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Shabab S, Mahmoudabady M, Gholamnezhad Z, Niazmand S, Fouladi M, Mousavi Emadi Z. Endurance Exercise Prevented Diabetic Cardiomyopathy through the Inhibition of Fibrosis and Hypertrophy in Rats. Rev Cardiovasc Med 2024; 25:173. [PMID: 39076482 PMCID: PMC11267178 DOI: 10.31083/j.rcm2505173] [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: 12/05/2023] [Revised: 02/13/2024] [Accepted: 02/27/2024] [Indexed: 07/31/2024] Open
Abstract
Background Exercise training could be essential in preventing pathological cardiac remodeling in diabetes. Therefore, the effects of moderate-intensity continuous training (MICT) and high-intensity interval training (HIIT) singly or plus metformin on diabetes-induced cardiomyopathy were investigated in this study. Methods Forty-nine Wistar rats (male) were recruited. Seven groups of animals were treated for six weeks as control, diabetes, MICT (15 m/min, 40 min/day), HIIT (20 m/min, 40 min/day), metformin (300 mg/kg), HIIT+metformin (Met-HIIT), and MICT+metformin (Met-MICT). The metformin was orally administered with an intragastrical needle, and the exercised rats were trained (5 days/week) with a motorized treadmill. Metabolic parameters, echocardiographic indices, histopathology evaluation, and assessment of gene expression connected with cardiac fibrosis, hypertrophy, mitochondrial performance, and intracellular calcium homeostasis were investigated. Results Our results demonstrated that all the interventions prevented weight loss and enhanced heart weight/body weight ratio and fasting plasma glucose in diabetic rats. Both types of exercise and their metformin combinations improved diabetic animals' echocardiography indices by enhancing heart rate, fractional shortening (FS), ejection fraction (EF) and reducing end-systolic and end-diastolic diameter of left ventricular (LVESD and LVEDD). Gene expression of atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), transforming growth factor (TGF)- β , and collagen increased in the diabetes group. In contrast, the gene expression of peroxisome proliferator-activated receptor gamma coactivator 1 alpha (PGC-1 α ), AMP-activated protein kinase (AMPK), ryanodine receptors (RyR), and Ca 2 + ATPase pump of the sarcoplasmic reticulum (SERCA) was reduced in diabetic animals. Exercise training alone or in combination with metformin reversed these changes. Moreover, diabetes-induced cardiac fibrosis was ameliorated in treated groups. All indicators of diabetic cardiomyopathy were improved more in the Met-HIIT group than in other groups. Conclusions Exercise training, notably with metformin combination, alleviated diabetes-induced cardiac complications. The beneficial effects of exercise could be related to improving pathological cardiac remodeling and enhancing cardiac function.
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Affiliation(s)
- Sadegh Shabab
- Department of Physiology, Faculty of Medicine, Mashhad University of
Medical Sciences, 91779 48564 Mashhad, Iran
| | - Maryam Mahmoudabady
- Department of Physiology, Faculty of Medicine, Mashhad University of
Medical Sciences, 91779 48564 Mashhad, Iran
- Applied Biomedical Research Center, Mashhad University of Medical
Sciences, 91779 48564 Mashhad, Iran
| | - Zahra Gholamnezhad
- Department of Physiology, Faculty of Medicine, Mashhad University of
Medical Sciences, 91779 48564 Mashhad, Iran
- Applied Biomedical Research Center, Mashhad University of Medical
Sciences, 91779 48564 Mashhad, Iran
| | - Saeed Niazmand
- Department of Physiology, Faculty of Medicine, Mashhad University of
Medical Sciences, 91779 48564 Mashhad, Iran
- Applied Biomedical Research Center, Mashhad University of Medical
Sciences, 91779 48564 Mashhad, Iran
| | - Mahtab Fouladi
- Department of Physiology, Faculty of Medicine, Mashhad University of
Medical Sciences, 91779 48564 Mashhad, Iran
| | - Zahra Mousavi Emadi
- Department of Pediatrics, Mashhad University of Medical Sciences, 91779
48564 Mashhad, Iran
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Shabab S, Mahmoudabady M, Gholamnezhad Z, Fouladi M, Asghari AA. Diabetic cardiomyopathy in rats was attenuated by endurance exercise through the inhibition of inflammation and apoptosis. Heliyon 2024; 10:e23427. [PMID: 38163155 PMCID: PMC10757033 DOI: 10.1016/j.heliyon.2023.e23427] [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: 04/24/2023] [Revised: 11/27/2023] [Accepted: 12/04/2023] [Indexed: 01/03/2024] Open
Abstract
