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Yang X, Sun J, Zhang W. Global trends in burden of type 2 diabetes attributable to physical inactivity across 204 countries and territories, 1990-2019. Front Endocrinol (Lausanne) 2024; 15:1343002. [PMID: 38469145 PMCID: PMC10925666 DOI: 10.3389/fendo.2024.1343002] [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: 11/22/2023] [Accepted: 02/08/2024] [Indexed: 03/13/2024] Open
Abstract
Background To promote a comprehensive understanding of global trends and burden of type 2 diabetes attributable to physical inactivity. Methods We utilized data regarding mortality, disability-adjusted life years (DALYs), as well as age-standardized mortality rates (ASMR) and DALYs rates (ASDR) derived from the global burden of disease study 2019 to evaluate the impact of physical inactivity on the prevalence of type 2 diabetes in 204 countries and territories over the period from 1990 to 2019. This method facilitated the analysis of the diabetes burden across different ages, genders, and regions. To determine the long-term progression of type 2 diabetes prevalence, we computed the estimated annual percentage change (EAPC) in burden rates. Results Globally, the number of deaths and DALYs from type 2 diabetes due to physical inactivity more than doubled between 1990 and 2019. Concurrently, there was an increase in the ASMR and ASDR, with EAPC of 0.26 (95% CI: 0.13-0.39) and 0.84 (95% CI: 0.78-0.89), respectively. As of 2019, the global ASMR and ASDR for physical inactivity stood at 1.6 (95% UI: 0.8-2.7) per 100 000 and 55.9 (95% UI: 27.2-97.6) per 100 000, respectively. Notable disparities were observed in the type 2 diabetes burden associated with physical inactivity worldwide, with higher sociodemographic index (SDI) countries experiencing lower ASDR and ASMR compared to lower SDI countries. Initially, females exhibited higher ASMR and ASDR than males, but this gender disparity in ASMR and ASDR has lessened in recent years. The mortality and DALYs rates associated with physical inactivity exhibit an inverted V-shaped pattern across various age groups, predominantly affecting the elderly population. Conclusion Between 1990 and 2019, there was a marked rise in the worldwide burden of type 2 diabetes associated with physical inactivity, underscoring the role of physical inactivity as a key changeable risk factor in the global landscape of this disease. This necessitates additional research to explore the variables contributing to the varying levels of disease burden across different countries and between sexes. Furthermore, it calls for the formulation of public health policies aimed at guiding prevention tactics, promoting early detection, and enhancing the management of type 2 diabetes.
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Affiliation(s)
| | | | - Wenjuan Zhang
- Department of Cardiovascular Medicine, Tianjin Medical University General Hospital, Tianjin, China
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Hall LG, Thyfault JP, Johnson JD. Exercise and inactivity as modifiers of β cell function and type 2 diabetes risk. J Appl Physiol (1985) 2023; 134:823-839. [PMID: 36759159 PMCID: PMC10042613 DOI: 10.1152/japplphysiol.00472.2022] [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: 08/15/2022] [Revised: 01/31/2023] [Accepted: 01/31/2023] [Indexed: 02/11/2023] Open
Abstract
Exercise and regular physical activity are beneficial for the prevention and management of metabolic diseases such as obesity and type 2 diabetes, whereas exercise cessation, defined as deconditioning from regular exercise or physical activity that has lasted for a period of months to years, can lead to metabolic derangements that drive disease. Adaptations to the insulin-secreting pancreatic β-cells are an important benefit of exercise, whereas less is known about how exercise cessation affects these cells. Our aim is to review the impact that exercise and exercise cessation have on β-cell function, with a focus on the evidence from studies examining glucose-stimulated insulin secretion (GSIS) using gold-standard techniques. Potential mechanisms by which the β-cell adapts to exercise, including exerkine and incretin signaling, autonomic nervous system signaling, and changes in insulin clearance, will also be explored. We will highlight areas for future research.
