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Qian Z, Ping L, Dongming X, Xuelin Z. Slow-velocity eccentric-only resistance training improves symptoms of type 2 diabetic mellitus patients by regulating plasma MMP-2 and -9. Medicine (Baltimore) 2024; 103:e38855. [PMID: 39029066 DOI: 10.1097/md.0000000000038855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/21/2024] Open
Abstract
OBJECTIVE This study investigated the intervention effect of slow-velocity eccentric-only resistance training on type 2 diabetic mellitus (T2DM) patients based on the role of matrix metalloproteinase-2 and -9 (MMP-2 and -9) in regulating extracellular matrix homeostasis. METHODS 50 T2DM patients were randomly divided into the slow-velocity eccentric-only resistance training group (E) and control group (C). The E group performed eccentric-only resistance training 3 times a week, every other day for 10 weeks, while the C group did not. Blood samples were collected before and after training, and subjects were tested for changes in clinical parameters, insulin resistance indices [fasting insulin, homeostatic model assessment insulin resistance (HOMA-IR)], MMP-2 and -9, and hydroxyproline, and muscle strength (12-RM), respectively. RESULTS After 10 weeks of training, the E group showed significant decreases in fasting glucose (P < .05), insulin (P < .05), insulin resistance indices (P < .05), hemoglobin A1c (HbA1c) (P < .01), triglycerides (P = .06) and MMP-2 (P < .05), while total cholesterol (P < .05), MMP-9 (P < .05), hydroxyproline (P < .01), Creatine Kinase (CK) (P < .05), and muscle strength (P < .001) significantly increased. There were no significant changes in the count of neutrophil, lymphocyte and platelet, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), high-density lipoprotein cholesterol (HDL-c), and low-density lipoprotein cholesterol (LDL-c). Compared with the C group, the E group showed a trend of a significant decrease in triglyceride (P < .05), lymphocyte count (P < .05), fasting glucose (P = .07), and plasma MMP-2 (P < .05), while MMP-9 (P < .05), hydroxyproline (P < .001), and muscle strength (P < .01) significantly increased. However, no significant changes were observed in insulin and insulin resistance indices, HbA1c, total cholesterol, HDL-c, LDL-c, CK, and other inflammatory indicators. CONCLUSIONS Slow-velocity eccentric-only resistance training was beneficial for T2DM, but the potential role of MMP-2 and -9 in regulating extracellular matrix homeostasis is very different in T2DM patients.
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Affiliation(s)
- Zhao Qian
- College of Physical Education, Qufu Normal University, Qufu, China
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Dores H, Antunes M, Caldeira D, Pereira HV. Cardiovascular benefits of resistance exercise: It's time to prescribe. Rev Port Cardiol 2024:S0870-2551(24)00117-3. [PMID: 38703948 DOI: 10.1016/j.repc.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/16/2024] [Accepted: 02/06/2024] [Indexed: 05/06/2024] Open
Abstract
Despite the well-known health benefits of regular physical activity, sedentary behavior and physical inactivity remain a real global pandemic. Exercise is associated with increased life expectancy, improved quality of life and prevention of multiple diseases. Although less implemented in practice compared to aerobic exercise, recent evidence shows that resistance exercise (RE) is also responsible for various benefits, including improvements in body composition, control of several cardiovascular (CV) risk factors, and reduction of CV outcomes. RE increases strength and muscle mass, is effective in controlling type 2 diabetes, and improves the management of obesity, lipids, and blood pressure profiles. In this setting, clinical guidelines recommend the inclusion of RE for primary and secondary CV risk prevention, particularly in combination with aerobic exercise, in which the benefits are most pronounced. Prescription of RE should follow a methodology that includes key variables such as frequency, intensity, type, time, and progression. Despite challenges, professionals in the CV field should be familiar with RE prescription in order to maximize its referral in clinical practice. This review aims to analyze the CV effects of RE and current recommendations regarding the prescription of this type of exercise.
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Affiliation(s)
- Hélder Dores
- Hospital da Luz, Lisbon, Portugal; CHRC, NOVA Medical School, Lisbon, Portugal; NOVA Medical School, Lisbon, Portugal.
| | | | - Daniel Caldeira
- Centro de Estudos de Medicina Baseada na Evidência (CEMBE), Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal; Centro Cardiovascular da Universidade de Lisboa - CCUL, CAML, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal; Serviço de Cardiologia, Hospital de Santa Maria - CHULN, Lisbon, Portugal; Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Hugo V Pereira
- Hospital da Luz, Lisbon, Portugal; CIDEFES, Universidade Lusófona, Lisbon, Portugal
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Qiao Y, Zhang P. Role of exercise in reducing the risk of cardiovascular diseases associated with sleep disorders. ZHONG NAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF CENTRAL SOUTH UNIVERSITY. MEDICAL SCIENCES 2024; 49:526-533. [PMID: 39019781 PMCID: PMC11255196 DOI: 10.11817/j.issn.1672-7347.2024.230426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Indexed: 07/19/2024]
Abstract
Cardiovascular diseases are the leading cause of death among urban and rural residents and have become a major global public health problem. The prevention and control of cardiovascular disease risk factors is crucial for preventing, stabilizing, and even reversing cardiovascular disease. Studies have found that certain sleep disorders are directly related to cardiovascular disease and may be induced through pathways such as endothelial dysfunction, dysregulation of autonomic homeostasis, inflammatory response, and metabolic dysfunction. Exercise helps improve sleep disorders and thus reduce the risk of cardiovascular disease, and has irreplaceable advantages over pharmacological treatments for improving sleep. Different types of sleep disorders should be adjusted by factors such as exercise mode, intensity, and duration of exercise. A good sleep state further reduces the risk of cardiovascular disease. Discussing the effect of exercise on the improvement of the risk of cardiovascular disease associated with sleep disorders, and elaborating the mechanism of action of exercise in reducing the risk of cardiovascular disease from the perspective of sleep, can lay a foundation for the treatment of sleep disorders by exercise and propose new directions for reducing cardiovascular disease risk.
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Affiliation(s)
- Yunheng Qiao
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing 100084, China.
| | - Peizhen Zhang
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing 100084, China.
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Lav Madsen P, Sejersen C, Nyberg M, Sørensen MH, Hellsten Y, Gaede P, Bojer AS. The cardiovascular changes underlying a low cardiac output with exercise in patients with type 2 diabetes mellitus. Front Physiol 2024; 15:1294369. [PMID: 38571722 PMCID: PMC10987967 DOI: 10.3389/fphys.2024.1294369] [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: 09/14/2023] [Accepted: 02/19/2024] [Indexed: 04/05/2024] Open
Abstract
The significant morbidity and premature mortality of type 2 diabetes mellitus (T2DM) is largely associated with its cardiovascular consequences. Focus has long been on the arterial atheromatosis of DM giving rise to early stroke and myocardial infarctions, whereas less attention has been given to its non-ischemic cardiovascular consequences. Irrespective of ischemic changes, T2DM is associated with heart failure (HF) most commonly with preserved ejection fraction (HFpEF). Largely due to increasing population ages, hypertension, obesity and T2DM, HFpEF is becoming the most prevalent form of heart failure. Unfortunately, randomized controlled trials of HFpEF have largely been futile, and it now seems logical to address the important different phenotypes of HFpEF to understand their underlying pathophysiology. In the early phases, HFpEF is associated with a significantly impaired ability to increase cardiac output with exercise. The lowered cardiac output with exercise results from both cardiac and peripheral causes. T2DM is associated with left ventricular (LV) diastolic dysfunction based on LV hypertrophy with myocardial disperse fibrosis and significantly impaired ability for myocardial blood flow increments with exercise. T2DM is also associated with impaired ability for skeletal muscle vasodilation during exercise, and as is the case in the myocardium, such changes may be related to vascular rarefaction. The present review discusses the underlying phenotypical changes of the heart and peripheral vascular system and their importance for an adequate increase in cardiac output. Since many of the described cardiovascular changes with T2DM must be considered difficult to change if fully developed, it is suggested that patients with T2DM are early evaluated with respect to their cardiovascular compromise.
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Affiliation(s)
- Per Lav Madsen
- Department Cardiology, Herlev-Gentofte Hospital, Copenhagen University, Copenhagen, Denmark
- Department Clinical Medicine, Copenhagen University, Copenhagen, Denmark
- The August Krogh Section for Human Physiology, Department Nutrition, Exercise and Sports, Copenhagen University, Copenhagen, Denmark
| | - Casper Sejersen
- The August Krogh Section for Human Physiology, Department Nutrition, Exercise and Sports, Copenhagen University, Copenhagen, Denmark
- Department of Anaesthesia, Rigshospitalet, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Michael Nyberg
- Department Kidney and Vascular Biology, Global Drug Discovery, Novo Nordisk, Copenhagen, Denmark
| | | | - Ylva Hellsten
- The August Krogh Section for Human Physiology, Department Nutrition, Exercise and Sports, Copenhagen University, Copenhagen, Denmark
| | - Peter Gaede
- Department Endocrinology, Slagelse-Næstved Hospital, Copenhagen, Denmark
| | - Annemie Stege Bojer
- Department Cardiology, Herlev-Gentofte Hospital, Copenhagen University, Copenhagen, Denmark
- Department Endocrinology, Slagelse-Næstved Hospital, Copenhagen, Denmark
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Zhang H, Guo Y, Hua G, Guo C, Gong S, Li M, Yang Y. Exercise training modalities in prediabetes: a systematic review and network meta-analysis. Front Endocrinol (Lausanne) 2024; 15:1308959. [PMID: 38440785 PMCID: PMC10911289 DOI: 10.3389/fendo.2024.1308959] [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: 10/07/2023] [Accepted: 01/19/2024] [Indexed: 03/06/2024] Open
Abstract
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.
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Affiliation(s)
- Hang Zhang
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yuting Guo
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Guangshun Hua
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Chenyang Guo
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Simiao Gong
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong, China
| | - Min Li
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yan Yang
- Medical Department of The Third Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Torun A. Role of Resistance Exercise in Cardiology. Anatol J Cardiol 2024; 28:217-221. [PMID: 38327182 PMCID: PMC11059226 DOI: 10.14744/anatoljcardiol.2023.4073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 01/09/2024] [Indexed: 02/09/2024] Open
Abstract
Resistance exercise is a form of exercise that increases muscular strength and endurance by exercising a muscle or muscle group against external resistance. Resistance exercises have an important potential in preventing cardiac diseases, increasing treatment efficiency, and improving quality of life. In spite of the fact that the vast majority of cardiology research to date has focused on aerobic exercise, an increasing number of studies on resistance exercise have been published in the past few years. Although resistance exercise was combined with aerobic exercise in most of these studies, its isolated efficacy was also examined. In conditions such as coronary artery disease, peripheral artery disease, heart failure, arrhythmias, and cardiac rehabilitation, resistance exercise (RE) is regarded as a potentially beneficial approach. In addition to interventional and medical treatments, resistance exercise can also be considered as a cost-effective and sustainable method. The effects of resistance exercise on a variety of cardiovascular conditions were investigated in this evaluation of the literature.
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Affiliation(s)
- Akın Torun
- Department of Cardiology, Sultan II. Abdulhamid Han Training and Research Hospital, İstanbul, Türkiye
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Li S, Yuan S, Zhang J, Xu F, Zhu F. The effect of periodic resistance training on obese patients with type 2 diabetic nephropathy. Sci Rep 2024; 14:2761. [PMID: 38307949 PMCID: PMC10837148 DOI: 10.1038/s41598-024-53333-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 01/31/2024] [Indexed: 02/04/2024] Open
Abstract
Resistance training is an exercise against resistance designed to train the endurance and strength of muscle. To observe the effect of intervention of periodic resistance training on obese patients with type 2 diabetic nephropathy. A total of 60 obese patients with type 2 diabetic nephropathy were randomized into resistance training group and aerobic exercise group (30 patients each group) for observing the changes of blood glucose, body weight, blood lipid, insulin resistance, serum creatinine (Scr), urinary microalbumin, urinary albumin excretion rate (UAER) calculated by urinary creatinine, and glomerular filtration rate (GFR) after 12 weeks of intervention, and relevant significance as well. The number of patients with hypoglycemia during the intervention was also recorded. After 12 weeks of intervention, the weight, Body mass index (BMI), Waist, Triglyceride (TG), Cholesterol (TC), Low-density lipoprotein cholesterol (LDL), Fasting glucose (FBG), Fasting insulin (FINS), Glycosylated hemoglobin (HbA1c) and urine Albumin-Creatinine Ratio (uACR) were decreased and GFR was increased in both groups (P < 0.05), but the effect was more significant in the resistance training group. GFR was increased from 92.21 ± 10.67 mL/(min·1.73 m2) to 100.13 ± 12.99 mL/(min·1.73 m2) in resistance training group (P < 0.05). In the aerobic exercise group, GFR was increased from 89.98 ± 9.48 mL/(min·1.73 m2) to 92.51 ± 11.35 mL/(min·1.73 m2) (P > 0.05). Periodic resistance training can not only control the weight, blood sugar and blood lipid of obese patients with type 2 diabetic nephropathy, but also improve the urinary albumin excretion rate and glomerular filtration rate of early obese patients with type 2 diabetic nephropathy, and delay the progression of diabetic nephropathy. It is an effective non-drug intervention.
