Comparing the effects of 6 months aerobic exercise and resistance training on metabolic control and β-cell function in Chinese patients with prediabetes: A multicenter randomized controlled trial

Clinical research progress on β-cell dysfunction in T2DM development in the Chinese population

The prevalence of type-2 diabetes mellitus (T2DM) has increased over 10-fold in the past 40 years in China, which now has the largest T2DM population in the world. Insulin resistance and β-cell dysfunction are the typical features of T2DM. Although both factors play a role, decreased β-cell function and β-cell mass are the predominant factors for progression to T2DM. Considering the differences between Chinese T2DM patients and those of other ethnicities, it is important to characterize β-cell dysfunction in Chinese patients during T2DM progression. Herein, we reviewed the studies on the relationships between β-cell function and T2DM progression in the Chinese population and discussed the differences among individuals of varying ethnicities. Meanwhile, we summarized the risk factors and current treatments of T2DM in Chinese individuals and discussed their impacts on β-cell function with the hope of identifying a better T2DM therapy.

Evaluation of the Effect of a Mobile Application on Glycated Hemoglobin in Older Adults with Type 2 Diabetes Mellitus-Protocol of a Randomized Clinical Trial

BACKGROUND

Digital educational technologies in health have been an important instrument for promoting learning, self-care, self-esteem, and security regarding prevention and health promotion actions that lead to changes in behavior, mainly for non-communicable disease patients, such as type 2 Diabetes Mellitus (DM 2).

OBJECTIVE

This study aimed to describe a protocol for evaluating the effect of an app for cell phones and tablets on the blood glucose of older adults with DM 2.

METHODS

The protocol will be used to compare the effectiveness of an application for mobile devices concerning the educational booklet in reducing Glycated Hemoglobin in older adults with DM 2 in Primary Health Care. This protocol is part of a Randomized Clinical Trial project entitled Effectiveness of a Mobile Device Application on Glycated Hemoglobin in Elderly People with Type 2 Diabetes Mellitus: a Randomized Clinical Trial.

RESULTS

The protocol was structured in the following phases: (i) sample calculation, (ii) invitation to participate in the study according to the eligibility criteria; (iii) participant registration; (iv) randomization and allocation of participants into groups (double blinding); (v) application of the intervention; (vi) post-intervention procedures (post-test); (vii) data analysis.

CONCLUSION

It is expected that encouraging studies on the impact of a mobile application will improve and enhance health education focused on self-care for older adults with DM 2, potentially influencing the local health system by reducing hospitalizations due to conditions that are sensitive to primary care, since health promotion and prevention of DM-related illnesses will be the main focus of the application and booklet developed.

Lifestyle Intervention in Reducing Insulin Resistance and Preventing type 2 Diabetes in Asia Pacific Region: A Systematic Review and Meta-Analysis

PURPOSE OF REVIEW

To update the evidence of lifestyle interventions for the prevention of type 2 diabetes mellites (T2DM) in adults, particularly in the Asia Pacific region. The key questions to ask are: 1) How effective are lifestyle interventions in preventing T2DM among at-risk adults in the Asia Pacific Region? 2)What are the key characteristics of the implementation of lifestyle interventions for diabetes prevention?

RECENT FINDINGS

Lifestyle interventions for the prevention of T2DM have been suggested to be effective. There is evidence of ethnic differences in some glycaemic and anthropometric outcomes. The meta-analysis suggested a significant result in reducing waist circumference (standardised mean difference - 019, 95%CI ( -0.31, -0.06)), and no significant effects in other outcomes. However, the implementation outcomes suggested lifestyle intervention might be a cost-effective and sustainable approach in T2DM particularly in countries in the Asia Pacific Region. The focus of lifestyle intervention in the Asia Pacific Region should not only lie in the effectiveness of the trial but a thorough evaluation of the implementation outcomes, as well as cultural adaptations, with the support of all stakeholders through all stages of the implementation.