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Affiliation(s)
- Liam G Hall
- Department of Cellular and Physiological Sciences, Life Sciences Institute, The University of British Columbia, Vancouver, British Columbia, Canada
| | - John P Thyfault
- Department of Cell Biology and Physiology, University of Kansas Medical Center, Kansas City, Kansas, United States
- Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas, United States
- KU Diabetes Institute, University of Kansas Medical Center, Kansas City, Kansas, United States
| | - James D Johnson
- Department of Cellular and Physiological Sciences, Life Sciences Institute, The University of British Columbia, Vancouver, British Columbia, Canada
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Ugurlu I, Baltaci SB, Unal O, Mogulkoc R, Ucaryilmaz H, Baltaci AK. Chronic Running Exercise Regulates Cytotoxic Cell Functions and Zinc Transporter SLC39A10/ZIP10 Levels in Diabetic Rats. Biol Trace Elem Res 2022; 200:699-705. [PMID: 33742346 DOI: 10.1007/s12011-021-02680-8] [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: 03/01/2021] [Accepted: 03/15/2021] [Indexed: 11/26/2022]
Abstract
The aim of this study is to investigate how chronic running exercise affects ZIP10 levels in thymus and spleen tissue as well as immune parameters in diabetic rats. A total of 40 adult male Wistar rats were divided into 4 equal groups: group 1, control; group 2, exercise control; group 3, diabetes; group 4, diabetes + exercise. Diabetes was induced by injecting intraperitoneal streptozotocin (STZ) at a dose of 40 mg/kg twice with 24-h intervals to the animals in groups 3 and 4. The animals in group 2 and group 4 underwent exercise for 45 min on the rat treadmill for 4 weeks at 20 m/min. Twenty-four hours after the last running exercise, the animals were sacrificed under general anesthesia. Immunological parameters were determined by flow cytometric method; tissue ZIP 10 levels were determined by ELISA method. The diabetic group had the lowest natural killer (NK) and natural killer T (NKT) cells percentages. Chronic exercise partially improved NK and NKT cell percentages in diabetic rats. The diabetic group had the lowest ZIP10 levels in spleen and thymus tissue. ZIP10 values in spleen and thymus tissue of diabetes exercise group were significantly higher than diabetes group. The results of our study show that the impaired cytotoxic cell functions in diabetes are partially corrected with 4 weeks of chronic exercise, and that the suppressed ZIP 10 levels in diabetic rats are reversed by 4 weeks of chronic exercise.
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Affiliation(s)
- Ibrahim Ugurlu
- Vocational School of Health Services, Selcuk University, Konya, Turkey
| | | | - Omer Unal
- Medical Faculty, Department of Physiology, Selcuk University, Konya, Turkey
| | - Rasim Mogulkoc
- Medical Faculty, Department of Physiology, Selcuk University, Konya, Turkey
| | - Hulya Ucaryilmaz
- Medical Faculty Department of Medical Biology, Selcuk University, Konya, Turkey
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Langlois A, Forterre A, Pinget M, Bouzakri K. Impact of moderate exercise on fatty acid oxidation in pancreatic β-cells and skeletal muscle. J Endocrinol Invest 2021; 44:1815-1825. [PMID: 33844166 PMCID: PMC8357749 DOI: 10.1007/s40618-021-01551-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 03/03/2021] [Indexed: 12/13/2022]
Abstract
Fatty acids (FA) play a crucial role in glycaemia regulation in healthy and metabolic disorders conditions through various mechanisms. FA oxidation is one of the processes involved in lipid metabolism and can be modulated by exercise. Nowadays, physical activity is known to be an effective strategy for the prevention and treatment of Type 2 Diabetes. Moreover, its intensity, its duration, the sex-gender, the prandial state, exerkines… are as many parameters that can influence glycaemic control. However, the widely debated question is to determine the best type of exercise for patients with metabolic disorders. In this review, we will discuss the impact of exercise intensity, especially moderate activity, on glycaemic control by focussing on FA oxidation in pancreatic β-cells and skeletal muscle. Finally, thanks to all the recent data, we will determine whether moderate physical activity is a good therapeutic strategy and if FA oxidation represents a target of interest to treat diabetic, obese and insulin-resistant patients.
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Affiliation(s)
- A Langlois
- Centre Européen D'étude du Diabète, Unité Mixte de Recherche de L'Université de Strasbourg « Diabète et Thérapeutique », Strasbourg, France
| | - A Forterre
- Centre Européen D'étude du Diabète, Unité Mixte de Recherche de L'Université de Strasbourg « Diabète et Thérapeutique », Strasbourg, France
| | - M Pinget
- Centre Européen D'étude du Diabète, Unité Mixte de Recherche de L'Université de Strasbourg « Diabète et Thérapeutique », Strasbourg, France
| | - K Bouzakri
- Centre Européen D'étude du Diabète, Unité Mixte de Recherche de L'Université de Strasbourg « Diabète et Thérapeutique », Strasbourg, France.