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Affiliation(s)
- Sumei Li
- Department of Endocrinology, Teaching Hospital, The First Hospital of Putian City, Fujian Medical University, Putian, Fujian, China
| | - Shouping Yuan
- Department of Endocrinology, Teaching Hospital, The First Hospital of Putian City, Fujian Medical University, Putian, Fujian, China.
| | - Jintian Zhang
- Department of Pathology, Putian University, Medical University, Putian, Fujian, China
| | - Feipeng Xu
- Department of Endocrinology, Teaching Hospital, The First Hospital of Putian City, Fujian Medical University, Putian, Fujian, China
| | - Feng Zhu
- Department of Endocrinology, Teaching Hospital, The First Hospital of Putian City, Fujian Medical University, Putian, Fujian, China
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Waghe VR, Athawale V. Physiotherapeutic Interventions in Diabetic Foot Ulcer Management: A Case Report. Cureus 2024; 16:e55244. [PMID: 38558580 PMCID: PMC10981459 DOI: 10.7759/cureus.55244] [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: 02/15/2024] [Accepted: 02/29/2024] [Indexed: 04/04/2024] Open
Abstract
Diabetic foot ulcers (DFUs) represent prominent complications arising from diabetes mellitus, characterized by the development of severe and persistent wounds involving the loss of epidermal and/or dermal layers, with the potential to extend into subcutaneous and underlying tissue structures. In the presented case, a 62-year-old male patient presented with complaints of pain and the emergence of blisters on the right foot, marked by an insidious onset and gradual progression in size, ultimately leading to ulcer formation subsequent to blister rupture. The patient had a medical history spanning 25 years of diabetes mellitus, accompanied by diminished range of motion and muscle strength in the affected foot. The primary goals in the management of DFU encompass addressing muscular weakness, skin manifestations, and any associated underlying health comorbidities. Central to this management approach lies the incorporation of physical therapy and rehabilitation modalities. The rehabilitation regimen designed for the patient was tailored to include targeted resistance exercises, infrared radiation therapy, and sensory integration therapy. Outcome measures, including the Numeric Pain Rating Scale (NPRS), World Health Organization Quality of Life questionnaire (WHO-QOL), and Diabetic Foot Self-Care Questionnaire (DFSQ-UMA), demonstrated substantial improvements, reflecting enhanced activities of daily living. This case underscores the pivotal role of incorporating physiotherapy into a comprehensive multidisciplinary approach for optimizing the management of DFUs. Such integration aims to improve patient outcomes and overall quality of life.
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Affiliation(s)
- Vaishnavi R Waghe
- Physical Medicine and Rehabilitation, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Vrushali Athawale
- Oncology Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Chen S, Zhou K, Shang H, Du M, Wu L, Chen Y. Effects of concurrent aerobic and resistance training on vascular health in type 2 diabetes: a systematic review and meta-analysis. Front Endocrinol (Lausanne) 2023; 14:1216962. [PMID: 37780628 PMCID: PMC10534066 DOI: 10.3389/fendo.2023.1216962] [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: 05/04/2023] [Accepted: 08/29/2023] [Indexed: 10/03/2023] Open
Abstract
Objective To determine the impacts of concurrent aerobic and resistance training on vascular structure (IMT) and function (PWV, FMD, NMD) in type 2 diabetes (T2D). Methods The electronic databases PubMed, Web of Science Core Collection, Cochrane Library, Embase, Scopus, CINAHL, and SPORTDiscus were systematically searched for articles on "type 2 diabetes" and "concurrent training" published from inception to August 2, 2022. We included randomized controlled trials that examined the effects of concurrent training versus passive controls on IMT, PWV, FMD and NMD in T2D. Results Ten studies were eligible, including a total of 361 participants. For IMT, concurrent training showed a slight decrease by 0.05 mm (95% CI -0.11 to 0.01, p > 0.05). concurrent training induced an overall significant improvement in FMD by 1.47% (95% CI 0.15 to 2.79, p < 0.05) and PWV by 0.66 m/s (95% CI -0.89 to -0.43, p < 0.01) in type 2 diabetics. However, concurrent training seemed to exaggerate the impaired NMD (WMD = -2.30%, 95% CI -4.02 to -0.58, p < 0.05). Conclusions Concurrent training is an effective method to improve endothelial function and artery stiffness in T2D. However, within 24 weeks concurrent training exacerbates vascular smooth muscle dysfunction. More research is needed to explore whether longer and/or higher-intensity concurrent training interventions could enhance the vascular structure and smooth muscle function in this population. Systematic review registration www.crd.york.ac.uk/PROSPERO/, identifier CRD42022350604.
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Affiliation(s)
- Shengju Chen
- School of Physical Education, Liaoning Normal University, Dalian, China
| | - Kaixiang Zhou
- Sports Health College, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Huayu Shang
- School of Sports Medicine and Health, Chengdu Sport University, Chengdu, China
| | - Mingyang Du
- College of Physical Education, Chongqing University, Chongqing, China
| | - Linfeng Wu
- College of Physical Education, Chongqing University, Chongqing, China
| | - Yu Chen
- College of Physical Education, Chongqing University, Chongqing, China
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Liu H, Wu B, Shi X, Cao Y, Zhao X, Liang D, Qin Q, Liang X, Lu W, Wang D, Liu J. Aerobic exercise-induced circulating extracellular vesicle combined decellularized dermal matrix hydrogel facilitates diabetic wound healing by promoting angiogenesis. Front Bioeng Biotechnol 2022; 10:903779. [PMID: 36082169 PMCID: PMC9445842 DOI: 10.3389/fbioe.2022.903779] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 07/27/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Insufficient blood supply results in unsatisfactory wound healing, especially for challenging wound repair such as diabetic wound defects. Regular exercise training brings a lot of benefits to cardiovascular fitness and metabolic health including attenuation of T2DM progression. Circulating extracellular vesicles (EVs) are postulated to carry a variety of signals involved in tissue crosstalk by their modified cargoes, representing novel mechanisms for the effects of exercise. Prominently, both acute and chronic aerobic exercise training can promote the release of exercise-induced cytokines and enhance the angiogenic function of circulating angiogenic cell–derived EVs.Methods: We investigated the possible angiogenesis potential of aerobic exercise-induced circulating EVs (EXE-EVs) on diabetic wound healing. Circulating EVs were isolated from the plasma of rats subjected to 4 weeks of moderate aerobic exercise or sedentariness 24 h after the last training session. The therapeutic effect of circulating EVs was evaluated in vitro by proliferation, migration, and tube formation assays of human umbilical vein endothelial cells (HUVECs), as well as in vivo by quantification of angiogenesis and cutaneous wound healing in diabetic rats.Results: The number of circulating EVs did not change significantly in exercised rats 24 h post-exercise in comparison with the sedentary rats. Nevertheless, EXE-EVs showed remarkable pro-angiogenic effect by augmenting proliferation, migration, and tube formation of HUVECs. Furthermore, the findings of animal experiments revealed that the EXE-EVs delivered by decellularized dermal matrix hydrogel (DDMH) could significantly promote the repair of skin defects through stimulating the regeneration of vascularized skin.Discussion: The present study is the first attempt to demonstrate that aerobic exercise-induced circulating EVs could be utilized as a cell-free therapy to activate angiogenesis and promote diabetic wound healing. Our findings suggest that EXE-EVs may stand for a potential strategy for diabetic soft tissue wound repair.
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Affiliation(s)
- Haifeng Liu
- Guangzhou Medical University, Guangzhou, China
- Department of Sports Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, China
| | - Bing Wu
- Department of Sports Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, China
| | - Xin Shi
- Department of Limbs (Foot and Hand) Microsurgery, Affiliated Chenzhou Hospital, Hengyang Medical School, University of South China, Chenzhou, China
| | - Yanpeng Cao
- Department of Limbs (Foot and Hand) Microsurgery, Affiliated Chenzhou Hospital, Hengyang Medical School, University of South China, Chenzhou, China
| | - Xin Zhao
- Department of Limbs (Foot and Hand) Microsurgery, Affiliated Chenzhou Hospital, Hengyang Medical School, University of South China, Chenzhou, China
| | - Daqiang Liang
- Department of Sports Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, China
| | - Qihuang Qin
- Department of Sports Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, China
| | - Xinzhi Liang
- Department of Sports Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, China
| | - Wei Lu
- Department of Sports Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, China
| | - Daping Wang
- Guangzhou Medical University, Guangzhou, China
- Department of Sports Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, China
- *Correspondence: Daping Wang, ; Jun Liu,
| | - Jun Liu
- Department of Limbs (Foot and Hand) Microsurgery, Affiliated Chenzhou Hospital, Hengyang Medical School, University of South China, Chenzhou, China
- *Correspondence: Daping Wang, ; Jun Liu,
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Chang W, Li M, Song L, Miao S, Yu W, Wang J. Noncoding RNAs from tissue-derived small extracellular vesicles: Roles in diabetes and diabetic complications. Mol Metab 2022; 58:101453. [PMID: 35121168 PMCID: PMC8866070 DOI: 10.1016/j.molmet.2022.101453] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/22/2022] [Accepted: 01/28/2022] [Indexed: 12/01/2022] Open
Abstract
Diabetes is a systemic disease, and its progression involves multiple organ dysfunction. However, the exact mechanisms underlying pathological progression remain unclear. Small extracellular vesicles (sEVs) mediate physiological and pathological signaling communication between organs and have been shown to have important regulatory roles in diabetes and its complications in recent years. In particular, the majority of studies in the diabetes-related research field have focused on the noncoding RNAs carried by sEVs. Researchers found that noncoding RNA sorting into sEVs is not random but selective. Both tissue origin differences and environmental variations affect the cargo of sEVs. In addition, the function of sEVs differs according to the tissue they derive from; for example, sEVs derived from adipose tissue regulate insulin sensitivity in the periphery, while sEVs derived from bone marrow promote β-cell regeneration. Therefore, understanding the roles of sEVs from different tissues is important for elucidating their molecular mechanisms and is necessary for the application of sEVs as therapeutic agents for diabetes treatment in the future. In this review, we summarized current studies on the mechanisms of noncoding RNA sorting into sEVs, as well as the research progress on the effects of sEVs from different tissue origins and noncoding RNAs in diabetes and diabetic complications. The knowledge of noncoding RNAs in sEVs will help us better understand the role of sEVs in the diabetes progression.
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Affiliation(s)
- Wenguang Chang
- Institute for Translational Medicine, The Affiliated Hospital, Qingdao University, Qingdao, China.
| | - Mengyang Li
- School of Basic Medical Sciences, College of Medicine, Qingdao University, Qingdao, China
| | - Lin Song
- School of Basic Medical Sciences, College of Medicine, Qingdao University, Qingdao, China
| | - Suo Miao
- School of Basic Medical Sciences, College of Medicine, Qingdao University, Qingdao, China
| | - Wanpeng Yu
- College of Medicine, Qingdao University, Qingdao, China
| | - Jianxun Wang
- School of Basic Medical Sciences, College of Medicine, Qingdao University, Qingdao, China
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Burghard M, Takken T, Nap-van der Vlist MM, Nijhof SL, van der Ent CK, Heijerman HGM, Hulzebos HJE. Physiological predictors of cardiorespiratory fitness in children and adolescents with cystic fibrosis without ventilatory limitation. Ther Adv Respir Dis 2022; 16:17534666211070143. [PMID: 35012387 PMCID: PMC8755930 DOI: 10.1177/17534666211070143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Objectives: [1] To investigate the cardiorespiratory fitness (CRF) levels in children and
adolescents with cystic fibrosis (CF) with no ventilatory limitation
(ventilatory reserve ⩾ 15%) during exercise, and [2] to assess which
physiological factors are related to CRF. Methods: A cross-sectional study design was used in 8- to 18-year-old children and
adolescents with CF. Cardiopulmonary exercise testing was used to determine
peak oxygen uptake normalized to body weight as a measure of CRF. Patients
were defined as having ‘low CRF’ when CRF was less than 82%predicted.
Physiological predictors used in this study were body mass index z-score,
P. Aeruginosa lung infection, impaired glucose
tolerance (IGT) including CF-related diabetes, CF-related liver disease,
sweat chloride concentration, and self-reported physical activity. Backward
likelihood ratio (LR) logistic regression analysis was used. Results: Sixty children and adolescents (51.7% boys) with a median age of 15.3 years
(25th–75th percentile: 12.9–17.0 years) and a mean percentage predicted
forced expiratory volume in 1 second of 88.5% (±16.9) participated. Mean
percentage predicted CRF (ppVO2peak/kg) was 81.4% (±12.4, range:
51%–105%). Thirty-three patients (55.0%) were classified as having ‘low
CRF’. The final model that best predicted low CRF included IGT
(p = 0.085; Exp(B) = 6.770) and P.
Aeruginosa lung infection (p = 0.095; Exp(B) = 3.945). This
model was able to explain between 26.7% and 35.6% of variance. Conclusions: CRF is reduced in over half of children and adolescents with CF with normal
ventilatory reserve. Glucose intolerance and P. Aeruginosa
lung infection seem to be associated to low CRF in children and adolescents
with CF.
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Affiliation(s)
- Marcella Burghard
- Child Development, Exercise, and Physical Literacy Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, P.O. Box 85090, 3508 EA Utrecht, The Netherlands.,Cystic Fibrosis Center Utrecht, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Tim Takken
- Child Development, Exercise, and Physical Literacy Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Merel M Nap-van der Vlist
- Department of Social Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Sanne L Nijhof
- Department of Social Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - C Kors van der Ent
- Cystic Fibrosis Center Utrecht, University Medical Center Utrecht, Utrecht, The Netherlands.,Department of Pediatric Pulmonology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Harry G M Heijerman
- Cystic Fibrosis Center Utrecht, University Medical Center Utrecht, Utrecht, The Netherlands.,Division Heart and Lung, Department of Pulmonology, Cystic Fibrosis Center Utrecht, University Medical Center Utrecht, Utrecht, The Netherlands
| | - H J Erik Hulzebos
- Child Development, Exercise, and Physical Literacy Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.,Cystic Fibrosis Center Utrecht, University Medical Center Utrecht, Utrecht, The Netherlands
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13
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Lino Rodrigues K, Vieira Dias Da Silva V, Nunes Goulart da Silva Pereira E, Rangel Silvares R, Peres de Araujo B, Eduardo Ilaquita Flores E, Ramos IP, Pereira Borges J, Fernandes-Santos C, Daliry A. Aerobic Exercise Training Improves Microvascular Function and Oxidative Stress Parameters in Diet-Induced Type 2 Diabetic Mice. Diabetes Metab Syndr Obes 2022; 15:2991-3005. [PMID: 36200064 PMCID: PMC9527816 DOI: 10.2147/dmso.s365496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 06/30/2022] [Indexed: 11/29/2022] Open
Abstract
PURPOSE Type 2 diabetic (T2D) patients have liver and adipose tissue microcirculation disturbances associated with metabolic dysfunction and disease progression. However, the potential role of aerobic training on hepatic and white adipose tissue (WAT) microcirculation and the underlying mechanisms have not been elucidated to date. Therefore, we investigated the role of aerobic training on liver and WAT microcirculation and AGE-RAGE modulation in T2D mice. METHODS The control group (CTL) was fed standard chow, and T2D was induced by feeding male C57BL/6 a high-fat, high-carbohydrate diet for 24 weeks. In the following 12 weeks, mice underwent aerobic training (CTL EX and T2D EX groups), or were kept sedentary (CTL and T2D groups). We assessed metabolic parameters, biochemical markers, oxidative damage, the AGE-RAGE axis, hepatic steatosis, hepatic stellate cells activation (HSC) and liver and WAT microcirculation. RESULTS Hepatic microcirculation was improved in T2D EX mice which were associated with improvements in body, liver and fat mass, blood pressure, hepatic steatosis and fibrosis, and decreased HSC and AGE-RAGE activation. In contrast, improvement in WAT microcirculation, that is, decreased leukocyte recruitment and increased perfusion, was associated with increased catalase antioxidant activity. CONCLUSION Physical training improves hepatic and adipose tissue microcirculatory dysfunction associated with T2D, likely due to downregulation of AGE-RAGE axis, decreased HSC activation and increased antioxidant activity.