Moderate resistance training reduces intermuscular adipose tissue and risk factors of atherosclerotic cardiovascular disease for elderly patients with type 2 diabetes

AIM

This study aimed to assess the impact of moderate resistance training on intermuscular adipose tissue (IMAT) in elderly patients with type 2 diabetes and the independent effect of IMAT reduction on metabolic outcomes.

METHODS

In this randomized controlled trial, 85 patients with type 2 diabetes were assigned to either the resistance training group (42 participants) or the control group (43 participants) for a 6-month intervention. The primary outcome was changes in IMAT measured by computed tomography scan and magnetic resonance imaging using the interactive decomposition of water and fat with echo asymmetry and least squares qualification sequence. Secondary outcomes included changes in metabolic parameters.

RESULTS

Thirty-seven participants in each group completed the study. The IMAT area (measured by a computed tomography scan) in the resistance group decreased from 5.176 ± 1.249 cm2 to 4.660 ± 1.147 cm2, which is a change of -0.512 ± 0.115 cm2, representing a 9.89% decrease from the least-squares adjusted mean at baseline, which was significantly different from that of the control group (a change of 0.587 ± 0.115 cm2, a 10.34% increase). The normal attenuation muscle area (representing normal muscle density) in the resistance group increased from 82.113 ± 8.776 cm2 to 83.054 ± 8.761 cm2, a change of 1.049 ± 0.416 cm2, a 1.3% increase, which was significantly different from that of the control group (a change of -1.113 ± 0.416 cm2, a 1.41% decrease). Homeostasis model assessment 2 of beta cell function (HOMA2-β; increased from 52.291 ± 24.765 to 56.368 ± 21.630, a change of 4.135 ± 1.910, a 7.91% increase from baseline) and ratio of insulin increase to blood glucose increase at 30 min after the oral glucose tolerance test (∆I30/∆G30; increased from 4.616 ± 1.653 to 5.302 ± 2.264, a change of 0.715 ± 0.262, a 15.49% increase) in the resistance group were significantly improved compared with those in the control group, which had a change of -3.457 ± 1.910, a 6.05% decrease in HOMA2-β, and a change of -0.195 ± 0.262, a 3.87% decrease in ∆I30/∆G30, respectively. Adjusting for sex, age, diabetes duration, baseline IMAT, and the dependent variable at baseline, linear regression showed that the change in IMAT area was not related to the change in HOMA2 insulin resistance (β = -0.178, p = .402) or the change in HOMA2-β (β = -1.891, p = .197), but was significantly related to the changes in ∆I30/∆G30 (β = -0.439, p = .047), 2-h postprandial glucose (β = 1.321, p = .026), diastolic blood pressure (β = 2.425, p = .018), normal attenuation muscle area (β = -0.907, p = .019) and 10-year risk of atherosclerotic cardiovascular disease (β = 0.976, p = .002).

CONCLUSION

Low-level, moderate resistance training reduces IMAT content. Even a small reduction in IMAT may be related to a decrease in risk factors for atherosclerotic cardiovascular disease, but this small reduction may not be sufficient to reduce insulin resistance.

Exercise training modalities in prediabetes: a systematic review and network meta-analysis

Background

Lifestyle modification based on exercise intervention is still the primary way to delay or reverse the development of diabetes in patients with prediabetes. However, there are still challenges in setting up a detailed exercise prescription for people with prediabetes. This study mainly ranks exercise prescriptions by comparing the improvement of glucose and lipid metabolism and the level of weight loss in patients.

Method

All studies on exercise intervention in prediabetes were identified by searching five electronic databases. Risk assessment and meta-analysis were performed on eligible studies.

