS Fourteen adolescents volunteered to participate to a 30-week combined training protocol whether in normoxia (FiO2 21%, NE, N.=7) or in hypoxia (FiO2 15%, HE, N.=7). Once a week, adolescents exercised for 50-60min including 12min on a cycloergometer and strength training of the abdominal, quadriceps and biceps muscles. RESULTS Combined training reduced body mass (NE: -12%; HE: -8%), mainly due to a loss in fat mass (NE: -26%; HE: -15%), similarly in both the hypoxic and normoxic groups. After training, maximal O2 consumption (VO2max) (NE: +30%; HE: +25%,), maximal aerobic power (MAP) (NE: +20%; HE: +36%), work capacity and one-repetition maximum (1RM) for the quadriceps (NE: +26%; HE: +12%), abdominal (NE: +48%; HE: +36%) and biceps muscles (NE: +26%; HE: +16%) were increased similarly in both groups but insulin sensitivity markers were not modified. CONCLUSIONS Except for insulin sensitivity, 1h a week of combined training for 30 weeks improved morphological and health-related markers as well as exercise performance in obese adolescents in both normoxic and hypoxic conditions. This is of particular importance for motivating those adolescents, who often are reluctant to exercise. Even a low dose of exercise per week can induce positive health outcomes.
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Affiliation(s)
- Florian A Britto
- Institute of Neuroscience, Catholic University of Louvain, Louvain-la-Neuve, Belgium
| | - Estelle De Groote
- Institute of Neuroscience, Catholic University of Louvain, Louvain-la-Neuve, Belgium
| | - Jaime Aranda
- Institute of Neuroscience, Catholic University of Louvain, Louvain-la-Neuve, Belgium.,Exercise Science Laboratory, School of Kinesiology, Faculty of Medicine, Finis Terrae University, Santiago, Chile
| | - Loïc Bullock
- Clairs Vallons Pediatric Medical Center, Louvain-la-Neuve, Belgium
| | - Henri Nielens
- Institute of Neuroscience, Catholic University of Louvain, Louvain-la-Neuve, Belgium
| | - Louise Deldicque
- Institute of Neuroscience, Catholic University of Louvain, Louvain-la-Neuve, Belgium -
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Lempesis IG, Meijel RLJ, Manolopoulos KN, Goossens GH. Oxygenation of adipose tissue: A human perspective. Acta Physiol (Oxf) 2020; 228:e13298. [PMID: 31077538 PMCID: PMC6916558 DOI: 10.1111/apha.13298] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 05/03/2019] [Accepted: 05/08/2019] [Indexed: 12/13/2022]
Abstract
Obesity is a complex disorder of excessive adiposity, and is associated with adverse health effects such as cardiometabolic complications, which are to a large extent attributable to dysfunctional white adipose tissue. Adipose tissue dysfunction is characterized by adipocyte hypertrophy, impaired adipokine secretion, a chronic low‐grade inflammatory status, hormonal resistance and altered metabolic responses, together contributing to insulin resistance and related chronic diseases. Adipose tissue hypoxia, defined as a relative oxygen deficit, in obesity has been proposed as a potential contributor to adipose tissue dysfunction, but studies in humans have yielded conflicting results. Here, we will review the role of adipose tissue oxygenation in the pathophysiology of obesity‐related complications, with a specific focus on human studies. We will provide an overview of the determinants of adipose tissue oxygenation, as well as the role of adipose tissue oxygenation in glucose homeostasis, lipid metabolism and inflammation. Finally, we will discuss the putative effects of physiological and experimental hypoxia on adipose tissue biology and whole‐body metabolism in humans. We conclude that several lines of evidence suggest that alteration of adipose tissue oxygenation may impact metabolic homeostasis, thereby providing a novel strategy to combat chronic metabolic diseases in obese humans.
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Affiliation(s)
- Ioannis G. Lempesis
- College of Medical and Dental Sciences, Institute of Metabolism and Systems Research (IMSR) University of Birmingham Birmingham UK
- Centre for Endocrinology, Diabetes and Metabolism Birmingham Health Partners Birmingham UK
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism Maastricht University Medical Centre Maastricht the Netherlands
| | - Rens L. J. Meijel
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism Maastricht University Medical Centre Maastricht the Netherlands
| | - Konstantinos N. Manolopoulos
- College of Medical and Dental Sciences, Institute of Metabolism and Systems Research (IMSR) University of Birmingham Birmingham UK
- Centre for Endocrinology, Diabetes and Metabolism Birmingham Health Partners Birmingham UK
| | - Gijs H. Goossens
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism Maastricht University Medical Centre Maastricht the Netherlands
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Chobanyan-Jürgens K, Scheibe RJ, Potthast AB, Hein M, Smith A, Freund R, Tegtbur U, Das AM, Engeli S, Jordan J, Haufe S. Influences of Hypoxia Exercise on Whole-Body Insulin Sensitivity and Oxidative Metabolism in Older Individuals. J Clin Endocrinol Metab 2019; 104:5238-5248. [PMID: 30942862 DOI: 10.1210/jc.2019-00411] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 03/28/2019] [Indexed: 12/11/2022]
Abstract
CONTEXT Aging is a primary risk factor for most chronic diseases, including type 2 diabetes. Both exercise and hypoxia regulate pathways that ameliorate age-associated metabolic muscle dysfunction. OBJECTIVE We hypothesized that the combination of hypoxia and exercise would be more effective in improving glucose metabolism than normoxia exercise. DESIGN AND PARTICIPANTS We randomized 29 older sedentary individuals (62 ± 6 years; 14 women, 15 men) to bicycle exercise under normobaric hypoxia (fraction of inspired oxygen = 15%) or normoxia (fraction of inspired oxygen = 21%). INTERVENTION Participants trained thrice weekly for 30 to 40 minutes over 8 weeks at a heart rate corresponding to 60% to 70% of peak oxygen update. MAIN OUTCOME MEASURES Insulin sensitivity measured by hyperinsulinemic-euglycemic glucose clamp and muscle protein expression before and after hyperinsulinemic-euglycemic glucose clamp. RESULTS Heart rate and perceived exertion during training were similar between groups, with lower oxygen saturation when exercising under hypoxia (88.7 ± 1.5 vs 96.2 ± 1.2%, P < 0.01). Glucose infusion rate after 8 weeks increased in both the hypoxia (5.7 ± 1.1 to 6.7 ± 1.3 mg/min/kg; P < 0.01) and the normoxia group (6.2 ± 2.1 to 6.8 ± 2.1 mg/min/kg; P = 0.04), with a mean difference between groups of -0.44 mg/min/kg; 95% CI, -1.22 to 0.34; (P = 0.25). Markers of mitochondrial content and oxidative capacity in skeletal muscle were similar after training in both groups. Changes in Akt phosphorylation and glucose transporter 4 under fasting and insulin-stimulated conditions were not different between groups over time. CONCLUSIONS Eight weeks of hypoxia endurance training led to similar changes in insulin sensitivity and markers of oxidative metabolism compared with normoxia training. Normobaric hypoxia exercise did not enhance metabolic effects in sedentary older women and men beyond exercise alone.