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Affiliation(s)
- Karine Lino Rodrigues
- Laboratory of Cardiovascular Investigation, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | | | | | - Raquel Rangel Silvares
- Laboratory of Cardiovascular Investigation, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - Beatriz Peres de Araujo
- Laboratory of Cardiovascular Investigation, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | | | - Isalira Peroba Ramos
- National Center of Structural Biology and Bio-imaging, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Juliana Pereira Borges
- Laboratory of Physical Activity and Health Promotion, University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Caroline Fernandes-Santos
- Laboratory of Cardiovascular Investigation, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro, RJ, Brazil
- Department of Basic Sciences, Federal Fluminense University, Nova Friburgo, RJ, Brazil
| | - Anissa Daliry
- Laboratory of Cardiovascular Investigation, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro, RJ, Brazil
- Correspondence: Anissa Daliry, Laboratory of Cardiovascular Investigation, Oswaldo Cruz Institute, FIOCRUZ, Pavilhão Ozorio de Almeida Av. Brasil, 4365 (Room 14), Manguinhos, Rio de Janeiro, RJ, CEP: 21040-900, Brazil, Tel +55 212562-1312, Email
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14
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Silva-Filho E, Albuquerque J, Bikson M, Pegado R, da Cruz Santos A, do Socorro Brasileiro-Santos M. Effects of transcranial direct current stimulation associated with an aerobic exercise bout on blood pressure and autonomic modulation of hypertensive patients: A pilot randomized clinical trial. Auton Neurosci 2021; 235:102866. [PMID: 34380099 DOI: 10.1016/j.autneu.2021.102866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 06/16/2021] [Accepted: 07/30/2021] [Indexed: 10/20/2022]
Abstract
The objective of this article was to evaluate the effects of an aerobic exercise bout associated with a single session of anodal transcranial direct current stimulation (tDCS) over the left temporal lobe on blood pressure (BP) and heart rate variability (HRV) in hypertensive people. After met the inclusion criteria, twenty hypertensive people were randomized to active-tDCS or sham-tDCS group. Initially, they provided their sociodemographic data, a blood sample, and went through an evaluation of the cardiorespiratory performance. Then, a single session of tDCS with an intensity of 2 mA over the left lobe during 20 min was carried out. After tDCS, it was performed a session of moderate-intensity aerobic exercise during 40 min. BP during 24 h and HRV measurements were performed before (baseline) and after the intervention. Systolic BP during sleep time decreased in the active-tDCS group (p = 0.008). Diastolic BP showed a significant decrease 3 h after the intervention in the active-tDCS group (p = 0.01). An intragroup comparison showed a significant decrease in systolic BP 3 h after intervention only for the active-tDCS group (p = 0.04). Besides, there was a trend toward a difference in wake for diastolic BP for active-tDCS (p = 0.07). Lastly, there were no changes in the HRV for both groups. It is suggested that anodal tDCS associated with moderate-intensity aerobic exercise can decrease systolic and diastolic BP of hypertensive people during sleep time and 3 h after the intervention.
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Affiliation(s)
- Edson Silva-Filho
- Associated Postgraduate Program in Physical Education, Federal University of Paraíba, João Pessoa, Paraíba, Brazil.
| | - Jéssica Albuquerque
- Department of Social Psychology, Federal University of Paraíba, João Pessoa, Paraíba, Brazil
| | - Marom Bikson
- Department of Biomedical Engineering, The City College of The City University of New York, New York, USA
| | - Rodrigo Pegado
- Postgraduate Program in Rehabilitation Sciences, Federal University of Rio Grande do Norte, Santa Cruz, Brazil
| | - Amilton da Cruz Santos
- Associated graduate Program in Physical Education, Federal University of Paraíba, João Pessoa, Paraíba, Brazil
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15
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Brousseau-Foley M, Blanchette V, Trudeau F, Houle J. Physical Activity Participation in People with an Active Diabetic Foot Ulceration: A Scoping Review. Can J Diabetes 2021; 46:313-327. [DOI: 10.1016/j.jcjd.2021.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 02/22/2021] [Accepted: 07/05/2021] [Indexed: 11/25/2022]
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16
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Lee EB, Hong S, Min J, Park DH, Cho W, Suh SH, Lee HD, Lee HJ, Kimm H, Jee SH, Kang ES, Lee DH, Jeon JY. Association between domain-specific physical activity and diabetes in Korean adults. Sci Rep 2021; 11:13066. [PMID: 34158561 PMCID: PMC8219728 DOI: 10.1038/s41598-021-92560-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 06/08/2021] [Indexed: 12/15/2022] Open
Abstract
This study aimed to investigate the association between domain-specific physical activity (PA) and diabetes in Korean adults. We analyzed 26,653 men and women (aged > 18 years) from the Korea National Health and Nutrition Examination Survey (2014–2018). PA was measured using a validated Global PA Questionnaire. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) after adjustment for various confounders. Transport PA accounted for the majority of total PA (46%, men; 58%, women), followed by leisure-time PA (30%; 22%) and work PA (24%; 20%). In men, ORs (95% CI) of diabetes comparing ≥ 600 metabolic task of equivalent (MET)-min/week vs. no activity were 0.82 (0.71–0.95) for leisure-time PA, 0.85 (0.75–0.96) for transport PA, and 0.88 (0.78–0.99) for leisure-time + transport PA. In women, ORs (95% CI) of diabetes comparing the same groups were 0.73 (0.60–0.89) for leisure-time PA, 0.97 (0.85–1.10) for transport PA, and 0.88 (0.78–1.00) for leisure-time + transport PA. However, work PA showed no association with diabetes. In conclusion, leisure-time PA was inversely associated with diabetes in both men and women, while transport PA was inversely associated only in men. But work PA was not associated with diabetes in Korean adults.
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Affiliation(s)
- Eun-Byeol Lee
- Department of Sport Industry Studies, Yonsei University, 50 Yonseiro, Seodaemun-gu, Seoul, 03722, South Korea.,Exercise Medicine Center for Diabetes and Cancer Patients, ICONS, Yonsei University, Seoul, South Korea.,Frontier Research Institute of Convergence Sports Science, Yonsei University, Seoul, South Korea
| | - Sunghyun Hong
- Department of Sport Industry Studies, Yonsei University, 50 Yonseiro, Seodaemun-gu, Seoul, 03722, South Korea.,Exercise Medicine Center for Diabetes and Cancer Patients, ICONS, Yonsei University, Seoul, South Korea
| | - Jihee Min
- Department of Sport Industry Studies, Yonsei University, 50 Yonseiro, Seodaemun-gu, Seoul, 03722, South Korea.,Exercise Medicine Center for Diabetes and Cancer Patients, ICONS, Yonsei University, Seoul, South Korea
| | - Dong-Hyuk Park
- Department of Sport Industry Studies, Yonsei University, 50 Yonseiro, Seodaemun-gu, Seoul, 03722, South Korea.,Exercise Medicine Center for Diabetes and Cancer Patients, ICONS, Yonsei University, Seoul, South Korea
| | - Wonhee Cho
- Department of Sport Industry Studies, Yonsei University, 50 Yonseiro, Seodaemun-gu, Seoul, 03722, South Korea.,Exercise Medicine Center for Diabetes and Cancer Patients, ICONS, Yonsei University, Seoul, South Korea
| | - Sang-Hoon Suh
- Frontier Research Institute of Convergence Sports Science, Yonsei University, Seoul, South Korea.,Department of Physical Education, Yonsei University, Seoul, South Korea
| | - Hae-Dong Lee
- Frontier Research Institute of Convergence Sports Science, Yonsei University, Seoul, South Korea.,Department of Physical Education, Yonsei University, Seoul, South Korea
| | - Han-Joo Lee
- Frontier Research Institute of Convergence Sports Science, Yonsei University, Seoul, South Korea.,Department of Physical Education, Yonsei University, Seoul, South Korea
| | - Heejin Kimm
- Frontier Research Institute of Convergence Sports Science, Yonsei University, Seoul, South Korea.,Graduate School of Public Health, Institute for Health Promotion, Yonsei University, Seoul, South Korea
| | - Sun Ha Jee
- Exercise Medicine Center for Diabetes and Cancer Patients, ICONS, Yonsei University, Seoul, South Korea.,Frontier Research Institute of Convergence Sports Science, Yonsei University, Seoul, South Korea.,Graduate School of Public Health, Institute for Health Promotion, Yonsei University, Seoul, South Korea
| | - Eun Seok Kang
- Frontier Research Institute of Convergence Sports Science, Yonsei University, Seoul, South Korea.,Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Dong Hoon Lee
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA.
| | - Justin Y Jeon
- Department of Sport Industry Studies, Yonsei University, 50 Yonseiro, Seodaemun-gu, Seoul, 03722, South Korea. .,Exercise Medicine Center for Diabetes and Cancer Patients, ICONS, Yonsei University, Seoul, South Korea. .,Frontier Research Institute of Convergence Sports Science, Yonsei University, Seoul, South Korea.
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17
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Florindo M, Nuno SL, Rodrigues LM. Lower limb dynamic activity significantly reduces foot skin perfusion- exploring data with different optical sensors in age-grouped healthy adults. Skin Pharmacol Physiol 2021; 35:13-22. [PMID: 34153970 DOI: 10.1159/000517906] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 06/08/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Margarida Florindo
- Research Center for Biosciences and Health Technologies, Universidade Lusófona CBIOS, Lisboa, Portugal
- Department of Physiotherapy, ESSCVP the Portuguese Red Cross Health School, Lisboa, Portugal
| | - Sérgio Loureiro Nuno
- Research Center for Biosciences and Health Technologies, Universidade Lusófona CBIOS, Lisboa, Portugal
- Clínica S João de Deus - CTD, Lisboa, Portugal
- Escola Superior de Tecnologia da Saúde de Lisboa -ESTeSL Lisboas' Polytechnic Institute, Lisboa, Portugal
| | - Luis Monteiro Rodrigues
- Research Center for Biosciences and Health Technologies, Universidade Lusófona CBIOS, Lisboa, Portugal
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18
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Ogura A, Izawa KP, Sato S, Tawa H, Kureha F, Wada M, Kanai M, Kubo I, Brubaker PH, Yoshikawa R, Matsuda Y. Relationship of end-tidal oxygen partial pressure to the determinants of anaerobic threshold in post-myocardial infarction patients. Heart Vessels 2021; 36:1811-1817. [PMID: 33990894 DOI: 10.1007/s00380-021-01870-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 05/07/2021] [Indexed: 10/21/2022]
Abstract
The anaerobic threshold (AT), obtained during cardiopulmonary exercise testing (CPET), is an important prognostic measure and can be used to develop an exercise prescription in patients after a myocardial infarction (post-MI). The purpose of this study was to examine the central and peripheral determinants of AT in post-MI patients end-tidal oxygen partial pressure (PETO2) measures. We performed cardiopulmonary exercise testing (CPET) on 148 consecutively enrolled post-MI patients to determine PETO2 measured at the AT (AT PETO2) and ΔPETO2 (difference between resting PETO2 and AT PETO2). We subsequently investigated the relationship between these measures of PETO2 and the individual AT for each patient. Multivariate linear regression analysis indicated that AT PETO2 and ΔPETO2 were independently and significantly associated with the AT (β = -0.344, p < 0.001 and β = 0.228, p < 0.001, respectively). Furthermore, the independent factors of AT PETO2 were left ventricular ejection fraction (p = 0.005), resting ventilatory equivalent for carbon dioxide (p = 0.002), and resting dead-space gas volume to tidal volume ratio (p < 0.001). However, the independent factors for ΔPETO2 were history of diabetes (p = 0.047), estimated glomerular filtration rate (p = 0.001), and resting systolic blood pressure (p = 0.017). These findings suggested that AT PETO2 was associated with central determinants; whereas, and ΔPETO2 was associated with peripheral determinants, The AT PETO2 and ΔPETO2 provide variable insight regarding the cause of exercise intolerance and can be used to determine appropriate therapies.