Diabetic cardiomyopathy (DCM), as a ventricular dysfunction, is one of the main causes of death in diabetic patients. Former evidence revealed the beneficial effects of exercise on cardiovascular complications of diabetes. We aimed to investigate the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on DCM. Male Wistar rats were divided into control, diabetic, metformin (300 mg/kg), HIIT, MICT, metformin + HIIT, and metformin + MICT diabetic groups. Serum biochemical, inflammatory, and oxidative stress indicators, gene expression of BCL2 and BAX, and histopathologic changes of cardiac tissue were assessed. Our analysis revealed an increase in fasting blood sugar (FBS), creatine kinase MB (CK-MB), lactate dehydrogenase (LDH), and aspartate aminotransferase (AST) in diabetes. Also, the superoxide dismutase (SOD) and catalase (CAT) activity, and the total thiol were decreased, in contrast, malondialdehyde (MDA) levels increased in the cardiac tissue of the diabetic group. All of these changes were significantly ameliorated in diabetic animals treated with exercise and metformin + exercise. The level of tumor necrosis factor-α (TNF-α) and Interleukin-1β (IL-1β), as well as the infiltration of inflammatory cells, were decreased in the heart of all exercise training groups. Up-regulation of BCL2 and down-regulation of BAX gene expressions were observed in the cardiac tissue of all exercise-treated groups. In conclusion, HIIT and MICT exercises are effective in preventing DCM development. Exercise training, besides improving oxidative stress and inflammation in cardiac tissue, alleviates cardiac damage by modulating the apoptotic gene expression in diabetic rats.
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Affiliation(s)
- Sadegh Shabab
- Department of Physiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Mahmoudabady
- Department of Physiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Gholamnezhad
- Department of Physiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahtab Fouladi
- Department of Physiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Akbar Asghari
- Department of Physiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Bennasar-Veny M, Malih N, Galmes-Panades AM, Hernandez-Bermudez IC, Garcia-Coll N, Ricci-Cabello I, Yañez AM. Effect of physical activity and different exercise modalities on glycemic control in people with prediabetes: a systematic review and meta-analysis of randomized controlled trials. Front Endocrinol (Lausanne) 2023; 14:1233312. [PMID: 37842295 PMCID: PMC10569497 DOI: 10.3389/fendo.2023.1233312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 08/14/2023] [Indexed: 10/17/2023] Open
Abstract
Background Numerous studies have shown the beneficial effects of exercise on glycemic control in people with prediabetes. However, the most effective exercise modality for improving glycemic control remains unclear. We aimed to assess which exercise training modality is most effective in improving glycemic control in a population with prediabetes. Methods We conducted searches in Pubmed/MEDLINE, EMBASE, SPORTDiscus, Web of Science, PEDro, BVS, and the Cochrane Library from inception to June 2022. Included studies reported fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), and 2-hour postprandial (2hPP) levels and implemented an exercise program lasting at least 12 weeks in adults with prediabetes. We performed a direct meta-analysis using a random-effects model and a network meta-analysis. Cochran's Q statistic and the inconsistency I2 test were used to assess the heterogenicity between studies. Results Twenty trials were included, with 15 trials (comprising 775 participants with prediabetes) combined in the meta-analysis, and 13 in the network meta-analysis. The meta-analysis results did not show a statistically significant reduction in fasting plasma glucose (FPG) after aerobic training (AT) intervention compared to a control group (mean (95%CI) difference = -5.18 (-13.48; 3.12) mg/dL, Z=1.22, p=0.22). However, a difference of -7.25 (-13.79; -0.71) mg/dL, p=0.03, in FPG after interval training (IT) intervention was detected compared to a control group. After resistance training (RT) intervention, FPG was significantly lower -6.71 (-12.65,-0.77) mg/dL, Z=2.21, p=0.03, and HbA1c by -0.13 (-0.55, 0.29), p=0.54, compared to the control group. The impact of RT compared to no intervention on 2hPP was not statistically significant (p=0.26). The network meta-analysis did not show statistical significance. Most of the studies presented an unclear risk of bias, and a low and very low-quality of evidence. According to the GRADE criteria, the strength of the body of evidence was low. Conclusion Resistance training and IT had demonstrated benefits on glycemic indices, especially on FPG, in a population with prediabetes. Further studies with larger sample sizes and a more robust methodology that compare different types of exercise modalities, frequencies, and durations, are needed to establish a beneficial exercise intervention. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=370688, identifier CRD42022370688.