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Affiliation(s)
- Kristine Chobanyan-Jürgens
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
- Department of Clinical Pharmacology and Pharmacoepidemiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Renate J Scheibe
- Institute of Cell Biochemistry, Hannover Medical School, Hannover, Germany
| | - Arne B Potthast
- Department of Pediatrics, Pediatric Metabolic Medicine, Hannover Medical School, Hannover, Germany
| | - Markus Hein
- Institute of Sports Medicine, Hannover Medical School, Hannover, Germany
| | - Andrea Smith
- Institute of Biometry, Hannover Medical School, Hannover, Germany
| | - Robert Freund
- Institute of Cell Biochemistry, Hannover Medical School, Hannover, Germany
| | - Uwe Tegtbur
- Institute of Sports Medicine, Hannover Medical School, Hannover, Germany
| | - Anibh M Das
- Department of Pediatrics, Pediatric Metabolic Medicine, Hannover Medical School, Hannover, Germany
| | - Stefan Engeli
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
| | - Jens Jordan
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
- Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
| | - Sven Haufe
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
- Institute of Sports Medicine, Hannover Medical School, Hannover, Germany
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Relationship Between Intermittent Hypoxia and Type 2 Diabetes in Sleep Apnea Syndrome. Int J Mol Sci 2019; 20:ijms20194756. [PMID: 31557884 PMCID: PMC6801686 DOI: 10.3390/ijms20194756] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 09/13/2019] [Accepted: 09/23/2019] [Indexed: 12/17/2022] Open
Abstract
Sleep apnea syndrome (SAS) is a very common disease involving intermittent hypoxia (IH), recurrent symptoms of deoxygenation during sleep, strong daytime sleepiness, and significant loss of quality of life. A number of epidemiological researches have shown that SAS is an important risk factor for insulin resistance and type 2 diabetes mellitus (DM), which is associated with SAS regardless of age, gender, or body habitus. IH, hallmark of SAS, plays an important role in the pathogenesis of SAS and experimental studies with animal and cellular models indicate that IH leads to attenuation of glucose-induced insulin secretion from pancreatic β cells and to enhancement of insulin resistance in peripheral tissues and cells, such as liver (hepatocytes), adipose tissue (adipocytes), and skeletal muscles (myocytes). In this review, we focus on IH-induced dysfunction in glucose metabolism and its underlying molecular mechanisms in several cells and tissues related to glucose homeostasis.
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Kimura H, Ota H, Kimura Y, Takasawa S. Effects of Intermittent Hypoxia on Pulmonary Vascular and Systemic Diseases. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16173101. [PMID: 31455007 PMCID: PMC6747246 DOI: 10.3390/ijerph16173101] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 08/19/2019] [Accepted: 08/21/2019] [Indexed: 12/21/2022]
Abstract
Obstructive sleep apnea (OSA) causes many systemic disorders via mechanisms related to sympathetic nerve activation, systemic inflammation, and oxidative stress. OSA typically shows repeated sleep apnea followed by hyperventilation, which results in intermittent hypoxia (IH). IH is associated with an increase in sympathetic activity, which is a well-known pathophysiological mechanism in hypertension and insulin resistance. In this review, we show the basic and clinical significance of IH from the viewpoint of not only systemic regulatory mechanisms focusing on pulmonary circulation, but also cellular mechanisms causing lifestyle-related diseases. First, we demonstrate how IH influences pulmonary circulation to cause pulmonary hypertension during sleep in association with sleep state-specific change in OSA. We also clarify how nocturnal IH activates circulating monocytes to accelerate the infiltration ability to vascular wall in OSA. Finally, the effects of IH on insulin secretion and insulin resistance are elucidated by using an in vitro chamber system that can mimic and manipulate IH. The obtained data implies that glucose-induced insulin secretion (GIS) in pancreatic β cells is significantly attenuated by IH, and that IH increases selenoprotein P, which is one of the hepatokines, as well as TNF-α, CCL-2, and resistin, members of adipokines, to induce insulin resistance via direct cellular mechanisms. Clinical and experimental findings concerning IH give us productive new knowledge of how lifestyle-related diseases and pulmonary hypertension develop during sleep.