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Affiliation(s)
- Asami Ogura
- Department of Rehabilitation, Sanda City Hospital, Sanda, Japan.,Department of Public Health, Graduate School of Health Sciences, Kobe University, 10-2 Tomogaoka 7-chome Suma, Kobe, 654-0142, Japan.,Cardiovascular stroke Renal Project (CRP), Kobe, Japan
| | - Kazuhiro P Izawa
- Department of Public Health, Graduate School of Health Sciences, Kobe University, 10-2 Tomogaoka 7-chome Suma, Kobe, 654-0142, Japan. .,Cardiovascular stroke Renal Project (CRP), Kobe, Japan.
| | - Shinji Sato
- Department of Physical Therapy, Teikyo Heisei University, Tokyo, Japan
| | - Hideto Tawa
- Department of Cardiology, Sanda City Hospital, Sanda, Japan
| | - Fumie Kureha
- Department of Cardiology, Sanda City Hospital, Sanda, Japan
| | - Masaaki Wada
- Department of Rehabilitation, Sanda City Hospital, Sanda, Japan
| | - Masashi Kanai
- Department of Public Health, Graduate School of Health Sciences, Kobe University, 10-2 Tomogaoka 7-chome Suma, Kobe, 654-0142, Japan.,Cardiovascular stroke Renal Project (CRP), Kobe, Japan
| | - Ikko Kubo
- Department of Public Health, Graduate School of Health Sciences, Kobe University, 10-2 Tomogaoka 7-chome Suma, Kobe, 654-0142, Japan.,Cardiovascular stroke Renal Project (CRP), Kobe, Japan
| | - Peter H Brubaker
- Departments of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | | | - Yuichi Matsuda
- Department of Cardiology, Sanda City Hospital, Sanda, Japan
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19
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Paquin J, Lagacé JC, Brochu M, Dionne IJ. Exercising for Insulin Sensitivity - Is There a Mechanistic Relationship With Quantitative Changes in Skeletal Muscle Mass? Front Physiol 2021; 12:656909. [PMID: 34054574 PMCID: PMC8149906 DOI: 10.3389/fphys.2021.656909] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 04/14/2021] [Indexed: 12/29/2022] Open
Abstract
Skeletal muscle (SM) tissue has been repetitively shown to play a major role in whole-body glucose homeostasis and overall metabolic health. Hence, SM hypertrophy through resistance training (RT) has been suggested to be favorable to glucose homeostasis in different populations, from young healthy to type 2 diabetic (T2D) individuals. While RT has been shown to contribute to improved metabolic health, including insulin sensitivity surrogates, in multiple studies, a universal understanding of a mechanistic explanation is currently lacking. Furthermore, exercised-improved glucose homeostasis and quantitative changes of SM mass have been hypothesized to be concurrent but not necessarily causally associated. With a straightforward focus on exercise interventions, this narrative review aims to highlight the current level of evidence of the impact of SM hypertrophy on glucose homeostasis, as well various mechanisms that are likely to explain those effects. These mechanistic insights could provide a strengthened rationale for future research assessing alternative RT strategies to the current classical modalities, such as low-load, high repetition RT or high-volume circuit-style RT, in metabolically impaired populations.
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Affiliation(s)
- Jasmine Paquin
- Research Centre on Aging, Affiliated With CIUSSS de l'Estrie-CHUS, Sherbrooke, QC, Canada.,Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Jean-Christophe Lagacé
- Research Centre on Aging, Affiliated With CIUSSS de l'Estrie-CHUS, Sherbrooke, QC, Canada.,Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Martin Brochu
- Research Centre on Aging, Affiliated With CIUSSS de l'Estrie-CHUS, Sherbrooke, QC, Canada.,Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Isabelle J Dionne
- Research Centre on Aging, Affiliated With CIUSSS de l'Estrie-CHUS, Sherbrooke, QC, Canada.,Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, QC, Canada
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20
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Gildea N, McDermott A, Rocha J, O’Shea D, Green S, Egaña M. Time course of changes in V̇o2peak and O2 extraction during ramp cycle exercise following HIIT versus moderate-intensity continuous training in type 2 diabetes. Am J Physiol Regul Integr Comp Physiol 2021; 320:R683-R696. [DOI: 10.1152/ajpregu.00318.2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
In the present study, we assessed the time course of adaptations in peak oxygen uptake (V̇o2peak) and muscle fractional oxygen (O2) extraction (using near-infrared spectroscopy) following 12 wk of low-volume high-intensity interval training (HIIT) versus moderate-intensity continuous endurance training (MICT) in adults with uncomplicated type 2 diabetes (T2D). Participants with T2D were randomly assigned to MICT ( n = 12, 50 min of moderate-intensity cycling) or HIIT ( n = 9, 10 × 1 min at ∼90% maximal heart rate) or to a nonexercising control group ( n = 9). Exercising groups trained three times per week and measurements were taken every 3 wk. The rate of muscle deoxygenation (i.e., deoxygenated hemoglobin and myoglobin concentration, Δ[HHb + Mb]) profiles of the vastus lateralis muscle were normalized to 100% of the response, plotted against % power output (PO), and fitted with a double linear regression model. V̇o2peak increased ( P < 0.05) by week 3 of MICT (+17%) and HIIT (+8%), with no further significant changes thereafter. Total increases in V̇o2peak posttraining ( P < 0.05) were 27% and 14%, respectively. The %Δ[HHb + Mb] versus %PO slope of the first linear segment ( slope1) was reduced ( P < 0.05) beyond 3 wk of HIIT and MICT, with no further significant changes thereafter. No changes in V̇o2peak or slope1 were observed in the control group. Low-volume HIIT and MICT induced improvements in V̇o2peak following a similar time course, and these improvements were likely, at least in part, due to an improved microvascular O2 delivery.
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Affiliation(s)
- Norita Gildea
- Department of Physiology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Adam McDermott
- Department of Physiology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Joel Rocha
- Division of Sport and Exercise Sciences, Abertay University, Dundee, United Kingdom
| | - Donal O’Shea
- Department of Endocrinology, St. Columcille’s Hospital, Dublin, Ireland
- Department of Endocrinology and Diabetes Mellitus, St. Vincent’s University Hospital, Dublin, Ireland
| | - Simon Green
- Schools of Health Sciences and Medicine, Western Sydney University, Sydney, Australia
| | - Mikel Egaña
- Department of Physiology, School of Medicine, Trinity College Dublin, Dublin, Ireland
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21
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Liu Y, Sun Z, Chen T, Yang C. Does exercise training improve the function of vascular smooth muscle? A systematic review and meta-analysis. Res Sports Med 2021; 30:577-592. [PMID: 33870820 DOI: 10.1080/15438627.2021.1917408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
We aimed to determine the effects of exercise training on the function of vascular smooth muscle cells. PubMed and Web of Science about the effects of exercise training on vascular smooth muscle cells were searched up to August 2020. The effect sizes were estimated in terms of the standardized mean difference. The number of studies included was thirty-five overall. Exercise training had positive effects on vascular smooth muscle cells function in participants older than 40. Effect sizes for HIGH intensity and MIX were positive but small, and also when training duration was longer than 12 weeks. We concluded that vascular smooth muscle cells response can be promoted by exercise training. Vigorous aerobic exercise and mixture training modality were the best ways to promote the dilation response of vascular smooth muscle cells. Additionally, the significant improvement induced by exercise training only occurred when training lasted for longer than 12 weeks.
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Affiliation(s)
- Yujia Liu
- Institute of Physical Education, Jiangsu Normal University, Xuzhou, Jiangsu, China
| | - Zhenjia Sun
- Institute of Physical Education, Jiangsu Normal University, Xuzhou, Jiangsu, China
| | - Tong Chen
- Institute of Physical Education, Jiangsu Normal University, Xuzhou, Jiangsu, China
| | - Chen Yang
- School of Sports and Health, Nanjing Sport Institute, Nanjing, Jiangsu, China
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22
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Bock JM, Hughes WE, Ueda K, Feider AJ, Hanada S, Casey DP. Glycemic management is inversely related to skeletal muscle microvascular endothelial function in patients with type 2 diabetes. Physiol Rep 2021; 9:e14764. [PMID: 33660935 PMCID: PMC7931618 DOI: 10.14814/phy2.14764] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/20/2021] [Accepted: 01/22/2021] [Indexed: 11/24/2022] Open
Abstract
Microvascular endothelial dysfunction precipitates cardiovascular disease mortality in patients with type 2 diabetes mellitus (T2DM). However, the relationship between glycemic management and microvascular endothelial function of these patients remains ill defined. We investigated the association between skeletal muscle microvascular endothelial function with glycemic management (HbA1c) and responses to an oral glucose challenge (OGTT) in 30 patients with T2DM (59 ± 9 years, 31.2 ± 5.1 kg/m2 , HbA1c = 7.3 ± 1.3%). On study day 1, microvascular endothelial function was quantified as the increase (Δ from rest) in forearm vascular conductance (FVC, ml/min/100 mmHg) during intra-arterial acetylcholine infusion at 4.0 and 8.0 μg/dl forearm volume/min (ACh4 and ACh8, respectively). [Glucose] and [insulin] were measured in a fasted state as well as following a 75 g OGTT on a second day with an additional fasting blood sample collected to measure HbA1c. FVC increased (Δ) 221 ± 118 and 251 ± 144 ml/min/100 mm Hg during ACh4 and ACh8 trials, respectively (p < 0.05 between doses). [Glucose] and [insulin] increased at the 1-h time point, relative to fasting levels, and remained elevated 2 h post-consumption (p < 0.05 for both variables and time points). [Glucose] nor [insulin], fasting or during the OGTT, were associated with ΔFVC during ACh4 or ACh8, respectively (p = 0.11-0.86), although HbA1c was inversely related (r = -0.47 and -0.46, respectively, p < 0.01 for both). Patients whose HbA1c met the ADA's therapeutic target of ≤7.0% had greater ΔFVC to ACh4 (272 ± 147 vs. 182 ± 74 ml/100 mm Hg/min) and ACh8 (324 ± 171 vs. 196 ± 90 ml/100 mm Hg/min, p < 0.05 for both trials) compared to those with >7.0%, respectively. Our data show glycemic management is related to acetylcholine-mediated vasodilation (e.g., microvascular endothelial function) in skeletal muscle of patients with T2DM.
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Affiliation(s)
- Joshua M Bock
- Department of Physical Therapy & Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - William E Hughes
- Department of Physical Therapy & Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Kenichi Ueda
- Department of Anesthesia, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Andrew J Feider
- Department of Anesthesia, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Satoshi Hanada
- Department of Anesthesia, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Darren P Casey
- Department of Physical Therapy & Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IA, USA.,Abboud Cardiovascular Research Center, Carver College of Medicine, University of Iowa, Iowa City, IA, USA.,Fraternal Order of Eagles Diabetes Research Center, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
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23
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Liang J, Zhang X, Xia W, Tong X, Qiu Y, Qiu Y, He J, Yu B, Huang H, Tao J. Promotion of Aerobic Exercise Induced Angiogenesis Is Associated With Decline in Blood Pressure in Hypertension: Result of EXCAVATION-CHN1. Hypertension 2021; 77:1141-1153. [PMID: 33611934 DOI: 10.1161/hypertensionaha.120.16107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Jianwen Liang
- From the Department of Hypertension and Vascular Disease, The First Affiliated Hospital of Sun Yat-sen University (J.L., X.Z., W.X., X.T., Yanxia Qiu, Yumin Qiu, J.H., B.Y., J.T.).,Department of Cardiology, The Eighth Affiliated Hospital of Sun Yat-sen University (J.L., H.H.)
| | - Xiaoyu Zhang
- From the Department of Hypertension and Vascular Disease, The First Affiliated Hospital of Sun Yat-sen University (J.L., X.Z., W.X., X.T., Yanxia Qiu, Yumin Qiu, J.H., B.Y., J.T.)
| | - Wenhao Xia
- From the Department of Hypertension and Vascular Disease, The First Affiliated Hospital of Sun Yat-sen University (J.L., X.Z., W.X., X.T., Yanxia Qiu, Yumin Qiu, J.H., B.Y., J.T.)
| | - Xinzhu Tong
- From the Department of Hypertension and Vascular Disease, The First Affiliated Hospital of Sun Yat-sen University (J.L., X.Z., W.X., X.T., Yanxia Qiu, Yumin Qiu, J.H., B.Y., J.T.)
| | - Yanxia Qiu
- From the Department of Hypertension and Vascular Disease, The First Affiliated Hospital of Sun Yat-sen University (J.L., X.Z., W.X., X.T., Yanxia Qiu, Yumin Qiu, J.H., B.Y., J.T.)
| | - Yumin Qiu
- From the Department of Hypertension and Vascular Disease, The First Affiliated Hospital of Sun Yat-sen University (J.L., X.Z., W.X., X.T., Yanxia Qiu, Yumin Qiu, J.H., B.Y., J.T.)
| | - Jiang He
- From the Department of Hypertension and Vascular Disease, The First Affiliated Hospital of Sun Yat-sen University (J.L., X.Z., W.X., X.T., Yanxia Qiu, Yumin Qiu, J.H., B.Y., J.T.)
| | - Bingbo Yu
- From the Department of Hypertension and Vascular Disease, The First Affiliated Hospital of Sun Yat-sen University (J.L., X.Z., W.X., X.T., Yanxia Qiu, Yumin Qiu, J.H., B.Y., J.T.)
| | - Hui Huang
- Department of Cardiology, The Eighth Affiliated Hospital of Sun Yat-sen University (J.L., H.H.)
| | - Jun Tao
- From the Department of Hypertension and Vascular Disease, The First Affiliated Hospital of Sun Yat-sen University (J.L., X.Z., W.X., X.T., Yanxia Qiu, Yumin Qiu, J.H., B.Y., J.T.).,Guangdong Provincial Engineering and Technology Center for Diagnosis and Treatment of Vascular Diseases (J.T.).,Key Laboratory on Assisted Circulation, Ministry of Health, China (J.T.).,National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases (J.T.)