Results

Twenty-four studies involving 1946 patients with prediabetes and seven exercise intervention models were included in the final analysis. The meta-analysis showed that exercise of any type was more effective for glycemic control in prediabetes than no exercise. However, the changes in blood glucose were moderate. In prediabetes, combining moderate-intensity aerobic exercise with low-to moderate-load resistance training showed the most significant improvements in glycosylated hemoglobin (HbA1c), body mass index (BMI), body weight (BW), total cholesterol (TC), and low-density lipoprotein cholesterol (LDL) (P-score=0.82; 0.70; 0.87; 1; 0.99), low-to moderate-load resistance training showed the most significant improvements in fasting blood glucose (FBG) (P-score=0.98), the vigorous-intensity aerobic exercise showed the most significant improvements in 2-hour post-meal blood glucose (2hPG) and systolic blood pressure (SBP) (P-score=0.79; 0.78), and moderate-intensity aerobic exercise showed the most significant improvements in diastolic blood pressure (DBP) (P-score=0.78).

Conclusion

In summary, moderate-intensity aerobic exercise, low-to moderate-load resistance training and the combination of both have beneficial effects on glycemic control, weight loss, and cardiovascular health in patients with prediabetes. These findings provide valuable guidance for rehabilitation clinicians and patients alike to follow.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/, identifier CRD 42021284922.

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

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.

Effects of aerobic exercises in prediabetes patients: a systematic review and meta-analysis

Aims

To evaluate the effects of different durations of continuous aerobic exercise on prediabetic patients.

Materials and methods

The research encompassed randomized controlled trials that examined how various durations of aerobic exercise training affected outcomes related to Body Mass Index (BMI), Fasting blood glucose (FBG), 2-hour plasma glucose (2hPG), and glycated hemoglobin (HbA1c) in individuals diagnosed with prediabetes. PubMed, Embase, Web of Science, and the Cochrane Library were searched as of January 7, 2023. The Cochrane Risk of Bias, version 2 (ROB 2) tool was used to assess the risk of bias.

Results

A total of 10 RCTs with 815 prediabetic patients were included. The average age of the participants was 56.1 years, with a standard deviation of 5.1 years. Among the participants, 39.2% were male. The interventions consisted of aerobic dance, treadmill running, walking, and a combination of aerobic exercises. The training sessions occurred three or four times per week. In prediabetic patients, aerobic exercise demonstrated a significant reduction in BMI compared to the control group, with a weighted mean difference (WMD) of -1.44 kg/m2 (95% confidence interval [CI] -1.89, -0.98). There was a decrease in FBG levels, with WMD of -0.51 mmol/L (95% CI -0.70, -0.32). Additionally, aerobic training led to significant improvements in 2hPG levels, with a WMD of -0.76 mmol/L (95% CI -1.14, -0.38). Furthermore, prediabetic patients showed a decrease in HbA1c levels after engaging in aerobic training compared to the control group, with a WMD of -0.34% (95% CI -0.45, -0.23).

Conclusion

In summary, engaging in aerobic exercise can have a significant positive impact on glycemic levels in individuals with prediabetes. It can also lead to reductions in BMI, FBG, 2hPG, HbA1c, and other relevant indicators. The extent of these improvements may vary slightly depending on the duration of the aerobic exercise intervention.

Systematic review registration

PROSPERO https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023395515.

Institute-based nurse-led care versus home-based resistance training for patients with acute pancreatitis: Clinical outcomes analysis