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Boschetti D, Muller CR, Américo ALV, Vecchiatto B, Martucci LF, Pereira RO, Oliveira CP, Fiorino P, Evangelista FS, Azevedo-Martins AK. Aerobic Physical Exercise Improves Exercise Tolerance and Fasting Glycemia Independent of Body Weight Change in Obese Females. Front Endocrinol (Lausanne) 2021; 12:772914. [PMID: 34970223 PMCID: PMC8713970 DOI: 10.3389/fendo.2021.772914] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 11/18/2021] [Indexed: 12/15/2022] Open
Abstract
Obesity is associated with increased risk of several chronic diseases and the loss of disease-free years, which has increased the focus of much research for the discovery of therapy to combat it. Under healthy conditions, women tend to store more fat in subcutaneous deposits. However, this sexual dimorphism tends to be lost in the presence of comorbidities, such as type 2 diabetes mellitus (T2DM). Aerobic physical exercise (APE) has been applied in the management of obesity, however, is still necessary to better understand the effects of APE in obese female. Thus, we investigated the effect of APE on body weight, adiposity, exercise tolerance and glucose metabolism in female ob/ob mice. Eight-weeks-old female wild-type C57BL/6J and leptin-deficient ob/ob mice (Lepob) were distributed into three groups: wild-type sedentary group (Wt; n = 6), leptin-deficient sedentary group (LepobS; n = 5) and leptin-deficient trained group (LepobT; n = 8). The LepobT mice were subjected to 8 weeks of aerobic physical exercise (APE) at 60% of the maximum velocity achieved in the running capacity test. The APE had no effect in attenuating body weight gain, and did not reduce subcutaneous and retroperitoneal white adipose tissue (SC-WAT and RP-WAT, respectively) and interscapular brown adipose tissue (iBAT) weights. The APE neither improved glucose intolerance nor insulin resistance in the LepobT group. Also, the APE did not reduce the diameter or the area of RP-WAT adipocytes, but the APE reduced the diameter and the area of SC-WAT adipocytes, which was associated with lower fasting glycemia and islet/pancreas area ratio in the LepobT group. In addition, the APE increased exercise tolerance and this response was also associated with lower fasting glycemia in the LepobT group. In conclusion, starting APE at a later age with a more severe degree of obesity did not attenuate the excessive body weight gain, however the APE promoted benefits that can improve the female health, and for this reason it should be recommended as a non-pharmacological therapy for obesity.
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Affiliation(s)
- Daniela Boschetti
- School of Arts, Science and Humanities, University of Sao Paulo, São Paulo, Brazil
| | - Cynthia R. Muller
- Department of Bioengineering, University of California San Diego, La Jolla, San Diego, CA, United States
- Department of Experimental Pathophysiology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Anna Laura V. Américo
- Department of Experimental Pathophysiology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Bruno Vecchiatto
- School of Arts, Science and Humanities, University of Sao Paulo, São Paulo, Brazil
- Department of Experimental Pathophysiology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Luiz Felipe Martucci
- Department of Experimental Pathophysiology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Renata O. Pereira
- Translational Medicine Division, Department of Medicine, Federal University of São Paulo, Sao Paulo, Brazil
| | - Cláudia P. Oliveira
- Division of Gastroenterology and Hepatology, Department of Gastroenterology (LIM 07), Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Patricia Fiorino
- Renal, Cardiovascular and Metabolic Physiopharmacology Laboratory, Health and Biological Science Center, Mackenzie Presbyterian University, São Paulo, Brazil
| | | | - Anna Karenina Azevedo-Martins
- School of Arts, Science and Humanities, University of Sao Paulo, São Paulo, Brazil
- *Correspondence: Anna Karenina Azevedo-Martins,
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Ho CC, Chang PS, Chen HW, Lee PF, Chang YC, Tseng CY, Lin PT. Ubiquinone Supplementation with 300 mg on Glycemic Control and Antioxidant Status in Athletes: A Randomized, Double-Blinded, Placebo-Controlled Trial. Antioxidants (Basel) 2020; 9:antiox9090823. [PMID: 32899227 PMCID: PMC7555239 DOI: 10.3390/antiox9090823] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 09/01/2020] [Accepted: 09/01/2020] [Indexed: 12/20/2022] Open
Abstract
The aim of this study is to investigate the glycemic profile, oxidative stress, and antioxidant capacity in athletes after 12 weeks of ubiquinone supplementation. It was a double-blinded, randomized, parallel, placebo-controlled study. Thirty-one well-trained college athletes were randomly assigned to ubiquinone (300 mg/d, n = 17) or placebo group (n = 14). The glycemic profile [fasting glucose, glycated hemoglobin (HbA1c), homeostatic model assessment-insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI)], plasma and erythrocyte malondialdehyde (MDA), total antioxidant capacity (TAC), and ubiquinone status were measured. After supplementation, the plasma ubiquinone concentration was significantly increased (p < 0.05) and the level of erythrocyte MDA was significantly lower in the ubiquinone group than in the placebo group (p < 0.01). There was a significant correlation between white blood cell (WBC) ubiquinone and glycemic parameters [HbA1c, r = −0.46, p < 0.05; HOMA-IR, r = −0.67, p < 0.01; QUICKI, r = 0.67, p < 0.01]. In addition, athletes with higher WBC ubiquinone level (≥0.5 nmol/g) showed higher erythrocyte TAC and QUICKI and lower HOMA-IR. In conclusion, we demonstrated that athletes may show a better antioxidant capacity with higher ubiquinone status after 12 weeks of supplementation, which may further improve glycemic control.