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24
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Sangha GS, Goergen CJ, Prior SJ, Ranadive SM, Clyne AM. Preclinical techniques to investigate exercise training in vascular pathophysiology. Am J Physiol Heart Circ Physiol 2021; 320:H1566-H1600. [PMID: 33385323 PMCID: PMC8260379 DOI: 10.1152/ajpheart.00719.2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Atherosclerosis is a dynamic process starting with endothelial dysfunction and inflammation and eventually leading to life-threatening arterial plaques. Exercise generally improves endothelial function in a dose-dependent manner by altering hemodynamics, specifically by increased arterial pressure, pulsatility, and shear stress. However, athletes who regularly participate in high-intensity training can develop arterial plaques, suggesting alternative mechanisms through which excessive exercise promotes vascular disease. Understanding the mechanisms that drive atherosclerosis in sedentary versus exercise states may lead to novel rehabilitative methods aimed at improving exercise compliance and physical activity. Preclinical tools, including in vitro cell assays, in vivo animal models, and in silico computational methods, broaden our capabilities to study the mechanisms through which exercise impacts atherogenesis, from molecular maladaptation to vascular remodeling. Here, we describe how preclinical research tools have and can be used to study exercise effects on atherosclerosis. We then propose how advanced bioengineering techniques can be used to address gaps in our current understanding of vascular pathophysiology, including integrating in vitro, in vivo, and in silico studies across multiple tissue systems and size scales. Improving our understanding of the antiatherogenic exercise effects will enable engaging, targeted, and individualized exercise recommendations to promote cardiovascular health rather than treating cardiovascular disease that results from a sedentary lifestyle.
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Affiliation(s)
- Gurneet S Sangha
- Fischell Department of Bioengineering, University of Maryland, College Park, Maryland
| | - Craig J Goergen
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana.,Purdue University Center for Cancer Research, Purdue University, West Lafayette, Indiana
| | - Steven J Prior
- Department of Kinesiology, University of Maryland School of Public Health, College Park, Maryland.,Baltimore Veterans Affairs Geriatric Research, Education, and Clinical Center, Baltimore, Maryland
| | - Sushant M Ranadive
- Department of Kinesiology, University of Maryland School of Public Health, College Park, Maryland
| | - Alisa M Clyne
- Fischell Department of Bioengineering, University of Maryland, College Park, Maryland
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25
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Memelink RG, Pasman WJ, Bongers A, Tump A, van Ginkel A, Tromp W, Wopereis S, Verlaan S, de Vogel-van den Bosch J, Weijs PJM. Effect of an Enriched Protein Drink on Muscle Mass and Glycemic Control during Combined Lifestyle Intervention in Older Adults with Obesity and Type 2 Diabetes: A Double-Blind RCT. Nutrients 2020; 13:nu13010064. [PMID: 33379181 PMCID: PMC7823734 DOI: 10.3390/nu13010064] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/21/2020] [Accepted: 12/23/2020] [Indexed: 12/15/2022] Open
Abstract
Background: Weight loss is key to treatment of older adults with obesity and type 2 diabetes, but also a risk for muscle mass loss. This study investigated whether a whey protein drink enriched with leucine and vitamin D could preserve muscle mass and improve glycemic control during combined lifestyle intervention in this population. Methods: 123 older adults with obesity and type 2 diabetes were randomized into a 13-week lifestyle intervention with dietary advice and exercise, receiving either the enriched protein drink (test) or an isocaloric control (control). Muscle mass was assessed with dual-energy X-ray absorptiometry and glycemic control by oral glucose tolerance test. Statistical analyses were performed using a linear mixed model. Results: There was a nonsignificant increase in leg muscle mass (+0.28 kg; 95% CI, −0.01 to 0.56) and a significant increase in appendicular muscle mass (+0.36 kg; 95% CI, 0.005 to 0.71) and total lean mass (+0.92 kg; 95% CI, 0.19 to 1.65) in test vs. control. Insulin sensitivity (Matsuda index) also increased in test vs. control (+0.52; 95% CI, 0.07 to 0.97). Conclusions: Use of an enriched protein drink during combined lifestyle intervention shows beneficial effects on muscle mass and glycemic control in older adults with obesity and type 2 diabetes.
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Affiliation(s)
- Robert G. Memelink
- Department of Nutrition and Dietetics, Faculty of Sports and Nutrition, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, 1067 SM Amsterdam, The Netherlands;
- Correspondence: ; Tel.: +31-20-5953400
| | - Wilrike J. Pasman
- Netherlands Organisation for Applied Scientific Research (TNO), 3704 HE Zeist, The Netherlands; (W.J.P.); (S.W.)
| | - Anke Bongers
- Danone Nutricia Research, Specialized Nutrition, 3584 CT Utrecht, The Netherlands; (A.B.); (J.d.V.-v.d.B.)
| | - Anita Tump
- Vialente-Diëtheek, 3447 GW Woerden, The Netherlands; (A.T.); (A.v.G.)
| | | | - Wim Tromp
- Tromp Medical, 1901 ND Castricum, The Netherlands;
| | - Suzan Wopereis
- Netherlands Organisation for Applied Scientific Research (TNO), 3704 HE Zeist, The Netherlands; (W.J.P.); (S.W.)
| | - Sjors Verlaan
- Department of Rehabilitation Medicine, Amsterdam University Medical Centers, Vrije Universiteit, 1081 HV Amsterdam, The Netherlands;
| | | | - Peter J. M. Weijs
- Department of Nutrition and Dietetics, Faculty of Sports and Nutrition, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, 1067 SM Amsterdam, The Netherlands;
- Department of Nutrition and Dietetics, Amsterdam University Medical Centers, Vrije Universiteit, 1081 HV Amsterdam, The Netherlands
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26
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Microvascular disease in chronic kidney disease: the base of the iceberg in cardiovascular comorbidity. Clin Sci (Lond) 2020; 134:1333-1356. [PMID: 32542397 PMCID: PMC7298155 DOI: 10.1042/cs20200279] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 05/29/2020] [Accepted: 06/08/2020] [Indexed: 02/07/2023]
Abstract
Chronic kidney disease (CKD) is a relentlessly progressive disease with a very high mortality mainly due to cardiovascular complications. Endothelial dysfunction is well documented in CKD and permanent loss of endothelial homeostasis leads to progressive organ damage. Most of the vast endothelial surface area is part of the microcirculation, but most research in CKD-related cardiovascular disease (CVD) has been devoted to macrovascular complications. We have reviewed all publications evaluating structure and function of the microcirculation in humans with CKD and animals with experimental CKD. Microvascular rarefaction, defined as a loss of perfused microvessels resulting in a significant decrease in microvascular density, is a quintessential finding in these studies. The median microvascular density was reduced by 29% in skeletal muscle and 24% in the heart in animal models of CKD and by 32% in human biopsy, autopsy and imaging studies. CKD induces rarefaction due to the loss of coherent vessel systems distal to the level of smaller arterioles, generating a typical heterogeneous pattern with avascular patches, resulting in a dysfunctional endothelium with diminished perfusion, shunting and tissue hypoxia. Endothelial cell apoptosis, hypertension, multiple metabolic, endocrine and immune disturbances of the uremic milieu and specifically, a dysregulated angiogenesis, all contribute to the multifactorial pathogenesis. By setting the stage for the development of tissue fibrosis and end organ failure, microvascular rarefaction is a principal pathogenic factor in the development of severe organ dysfunction in CKD patients, especially CVD, cerebrovascular dysfunction, muscular atrophy, cachexia, and progression of kidney disease. Treatment strategies for microvascular disease are urgently needed.
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27
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Wake AD. Antidiabetic Effects of Physical Activity: How It Helps to Control Type 2 Diabetes. Diabetes Metab Syndr Obes 2020; 13:2909-2923. [PMID: 32884317 PMCID: PMC7443456 DOI: 10.2147/dmso.s262289] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 07/01/2020] [Indexed: 12/15/2022] Open
Abstract
Despite the improvements in clinical care of the patients, research updates, and public health interventions, there is still an increase in the prevalence, incidence, and mortality because of diabetes mellitus (DM). DM is a public health problem in both developed and developing countries. It has increased alarmingly, putting this disease in the dimension of an epidemic. Diabetes is associated with several complications which increase the risk of many serious health problems on the other side. Therefore, this review was aimed to discuss the antidiabetic effects of physical activity (PA) on type 2 DM (T2DM) by summarizing the significant studies on this topic. This review found that several studies have recommended the utilization of PA for the effective management of T2DM. PA is a non-pharmacologic therapy which is a significant strategy for the management of T2DM and is an appropriate lifestyle modification approach to be practiced by these patients. The studies showed that PA has antidiabetic effects which are evidenced by its substantial role in improving the blood glucose (BG) levels of the individuals with T2DM where it helps them to control their levels of glucose in the blood. It plays a significant role in glycemic control of this disease by lowering the BG levels through possible mechanisms such as decreasing insulin resistance, increasing production of glucose transporter type 4 (GLUT-4), lowering visceral adipose tissue (VAT), increasing pancreatic β-cell functions, using glucose for energy, and so on. In turn, the controlled glycemia helps to prevent the complications associated with uncontrolled T2DM and this would further improve the overall health of the patients and the burden on the health professionals as well. Finally, this review concludes that PA is the cornerstone in the management of T2DM. It also suggests that more attention is needed to its significance in the prevention, glycemic control, and its role in the management of the morbidity and mortality associated with T2DM. Practical PA recommendations and suggestions for the future direction of research in this area are also provided.
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Affiliation(s)
- Addisu Dabi Wake
- Nursing Department, College of Health Sciences, Arsi University, Assela, Oromia, Ethiopia
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28
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Brown EC, Franklin BA, Regensteiner JG, Stewart KJ. Effects of single bout resistance exercise on glucose levels, insulin action, and cardiovascular risk in type 2 diabetes: A narrative review. J Diabetes Complications 2020; 34:107610. [PMID: 32402840 DOI: 10.1016/j.jdiacomp.2020.107610] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 03/09/2020] [Accepted: 03/11/2020] [Indexed: 01/24/2023]
Abstract
AIMS Previous studies have reported beneficial effects of chronic resistance exercise in the prevention and treatment of type 2 diabetes. To clarify potential modulators of acute responses to resistance exercise, we reviewed the literature to determine the effects of a single bout of resistance exercise on cardiometabolic risk factors in type 2 diabetes. METHODS Pubmed and Embase were searched for studies investigating the effects of single bouts of resistance exercise on glucose and insulin levels, and cardiovascular disease risk in people with diabetes. Fourteen reports were identified and reviewed to formulate evidence-based resistance exercise prescription recommendations. RESULTS Glucose and insulin levels appear to decrease with resistance exercise with effects lasting up to 24 and 18 h, respectively. Bouts of resistance exercise may outperform aerobic exercise in reducing ambulatory blood pressure, with effects lasting up to 24 h. Moreover, resistance exercise after rather than before a meal may be more effective in reducing glucose, insulin, and triacylglycerol levels. However, reducing injectable insulin dosage prior to resistance exercise may blunt its favorable effects on glucose levels. CONCLUSIONS This review suggests that a single bout of resistance exercise may be effective for acutely improving cardiometabolic markers in people with diabetes.
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Affiliation(s)
- Elise C Brown
- School of Health Sciences, Oakland University, 433 Meadow Brook Rd, Rochester, MI 48309, USA.
| | - Barry A Franklin
- Preventative Cardiology/Cardiac Rehabilitation, Division of Cardiovascular Diseases, Beaumont Health and Wellness Center, Royal Oak, MI, USA.
| | - Judith G Regensteiner
- Center for Women's Health Research, School of Medicine, University of Colorado, Denver, CO, USA.
| | - Kerry J Stewart
- Division of Cardiology, School of Medicine, Department of Medicine, John Hopkins University, Baltimore, MD, USA.
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29
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Parise G, Murrant CL, Cocks M, Snijders T, Baum O, Plyley MJ. Capillary facilitation of skeletal muscle function in health and disease. Appl Physiol Nutr Metab 2020; 45:453-462. [DOI: 10.1139/apnm-2019-0416] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Skeletal muscle is highly vascularized, with perfusion being tightly regulated to meet wide-ranging metabolic demands. For decades, the capillary supply has been explored mainly in terms of evaluating the capillary numbers and their function in the supply of oxygen and substrates and the removal of metabolic byproducts. This review will focus on recent discoveries concerning the role played by capillaries in facilitating other aspects of cell regulation and maintenance, in health and disease, as well as alterations during the aging process. Novelty Capillaries play a central role in the coordination of the vascular response that controls blood flow during contraction and the cellular responses to which they feed into. Nitric oxide is an important regulatory compound within the cardiovascular system, and a significant contributor to skeletal muscle capillary angiogenesis and vasodilatory response to agonists. The microvascular network between muscle fibres may play a critical role in the distribution of signalling factors necessary for optimal muscle satellite cell function.