Surgeries may have worse clinical outcomes in pancreatitis. In our institute surgical procedure is barely used surgery to treat pancreatitis nowadays. Chinese guidelines recommended regular exercise for severe pancreatitis. The objectives of the current study were to compare nurse-led resistance training at the institute against usual care provided to patients with acute pancreatitis for favorable clinical outcome measures. For acute pancreatitis, patients (≥18 years, of age) received 6 months of resistance training in the garden of the institute under the supervision of registered nurses (NR cohort, n = 102), or received 6 months of resistance training at their home by themselves according to a training manual (HR cohort, n = 120) or received 6 months of usual care only (UC cohort, n = 120). Fewer numbers patients died in the follow-up period in the NR cohort than those of the HR (8 vs 21, P = .0447) and the UC (8 vs 32, P = .0046) cohorts. The frequency of rehospitalization of patients due to any of the reasons in the follow-up period was fewer for patients of the NR cohort than those of the HR and the UC cohorts (P < .05 for both). Hospitalization of patients due to any of the reasons in the follow-up period was fewer for patients of the HR cohort than those of the UC cohort (P < .05). A 52 median score was the quality of life of patients before the start of the non-treatment intervention(s). After 6 months of non-treatment intervention(s), patients of the NR cohort improved their quality of life as compared to their initial quality of life (P < .001), those of HR cohort (P < .05), and those of UC cohort (P < .001). The quality of life of patients with severe pancreatitis after the surgical procedure was worse. Six months of nurse-assisted resistant training at the institute has significant improvement on the quality of life of patients in the follow-up periods of acute pancreatitis. Resistant training at the institute would improve the quality of life of patients with acute pancreatitis (Level of Evidence: IV; Technical Efficacy Stage: 5).

Effects of the Training of Aerobic Function on Clinical Symptoms and Quality of Life in Patients with Medium and Advanced Lung Cancer

Objective

To investigate the effects of the training of aerobic function on clinical symptoms and quality of life in patients with medium and advanced lung cancer.

Methods

The study objects were 84 patients with medium and advanced lung cancer who were treated in our hospital (July 2019-July 2021) and their materials were retrospectively reviewed. Depending on the different intervention modes, they were equally divided into control group (routine nursing intervention measures) and experiment group (training of aerobic function), with 42 cases in each group. The clinical symptoms and living quality were compared between the two groups.

Results

After intervention, affective meaning, behavior/severity, cognitive/mood, and sensory scores in both groups were decreased, and the various indexes in the experiment group were lower compared with the control group (P < 0.05). After intervention, the patients' clinical symptoms, such as pain, inappetence, insomnia, and dyspnea in the two groups were improved, and the experiment group achieved eminently better improvement compared with the control group (P < 0.05). After intervention, the walking distances in 6 minute walk test (6MWT) in both groups were increased, and the experiment group achieved observably longer walking distance compared with the control group (P < 0.05). After intervention, the patients' pulmonary function indexes of forced vital capacity (FVC), forced expiratory volume in 1s (FEV1), and FEV1/FVC% level in the two groups were all improved, and the experiment group had signally better indexes compared with the control group (P < 0.05). After intervention, the patients' scores of Quality of Life Questionnaire-Core Questionnaire (QLQ-C30) in both groups were decreased, and the experiment group achieved much lower score compared with the control group (P < 0.05).

Conclusion

The training of aerobic function has obvious therapeutic effect on medium and advanced lung cancer. This training can mitigate the patients' cancer-related fatigue and clinical symptoms, improve their pulmonary function, and enhance their athletic ability and quality of life.

Association between physical activity before diagnosis and the presence of clinical remission in type 1 diabetes - InlipoDiab1 study

AIM

To investigate whether physical activity is associated with the occurrence of remission in adults with type 1 diabetes.

METHODS

Ninety nine adult participants with newly diagnosed type 1 diabetes were enroled into a prospective, observational study. The participants were advised to exercise 2-3 times a week with moderate intensity for a one-year period. Physical activity was assessed by a self-administrated questionnaire on every fourth visit. We counted the months in which participants fulfiled a partial-remission criteria: HbA1c < 6.5%, C-peptide > 0.5 ng/ml, and daily dose of insulin <0.3 U/kg/day. We assigned the participants to two groups: MORE EFFORT and LESS EFFORT, depending on the median value of physical activity in the studied population.

RESULTS

The occurrence of the remission achieved statistical significance at 6th month with a greater prevalence in MORE EFFORT group (55% vs. 35% p = 0.047). In multivariate logistic regression analysis for the occurrence of remission at 12th month, physical activity before the diagnosis was the only variable that influences the occurrence of the remission (adjusted odds ratios = 3.32 [95% confidence intervals 1.25-8.80]; p = 0.02).