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Affiliation(s)
- Miquel Bennasar-Veny
- Global Health and Lifestyles Research Group, Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain
- Department of Nursing and Physiotherapy, University of the Balearic Islands (UIB), Palma, Spain
| | - Narges Malih
- Research Group on Global Health, University of the Balearic Islands (UIB), Palma, Spain
| | - Aina M. Galmes-Panades
- Global Health and Lifestyles Research Group, Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Research Group on Global Health, University of the Balearic Islands (UIB), Palma, Spain
- CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Physical Activity and Sport Sciences Research Group (GICAFE), Institute for Educational Research and Innovation (IRIE), University of the Balearic Islands, Palma, Spain
| | | | - Natalia Garcia-Coll
- Research Group on Global Health, University of the Balearic Islands (UIB), Palma, Spain
| | - Ignacio Ricci-Cabello
- CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain
- Research Group in Primary Care and Promotion—Balearic Islands Community (GRAPP-caIB), Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Primary Care Research Unit of Mallorca (IB-Salut), Balearic Health Service, Palma de Mallorca, Spain
| | - Aina M. Yañez
- Global Health and Lifestyles Research Group, Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Department of Nursing and Physiotherapy, University of the Balearic Islands (UIB), Palma, Spain
- Research Group on Global Health, University of the Balearic Islands (UIB), Palma, Spain
- Research Network on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, Madrid, Spain
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Comparison of Three-Month HIIT and CMT Effects on Left Ventricle Echocardiography Observations in Male Employees. J Clin Med 2022; 11:jcm11164795. [PMID: 36013034 PMCID: PMC9410475 DOI: 10.3390/jcm11164795] [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: 06/29/2022] [Revised: 08/04/2022] [Accepted: 08/10/2022] [Indexed: 11/21/2022] Open
Abstract
The present study aimed to identify changes in echocardiographic parameters before and after three-month high-intensity interval training (HIIT) and continuous moderate-intensity training (CMT) in male employees. For this purpose, using a convenience sampling method, 33 male employees of the Islamic Republic of Iran Army (office workers with a sedentary lifestyle) aged 30 through 40 were selected. Participants were divided into three groups of HIIT, CMT, and control (11 for each group) including all anthropometric data (body fat percentage, body mass index, height, weight, and VO2 max) with no history of chronic diseases, metabolic syndrome, confirmed heart disease or congenital heart defect, and hospitalization due to chronic diseases or consumption of medication affecting cardiovascular indicators. A one-way ANOVA was conducted to compare the groups. The results demonstrated that the end-systolic volumes (ESVs) (p < 0.01) and relative wall thickness (RWT) in the CMT group (p < 0.01) and the end-diastolic volumes (EDVs) (p < 0.01), stroke volumes (SVs) (p < 0.01), end-systolic and diastolic diameters (ESD, EDD) (p < 0.01), as well as the RWT and left ventricle diastolic function (E/A ratio) in the HIIT group (p < 0.05) were significantly different before and after the 12-week training (Bonferroni correction was used for pairwise comparisons). The results revealed a significant increase in the end-systolic diameters (ESDs) of the HIIT group, whereas no such increase was observed in the ESDs of the CMT group (p < 0.51). Moreover, a significant increase was observed in left ventricular (LV) RWT and aerobic power of both training groups. The significant decrease of ESVs and the significant increase in E/A ratio, ESDs, EDDs following HIIT (two to three sessions per week) may indicate beneficial and optimal LV structural adaptations and improved LV function in nonathletes (even with a sedentary lifestyle).