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Affiliation(s)
- Hiroshi Kimura
- Department of Advanced Medicine for Pulmonary Circulation and Respiratory Failure, Graduate School of Medicine, Nippon Medical School, Bunkyo, Tokyo 113-8603, Japan.
| | - Hiroyo Ota
- Department of Respiratory Medicine, Nara Medical University, Kashihara, Nara 634-8522, Japan
| | - Yuya Kimura
- Center for Pulmonary Diseases, NHO Tokyo National Hospital, Kiyose, Tokyo 204-0023, Japan
| | - Shin Takasawa
- Department of Biochemistry, Nara Medical University, Kashihara, Nara 634-8521, Japan
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Two weeks of moderate hypoxia improves glucose tolerance in individuals with type 2 diabetes. Int J Obes (Lond) 2019; 44:744-747. [PMID: 31324880 DOI: 10.1038/s41366-019-0422-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 06/05/2019] [Accepted: 06/17/2019] [Indexed: 12/31/2022]
Abstract
We previously showed that nightly exposure to moderate hypoxia reduces fasting glucose levels and improves both whole-body skeletal muscle and hepatic insulin sensitivity in individuals with obesity. The goal of this study was to extend this observation in an "at home" setting and determine if nightly exposure to moderate hypoxia improves glucose tolerance in individuals with type 2 diabetes. Eight adults, ages 20-65 years with type 2 diabetes enrolled in our study and slept for 14 consecutive nights at home in a hypoxic tent maintained at 15% O2 (~2400 m). The primary endpoint was insulin sensitivity (Matsuda Index) calculated from a 75-g oral glucose tolerance test. Secondary endpoints included calculations of insulin secretion and beta-cell function, including the area-under-the-curve (AUC) for glucose and insulin, the Insulinogenic Index, and the Disposition Index. We observed the Matsuda Index trended towards a 29% increase following 14 nights of moderate hypoxia (from 1.7 ± 0.7 to 2.2 ± 1.7; p = 0.06). Two-hour glucose AUC was significantly reduced from 501 ± 99 to 439 ± 65 mg/dL × h (p = 0.01). We conclude that 14 nights of moderate hypoxia improves glucose tolerance in individuals with type 2 diabetes. Future studies should confirm whether exposure to moderate hypoxia consistently improves glucose homeostasis in larger sample sizes.
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Krueger K, Catanese L, Scholz H. Intermittent hypoxia: Friend and foe. Acta Physiol (Oxf) 2019; 226:e13276. [PMID: 30892796 DOI: 10.1111/apha.13276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 03/15/2019] [Indexed: 12/18/2022]
Affiliation(s)
- Katharina Krueger
- Institut für Vegetative Physiologie, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Lorenzo Catanese
- Institut für Vegetative Physiologie, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Holger Scholz
- Institut für Vegetative Physiologie, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Ramos-Campo DJ, Girard O, Pérez A, Rubio-Arias JÁ. Additive stress of normobaric hypoxic conditioning to improve body mass loss and cardiometabolic markers in individuals with overweight or obesity: A systematic review and meta-analysis. Physiol Behav 2019; 207:28-40. [PMID: 31047948 DOI: 10.1016/j.physbeh.2019.04.027] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 04/26/2019] [Accepted: 04/27/2019] [Indexed: 02/07/2023]
Abstract
We performed a systematic review and meta-analysis to determine if hypoxic conditioning, compared to similar training near sea level, maximizes body mass loss and further improves cardiometabolic markers in overweight and obese individuals. A systematic search of PubMed, Web of Science and the Cochrane Library databases (up to January 2019) was performed. This analysis included randomized controlled trials with humans with overweight or obesity assessing the effects of HC on body mass loss or cardiometabolic markers. A subgroup analysis was performed to examine if HC effects differed between individuals with overweight or obesity. 13 articles (336 participants) qualified for inclusion. HC significantly decreased body mass (p = .01), fat mass (p = .04), waist/hip ratio (p < .001), waist (p < .001), LDL (p = .01), diastolic (p < .01) and systolic blood pressure (p < .01) with these effects not being larger than equivalent normoxic interventions. There were trends towards higher triglycerides decrement (p = .06) and higher muscle mass gain in hypoxic (p = .08) compared with normoxic condition. Also, the two BMI categories displayed no difference in the magnitude of the responses. Compared to normoxic equivalent, HC provides greater reductions in triglycerides and greater muscle growth, while body mass changes are similar. In addition, HC responses were essentially similar between individuals with overweight or obesity.
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Affiliation(s)
- Domingo J Ramos-Campo
- Department of Physical Activity and Sports Sciences, Faculty of Sports, UCAM, Catholic University San Antonio, Murcia, Spain.
| | - Olivier Girard
- Murdoch Applied Sport Science Laboratory, Murdoch University, Perth, Australia
| | - Andrés Pérez
- UCAM Research Centre for High Performance Sport, Catholic University San Antonio, Murcia, Spain
| | - Jacobo Á Rubio-Arias
- Department of Physical Activity and Sports Sciences, Faculty of Sports, UCAM, Catholic University San Antonio, Murcia, Spain
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Camacho-Cardenosa M, Camacho-Cardenosa A, Brazo-Sayavera J, Guerrero-Flores S, Olcina G, Timón R. Repeated-sprint training under cyclic hypoxia improves body composition in healthy women. J Sports Med Phys Fitness 2019; 59:1700-1708. [PMID: 30722657 DOI: 10.23736/s0022-4707.18.09368-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND To investigate if the cyclic hypoxia exposure combined with repeat-sprints training would be more effective in reducing body fat of health women than the same protocols performed in normoxia. METHODS Twelve female volunteers were randomly divided into two groups: 1) repeated-sprint in hypoxia (RSH; N.=6; FiO2: 17.2%); and 2) repeated-sprint in normoxia (RSN; N.=6; FiO2: 20.9%). During 6 weeks, both groups undertook 30 seconds of all-out (130%Wmax) followed by 3 minutes of active recovery at 55-65%Wmax on a cycle ergometer. Anthropometric, body composition and biochemical parameters were assessed at baseline and after intervention. RESULTS RSH experimented a greater significant decrease of body mass index (P=0.017) and percentage of fat mass (P=0.05) respect to normoxia group. Total cholesterol of RSN experimented a significant (P=0.001) reduction (-12.66±14.35) compared with RSH (24.00±14.61). CONCLUSIONS Repeated-sprint training under normobaric cyclic hypoxia during 6-weeks could be a more effective prevention program because it causes a higher decrease in body mass index and fat mass compared with the same training in normoxic conditions in healthy women.