CONCLUSION

In adults with newly diagnosed type 1 diabetes physical activity before the diagnosis is associated with higher occurrence of remission.

β-cell function and body mass index are predictors of exercise response in elderly patients with pre-diabetes

Aims/Introduction

To explore the predicting factors of exercise response (whether the participants converted to diabetes) in elderly patients with prediabetes.

Materials and Methods

This is a retrospective subgroup analysis of the registered clinical trial with previous publication of the same cohort. A total of 248 participants with prediabetes were randomized to the aerobic training (n = 83) group, resistance training (n = 82) group and control group (n = 83). The patients who finished the 2‐year exercise intervention were included in this analysis to explore the factors impacting exercise response.

Results

A total of 113 patients with prediabetes completed 2 years of exercise, with 56 participants in the aerobic exercise group and 57 in the resistance exercise group. Patients who reversed to normal glucose tolerance, remained in prediabetes and developed diabetes were 18 (15.90%), 70 (62.00%) and 25 (22.10%), respectively. Logistic regression showed that baseline, homeostatic model 2 assessment of β‐cell function (β = −0.143, P = 0.039), hemoglobin A1c (β = 3.301, P = 0.007) and body mass index (β = 0.402, P = 0.012) were related to exercise response, whereas the waist‐to‐hip ratio (β = −3.277, P = 0.693) and types of exercise (β = 1.192, P = 0.093) were not significantly related to exercise response.

Conclusions

Baseline homeostatic model 2 assessment of β‐cell function, hemoglobin A1c and body mass index were the predictors for the response to exercise in elderly patients with prediabetes.

Effects of aerobic training and resistance training in reducing cardiovascular disease risk for patients with prediabetes: A multi-center randomized controlled trial

AIMS

Aerobic training (AT) and resistance training (RT) can reduce blood glucose and type 2 diabetes risk, and increase muscle mass for prediabetes patients. However, the impact of long-term AT and RT on cardiovascular disease (CVD) risk remains unclear. The purpose of this study was to investigate the impact of AT and RT on CVD risk reduction in prediabetes patients.

MATERIALS AND METHODS

248 prediabetes patients were enrolled in this multi-center randomized controlled trial (RCT). Patients were randomly divided into 3 groups: RT (n = 82), aerobic training (AT (n = 83)), and control group (n = 83). Participants in RT and AT groups had moderate RT or AT 3 times a week (150 min/week) under supervision in 3 research centers for 24 months. Primary outcome was CVD risk measured by Framingham Risk Score (FRS) and The Chinese 10-year ischemic cardiovascular disease (ICVD) risk assessment tool. Secondary outcomes included in HOMA2-IR, HbA1c, blood pressure and serum lipid profile.

RESULTS

Both RT and AT groups experienced a significant reduction in HOMA2-IR, HbA1c, LDL-C, TC, SBP, and DBP at the end of 12 and 24 months. Compared to the control group, Both RT and AT groups had significant reduction of the Chinese 10-year ICVD risk (P < 0.05), but FRS CVD risk declined significantly only in the AT group (all P < 0.05). Although FRS CVD risk decreased more in the RT group than in the control group, the difference was not statistically significant. After adjusting for age, gender, statin use, BMI, and WHR, in COX's proportional hazard model, RT (HR = 0.419, P = 0.037) and AT (HR = 0.310, P = 0.026) were protective factors for CVD risk in prediabetes patients. 24-month RT and AT decreased respectively 58.1% and 69.0% of CVD risk (10-year ICVD risk assessment) in prediabetes patients.

CONCLUSIONS

This study demonstrated that 24-month moderate AT reduces the Chinese 10-year ICVD risk and FRS CVD risk in prediabetes patients. RT groups had significant reduction of CVD risk (10-year ICVD risk assessment) in prediabetes patients.

TRIAL REGISTRATION

Clinical trial registration number: NCT02561377.