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Shah SZA, Karam JA, Zeb A, Ullah R, Shah A, Haq IU, Ali I, Darain H, Chen H. Movement is Improvement: The Therapeutic Effects of Exercise and General Physical Activity on Glycemic Control in Patients with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Diabetes Ther 2021; 12:707-732. [PMID: 33547579 PMCID: PMC7947168 DOI: 10.1007/s13300-021-01005-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 01/15/2021] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Exercise is considered a cornerstone in achieving an optimized blood glucose level and reducing body weight, body mass index (BMI), and waist circumference. This study aimed to investigate and quantitatively summarize the literature regarding the therapeutic effects of exercise and general physical activity on glycemic control. METHODS A systematic review and meta-analysis of the literature on the therapeutic effects of exercise on glycemic control in patients with type 2 diabetes mellitus (type 2 DM) were conducted using electronic databases. Studies with an exercise intervention lasting more than 8 weeks were included. Both qualitative and quantitative analyses were performed. Qualitative data were presented narratively in table form. Quantitative analysis was performed using a random-effects model with a 95% confidence interval and a significance level of 0.05. The Physiotherapy Evidence Database (PEDro) scale and the Cochrane Risk of Bias 2 (RoB2) tool were used to assess the quality of evidence and the risk of bias. RESULTS A total of 21,559 articles were identified through different databases. Out of 21559 studies, only 32 randomized controlled trials were deemed eligible for inclusion in this study. The average exercise session was 45.15 min, while the average follow-up duration was 21.94 weeks. The mean exercise frequency according to our findings was 3.25 days/week. Almost all the studies reported decreases in glycated hemoglobin (HbA1c; P < 0.0001), fasting blood glucose (P = 0.03), BMI (P = 0.04), and waist circumference (P = 0.007) after the exercise intervention. CONCLUSION Exercise plays an important role in optimizing glycemic control and improving quality of life (QoL), BMI, and waist circumference in type 2 DM patients. Exercise could be a safe adjunct therapy to medical treatments in these patients. REGISTRATION PROSPERO: CRD42020210816.
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Affiliation(s)
- Sayed Z A Shah
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Jawad A Karam
- Department of applied exercise science, Concordia University Chicago, 7400 Augusta St., River Forest, IL, 60305, United States
| | - Alam Zeb
- School of Health Sciences, Peshawar, Pakistan
| | - Rafi Ullah
- Paraplegic Centre, Phase#4, Hayatabad, Peshawar, Pakistan
| | - Arif Shah
- Paraplegic Centre, Phase#4, Hayatabad, Peshawar, Pakistan
| | - Ijaz Ul Haq
- Paraplegic Centre, Phase#4, Hayatabad, Peshawar, Pakistan
| | - Iftikhar Ali
- Paraplegic Centre, Phase#4, Hayatabad, Peshawar, Pakistan
| | - Haider Darain
- Institute of Physical Medicine and Rehabilitation Sciences, Khyber Medical University, Hayatabad, Peshawar, Pakistan
| | - Hong Chen
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.
- WHO Collaborating Center for Training and Research in Rehabilitation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.
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Heiskanen MA, Honkala SM, Hentilä J, Ojala R, Lautamäki R, Koskensalo K, Lietzén MS, Saunavaara V, Saunavaara J, Helmiö M, Löyttyniemi E, Nummenmaa L, Collado MC, Malm T, Lahti L, Pietiläinen KH, Kaprio J, Rinne JO, Hannukainen JC. Systemic cross-talk between brain, gut, and peripheral tissues in glucose homeostasis: effects of exercise training (CROSSYS). Exercise training intervention in monozygotic twins discordant for body weight. BMC Sports Sci Med Rehabil 2021; 13:16. [PMID: 33627179 PMCID: PMC7905681 DOI: 10.1186/s13102-021-00241-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 02/03/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Obesity and physical inactivity are major global public health concerns, both of which increase the risk of insulin resistance and type 2 diabetes. Regulation of glucose homeostasis involves cross-talk between the central nervous system, peripheral tissues, and gut microbiota, and is affected by genetics. Systemic cross-talk between brain, gut, and peripheral tissues in glucose homeostasis: effects of exercise training (CROSSYS) aims to gain new systems-level understanding of the central metabolism in human body, and how exercise training affects this cross-talk. METHODS CROSSYS is an exercise training intervention, in which participants are monozygotic twins from pairs discordant for body mass index (BMI) and within a pair at least the other is overweight. Twins are recruited from three population-based longitudinal Finnish twin studies, including twins born in 1983-1987, 1975-1979, and 1945-1958. The participants undergo 6-month-long exercise intervention period, exercising four times a week (including endurance, strength, and high-intensity training). Before and after the exercise intervention, comprehensive measurements are performed in Turku PET Centre, Turku, Finland. The measurements include: two positron emission tomography studies (insulin-stimulated whole-body and tissue-specific glucose uptake and neuroinflammation), magnetic resonance imaging (brain morphology and function, quantification of body fat masses and organ volumes), magnetic resonance spectroscopy (quantification of fat within heart, pancreas, liver and tibialis anterior muscle), echocardiography, skeletal muscle and adipose tissue biopsies, a neuropsychological test battery as well as biosamples from blood, urine and stool. The participants also perform a maximal exercise capacity test and tests of muscular strength. DISCUSSION This study addresses the major public health problems related to modern lifestyle, obesity, and physical inactivity. An eminent strength of this project is the possibility to study monozygotic twin pairs that share the genome at the sequence level but are discordant for BMI that is a risk factor for metabolic impairments such as insulin resistance. Thus, this exercise training intervention elucidates the effects of obesity on metabolism and whether regular exercise training is able to reverse obesity-related impairments in metabolism in the absence of the confounding effects of genetic factors. TRIAL REGISTRATION ClinicalTrials.gov , NCT03730610 . Prospectively registered 5 November 2018.