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Affiliation(s)
| | | | | | | | - Guillermo Olcina
- Faculty of Sport Sciences, University of Extremadura, Cáceres, Spain
| | - Rafael Timón
- Faculty of Sport Sciences, University of Extremadura, Cáceres, Spain
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DE Groote E, Britto FA, Bullock L, François M, DE Buck C, Nielens H, Deldicque L. Hypoxic Training Improves Normoxic Glucose Tolerance in Adolescents with Obesity. Med Sci Sports Exerc 2018; 50:2200-2208. [PMID: 29923910 DOI: 10.1249/mss.0000000000001694] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE This study aimed to test whether environmental hypoxia could potentiate the effects of exercise training on glucose metabolism and insulin sensitivity. METHODS Fourteen adolescents with obesity were assigned to 6 wk of exercise training either in normoxic or in hypoxic conditions (FiO2 15%). Adolescents trained three times per week for 50-60 min, including endurance and resistance exercises. Oral glucose tolerance test, blood and morphological analyses, and physical performance tests were performed before and after the training period. RESULTS After training, hypoxia, but not normoxia, decreased the area under the curve of plasma insulin (-49%; P = 0.001) and glucose levels (-14%; P = 0.005) during oral glucose tolerance test. Decreased plasma triglycerides levels (P = 0.03) and increased maximal aerobic power (P = 0.002), work capacity at 160 bpm (P = 0.002), and carbohydrate consumption during exercise (P = 0.03) were measured only in the hypoxic group. CONCLUSIONS Hypoxic exercise training was particularly efficient at improving glucose tolerance and insulin response to a glucose challenge in adolescents with obesity. These results suggest that exercise training in hypoxia could be an interesting strategy against insulin resistance and type 2 diabetes development in adolescents with obesity.
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Affiliation(s)
- Estelle DE Groote
- Institute of Neuroscience, Université catholique de Louvain, Louvain-la-Neuve, BELGIUM
| | - Florian A Britto
- Institute of Neuroscience, Université catholique de Louvain, Louvain-la-Neuve, BELGIUM
| | - Loïc Bullock
- Centre Médical Pédiatrique Clairs Vallons, Louvain-la-Neuve, BELGIUM
| | - Marie François
- Centre Médical Pédiatrique Clairs Vallons, Louvain-la-Neuve, BELGIUM
| | - Carine DE Buck
- Centre Médical Pédiatrique Clairs Vallons, Louvain-la-Neuve, BELGIUM
| | - Henri Nielens
- Institute of Neuroscience, Université catholique de Louvain, Louvain-la-Neuve, BELGIUM
| | - Louise Deldicque
- Institute of Neuroscience, Université catholique de Louvain, Louvain-la-Neuve, BELGIUM
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Wang Y, Wen L, Zhou S, Zhang Y, Wang XH, He YY, Davie A, Broadbent S. Effects of four weeks intermittent hypoxia intervention on glucose homeostasis, insulin sensitivity, GLUT4 translocation, insulin receptor phosphorylation, and Akt activity in skeletal muscle of obese mice with type 2 diabetes. PLoS One 2018; 13:e0203551. [PMID: 30199540 PMCID: PMC6130870 DOI: 10.1371/journal.pone.0203551] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 08/22/2018] [Indexed: 01/03/2023] Open
Abstract
AIMS The aims of this study were to determine the effects of four weeks of intermittent exposure to a moderate hypoxia environment (15% oxygen), and compare with the effects of exercise in normoxia or hypoxia, on glucose homeostasis, insulin sensitivity, GLUT4 translocation, insulin receptor phosphorylation, Akt-dependent GSK3 phosphorylation and Akt activity in skeletal muscle of obese mice with type 2 diabetes. METHODS C57BL/6J mice that developed type 2 diabetes with a high-fat-diet (55% fat) (fasting blood glucose, FBG = 13.9 ± 0.69 (SD) mmol/L) were randomly allocated into diabetic control (DC), rest in hypoxia (DH), exercise in normoxia (DE), and exercise in hypoxia (DHE) groups (n = 7, each), together with a normal-diet (4% fat) control group (NC, FBG = 9.1 ± 1.11 (SD) mmol/L). The exercise groups ran on a treadmill at intensities of 75-90% VO2max. The interventions were applied one hour per day, six days per week for four weeks. Venous blood samples were analysed for FBG, insulin (FBI) and insulin sensitivity (QUICKI) pre and post the intervention period. The quadriceps muscle samples were collected 72 hours post the last intervention session for analysis of GLUT4 translocation, insulin receptor phosphorylation, Akt expression and phosphorylated GSK3 fusion protein by western blot. Akt activity was determined by the ratio of the phosphorylated GSK3 fusion protein to the total Akt protein. RESULTS The FBG of the DH, DE and DHE groups returned to normal level (FBG = 9.4 ± 1.50, 8.86 ± 0.94 and 9.0 ± 1.13 (SD) mmol/L for DH, DE and DHE respectively, P < 0.05), with improved insulin sensitivity compared to DC (P < 0.05), after the four weeks treatment, while the NC and DC showed no significant changes, as analysed by general linear model with repeated measures. All three interventions resulted in a significant increase of GLUT4 translocation to cell membrane compared to the DC group (P < 0.05). The DE and DH showed a similar level of insulin receptor phosphorylation compared with NC that was significantly lower than the DC (P < 0.05) post intervention. The DH and DHE groups showed a significantly higher Akt activity compared to the DE, DC and NC (P < 0.05) post intervention, as analysed by one-way ANOVA. CONCLUSIONS This study produced new evidence that intermittent exposure to mild hypoxia (0.15 FiO2) for four weeks resulted in normalisation of FBG, improvement in whole body insulin sensitivity, and a significant increase of GLUT4 translocation in the skeletal muscle, that were similar to the effects of exercise intervention during the same time period, in mice with diet-induced type 2 diabetes. However, exercise in hypoxia for four weeks did not have additive effects on these responses. The outcomes of the research may contribute to the development of effective, alternative and complementary interventions for management of hyperglycaemia and type 2 diabetes, particularly for individuals with limitations in participation of physical activity.