DATE OF REGISTRATION

24/09/2015.

Effects of resistance training on insulin sensitivity in the elderly: A meta-analysis of randomized controlled trials

We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) assessing the effect of resistance training in older adults on insulin sensitivity.

METHODS

Cochrane, Embase, PubMed, Web of Science and EBSCO were searched from inception to April 2021. We integrated randomized controlled trials published in English, and participants were non-athletic and aged ≥60 years. The outcome of interest was the change in insulin sensitivity, derived from the homeostatic model of insulin resistance (HOMA-IR) and hemoglobin A1c (HbA1c).

RESULTS

12 RCTs were included in this meta-analysis comparing resistance training (n = 232) with control (n = 209). Resistance exercise significantly reduced HOMA-IR level (d = -0.25, 95% CI, -0.43 to -0.06; P < 0.05) and HbA1c levels of (d = -0.51, 95% CI, -0.84 to -0.18; P < 0.05). Subgroup analysis of HOMA-IR revealed that the variables "population", "training intensity" and "period" had significant effects on HOMA-IR, with the largest effect sizes for high-intensity (d = -0.43, 95%CI, -0.85 to -0.22, P < 0.05) and long-term (more than 12 weeks) (d = -0.43, 95%CI, -0.85 to -0.22, P < 0.05) training programs in older adults without type 2 diabetes (T2D) (d = -0.23, 95%CI, -0.42 to -0.04, P < 0.05). Subgroup analysis of HbA1c suggested that resistance training programs with moderate intensity (d = -0.51, 95%CI, -0.90 to -0.12, P < 0.05) and short term (less than or equal to 12 weeks) (d = -0.49, 95%CI, -0.84 to -0.14, P < 0.05) have greater effects on HbA1c.

CONCLUSION

The findings of this meta-analysis suggest that resistance training is effective for inducing improvement in insulin sensitivity for elderly. Subgroup analysis showed that high intensity and long period of resistance exercise improve HOMA-IR in healthy old adults, and that resistance training with moderate intensity and short period improve HbA1c in T2D old people. More studies with high methodological qualities and large sample sizes need to be done to further confirm our conclusion.

The mediation role of SOCS3 methylation in the effect of serum testosterone on type 2 diabetes

BACKGROUND

Previous studies reported that testosterone and DNA methylation of suppressor of cytokine signaling-3 (SOCS3) were associated with type 2 diabetes (T2D). Testosterone affects SOCS3 gene expression. Therefore, we aimed to investigate how the SOCS3 methylation mediates the relationship between testosterone and T2D among Chinese rural adults.

METHODS

A case-control study comprised 365 T2D patients and 651 controls was conducted. Liquid chromatography-tandem mass spectrometry and MethylTarget were used to determine the levels of serum testosterone and DNA methylation of SOCS3 gene, respectively. The odds ratio (OR) of testosterone or SOCS3 methylation for T2D was calculated using logistic regression models, and β value of testosterone for SOCS3 methylation was evaluated by linear regression models. Furthermore, through mediation analysis the mediating effect of SOCS3 methylation on the association of testosterone with T2D was estimated.

RESULTS

After adjusting for multiple variables, the protective effect of testosterone on T2D was found in men (OR = 0.61, 95% confidence interval [CI]: 0.47-0.80), and the methylation of Chr17:76356190 or Chr17:76356199 was negatively related to T2D in both men and women. Moreover, testosterone was positively associated with Chr17:76356190 methylation in men and Chr17:76356199 methylation in women (both P < .05). The mediation analysis showed that the Chr17:76356190 methylation partly mediated effect of testosterone on T2D in men was approximately 8.2%.

CONCLUSIONS

High levels of serum testosterone in men and Chr17:76356190 and Chr17:76356199 (SOCS3) methylation were related to a lower prevalent T2D. In addition, Chr17:76356190 methylation partially mediated the effect of testosterone on T2D in Chinese rural men.