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Affiliation(s)
- Marja A Heiskanen
- Turku PET Centre, University of Turku, P.O. Box 52, FIN-20521, Turku, Finland
| | - Sanna M Honkala
- Turku PET Centre, University of Turku, P.O. Box 52, FIN-20521, Turku, Finland
| | - Jaakko Hentilä
- Turku PET Centre, University of Turku, P.O. Box 52, FIN-20521, Turku, Finland
| | - Ronja Ojala
- Turku PET Centre, University of Turku, P.O. Box 52, FIN-20521, Turku, Finland
| | | | - Kalle Koskensalo
- Department of Medical Physics, Turku University Hospital, Turku, Finland
| | - Martin S Lietzén
- Turku PET Centre, University of Turku, P.O. Box 52, FIN-20521, Turku, Finland
| | - Virva Saunavaara
- Turku PET Centre, University of Turku, P.O. Box 52, FIN-20521, Turku, Finland
- Department of Medical Physics, Turku University Hospital, Turku, Finland
| | - Jani Saunavaara
- Department of Medical Physics, Turku University Hospital, Turku, Finland
| | - Mika Helmiö
- Division of Digestive Surgery and Urology, Turku University Hospital, Turku, Finland
| | | | - Lauri Nummenmaa
- Turku PET Centre, University of Turku, P.O. Box 52, FIN-20521, Turku, Finland
- Department of Psychology, University of Turku, Turku, Finland
| | - Maria C Collado
- Institute of Agrochemistry and Food Technology-National Research Council (IATA-CSIC), Valencia, Spain
- Functional Food Forum, University of Turku, Turku, Finland
| | - Tarja Malm
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
| | - Leo Lahti
- Department of Future Technologies, University of Turku, Turku, Finland
| | - Kirsi H Pietiläinen
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Abdominal Center, Obesity Center, Endocrinology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland FIMM, HiLIFE, University of Helsinki, Helsinki, Finland
| | - Juha O Rinne
- Turku PET Centre, University of Turku, P.O. Box 52, FIN-20521, Turku, Finland
- Turku PET Centre, Turku University Hospital, Turku, Finland
| | - Jarna C Hannukainen
- Turku PET Centre, University of Turku, P.O. Box 52, FIN-20521, Turku, Finland.
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Motiani KK, Collado MC, Eskelinen JJ, Virtanen KA, Löyttyniemi E, Salminen S, Nuutila P, Kalliokoski KK, Hannukainen JC. Exercise Training Modulates Gut Microbiota Profile and Improves Endotoxemia. Med Sci Sports Exerc 2020; 52:94-104. [PMID: 31425383 PMCID: PMC7028471 DOI: 10.1249/mss.0000000000002112] [Citation(s) in RCA: 132] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Supplemental digital content is available in the text. Introduction Intestinal metabolism and microbiota profiles are impaired in obesity and insulin resistance. Moreover, dysbiotic gut microbiota has been suggested to promote systemic low-grade inflammation and insulin resistance through the release of endotoxins particularly lipopolysaccharides. We have previously shown that exercise training improves intestinal metabolism in healthy men. To understand whether changes in intestinal metabolism interact with gut microbiota and its release of inflammatory markers, we studied the effects of sprint interval (SIT) and moderate-intensity continuous training (MICT) on intestinal metabolism and microbiota in subjects with insulin resistance. Methods Twenty-six, sedentary subjects (prediabetic, n = 9; type 2 diabetes, n = 17; age, 49 [SD, 4] yr; body mass index, 30.5 [SD, 3]) were randomized into SIT or MICT. Intestinal insulin-stimulated glucose uptake (GU) and fatty acid uptake (FAU) from circulation were measured using positron emission tomography. Gut microbiota composition was analyzed by 16S rRNA gene sequencing and serum inflammatory markers with multiplex assays and enzyme-linked immunoassay kit. Results V˙O2peak improved only after SIT (P = 0.01). Both training modes reduced systematic and intestinal inflammatory markers (tumor necrosis factor-α, lipopolysaccharide binding protein) (time P < 0.05). Training modified microbiota profile by increasing Bacteroidetes phylum (time P = 0.03) and decreasing Firmicutes/Bacteroidetes ratio (time P = 0.04). Moreover, there was a decrease in Clostridium genus (time P = 0.04) and Blautia (time P = 0.051). Only MICT decreased jejunal FAU (P = 0.02). Training had no significant effect on intestinal GU. Colonic GU associated positively with Bacteroidetes and inversely with Firmicutes phylum, ratio Firmicutes/Bacteroidetes and Blautia genus. Conclusions Intestinal substrate uptake associates with gut microbiota composition and whole-body insulin sensitivity. Exercise training improves gut microbiota profiles and reduces endotoxemia.