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Affiliation(s)
- Yun Wang
- School of Health and Human Sciences, Southern Cross University, Lismore, Australia
| | - Li Wen
- Key Laboratory of Exercise Physiology and Sports Medicine, Tianjin University of Sport, Tianjin, China
| | - Shi Zhou
- School of Health and Human Sciences, Southern Cross University, Lismore, Australia
| | - Yong Zhang
- Key Laboratory of Exercise Physiology and Sports Medicine, Tianjin University of Sport, Tianjin, China
| | - Xin-Hao Wang
- Department of Health and Exercise Science, Tianjin University of Sport, Tianjin, China
| | - You-Yu He
- Department of Health and Exercise Science, Tianjin University of Sport, Tianjin, China
| | - Allan Davie
- School of Health and Human Sciences, Southern Cross University, Lismore, Australia
| | - Suzanne Broadbent
- School of Health and Human Sciences, Southern Cross University, Lismore, Australia
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Park HY, Kim J, Park MY, Chung N, Hwang H, Nam SS, Lim K. Exposure and Exercise Training in Hypoxic Conditions as a New Obesity Therapeutic Modality: A Mini Review. J Obes Metab Syndr 2018; 27:93-101. [PMID: 31089548 PMCID: PMC6489458 DOI: 10.7570/jomes.2018.27.2.93] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 05/08/2018] [Accepted: 05/16/2018] [Indexed: 01/15/2023] Open
Abstract
Obesity is an important health problem caused by positive energy balance. Generally, low calorie dietary intake combined with regular exercise is the most common modality to lose bodily fat in obese people. Although this is the first modality of choice for obesity treatment, it needs to be applied to obese patients for at least 12 weeks or more and it does not provide consistent results because it is difficult to suppress increased appetite due to exercise. Recently, many researchers have been applying hypoxic conditions for the treatment of obesity, as many studies show that people residing in high altitudes have a lower percentage of body fat and fewer obesity-related illnesses than people living at sea level. Hypoxic therapy treatment, including hypoxic exposure or hypoxic exercise training, is recommended as a way to treat and prevent obesity by suppression of appetite, increasing basal metabolic rate and fat oxidation, and minimizing side effects. Hypoxic therapy inhibits energy intake and appetite-related hormones, and enhances various cardiovascular and metabolic function parameters. These observations indicate that hypoxic therapy is a new treatment modality for inducing fat reduction and promoting metabolic and cardiovascular health, which may be an important and necessary strategy for the treatment of obesity. As such, hypoxic therapy is now used as a general medical practice for obesity treatment in many developed countries. Therefore, hypoxic therapy could be a new, practical, and useful therapeutic modality for obesity and obesity-related comorbidities.
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Affiliation(s)
- Hun-Young Park
- Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul, Korea
| | - Jisu Kim
- Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul, Korea
| | - Mi-Young Park
- Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul, Korea
| | - Nana Chung
- Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul, Korea
| | - Hyejung Hwang
- Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul, Korea
| | - Sang-Seok Nam
- Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul, Korea
| | - Kiwon Lim
- Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul, Korea.,Laboratory of Exercise Nutrition, Department of Physical Education, Konkuk University, Seoul, Korea
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45
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Naufahu J, Elliott B, Markiv A, Dunning-Foreman P, McGrady M, Howard D, Watt P, Mackenzie RWA. High-Intensity Exercise Decreases IP6K1 Muscle Content and Improves Insulin Sensitivity (SI2*) in Glucose-Intolerant Individuals. J Clin Endocrinol Metab 2018; 103:1479-1490. [PMID: 29300979 DOI: 10.1210/jc.2017-02019] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 12/20/2017] [Indexed: 12/13/2022]
Abstract
CONTEXT Insulin resistance (IR) in skeletal muscle contributes to whole body hyperglycemia and the secondary complications associated with type 2 diabetes. Inositol hexakisphosphate kinase-1 (IP6K1) may inhibit insulin-stimulated glucose transport in this tissue type. OBJECTIVE Muscle and plasma IP6K1 were correlated with two-compartment models of glucose control in insulin-resistant hyperinsulinemic individuals. Muscle IP6K1 was also compared after two different exercise trials. DESIGN Nine prediabetic [hemoglobin A1c; 6.1% (0.2%)] patients were recruited to take part in a resting control, a continuous exercise (90% of lactate threshold), and a high-intensity exercise trial (6 30-second sprints). Muscle biopsies were drawn before and after each 60-minute trial. A labeled ([6,62H2]glucose) intravenous glucose tolerance test was performed immediately after the second muscle sample. RESULTS Fasting muscle IP6K1 content did not correlate with insulin sensitivity (SI2*) (P = 0.961). High-intensity exercise reduced IP6K1 muscle protein and messenger RNA expression (P = 0.001). There was no effect on protein IP6K1 content after continuous exercise. Akt308 phosphorylation of was significantly greater after high-intensity exercise. Intermittent exercise reduced hepatic glucose production after the same trial. The same intervention also increased SI2*, and this effect was significantly greater compared with the effect of continuous exercise improvements. Our in vitro experiment demonstrated that the chemical inhibition of IP6K1 increased insulin signaling in C2C12 myotubes. CONCLUSIONS The in vivo and in vitro approaches used in the current study suggest that a decrease in muscle IP6K1 may be linked to whole body increases in SI2*. In addition, high-intensity exercise reduces hepatic glucose production in insulin-resistant individuals.