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Affiliation(s)
- Chien-Chang Ho
- Department of Physical Education, Fu Jen Catholic University, New Taipei City 242304, Taiwan; (C.-C.H.); (P.-F.L.); (Y.-C.C.); (C.-Y.T.)
- Research and Development Center for Physical Education, Health, and Information Technology, College of Education, Fu Jen Catholic University, New Taipei City 242304, Taiwan
| | - Po-Sheng Chang
- Department of Nutrition, Chung Shan Medical University, Taichung 402367, Taiwan; (P.-S.C.); (H.-W.C.)
- Graduate Program in Nutrition, Chung Shan Medical University, Taichung 402367, Taiwan
| | - Hung-Wun Chen
- Department of Nutrition, Chung Shan Medical University, Taichung 402367, Taiwan; (P.-S.C.); (H.-W.C.)
| | - Po-Fu Lee
- Department of Physical Education, Fu Jen Catholic University, New Taipei City 242304, Taiwan; (C.-C.H.); (P.-F.L.); (Y.-C.C.); (C.-Y.T.)
- Graduate Institute of Sport Coaching Science, Chinese Culture University, Taipei City 111396, Taiwan
| | - Yun-Chi Chang
- Department of Physical Education, Fu Jen Catholic University, New Taipei City 242304, Taiwan; (C.-C.H.); (P.-F.L.); (Y.-C.C.); (C.-Y.T.)
- Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei City 112304, Taiwan
| | - Ching-Yu Tseng
- Department of Physical Education, Fu Jen Catholic University, New Taipei City 242304, Taiwan; (C.-C.H.); (P.-F.L.); (Y.-C.C.); (C.-Y.T.)
- Research and Development Center for Physical Education, Health, and Information Technology, College of Education, Fu Jen Catholic University, New Taipei City 242304, Taiwan
| | - Ping-Ting Lin
- Department of Nutrition, Chung Shan Medical University, Taichung 402367, Taiwan; (P.-S.C.); (H.-W.C.)
- Department of Nutrition, Chung Shan Medical University Hospital, Taichung 402367, Taiwan
- Correspondence: ; Tel.: +886-4-24730022 (ext. 12187); Fax: +886-4-2324-8175
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Changes in the Brain-Derived Neurotrophic Factor Are Associated with Improvements in Diabetes Risk Factors after Exercise Training in Adolescents with Obesity: The HEARTY Randomized Controlled Trial. Neural Plast 2018; 2018:7169583. [PMID: 30363954 PMCID: PMC6186331 DOI: 10.1155/2018/7169583] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Revised: 07/24/2018] [Accepted: 08/19/2018] [Indexed: 12/20/2022] Open
Abstract
Obesity in youth increases the risk of type 2 diabetes (T2D), and both are risk factors for neurocognitive deficits. Exercise attenuates the risk of obesity and T2D while improving cognitive function. In adults, these benefits are associated with the actions of the brain-derived neurotrophic factor (BDNF), a protein critical in modulating neuroplasticity, glucose regulation, fat oxidation, and appetite regulation in adults. However, little research exists in youth. This study examined the associations between changes in diabetes risk factors and changes in BDNF levels after 6 months of exercise training in adolescents with obesity. The sample consisted of 202 postpubertal adolescents with obesity (70% females) aged 14-18 years who were randomized to 6 months of aerobic and/or resistance training or nonexercise control. All participants received a healthy eating plan designed to induce a 250/kcal deficit per day. Resting serum BDNF levels and diabetes risk factors, such as fasting glucose, insulin, homeostasis model assessment (HOMA-B-beta cell insulin secretory capacity) and (HOMA-IS-insulin sensitivity), and hemoglobin A1c (HbA1c), were measured after an overnight fast at baseline and 6 months. There were no significant intergroup differences on changes in BDNF or diabetes risk factors. In the exercise group, increases in BDNF were associated with reductions in fasting glucose (β = -6.57, SE = 3.37, p = 0.05) and increases in HOMA-B (β = 0.093, SE = 0.03, p = 0.004) after controlling for confounders. No associations were found between changes in diabetes risk factors and BDNF in controls. In conclusion, exercise-induced reductions in some diabetes risk factors were associated with increases in BDNF in adolescents with obesity, suggesting that exercise training may be an effective strategy to promote metabolic health and increases in BDNF, a protein favoring neuroplasticity. This trial is registered with ClinicalTrials.gov NCT00195858, September 12, 2005 (funded by the Canadian Institutes of Health Research).