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Jiménez-Maldonado A, García-Suárez PC, Rentería I, Moncada-Jiménez J, Plaisance EP. Impact of high-intensity interval training and sprint interval training on peripheral markers of glycemic control in metabolic syndrome and type 2 diabetes. Biochim Biophys Acta Mol Basis Dis 2020; 1866:165820. [PMID: 32360396 DOI: 10.1016/j.bbadis.2020.165820] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 04/14/2020] [Accepted: 04/25/2020] [Indexed: 12/17/2022]
Abstract
Glycemic control is essential to reduce the risk of complications associated with metabolic syndrome (MetS) and type 2 diabetes (T2D). Aerobic and resistance exercise performed alone or in combination improve glycemic control in both conditions. However, perceived lack of time and commitment are considered principal barriers to performing exercise regularly. High intensity interval training (HIIT) and sprint interval training (SIT) can be performed in a fraction of the time required for continuous aerobic exercise. A substantial scientific evidence indicates that HIIT/SIT improve glycemic control to a similar or greater extent than aerobic exercise in populations without MetS or T2D. Likewise, growing evidence suggest that HIIT/SIT improve the glycemic control during MetS and T2D. The aim of this review is to discuss the effects of interval training protocols on peripheral markers of glucose metabolism in patients with MetS and T2D.
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Affiliation(s)
| | | | - Iván Rentería
- Facultad de Deportes Campus Ensenada, Universidad Autónoma de Baja California, Mexico
| | - José Moncada-Jiménez
- Human Movement Sciences Research Center, University of Costa Rica, San José, Costa Rica
| | - Eric P Plaisance
- Department of Human Studies, University of Alabama at Birmingham, Birmingham, AL, United States of America
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Motiani KK, Savolainen AM, Toivanen J, Eskelinen JJ, Yli-Karjanmaa M, Virtanen KA, Saunavaara V, Heiskanen MA, Parkkola R, Haaparanta-Solin M, Solin O, Savisto N, Löyttyniemi E, Knuuti J, Nuutila P, Kalliokoski KK, Hannukainen JC. Effects of short-term sprint interval and moderate-intensity continuous training on liver fat content, lipoprotein profile, and substrate uptake: a randomized trial. J Appl Physiol (1985) 2019; 126:1756-1768. [PMID: 30998125 DOI: 10.1152/japplphysiol.00900.2018] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Type 2 diabetes (T2D) and increased liver fat content (LFC) alter lipoprotein profile and composition and impair liver substrate uptake. Exercise training mitigates T2D and reduces LFC, but the benefits of different training intensities in terms of lipoprotein classes and liver substrate uptake are unclear. The aim of this study was to evaluate the effects of moderate-intensity continuous training (MICT) or sprint interval training (SIT) on LFC, liver substrate uptake, and lipoprotein profile in subjects with normoglycemia or prediabetes/T2D. We randomized 54 subjects (normoglycemic group, n = 28; group with prediabetes/T2D, n = 26; age = 40-55 yr) to perform either MICT or SIT for 2 wk and measured LFC with magnetic resonance spectroscopy, lipoprotein composition with NMR, and liver glucose uptake (GU) and fatty acid uptake (FAU) using PET. At baseline, the group with prediabetes/T2D had higher LFC, impaired lipoprotein profile, and lower whole body insulin sensitivity and aerobic capacity compared with the normoglycemic group. Both training modes improved aerobic capacity (P < 0.001) and lipoprotein profile (reduced LDL and increased large HDL subclasses; all P < 0.05) with no training regimen (SIT vs. MICT) or group effect (normoglycemia vs. prediabetes/T2D). LFC tended to be reduced in the group with prediabetes/T2D compared with the normoglycemic group posttraining (P = 0.051). When subjects were divided according to LFC (high LFC, >5.6%; low LFC, <5.6%), training reduced LFC in subjects with high LFC (P = 0.009), and only MICT increased insulin-stimulated liver GU (P = 0.03). Short-term SIT and MICT are effective in reducing LFC in subjects with fatty liver and in improving lipoprotein profile regardless of baseline glucose tolerance. Short-term MICT is more efficient in improving liver insulin sensitivity compared with SIT. NEW & NOTEWORTHY In the short term, both sprint interval training and moderate-intensity continuous training (MICT) reduce liver fat content and improve lipoprotein profile; however, MICT seems to be preferable in improving liver insulin sensitivity.