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Affiliation(s)
- Jane Naufahu
- Faculty of Science and Technology, Department of Life Sciences, University of Westminster, London, United Kingdom
| | - Bradley Elliott
- Faculty of Science and Technology, Department of Life Sciences, University of Westminster, London, United Kingdom
| | - Anatoliy Markiv
- Biosciences Education, King's College London, London, United Kingdom
| | - Petra Dunning-Foreman
- Faculty of Science and Technology, Department of Life Sciences, University of Westminster, London, United Kingdom
| | - Maggie McGrady
- Faculty of Science and Technology, Department of Life Sciences, University of Westminster, London, United Kingdom
| | - David Howard
- Department of Oncology, Charing Cross Hospital, Imperial NHS Trust Hospitals, London, United Kingdom
| | - Peter Watt
- Centre for Sport and Exercise Science and Medicine (SESAME), University of Brighton, Eastbourne, United Kingdom
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46
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Görgens SW, Benninghoff T, Eckardt K, Springer C, Chadt A, Melior A, Wefers J, Cramer A, Jensen J, Birkeland KI, Drevon CA, Al-Hasani H, Eckel J. Hypoxia in Combination With Muscle Contraction Improves Insulin Action and Glucose Metabolism in Human Skeletal Muscle via the HIF-1α Pathway. Diabetes 2017; 66:2800-2807. [PMID: 28811274 DOI: 10.2337/db16-1488] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 08/08/2017] [Indexed: 11/13/2022]
Abstract
Skeletal muscle insulin resistance is the hallmark of type 2 diabetes and develops long before the onset of the disease. It is well accepted that physical activity improves glycemic control, but the knowledge on underlying mechanisms mediating the beneficial effects remains incomplete. Exercise is accompanied by a decrease in intramuscular oxygen levels, resulting in induction of HIF-1α. HIF-1α is a master regulator of gene expression and might play an important role in skeletal muscle function and metabolism. Here we show that HIF-1α is important for glucose metabolism and insulin action in skeletal muscle. By using a genome-wide gene expression profiling approach, we identified RAB20 and TXNIP as two novel exercise/HIF-1α-regulated genes in skeletal muscle. Loss of Rab20 impairs insulin-stimulated glucose uptake in human and mouse skeletal muscle by blocking the translocation of GLUT4 to the cell surface. In addition, exercise/HIF-1α downregulates the expression of TXNIP, a well-known negative regulator of insulin action. In conclusion, we are the first to demonstrate that HIF-1α is a key regulator of glucose metabolism in skeletal muscle by directly controlling the transcription of RAB20 and TXNIP These results hint toward a novel function of HIF-1α as a potential pharmacological target to improve skeletal muscle insulin sensitivity.
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Affiliation(s)
- Sven W Görgens
- Paul-Langerhans-Group for Integrative Physiology, German Diabetes Center (DDZ), Düsseldorf, Germany
| | - Tim Benninghoff
- Institute for Clinical Biochemistry and Pathobiochemistry, German Diabetes Center (DDZ), Düsseldorf, Germany
| | - Kristin Eckardt
- Paul-Langerhans-Group for Integrative Physiology, German Diabetes Center (DDZ), Düsseldorf, Germany
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Christian Springer
- Institute for Clinical Biochemistry and Pathobiochemistry, German Diabetes Center (DDZ), Düsseldorf, Germany
| | - Alexandra Chadt
- Institute for Clinical Biochemistry and Pathobiochemistry, German Diabetes Center (DDZ), Düsseldorf, Germany
| | - Anita Melior
- Paul-Langerhans-Group for Integrative Physiology, German Diabetes Center (DDZ), Düsseldorf, Germany
| | - Jakob Wefers
- Paul-Langerhans-Group for Integrative Physiology, German Diabetes Center (DDZ), Düsseldorf, Germany
| | - Andrea Cramer
- Paul-Langerhans-Group for Integrative Physiology, German Diabetes Center (DDZ), Düsseldorf, Germany
| | - Jørgen Jensen
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Kåre I Birkeland
- Department of Endocrinology, Morbid Obesity, and Preventive Medicine, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Christian A Drevon
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Hadi Al-Hasani
- Institute for Clinical Biochemistry and Pathobiochemistry, German Diabetes Center (DDZ), Düsseldorf, Germany
- German Center for Diabetes Research (DZD e.V.), Düsseldorf, Germany
| | - Jürgen Eckel
- Paul-Langerhans-Group for Integrative Physiology, German Diabetes Center (DDZ), Düsseldorf, Germany
- German Center for Diabetes Research (DZD e.V.), Düsseldorf, Germany
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Saha S, Cano-Garcia H, Sotiriou I, Lipscombe O, Gouzouasis I, Koutsoupidou M, Palikaras G, Mackenzie R, Reeve T, Kosmas P, Kallos E. A Glucose Sensing System Based on Transmission Measurements at Millimetre Waves using Micro strip Patch Antennas. Sci Rep 2017; 7:6855. [PMID: 28761121 PMCID: PMC5537249 DOI: 10.1038/s41598-017-06926-1] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 07/04/2017] [Indexed: 11/29/2022] Open
Abstract
We present a sensing system operating at millimetre (mm) waves in transmission mode that can measure glucose level changes based on the complex permittivity changes across the signal path. The permittivity of a sample can change significantly as the concentration of one of its substances varies: for example, blood permittivity depends on the blood glucose levels. The proposed sensing system uses two facing microstrip patch antennas operating at 60 GHz, which are placed across interrogated samples. The measured transmission coefficient depends on the permittivity change along the signal path, which can be correlated to the change in concentration of a substance. Along with theoretical estimations, we experimentally demonstrate the sensing performance of the system using controlled laboratory samples, such as water-based glucose-loaded liquid samples. We also present results of successful glucose spike detection in humans during an in-vivo Intravenous Glucose Tolerance Test (IVGTT). The system could eventually be developed into a non-invasive glucose monitor for continuous monitoring of glucose levels for people living with diabetes, as it can detect as small as 1.33 mmol/l (0.025 wt%) glucose concentrations in the controlled water-based samples satisfactorily, which is well below the typical human glucose levels of 4 mmol/l.