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Affiliation(s)
- Gianni Parise
- McMaster University, Departments of Kinesiology and Medical Physics & Applied Radiation Science, Hamilton, ON L8S 4K1, Canada
| | - Coral L. Murrant
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, N1G 2W1, Canada
| | - Matthew Cocks
- Liverpool John Moores University, Research Institute for Sport and Exercise Sciences, Liverpool, L3 5UG, UK
| | - Tim Snijders
- Maastricht University, NUTRIM School of Nutrition and Translational Research in Metabolism, Department of Human Biology, Maastricht 6200 MD, the Netherlands
| | - Oliver Baum
- Institute of Physiology, Charité-Universitäts medizin Berlin, Berlin D-10117, Germany
| | - Michael J. Plyley
- Brock University, Department of Kinesiology, St. Catharines, ON L2S 3A1, Canada
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30
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Hetherington-Rauth M, Magalhães JP, Júdice PB, Melo X, Sardinha LB. Vascular improvements in individuals with type 2 diabetes following a 1 year randomised controlled exercise intervention, irrespective of changes in cardiorespiratory fitness. Diabetologia 2020; 63:722-732. [PMID: 31960071 DOI: 10.1007/s00125-020-05089-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Accepted: 12/18/2019] [Indexed: 12/20/2022]
Abstract
AIMS/HYPOTHESIS Vascular changes in individuals with type 2 diabetes mellitus majorly contribute to the development of cardiovascular disease. Increased cardiorespiratory fitness (CRF) has been associated with improvements in vascular health. Although CRF tends to improve with exercise training, there remains a portion of participants with little or no improvement. Given the importance of vascular function in individuals with type 2 diabetes, we assessed whether individuals who failed to improve CRF following a 1 year exercise intervention also failed to improve arterial stiffness and structural indices. METHODS Individuals with type 2 diabetes with no major micro- and macrovascular complications and aged between 30 and 75 years old (n = 63) participated in a three-arm, 1 year, randomised controlled exercise intervention in Lisbon, Portugal. The study involved a non-exercise control group, a moderate continuous training combined with resistance training (RT) group and a high-intensity interval training with RT group. Allocation of participants into the intervention and control groups was done using a computer-generated list of random numbers. An improvement in CRF was defined as a change in [Formula: see text] ≥5%. Vascular stiffness and structural indices were measured using ultrasound imaging and applanation tonometry. Generalised estimating equations were used to compare changes in vascular measures across individuals in the control group (n = 22) and those in the exercise groups who either had improved CRF (CRF responders; n = 14) or whose CRF did not improve (CRF non-responders; n = 27) following 1 year of exercise training. RESULTS Compared with the control group, exercisers, with and without improvements in CRF, had decreased carotid intima-media thickness (IMT) (CRF responders: β = -2.84 [95% CI -5.63, -0.04]; CRF non-responders: β = -5.89 [95% CI -9.38, -2.40]) and lower-limb pulse wave velocity (PWV) (CRF responders: β = -0.14 [95% CI -0.25, -0.03]; CRF non-responders: β = -0.14 [95% CI -0.25, -0.03]), the latter being an indicator of peripheral arterial stiffness. Only CRF responders had decreased PWV of the upper limb compared with control participants (β = -0.12 [95% CI -0.23, -0.01]). As for central stiffness, CRF non-responders had increased aortic PWV compared with CRF responders (β = 0.19 [95% CI 0.07, 0.31]), whereas only the CRF non-responders had altered carotid distensibility coefficient compared with the control group (β = 0.00 [95% CI 3.01 × 10-5, 0.00]). No interaction effects between the CRF responders and non-responders vs control group were found for the remaining stiffness or haemodynamic indices (p>0.05). CONCLUSIONS/INTERPRETATION Regardless of improvements in CRF, individuals with type 2 diabetes had significant improvements in carotid IMT and lower-limb arterial stiffness following a 1 year exercise intervention. Thus, a lack of improvement in CRF following exercise in people with type 2 diabetes does not necessarily entail a lack of improvement in vascular health. TRIAL REGISTRATION ClinicalTrials.gov NCT03144505 FUNDING: This work was supported by fellowships from the Portuguese Foundation for Science and Technology. This work is also financed by a national grant through the Fundação para a Ciência e Tecnologia (FCT), within the unit I&D 472.
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Affiliation(s)
- Megan Hetherington-Rauth
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal
| | - João P Magalhães
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal
| | - Pedro B Júdice
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal
| | - Xavier Melo
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal
- Ginásio Clube Português, GCP Lab, Lisbon, Portugal
| | - Luís B Sardinha
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal.
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31
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Effect of Exercise on Risk Factors of Diabetic Foot Ulcers: A Systematic Review and Meta-Analysis. Am J Phys Med Rehabil 2019; 98:103-116. [PMID: 30020090 DOI: 10.1097/phm.0000000000001002] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The objectives of this study were to examine the effectiveness of different types of exercise on risk factors of diabetic foot ulcers, including glycated hemoglobin, peripheral arterial disease, and diabetic peripheral neuropathy, in people with type 2 diabetes mellitus. PubMed, Web of Science, Cochrane Library, Scopus, and CINAHL were searched from inception to January 2018 for relevant articles. Eligible studies were randomized controlled trials that examined effects of exercise on the selected risk factors. Twenty randomized controlled trials with 1357 participants were included in the meta-analyses. The differences in postintervention values of glycated hemoglobin and ankle brachial index between exercise and control groups were synthesized, yielding mean differences of -0.45% (P < 0.00001) and 0.03 (P = 0.002), respectively; the differences in within-group changes in glycated hemoglobin were synthesized, yielding mean differences of -0.19% (P = 0.1), -0.25% (P = 0.0006), and -0.64% (P = 0.006) for aerobic versus resistance, combined versus aerobic, and combined versus resistance exercise, respectively. Exercise has a significant effect on reducing glycated hemoglobin, whereas combined exercise is more effective compared with aerobic or resistance exercise alone. Exercise also improves ankle brachial index. However, evidence regarding the association between exercise and peripheral neuropathy and risks of diabetic foot ulcers in people with type 2 diabetes mellitus remains insufficient.
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32
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Olver TD, Grunewald ZI, Ghiarone T, Restaino RM, Sales ARK, Park LK, Thorne PK, Ganga RR, Emter CA, Lemon PWR, Shoemaker JK, Manrique-Acevedo C, Martinez-Lemus LA, Padilla J. Persistent insulin signaling coupled with restricted PI3K activation causes insulin-induced vasoconstriction. Am J Physiol Heart Circ Physiol 2019; 317:H1166-H1172. [PMID: 31603345 DOI: 10.1152/ajpheart.00464.2019] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Insulin modulates vasomotor tone through vasodilator and vasoconstrictor signaling pathways. The purpose of the present work was to determine whether insulin-stimulated vasoconstriction is a pathophysiological phenomenon that can result from a combination of persistent insulin signaling, suppressed phosphatidylinositol-3 kinase (PI3K) activation, and an ensuing relative increase in MAPK/endothelin-1 (ET-1) activity. First, we examined previously published work from our group where we assessed changes in lower-limb blood flow in response to an oral glucose tolerance test (endogenous insulin stimulation) in lean and obese subjects. The new analyses showed that the peak rise in vascular resistance during the postprandial state was greater in obese compared with lean subjects. We next extended on these findings by demonstrating that insulin-induced vasoconstriction in isolated resistance arteries from obese subjects was attenuated with ET-1 receptor antagonism, thus implicating ET-1 signaling in this constriction response. Last, we examined in isolated resistance arteries from pigs the dual roles of persistent insulin signaling and blunted PI3K activation in modulating vasomotor responses to insulin. We found that prolonged insulin stimulation did not alter vasomotor responses to insulin when insulin-signaling pathways remained unrestricted. However, prolonged insulinization along with pharmacological suppression of PI3K activity resulted in insulin-induced vasoconstriction, rather than vasodilation. Notably, such aberrant vascular response was rescued with either MAPK inhibition or ET-1 receptor antagonism. In summary, we demonstrate that insulin-induced vasoconstriction is a pathophysiological phenomenon that can be recapitulated when sustained insulin signaling is coupled with depressed PI3K activation and the concomitant relative increase in MAPK/ET-1 activity.NEW & NOTEWORTHY This study reveals that insulin-induced vasoconstriction is a pathophysiological phenomenon. We also provide evidence that in the setting of persistent insulin signaling, impaired phosphatidylinositol-3 kinase activation appears to be a requisite feature precipitating MAPK/endothelin 1-dependent insulin-induced vasoconstriction.
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Affiliation(s)
- T Dylan Olver
- Department of Biomedical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatchewan, Canada
| | - Zachary I Grunewald
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri.,Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri
| | - Thaysa Ghiarone
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri
| | - Robert M Restaino
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri.,Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, New York
| | - Allan R K Sales
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri.,Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.,D'Or Institute for Research and Education, São Paulo, Brazil
| | - Lauren K Park
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri.,Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri
| | - Pamela K Thorne
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri
| | - Rama Rao Ganga
- Department of Surgery, University of Missouri, Columbia, Missouri
| | - Craig A Emter
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri
| | - Peter W R Lemon
- School of Kinesiology, The University of Western Ontario, London, Ontario, Canada
| | - J Kevin Shoemaker
- School of Kinesiology, The University of Western Ontario, London, Ontario, Canada
| | - Camila Manrique-Acevedo
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri.,Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Missouri, Columbia, Missouri.,Research Services, Harry S. Truman Memorial Veterans Hospital, Columbia, Missouri
| | - Luis A Martinez-Lemus
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri.,Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, Missouri
| | - Jaume Padilla
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri.,Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri
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Scott SN, Shepherd SO, Hopkins N, Dawson EA, Strauss JA, Wright DJ, Cooper RG, Kumar P, Wagenmakers AJM, Cocks M. Home‐hit improves muscle capillarisation and eNOS/NAD(P)Hoxidase protein ratio in obese individuals with elevated cardiovascular disease risk. J Physiol 2019; 597:4203-4225. [DOI: 10.1113/jp278062] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 06/05/2019] [Indexed: 12/17/2022] Open
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Olver TD, Laughlin MH, Padilla J. Exercise and Vascular Insulin Sensitivity in the Skeletal Muscle and Brain. Exerc Sport Sci Rev 2019; 47:66-74. [PMID: 30883470 DOI: 10.1249/jes.0000000000000182] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
We present the hypothesis that exercise-induced hyperemia, perhaps through vascular shear stress, represents an important factor responsible for the effects of physical activity (PA) on vascular insulin sensitivity. Specifically, we postulate PA involving the greatest amount of skeletal muscle mass and the greatest central neural recruitment maximizes perfusion and consequently enhances vascular insulin sensitivity in the skeletal muscle and brain.
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Affiliation(s)
- T Dylan Olver
- Department of Biomedical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - M Harold Laughlin
- Department of Biomedical Sciences.,Dalton Cardiovascular Research Center
| | - Jaume Padilla
- Dalton Cardiovascular Research Center.,Department of Nutrition and Exercise Physiology, and.,Department of Child Health, University of Missouri, Columbia, MO
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Saeidifard F, Medina-Inojosa JR, West CP, Olson TP, Somers VK, Bonikowske AR, Prokop LJ, Vinciguerra M, Lopez-Jimenez F. The association of resistance training with mortality: A systematic review and meta-analysis. Eur J Prev Cardiol 2019; 26:1647-1665. [PMID: 31104484 DOI: 10.1177/2047487319850718] [Citation(s) in RCA: 101] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND The benefits of aerobic exercise are well-studied; there is no consensus on the association between resistance training and major adverse cardiovascular outcomes. This systematic review and meta-analysis aimed to address this issue. DESIGN AND METHODS We searched for randomized trials and cohort studies that evaluated the association between resistance training and mortality and cardiovascular events. Two investigators screened the identified abstracts and full-texts independently and in duplicate. Cochrane tools were used to assess the risk of bias. We calculated hazard ratios and 95% confidence intervals using random effect models. RESULTS From the 1430 studies identified, 11 (one randomized trial and 10 cohort studies) met the inclusion criteria, totaling 370,256 participants with mean follow-up of 8.85 years. The meta-analysis showed that, compared with no exercise, resistance training was associated with 21% (hazard ratio (95% confidence interval (CI)), 0.79 (0.69-0.91)) and 40% (hazard ratio (95% CI), 0.60 (0.49-0.72)) lower all-cause mortality alone and when combined with aerobic exercise, respectively. Furthermore, resistance training had a borderline association with lower cardiovascular mortality (hazard ratio (95% CI), 0.83 (0.67-1.03)). In addition, resistance training showed no significant association with cancer mortality. Risk of bias was low to intermediate in the included studies. One cohort study looked at the effect of resistance training on coronary heart disease events in men and found a 23% risk reduction (risk ratio, 0.77, CI: 0.61-0.98). CONCLUSION Resistance training is associated with lower mortality and appears to have an additive effect when combined with aerobic exercise. There are insufficient data to determine the potential beneficial effect of resistance training on non-fatal events or the effect of substituting aerobic exercise with resistance training.
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Affiliation(s)
- Farzane Saeidifard
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic Rochester, USA
| | - Jose R Medina-Inojosa
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic Rochester, USA
| | - Colin P West
- Division of General Internal Medicine, Mayo Clinic, Rochester, USA.,Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, USA
| | - Thomas P Olson
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic Rochester, USA
| | - Virend K Somers
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic Rochester, USA
| | - Amanda R Bonikowske
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic Rochester, USA
| | | | - Manlio Vinciguerra
- International Clinical Research Center (ICRC), St. Anne's University Hospital, Brno, Czech Republic
| | - Francisco Lopez-Jimenez
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic Rochester, USA
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Magalhães JP, Melo X, Correia IR, Ribeiro RT, Raposo J, Dores H, Bicho M, Sardinha LB. Effects of combined training with different intensities on vascular health in patients with type 2 diabetes: a 1-year randomized controlled trial. Cardiovasc Diabetol 2019; 18:34. [PMID: 30885194 PMCID: PMC6423850 DOI: 10.1186/s12933-019-0840-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 03/04/2019] [Indexed: 12/13/2022] Open
Abstract
Background Exercise, when performed on a regular basis, is a well-accepted strategy to improve vascular function in patients with type 2 diabetes. However, the exercise intensity that yields maximal adaptations on structural and functional indices in patients with type 2 diabetes remains uncertain. Our objective was to analyze the impact of a 1-year randomized controlled trial of combined high-intensity interval training (HIIT) with resistance training (RT) vs. a combined moderate continuous training (MCT) with RT on structural and functional arterial indices in patients with type 2 diabetes. Methods Patients with type 2 diabetes (n = 80) were randomized into an exercise intervention with three groups: control, combined HIIT with RT and combined MCT with RT. The 1-year intervention had 3 weekly exercise sessions. High-resolution ultrasonography of the common carotid artery and central and peripheral applanation tonometry were used to assess the changes in structural and functional arterial indices. Generalized estimating equations were used to model the corresponding outcomes. Results After adjusting the models for sex, baseline moderate-to-vigorous physical activity, and mean arterial pressure changes, while using the intention-to-treat analysis, a significant interaction was observed on the carotid intima-media thickness (cIMT) for both the MCT (β = − 4.25, p < 0.01) and HIIT group (β = − 3.61, p < 0.01). However, only the HIIT observed favorable changes from baseline to 1-year on peripheral arterial stiffness indices such as carotid radial arterial pulse wave velocity (β = − 0.10, p = 0.044), carotid to distal posterior tibial artery pulse wave velocity (β = − 0.14, p < 0.01), and on the distensibility coefficient (β = − 0.00, p < 0.01). No effect was found for hemodynamic variables after the intervention. Conclusions Following a 1-year intervention in patients with type 2 diabetes, both the MCT and HIIT group reduced their cIMT, whereas only the HIIT group improved their peripheral arterial stiffness indices and distensibility coefficient. Taken together, HIIT may be a meaningful tool to improve long-term vascular complications in type 2 diabetes. Trial registration clinicaltrials.gov ID: NCT03144505
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Affiliation(s)
- João P Magalhães
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal
| | - Xavier Melo
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal.,GCP Lab, Ginásio Clube Português, Lisbon, Portugal
| | - Inês R Correia
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal
| | - Rogério T Ribeiro
- Education and Research Centre, APDP-Diabetes Portugal (APDP-ERC), Lisbon, Portugal
| | - João Raposo
- Education and Research Centre, APDP-Diabetes Portugal (APDP-ERC), Lisbon, Portugal
| | - Hélder Dores
- Military Forces Hospital, Lisbon, Portugal.,Light Hospital, Lisbon, Portugal.,NOVA Medical School, Lisbon, Portugal
| | - Manuel Bicho
- Genetics Laboratory Environmental Health Institute (ISAMB), Faculty of Medicine, University of Lisbon, Lisbon, Portugal.,Institute of Scientific Research Bento da Rocha Cabral, Lisbon, Portugal
| | - Luís B Sardinha
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal.