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Affiliation(s)
| | | | | | | | | | | | - Virva Saunavaara
- Turku PET Centre, University of Turku , Turku , Finland.,Department of Medical Physics, Turku University Hospital , Turku , Finland
| | | | - Riitta Parkkola
- Department of Radiology, Turku University Hospital , Turku , Finland
| | - Merja Haaparanta-Solin
- Turku PET Centre, University of Turku , Turku , Finland.,MediCity Research Laboratory Turku, University of Turku , Turku , Finland
| | - Olof Solin
- Turku PET Centre, University of Turku , Turku , Finland.,Department of Chemistry, University of Turku , Turku , Finland.,Turku PET Centre, Åbo Akademi University , Turku , Finland
| | - Nina Savisto
- Turku PET Centre, University of Turku , Turku , Finland
| | | | - Juhani Knuuti
- Turku PET Centre, University of Turku , Turku , Finland
| | - Pirjo Nuutila
- Turku PET Centre, University of Turku , Turku , Finland.,Department of Endocrinology, Turku University Hospital , Turku , Finland
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10
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Heiskanen MA, Motiani KK, Mari A, Saunavaara V, Eskelinen JJ, Virtanen KA, Koivumäki M, Löyttyniemi E, Nuutila P, Kalliokoski KK, Hannukainen JC. Exercise training decreases pancreatic fat content and improves beta cell function regardless of baseline glucose tolerance: a randomised controlled trial. Diabetologia 2018; 61:1817-1828. [PMID: 29717337 PMCID: PMC6061150 DOI: 10.1007/s00125-018-4627-x] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 03/22/2018] [Indexed: 12/21/2022]
Abstract
AIMS/HYPOTHESIS Pancreatic fat accumulation may contribute to the development of beta cell dysfunction. Exercise training improves whole-body insulin sensitivity, but its effects on pancreatic fat content and beta cell dysfunction are unclear. The aim of this parallel-group randomised controlled trial was to evaluate the effects of exercise training on pancreatic fat and beta cell function in healthy and prediabetic or type 2 diabetic participants and to test whether the responses were similar regardless of baseline glucose tolerance. METHODS Using newspaper announcements, a total of 97 sedentary 40-55-year-old individuals were assessed for eligibility. Prediabetes (impaired fasting glucose and/or impaired glucose tolerance) and type 2 diabetes were defined by ADA criteria. Of the screened candidates, 28 healthy men and 26 prediabetic or type 2 diabetic men and women met the inclusion criteria and were randomised into 2-week-long sprint interval or moderate-intensity continuous training programmes in a 1:1 allocation ratio using random permuted blocks. The primary outcome was pancreatic fat, which was measured by magnetic resonance spectroscopy. As secondary outcomes, beta cell function was studied using variables derived from OGTT, and whole-body insulin sensitivity and pancreatic fatty acid and glucose uptake were measured using positron emission tomography. The measurements were carried out at the Turku PET Centre, Finland. The analyses were based on an intention-to-treat principle. Given the nature of the intervention, blinding was not applicable. RESULTS At baseline, the group of prediabetic or type 2 diabetic men had a higher pancreatic fat content and impaired beta cell function compared with the healthy men, while glucose and fatty acid uptake into the pancreas was similar. Exercise training decreased pancreatic fat similarly in healthy (from 4.4% [3.0%, 6.1%] to 3.6% [2.4%, 5.2%] [mean, 95% CI]) and prediabetic or type 2 diabetic men (from 8.7% [6.0%, 11.9%] to 6.7% [4.4%, 9.6%]; p = 0.036 for time effect) without any changes in pancreatic substrate uptake (p ≥ 0.31 for time effect in both insulin-stimulated glucose and fasting state fatty acid uptake). In prediabetic or type 2 diabetic men and women, both exercise modes similarly improved variables describing beta cell function. CONCLUSIONS/INTERPRETATION Two weeks of exercise training improves beta cell function in prediabetic or type 2 diabetic individuals and decreases pancreatic fat regardless of baseline glucose tolerance. This study shows that short-term training efficiently reduces ectopic fat within the pancreas, and exercise training may therefore reduce the risk of type 2 diabetes. TRIAL REGISTRATION ClinicalTrials.gov NCT01344928 FUNDING: This study was funded by the Emil Aaltonen Foundation, the European Foundation for the Study of Diabetes, the Finnish Diabetes Foundation, the Orion Research Foundation, the Academy of Finland (grants 251399, 256470, 281440, and 283319), the Ministry of Education of the State of Finland, the Paavo Nurmi Foundation, the Novo Nordisk Foundation, the Finnish Cultural Foundation, the Hospital District of Southwest Finland, the Turku University Foundation, and the Finnish Medical Foundation.