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Affiliation(s)
- Shimul Saha
- MediWise
- Medical Wireless Sensing Ltd, Queen Mary Bio Enterprises Innovation Centre, (QMB), 42 New Road, London, E1 2AX, UK.
| | - Helena Cano-Garcia
- MediWise
- Medical Wireless Sensing Ltd, Queen Mary Bio Enterprises Innovation Centre, (QMB), 42 New Road, London, E1 2AX, UK.,School of Natural and Mathematical Sciences, Kings College London, London, WC2R 2LS, UK
| | - Ioannis Sotiriou
- MediWise
- Medical Wireless Sensing Ltd, Queen Mary Bio Enterprises Innovation Centre, (QMB), 42 New Road, London, E1 2AX, UK
| | - Oliver Lipscombe
- MediWise
- Medical Wireless Sensing Ltd, Queen Mary Bio Enterprises Innovation Centre, (QMB), 42 New Road, London, E1 2AX, UK.,School of Natural and Mathematical Sciences, Kings College London, London, WC2R 2LS, UK
| | - Ioannis Gouzouasis
- MediWise
- Medical Wireless Sensing Ltd, Queen Mary Bio Enterprises Innovation Centre, (QMB), 42 New Road, London, E1 2AX, UK.,School of Natural and Mathematical Sciences, Kings College London, London, WC2R 2LS, UK
| | - Maria Koutsoupidou
- School of Natural and Mathematical Sciences, Kings College London, London, WC2R 2LS, UK
| | - George Palikaras
- MediWise
- Medical Wireless Sensing Ltd, Queen Mary Bio Enterprises Innovation Centre, (QMB), 42 New Road, London, E1 2AX, UK
| | - Richard Mackenzie
- Institute of Life Sciences, University of Roehampton, London, SW15 5PJ, UK
| | - Thomas Reeve
- Institute of Life Sciences, University of Roehampton, London, SW15 5PJ, UK
| | - Panagiotis Kosmas
- School of Natural and Mathematical Sciences, Kings College London, London, WC2R 2LS, UK
| | - Efthymios Kallos
- MediWise
- Medical Wireless Sensing Ltd, Queen Mary Bio Enterprises Innovation Centre, (QMB), 42 New Road, London, E1 2AX, UK
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48
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Brinkmann C, Bloch W, Brixius K. Exercise during short-term exposure to hypoxia or hyperoxia - novel treatment strategies for type 2 diabetic patients?! Scand J Med Sci Sports 2017. [PMID: 28649714 DOI: 10.1111/sms.12937] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Both hypoxia (decreased oxygen availability) and hyperoxia (increased oxygen availability) have been shown to alter exercise adaptations in healthy subjects. This review aims to clarify the possible benefits of exercise during short-term exposure to hypoxia or hyperoxia for patients with type 2 diabetes mellitus (T2DM). There is evidence that exercise during short-term exposure to hypoxia can acutely increase skeletal muscle glucose uptake more than exercise in normoxia, and that post-exercise insulin sensitivity in T2DM patients is more increased when exercise is performed under hypoxic conditions. Furthermore, interventional studies show that glycemic control can be improved through regular physical exercise in short-term hypoxia at a lower workload than in normoxia, and that exercise training in short-term hypoxia can contribute to increased weight loss in overweight/obese (insulin-resistant) subjects. While numerous studies involving healthy subjects report that regular exercise in hypoxia can increase vascular health (skeletal muscle capillarization and vascular dilator function) to a higher extent than exercise training in normoxia, there is no convincing evidence yet that hypoxia has such additive effects in T2DM patients in the long term. Some studies indicate that the use of hyperoxia during exercise can decrease lactate concentrations and subjective ratings of perceived exertion. Thus, there are interesting starting points for future studies to further evaluate possible beneficial effects of exercise in short-term hypoxia or hyperoxia at different oxygen concentrations and exposure durations. In general, exposure to hypoxia/hyperoxia should be considered with caution. Possible health risks-especially for T2DM patients-are also analyzed in this review.