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Gu Y, Dennis SM, Kiernan MC, Harmer AR. Aerobic exercise training may improve nerve function in type 2 diabetes and pre-diabetes: A systematic review. Diabetes Metab Res Rev 2019; 35:e3099. [PMID: 30462877 DOI: 10.1002/dmrr.3099] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 09/03/2018] [Accepted: 11/04/2018] [Indexed: 12/14/2022]
Abstract
Diabetic neuropathy is a major complication of type 2 diabetes. Emerging evidence also suggests that people with pre-diabetes may develop similar symptoms related to nerve dysfunction. While regular exercise provides many benefits to patients with diabetes, whether exercise influences nerve function has not been established. As such, the aim of this systematic review was to evaluate current evidence regarding the effect of exercise training on the progression and development of diabetic neuropathy. A systematic search of MEDLINE (Ovid), CINAHL, AMED, PEDro, the Cochrane Library, Embase, and Scopus databases identified a total of 12 studies that were eligible for inclusion in this systematic review. Quality rating and data extraction were performed by two independent reviewers. The 12 included studies examined people with pre-diabetes (n = 1) and with type 2 diabetes (n = 11). There was heterogeneity of study quality and exercise type and dosage among these studies. Eleven studies reported that exercise training had a positive influence on nerve function or neuropathy-related symptoms; and only one study reported mild adverse events. Evidence from this systematic review suggests aerobic exercise training may positively influence nerve function among people with type 2 diabetes, with minimal risk of adverse events. Further research will be required to determine the optimal dosage of exercise training and the effect on nerve function in pre-diabetes and in women with previous gestational diabetes. This review is registered on PROSPERO (CRD42018088182).
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Affiliation(s)
- Yu Gu
- Musculoskeletal Health Research Group, Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW, Australia
- Physiotherapy Department, Royal Prince Alfred Hospital, Sydney Local Health District, Camperdown, NSW, Australia
| | - Sarah M Dennis
- Ingham Institute for Applied Medical Research, South Western Sydney Local Health District, Liverpool, NSW, Australia
- Physical Activity, Lifestyle, Ageing & Wellness Research Group, Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW, Australia
| | - Matthew C Kiernan
- Discovery and Translation, Brain and Mind Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Alison R Harmer
- Musculoskeletal Health Research Group, Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW, Australia
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Roberto S, Milia R, Doneddu A, Pinna V, Palazzolo G, Serra S, Orrù A, Hosseini Kakhak SA, Ghiani G, Mulliri G, Pagliaro P, Crisafulli A. Hemodynamic abnormalities during muscle metaboreflex activation in patients with type 2 diabetes mellitus. J Appl Physiol (1985) 2018; 126:444-453. [PMID: 30543497 DOI: 10.1152/japplphysiol.00794.2018] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Metaboreflex is a reflex triggered during exercise or postexercise muscle ischemia (PEMI) by metaboreceptor stimulation. Typical features of metaboreflex are increased cardiac output (CO) and blood pressure. Patients suffering from metabolic syndrome display hemodynamic abnormalities, with an exaggerated systemic vascular resistance (SVR) and reduced CO response during PEMI-induced metaboreflex. Whether patients with type 2 diabetes mellitus (DM2) have similar hemodynamic abnormalities is unknown. Here we contrast the hemodynamic response to PEMI in 14 patients suffering from DM2 (age 62.7 ± 8.3 yr) and in 15 age-matched controls (CTLs). All participants underwent a control exercise recovery reference test and a PEMI test to obtain the metaboreflex response. Central hemodynamics were evaluated by unbiased operator-independent impedance cardiography. Although the blood pressure response to PEMI was not significantly different between the groups, we found that the SVR and CO responses were reversed in patients with DM2 as compared with the CTLs (SVR: 392.5 ± 549.6 and -14.8 ± 258.9 dyn·s-1·cm-5; CO: -0.25 ± 0.63 and 0.46 ± 0.50 l/m, respectively, in DM2 and in CTL groups, respectively; P < 0.05 for both). Of note, stroke volume (SV) increased during PEMI in the CTL group only. Failure to increase SV and CO was the consequence of reduced venous return, impaired cardiac performance, and augmented afterload in patients with DM2. We conclude that patients with DM2 have an exaggerated vasoconstriction in response to metaboreflex activation not accompanied by a concomitant increase in heart performance. Therefore, in these patients, blood pressure response to the metaboreflex relies more on SVR increases rather than on increases in SV and CO. NEW & NOTEWORTHY The main new finding of the present investigation is that subjects with type 2 diabetes mellitus have an exaggerated vasoconstriction in response to metaboreflex activation. In these patients, blood pressure response to the metaboreflex relies more on systemic vascular resistance than on cardiac output increments.
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Affiliation(s)
- Silvana Roberto
- Sports Physiology Laboratory, Department of Medical Sciences and Public Health, University of Cagliari , Cagliari , Italy
| | - Raffaele Milia
- Sports Physiology Laboratory, Department of Medical Sciences and Public Health, University of Cagliari , Cagliari , Italy
| | - Azzurra Doneddu
- Sports Physiology Laboratory, Department of Medical Sciences and Public Health, University of Cagliari , Cagliari , Italy
| | - Virginia Pinna
- Sports Physiology Laboratory, Department of Medical Sciences and Public Health, University of Cagliari , Cagliari , Italy
| | - Girolamo Palazzolo
- Sports Physiology Laboratory, Department of Medical Sciences and Public Health, University of Cagliari , Cagliari , Italy
| | - Stefano Serra
- Sports Physiology Laboratory, Department of Medical Sciences and Public Health, University of Cagliari , Cagliari , Italy
| | - Andrea Orrù
- Sports Physiology Laboratory, Department of Medical Sciences and Public Health, University of Cagliari , Cagliari , Italy
| | | | - Giovanna Ghiani
- Sports Physiology Laboratory, Department of Medical Sciences and Public Health, University of Cagliari , Cagliari , Italy
| | - Gabriele Mulliri
- Sports Physiology Laboratory, Department of Medical Sciences and Public Health, University of Cagliari , Cagliari , Italy
| | - Pasquale Pagliaro
- Cardiovascular Physiology Laboratory, Department of Clinical and Biological Science, University of Torino , Turin , Italy
| | - Antonio Crisafulli
- Sports Physiology Laboratory, Department of Medical Sciences and Public Health, University of Cagliari , Cagliari , Italy
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Pereira F, de Moraes R, Van Bavel D, De Lorenzo A, Tibirica E. Effects of Riot Control Training on Systemic Microvascular Reactivity and Capillary Density. Mil Med 2018; 183:e713-e720. [PMID: 29547935 DOI: 10.1093/milmed/usy006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 01/06/2018] [Indexed: 11/13/2022] Open
Abstract
Introduction The main aim of the present study is to evaluate the effects of strenuous exercise, related to special military training for riot control, on systemic microvascular endothelial function and skin capillary density. Materials and Methods Endothelium-dependent microvascular reactivity was evaluated in the forearm skin of healthy military trainees (age 23.4 ± 2.3 yr; n = 15) using laser speckle contrast imaging coupled with cutaneous acetylcholine (ACh) iontophoresis and post-occlusive reactive hyperemia (PORH). Functional capillary density was assessed using high-resolution, intra-vital color microscopy in the dorsum of the middle phalanx. Capillary recruitment (capillary reserve) was evaluated using PORH. Microcirculatory tests were performed before and after a 5-wk special military training for riot control. Results Microvascular endothelium-dependent vasodilatory responses were markedly and significantly reduced after training, compared with values obtained before training. The peak values of microvascular conductance obtained during iontophoresis of ACh or PORH before training (0.84 ± 0.22 and 0.94 ± 0.72 APU/mmHg, respectively) were markedly reduced after training (0.47 ± 0.11 and 0.71 ± 0.14 APU/mmHg; p < 0.0001 and p = 0.0037, respectively). Endothelium-dependent capillary recruitment was significantly reduced after training (before 101 ± 9 and after 95 ± 8 capillaries/mm2; p = 0.0007). Conclusions The present study showed that a 5-wk strenuous military training, performed in unfavorable climatic conditions, induces marked systemic microvascular dysfunction, mainly characterized by reduced endothelium-dependent microvascular vasodilation and blunted capillary recruitment.
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Affiliation(s)
- Flavio Pereira
- Department of Clinical Research, National Institute of Cardiology, Ministry of Health, Rio de Janeiro, Brazil
| | - Roger de Moraes
- Department of Clinical Research, National Institute of Cardiology, Ministry of Health, Rio de Janeiro, Brazil.,Research and Productivity Program, Estacio de Sá University, Rio de Janeiro, Brazil
| | - Diogo Van Bavel
- Department of Clinical Research, National Institute of Cardiology, Ministry of Health, Rio de Janeiro, Brazil
| | - Andrea De Lorenzo
- Department of Clinical Research, National Institute of Cardiology, Ministry of Health, Rio de Janeiro, Brazil
| | - Eduardo Tibirica
- Department of Clinical Research, National Institute of Cardiology, Ministry of Health, Rio de Janeiro, Brazil.,Laboratory of Cardiovascular Investigation, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil
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Vinet A, Obert P, Courteix D, Chapier R, Lesourd B, Verney J, Dutheil F, Walther G. Different modalities of exercise improve macrovascular function but not microvascular function in metabolic syndrome: The RESOLVE randomized trial. Int J Cardiol 2018; 267:165-170. [DOI: 10.1016/j.ijcard.2018.05.073] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 05/07/2018] [Accepted: 05/21/2018] [Indexed: 12/25/2022]
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Zucker IH, Musch TI. Benefits of exercise training on cardiovascular dysfunction: molecular and integrative. Am J Physiol Heart Circ Physiol 2018; 315:H1027-H1031. [PMID: 30074833 DOI: 10.1152/ajpheart.00516.2018] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Exercise training has been shown to ameliorate a wide variety of cardiovascular disorders. The mechanisms by which long-term benefits of exercise training are mediated remains incomplete, despite intense research in this area. Exactly how the act of chronic exercise improves function in every tissue is unknown, but many of the cellular, molecular, and genetic mechanisms are becoming progressively clearer. This "Perspectives" article reviews the contributions of 15 articles published in the American Journal of Physiology-Heart and Circulatory Physiology in response to a Call for Papers in this area. Here, we summarize the contributions of these studies at the cardiac, vascular, immune, and molecular levels. We discuss the translational benefit of these studies and conclude that the beneficial effects of exercise training in cardiovascular disease is due to a large interplay of cellular and molecular mediators in the heart and peripheral vasculature as well as changes in neural elements that regulate blood pressure and blood flow. Readers are encouraged to evaluate and learn from this collection of novel studies.
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Affiliation(s)
- Irving H Zucker
- Department of Cellular and Integrative Physiology, University of Nebraska Medical Center , Omaha, Nebraska
| | - Timothy I Musch
- Departments of Kinesiology, Anatomy and Physiology, Kansas State University , Manhattan, Kansas
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de Bem GF, Costa CA, Santos IB, Cristino Cordeiro VDS, de Carvalho LCRM, de Souza MAV, Soares RDA, Sousa PJDC, Ognibene DT, Resende AC, de Moura RS. Antidiabetic effect of Euterpe oleracea Mart. (açaí) extract and exercise training on high-fat diet and streptozotocin-induced diabetic rats: A positive interaction. PLoS One 2018; 13:e0199207. [PMID: 29920546 PMCID: PMC6007924 DOI: 10.1371/journal.pone.0199207] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 06/04/2018] [Indexed: 12/17/2022] Open
Abstract
A growing body of evidence suggests a protective role of polyphenols and exercise training on the disorders of type 2 diabetes mellitus (T2DM). We aimed to assess the effect of the açaí seed extract (ASE) associated with exercise training on diabetic complications induced by high-fat (HF) diet plus streptozotocin (STZ) in rats. Type 2 diabetes was induced by feeding rats with HF diet (55% fat) for 5 weeks and a single dose of STZ (35 mg/kg i.p.). Control (C) and Diabetic (D) animals were subdivided into four groups each: Sedentary, Training, ASE Sedentary, and ASE Training. ASE (200 mg/kg/day) was administered by gavage and the exercise training was performed on a treadmill (30min/day; 5 days/week) for 4 weeks after the diabetes induction. In type 2 diabetic rats, the treatment with ASE reduced blood glucose, insulin resistance, leptin and IL-6 levels, lipid profile, and vascular dysfunction. ASE increased the expression of insulin signaling proteins in skeletal muscle and adipose tissue and plasma GLP-1 levels. ASE associated with exercise training potentiated the reduction of glycemia by decreasing TNF-α levels, increasing pAKT and adiponectin expressions in adipose tissue, and IR and pAMPK expressions in skeletal muscle of type 2 diabetic rats. In conclusion, ASE treatment has an antidiabetic effect in type 2 diabetic rats by activating the insulin-signaling pathway in muscle and adipose tissue, increasing GLP-1 levels, and an anti-inflammatory action. Exercise training potentiates the glucose-lowering effect of ASE by activating adiponectin-AMPK pathway and increasing IR expression.