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Affiliation(s)
- Marja A Heiskanen
- Turku PET Centre, University of Turku, P.O. Box 52, FIN-20521, Turku, Finland
| | - Kumail K Motiani
- Turku PET Centre, University of Turku, P.O. Box 52, FIN-20521, Turku, Finland
| | - Andrea Mari
- Institute of Neuroscience, National Research Council, Padova, Italy
| | - Virva Saunavaara
- Turku PET Centre, Turku University Hospital, Turku, Finland
- Department of Medical Physics, Turku University Hospital, Turku, Finland
| | | | | | - Mikko Koivumäki
- Turku PET Centre, University of Turku, P.O. Box 52, FIN-20521, Turku, Finland
| | | | - Pirjo Nuutila
- Turku PET Centre, University of Turku, P.O. Box 52, FIN-20521, Turku, Finland
- Turku PET Centre, Turku University Hospital, Turku, Finland
- Turku PET Centre, Åbo Akademi University, Turku, Finland
| | - Kari K Kalliokoski
- Turku PET Centre, University of Turku, P.O. Box 52, FIN-20521, Turku, Finland
| | - Jarna C Hannukainen
- Turku PET Centre, University of Turku, P.O. Box 52, FIN-20521, Turku, Finland.
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Minghetti A, Faude O, Hanssen H, Zahner L, Gerber M, Donath L. Sprint interval training (SIT) substantially reduces depressive symptoms in major depressive disorder (MDD): A randomized controlled trial. Psychiatry Res 2018; 265:292-297. [PMID: 29775886 DOI: 10.1016/j.psychres.2018.04.053] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 04/06/2018] [Accepted: 04/23/2018] [Indexed: 12/20/2022]
Abstract
Continuous aerobic exercise training (CAT) is considered a complementary treatment option in patients with major depressive disorder (MDD). Intermittent exercise training protocols, such as sprint interval training (SIT) have gained increasing popularity, but no studies on depressive symptoms following SIT in patients with MDD are available. Fifty-nine in-patients with MDD were randomly assigned to a SIT or CAT group. Medication was counterbalanced in both intervention arms. Both intervention groups received 3 weekly training sessions for 4-weeks (12 sessions in total). SIT comprised 25 bouts of 30 seconds at 80% of maximal power, whereas CAT consisted of 20 minutes of physical activity at 60% of maximal power. The training protocols were isocalorically designed. Maximal bicycle ergometer exercise testing yielded maximal and submaximal physical fitness parameters. The Beck-Depression-Inventory-II (BDI-II) was filled out by the patients before and after the intervention period. BDI-II scores substantially decreased in both groups with an effect size pointing towards a large effect (p < 0.001, ηp² = 0.70) while submaximal (0.07 < d < 0.89) and maximal (0.05 < d < 0.85) fitness variables improved in both groups. Short-term SIT leads to similar results as CAT in patients with MDD and can be regarded as a time-efficient and promising exercise-based treatment strategy.
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Affiliation(s)
- Alice Minghetti
- Department of Sport, Exercise and Health, University of Basel, Basel 4052, Switzerland.
| | - Oliver Faude
- Department of Sport, Exercise and Health, University of Basel, Basel 4052, Switzerland.
| | - Henner Hanssen
- Department of Sport, Exercise and Health, University of Basel, Basel 4052, Switzerland.
| | - Lukas Zahner
- Department of Sport, Exercise and Health, University of Basel, Basel 4052, Switzerland.
| | - Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, Basel 4052, Switzerland.
| | - Lars Donath
- Department of Sport, Exercise and Health, University of Basel, Basel 4052, Switzerland; Department of Intervention Research in Exercise Training, German Sport University Cologne, Köln, Germany.
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