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de Las Heras N, Klett-Mingo M, Ballesteros S, Martín-Fernández B, Escribano Ó, Blanco-Rivero J, Balfagón G, Hribal ML, Benito M, Lahera V, Gómez-Hernández A. Chronic Exercise Improves Mitochondrial Function and Insulin Sensitivity in Brown Adipose Tissue. Front Physiol 2018; 9:1122. [PMID: 30174613 PMCID: PMC6107710 DOI: 10.3389/fphys.2018.01122] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 07/27/2018] [Indexed: 12/18/2022] Open
Abstract
The aim of the present work was to study the consequences of chronic exercise training on factors involved in the regulation of mitochondrial remodeling and biogenesis, as well as the ability to produce energy and improve insulin sensitivity and glucose uptake in rat brown adipose tissue (BAT). Male Wistar rats were divided into two groups: (1) control group (C; n = 10) and (2) exercise-trained rats (ET; n = 10) for 8 weeks on a motor treadmill (five times per week for 50 min). Exercise training reduced body weight, plasma insulin, and oxidized LDL concentrations. Protein expression of ATP-independent metalloprotease (OMA1), short optic atrophy 1 (S-OPA1), and dynamin-related protein 1 (DRP1) in BAT increased in trained rats, and long optic atrophy 1 (L-OPA1) and mitofusin 1 (MFN1) expression decreased. BAT expression of nuclear respiratory factor type 1 (NRF1) and mitochondrial transcription factor A (TFAM), the main factors involved in mitochondrial biogenesis, was higher in trained rats compared to controls. Exercise training increased protein expression of sirtuin 1 (SIRT1), peroxisome proliferator-activated receptor γ coactivator 1α (PGC1α) and AMP-activated protein kinase (pAMPK/AMPK ratio) in BAT. In addition, training increased carnitine palmitoyltransferase II (CPT II), mitochondrial F1 ATP synthase α-chain, mitochondrial malate dehydrogenase 2 (mMDH) and uncoupling protein (UCP) 1,2,3 expression in BAT. Moreover, exercise increased insulin receptor (IR) ratio (IRA/IRB ratio), IRA-insulin-like growth factor 1 receptor (IGF-1R) hybrids and p42/44 activation, and decreased IGF-1R expression and IR substrate 1 (p-IRS-1) (S307) indicating higher insulin sensitivity and favoring glucose uptake in BAT in response to chronic exercise training. In summary, the present study indicates that chronic exercise is able to improve the energetic profile of BAT in terms of increased mitochondrial function and insulin sensitivity.
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Affiliation(s)
- Natalia de Las Heras
- Department of Physiology, School of Medicine, Complutense University of Madrid, Madrid, Spain
| | - Mercedes Klett-Mingo
- Department of Physiology, School of Medicine, Complutense University of Madrid, Madrid, Spain
| | - Sandra Ballesteros
- Department of Physiology, School of Medicine, Complutense University of Madrid, Madrid, Spain
| | | | - Óscar Escribano
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, Complutense University of Madrid, Madrid, Spain.,CIBER of Diabetes and Associated Metabolic Diseases, Barcelona, Spain
| | - Javier Blanco-Rivero
- Department of Physiology, School of Medicine, Autonomous University of Madrid, Madrid, Spain
| | - Gloria Balfagón
- Department of Physiology, School of Medicine, Autonomous University of Madrid, Madrid, Spain
| | - Marta L Hribal
- Department of Medical and Surgical Sciences, Magna Græcia University of Catanzaro, Catanzaro, Italy
| | - Manuel Benito
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, Complutense University of Madrid, Madrid, Spain.,CIBER of Diabetes and Associated Metabolic Diseases, Barcelona, Spain
| | - Vicente Lahera
- Department of Physiology, School of Medicine, Complutense University of Madrid, Madrid, Spain
| | - Almudena Gómez-Hernández
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, Complutense University of Madrid, Madrid, Spain.,CIBER of Diabetes and Associated Metabolic Diseases, Barcelona, Spain
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