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Affiliation(s)
- C Brinkmann
- Institute of Cardiovascular Research and Sport Medicine, Department of Molecular and Cellular Sport Medicine, German Sport University Cologne, Cologne, Germany.,Institute of Cardiovascular Research and Sport Medicine, Department of Preventive and Rehabilitative Sport Medicine, German Sport University Cologne, Cologne, Germany
| | - W Bloch
- Institute of Cardiovascular Research and Sport Medicine, Department of Molecular and Cellular Sport Medicine, German Sport University Cologne, Cologne, Germany
| | - K Brixius
- Institute of Cardiovascular Research and Sport Medicine, Department of Molecular and Cellular Sport Medicine, German Sport University Cologne, Cologne, Germany
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49
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Hobbins L, Hunter S, Gaoua N, Girard O. Normobaric hypoxic conditioning to maximize weight loss and ameliorate cardio-metabolic health in obese populations: a systematic review. Am J Physiol Regul Integr Comp Physiol 2017; 313:R251-R264. [PMID: 28679682 DOI: 10.1152/ajpregu.00160.2017] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 06/23/2017] [Accepted: 07/04/2017] [Indexed: 02/07/2023]
Abstract
Normobaric hypoxic conditioning (HC) is defined as exposure to systemic and/or local hypoxia at rest (passive) or combined with exercise training (active). HC has been previously used by healthy and athletic populations to enhance their physical capacity and improve performance in the lead up to competition. Recently, HC has also been applied acutely (single exposure) and chronically (repeated exposure over several weeks) to overweight and obese populations with the intention of managing and potentially increasing cardio-metabolic health and weight loss. At present, it is unclear what the cardio-metabolic health and weight loss responses of obese populations are in response to passive and active HC. Exploration of potential benefits of exposure to both passive and active HC may provide pivotal findings for improving health and well being in these individuals. A systematic literature search for articles published between 2000 and 2017 was carried out. Studies investigating the effects of normobaric HC as a novel therapeutic approach to elicit improvements in the cardio-metabolic health and weight loss of obese populations were included. Studies investigated passive (n = 7; 5 animals, 2 humans), active (n = 4; all humans) and a combination of passive and active (n = 4; 3 animals, 1 human) HC to an inspired oxygen fraction ([Formula: see text]) between 4.8 and 15.0%, ranging between a single session and daily sessions per week, lasting from 5 days up to 8 mo. Passive HC led to reduced insulin concentrations (-37 to -22%) in obese animals and increased energy expenditure (+12 to +16%) in obese humans, whereas active HC lead to reductions in body weight (-4 to -2%) in obese animals and humans, and blood pressure (-8 to -3%) in obese humans compared with a matched workload in normoxic conditions. Inconclusive findings, however, exist in determining the impact of acute and chronic HC on markers such as triglycerides, cholesterol levels, and fitness capacity. Importantly, most of the studies that included animal models involved exposure to severe levels of hypoxia ([Formula: see text] = 5.0%; simulated altitude >10,000 m) that are not suitable for human populations. Overall, normobaric HC demonstrated observable positive findings in relation to insulin and energy expenditure (passive), and body weight and blood pressure (active), which may improve the cardio-metabolic health and body weight management of obese populations. However, further evidence on responses of circulating biomarkers to both passive and active HC in humans is warranted.
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Affiliation(s)
- L Hobbins
- Sport and Exercise Science Research Centre, London South Bank University, London, United Kingdom;
| | - S Hunter
- Sport and Exercise Science Research Centre, London South Bank University, London, United Kingdom
| | - N Gaoua
- Sport and Exercise Science Research Centre, London South Bank University, London, United Kingdom
| | - O Girard
- Athlete Health and Performance Research Centre, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar; and.,Institute of Sport Sciences, University of Lausanne, Switzerland
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50
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Kelly LP, Basset FA. Acute Normobaric Hypoxia Increases Post-exercise Lipid Oxidation in Healthy Males. Front Physiol 2017; 8:293. [PMID: 28567018 PMCID: PMC5434119 DOI: 10.3389/fphys.2017.00293] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Accepted: 04/24/2017] [Indexed: 11/18/2022] Open
Abstract
The primary objective of the current study was to determine the effect of moderate normobaric hypoxia exposure during constant load cycling on post-exercise energy metabolism recorded in normoxia. Indirect calorimetry was used to examine whole body substrate oxidation before, during, 40–60 min post, and 22 h after performing 60 min of cycling exercise at two different fractions of inspired oxygen (FIO2): (i) FIO2 = 0.2091 (normoxia) and (ii) FIO2 = 0.15 (hypoxia). Seven active healthy male participants (26 ± 4 years of age) completed both experimental trials in randomized order with a 7-day washout period to avoid carryover effects between conditions. Resting energy expenditure was initially elevated following cycling exercise in normoxia and hypoxia (Δ 0.14 ± 0.05, kcal min−1, p = 0.037; Δ 0.19 ± 0.03 kcal min−1, p < 0.001, respectively), but returned to baseline levels the next morning in both conditions. Although, the same absolute workload was used in both environmental conditions (157 ± 10 W), a shift in resting substrate oxidation occurred after exercise performed in hypoxia while post-exercise measurements were similar to baseline after cycling exercise in normoxia. The additional metabolic stress of hypoxia exposure was sufficient to increase the rate of lipid oxidation (Δ 42 ± 11 mg min−1, p = 0.019) and tended to suppress carbohydrate oxidation (Δ −55 ± 26 mg min−1, p = 0.076) 40–60 min post-exercise. This shift in substrate oxidation persisted the next morning, where lipid oxidation remained elevated (Δ 9 ± 3 mg min−1, p = 0.0357) and carbohydrate oxidation was suppressed (Δ −22 ± 6 mg min−1, p = 0.019). In conclusion, prior exercise performed under moderate normobaric hypoxia alters post-exercise energy metabolism. This is an important consideration when evaluating the metabolic consequences of hypoxia exposure during prolonged exercise, and future studies should evaluate its role in the beneficial effects of intermittent hypoxia training observed in persons with obesity and insulin resistance.
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Affiliation(s)
- Liam P Kelly
- Faculty of Medicine, Memorial University of NewfoundlandSt. John's, NL, Canada.,School of Human Kinetics and Recreation, Memorial University of NewfoundlandSt. John's, NL, Canada
| | - Fabien A Basset
- School of Human Kinetics and Recreation, Memorial University of NewfoundlandSt. John's, NL, Canada
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