Effectiveness of Resistance Training and Associated Program Characteristics in Patients at Risk for Type 2 Diabetes: a Systematic Review and Meta-analysis

BACKGROUND

Resistance training (RT) is an effective intervention for glycemic control and cardiometabolic health in individuals with type 2 diabetes (T2D). However, the use of RT in individuals at risk for T2D to prevent or delay the onset of T2D, and RT program characteristics that are most effective are still unknown. The purpose of this review is to determine the effects of RT on cardiometabolic risk factors in those at risk for T2D and to examine RT program characteristics associated with intervention effectiveness.

METHODS

PubMed, Cochrane, Web of Science, and Embase databases were systematically searched for published controlled trials that compared cardiometabolic outcomes in adults with cardiometabolic risk for those that underwent an RT intervention with those that did not. A systematic review and meta-analysis was conducted to determine the effect of RT on glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), body fat percentage (BF%), total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglycerides (TG). Additional analyses examined effects of intervention duration and dietary intervention on FPG and TG.

RESULTS

Fourteen trials with 668 participants were included. For RT compared to controls, the standardized mean difference (SMD) was -1.064 for HbA1c (95% confidence interval [CI] -1.802 to -0.327; p=0.005), -0.99 for FPG (95% CI -1.798 to -0.183; p=0.016), -0.933 for TC (95% CI -1.66 to -0.206; p=0.012), -0.840 for BF% (95% CI -1.429 to -0.251; p=0.005), -0.693 for HDL (95% CI -1.230 to -0.156; p=0.011), -1.03 for LDL (95% CI -2.03 to -0.050; p=0.039), and -0.705 for TG (95% CI -1.132 to -0.279; p=0.001).

CONCLUSIONS

RT is beneficial for improving glycemic control, BF%, and blood lipids in those at risk for diabetes. The addition of a dietary component did not result in larger reductions in FPG and TG than RT alone.

PROSPERO REGISTRATION ID

CRD42019122217.

Comparing the effects of 12 months aerobic exercise and resistance training on glucose metabolism among prediabetes phenotype: A explorative randomized controlled trial

AIMS

The pathophysiology of each phenotype of prediabetes is unique that promotes different levels of diabetes and cardiovascular disease risks. Exercise guidelines for individuals with prediabetes including both aerobic and resistance training could improve metabolic control, but its effects on different prediabetes subtypes are unclear. The aim of this explorative randomized controlled trial was to evaluate the effects of aerobic training (AT) or resistance training (RT) on glucose metabolism and lipid profile by different prediabetes subtypes with.

METHODS

A randomized controlled trial in which 128 individuals with isolated impaired fasting glucose (i-IFG; n = 39), isolated impaired glucose tolerance (i-IGT; n = 29), combined glucose tolerance (CGI; n = 27) and isolated elevated HbA_1c (n = 33) were randomly assigned to the control group, AT group and RT group, respectively. Supervised exercise training, including AT and RT were completed at moderate intensity for 60 min per day, three non-consecutive days per week for 12 months. The primary outcome was improvement in glucose metabolism. Secondary outcomes included measure of lipid profile and if these effects were moderated by the prediabetes phenotype.

RESULTS

Of the initial 128 participants, 118 finished the study, but all participants were included in the intention-to-treat analyses. The improvement in 2 h postprandial plasma glucose (2 hPG) between group difference (AT vs. RT) at 12 months was 0.87 (95% CI, -1.59 to-0.16; p < 0.05). Compared with RT group, AT significantly decreased the 2hPG in participants with i-IGT at 12 months (-1.66, 95% CI -3.04 to -0.28; p < 0.05).

CONCLUSIONS

AT program conferred benefits in improving 2 h PG and HbA_1c compared with RT for prediabetes. These findings may moderate by prediabetes phenotype, and AT appeared more effective in i-IGT. A future trial with large sample size and long time follow up of prediabetes phenotype groups are needed.