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Affiliation(s)
- Graziele Freitas de Bem
- Department of Pharmacology, Institute of Biology, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil
| | - Cristiane Aguiar Costa
- Department of Pharmacology, Institute of Biology, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil
| | - Izabelle Barcellos Santos
- Department of Pharmacology, Institute of Biology, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil
| | | | | | | | - Ricardo de Andrade Soares
- Department of Pharmacology, Institute of Biology, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil
| | | | - Dayane Teixeira Ognibene
- Department of Pharmacology, Institute of Biology, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil
| | - Angela Castro Resende
- Department of Pharmacology, Institute of Biology, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil
- * E-mail: ,
| | - Roberto Soares de Moura
- Department of Pharmacology, Institute of Biology, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil
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Fujita N, Aono S, Karasaki K, Sera F, Kurose T, Fujino H, Urakawa S. Changes in lipid metabolism and capillary density of the skeletal muscle following low-intensity exercise training in a rat model of obesity with hyperinsulinemia. PLoS One 2018; 13:e0196895. [PMID: 29718998 PMCID: PMC5931644 DOI: 10.1371/journal.pone.0196895] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 04/20/2018] [Indexed: 02/06/2023] Open
Abstract
Although exercise is effective in improving obesity and hyperinsulinemia, the exact influence of exercise on the capillary density of skeletal muscles remains unknown. The aim of this study was to investigate the effects of low-intensity exercise training on metabolism in obesity with hyperinsulinemia, focusing specifically on the capillary density within the skeletal muscle. Otsuka Long-Evans Tokushima fatty (OLETF) rats were used as animal models of obesity with hyperinsulinemia, whereas Long-Evans Tokushima Otsuka (LETO) rats served as controls (no obesity, no hyperinsulinemia). The animals were randomly assigned to either non-exercise or exercise groups (treadmill running for 60 min/day, for 4 weeks). The exercise groups were further divided into subgroups according to training mode: single bout (60 min, daily) vs. multiple bout (three bouts of 20 min, daily). Fasting insulin levels were significantly higher in OLETF than in LETO rats. Among OLETF rats, there were no significant differences in fasting glucose levels between the exercise and the non-exercise groups, but the fasting insulin levels were significantly lower in the exercise group. Body weight and triacylglycerol levels in the liver were significantly higher in OLETF than in LETO rats; however, among OLETF rats, these levels were significantly lower in the exercise than in the non-exercise group. The capillary-to-fiber ratio of the soleus muscle was significantly higher in OLETF than in LETO rats; however, among OLETF rats, the ratio was lower in the exercise group than in the non-exercise group. No significant differences in any of the studied parameters were noted between the single-bout and multiple-bout exercise training modes among either OLETF or LETO rats. These results suggest that low-intensity exercise training improves insulin sensitivity and fatty liver. Additionally, the fact that attenuation of excessive capillarization in the skeletal muscle of OLETF rats was accompanied by improvement in increased body weight.
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Affiliation(s)
- Naoto Fujita
- Department of Musculoskeletal Functional Research and Regeneration, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
- * E-mail:
| | - Saki Aono
- Department of Musculoskeletal Functional Research and Regeneration, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Kohei Karasaki
- Department of Musculoskeletal Functional Research and Regeneration, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Fumi Sera
- Department of Musculoskeletal Functional Research and Regeneration, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Tomoyuki Kurose
- Department of Musculoskeletal Functional Research and Regeneration, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Hidemi Fujino
- Life and Medical Science Area, Health Sciences Discipline, Kobe University, Suma-ku, Kobe, Japan
| | - Susumu Urakawa
- Department of Musculoskeletal Functional Research and Regeneration, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
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HOLLOWAY TANYAM, SNIJDERS TIM, VAN KRANENBURG JANNEAU, VAN LOON LUCJC, VERDIJK LEXB. Temporal Response of Angiogenesis and Hypertrophy to Resistance Training in Young Men. Med Sci Sports Exerc 2018; 50:36-45. [DOI: 10.1249/mss.0000000000001409] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Olver TD, Grunewald ZI, Jurrissen TJ, MacPherson REK, LeBlanc PJ, Schnurbusch TR, Czajkowski AM, Laughlin MH, Rector RS, Bender SB, Walters EM, Emter CA, Padilla J. Microvascular insulin resistance in skeletal muscle and brain occurs early in the development of juvenile obesity in pigs. Am J Physiol Regul Integr Comp Physiol 2017; 314:R252-R264. [PMID: 29141949 DOI: 10.1152/ajpregu.00213.2017] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Impaired microvascular insulin signaling may develop before overt indices of microvascular endothelial dysfunction and represent an early pathological feature of adolescent obesity. Using a translational porcine model of juvenile obesity, we tested the hypotheses that in the early stages of obesity development, impaired insulin signaling manifests in skeletal muscle (triceps), brain (prefrontal cortex), and corresponding vasculatures, and that depressed insulin-induced vasodilation is reversible with acute inhibition of protein kinase Cβ (PKCβ). Juvenile Ossabaw miniature swine (3.5 mo of age) were divided into two groups: lean control ( n = 6) and obese ( n = 6). Obesity was induced by feeding the animals a high-fat/high-fructose corn syrup/high-cholesterol diet for 10 wk. Juvenile obesity was characterized by excess body mass, hyperglycemia, physical inactivity (accelerometer), and marked lipid accumulation in the skeletal muscle, with no evidence of overt atherosclerotic lesions in athero-prone regions, such as the abdominal aorta. Endothelium-dependent (bradykinin) and -independent (sodium nitroprusside) vasomotor responses in the brachial and carotid arteries (wire myography), as well as in the skeletal muscle resistance and 2A pial arterioles (pressure myography) were unaltered, but insulin-induced microvascular vasodilation was impaired in the obese group. Blunted insulin-stimulated vasodilation, which was reversed with acute PKCβ inhibition (LY333-531), occurred alongside decreased tissue perfusion, as well as reduced insulin-stimulated Akt signaling in the prefrontal cortex, but not the triceps. In the early stages of juvenile obesity development, the microvasculature and prefrontal cortex exhibit impaired insulin signaling. Such adaptations may underscore vascular and neurological derangements associated with juvenile obesity.
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Affiliation(s)
- T Dylan Olver
- Department of Biomedical Sciences, University of Missouri , Columbia, Missouri
| | - Zachary I Grunewald
- Department of Nutrition and Exercise Physiology, University of Missouri , Columbia, Missouri
| | - Thomas J Jurrissen
- Department of Nutrition and Exercise Physiology, University of Missouri , Columbia, Missouri
| | | | - Paul J LeBlanc
- Department of Health Sciences, Brock University , St. Catharines, Ontario , Canada
| | - Teagan R Schnurbusch
- National Swine Resource and Research Center University of Missouri , Columbia, Missouri
| | - Alana M Czajkowski
- National Swine Resource and Research Center University of Missouri , Columbia, Missouri
| | - M Harold Laughlin
- Department of Biomedical Sciences, University of Missouri , Columbia, Missouri.,Dalton Cardiovascular Research Center, University of Missouri , Columbia, Missouri
| | - R Scott Rector
- Department of Nutrition and Exercise Physiology, University of Missouri , Columbia, Missouri.,Research Service, Harry S. Truman Memorial Veterans Affairs Hospital , Columbia, Missouri.,Department of Medicine, Division of Gastroenterology and Hepatology, University of Missouri , Columbia, Missouri
| | - Shawn B Bender
- Department of Biomedical Sciences, University of Missouri , Columbia, Missouri.,Dalton Cardiovascular Research Center, University of Missouri , Columbia, Missouri.,Research Service, Harry S. Truman Memorial Veterans Affairs Hospital , Columbia, Missouri
| | - Eric M Walters
- National Swine Resource and Research Center University of Missouri , Columbia, Missouri
| | - Craig A Emter
- Department of Biomedical Sciences, University of Missouri , Columbia, Missouri
| | - Jaume Padilla
- Department of Nutrition and Exercise Physiology, University of Missouri , Columbia, Missouri.,Dalton Cardiovascular Research Center, University of Missouri , Columbia, Missouri.,Department of Child Health, University of Missouri , Columbia, Missouri
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Roberto S, Crisafulli A. Consequences of Type 1 and 2 Diabetes Mellitus on the Cardiovascular Regulation During Exercise: A Brief Review. Curr Diabetes Rev 2017; 13:560-565. [PMID: 27306960 PMCID: PMC5684785 DOI: 10.2174/1573399812666160614123226] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 06/08/2016] [Accepted: 06/10/2016] [Indexed: 01/26/2023]
Abstract
INTRODUCTION One challenging problem in patients suffering from Diabetes Mellitus (DM) is the elevate incidence of cardiovascular events. Exercise has been proved useful in reducing cardiovascular risks in these patients. However, both type 1 and 2 DM significantly affect the cardiovascular response during exercise. Therefore, on one side exercise is considered to be a valid therapeutic tool for DM, whereas on the other side during exercise these patients may experience troubles in the cardiovascular regulation. BACKGROUND Several impairments at central and at peripheral level have been reported during exercise in both types of DM. For example, sympathetic dysfunctions have been demonstrated in type 1 and 2 DM. Furthermore, impairments in hemodynamics have been often reported. The purpose of the present paper is to briefly review the latest data on the role played by type 1 and 2 DM in the cardiovascular regulation during dynamic exercise. CONCLUSION Hemodynamic dysfunctions may develop in both type 1 and 2 DM during exercise. However, these cardiovascular dys-regulations are different between the two kinds of diabetes.
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Affiliation(s)
| | - Antonio Crisafulli
- Address correspondence to this author at the Department of Medical
Sciences, Sports Physiology Lab., University of Cagliari, Via Porcell 4, 09124 Cagliari, Italy; Tel: +390706758937; Fax: +390706758917;
E-mail:
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Abstract
PURPOSE OF REVIEW Exercise is recommended as therapeutic intervention for people at risk to develop type 2 diabetes to prevent or treat the disease. Recent studies on the influence of obesity and type 2 diabetes on the outcome of exercise programs are discussed. RECENT FINDINGS Poor glycemic control before an intervention can be a risk factor of reduced therapeutic benefit from exercise. But the acute metabolic response to exercise and the transcriptional profile of the working muscle is similar in healthy controls and type 2 diabetic patients, including but not limited to intact activation of skeletal muscle AMP-activated kinase signaling, glucose uptake and expression of peroxisome proliferator-activated receptor gamma coactivator 1α. The increase in plasma acylcarnitines during exercise is not influenced by type 2 diabetes or obesity. The hepatic response to exercise is dependent on the glucagon/insulin ratio and the exercise-induced increase in hepatokines such as fibroblast growth factor 21 and follistatin is impaired in type 2 diabetes and obesity, but consequences for the benefit from exercise are unknown yet. SUMMARY Severe metabolic dysregulation can reduce the benefit from exercise, but the intact response of key metabolic regulators in exercising skeletal muscle of diabetic patients demonstrates the effectiveness of exercise programs to treat the disease.
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Affiliation(s)
- Peter Plomgaard
- aThe Centre of Inflammation and Metabolism, Centre for Physical Activity Research bDepartment of Clinical Biochemistry, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark cDivision of Endocrinology, Diabetology, Angiology, Nephrology, Pathobiochemistry and Clinical Chemistry, Department of Internal Medicine IV dInstitute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tuebingen eGerman Center for Diabetes Research (DZD), Tuebingen, Germany
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48
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Shi Y, Vanhoutte PM. Macro- and microvascular endothelial dysfunction in diabetes. J Diabetes 2017; 9:434-449. [PMID: 28044409 DOI: 10.1111/1753-0407.12521] [Citation(s) in RCA: 313] [Impact Index Per Article: 44.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 12/06/2016] [Accepted: 12/29/2016] [Indexed: 12/12/2022] Open
Abstract
Endothelial cells, as well as their major products nitric oxide (NO) and prostacyclin, play a key role in the regulation of vascular homeostasis. Diabetes mellitus is an important risk factor for cardiovascular disease. Diabetes-induced endothelial dysfunction is a critical and initiating factor in the genesis of diabetic vascular complications. The present review focuses on both large blood vessels and the microvasculature. The endothelial dysfunction in diabetic macrovascular complications is characterized by reduced NO bioavailability, poorly compensated for by increased production of prostacyclin and/or endothelium-dependent hyperpolarizations, and increased production or action of endothelium-derived vasoconstrictors. The endothelial dysfunction of microvascular complications is primarily characterized by decreased release of NO, enhanced oxidative stress, increased production of inflammatory factors, abnormal angiogenesis, and impaired endothelial repair. In addition, non-coding RNAs (microRNAs) have emerged as participating in numerous cellular processes. Thus, this reviews pays special attention to microRNAs and their modulatory role in diabetes-induced vascular dysfunction. Some therapeutic strategies for preventing and restoring diabetic endothelial dysfunction are also highlighted.
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Affiliation(s)
- Yi Shi
- Biomedical Research Centre, Shanghai Key Laboratory of organ Transplantation, Zhongshan Hospital, Fudan University, Shanghai, PR China
| | - Paul M Vanhoutte
- State Key Laboratory of Pharmaceutical Biotechnology and Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR China
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Sauvet F, Arnal PJ, Tardo-Dino PE, Drogou C, Van Beers P, Bougard C, Rabat A, Dispersyn G, Malgoyre A, Leger D, Gomez-Merino D, Chennaoui M. Protective effects of exercise training on endothelial dysfunction induced by total sleep deprivation in healthy subjects. Int J Cardiol 2017; 232:76-85. [DOI: 10.1016/j.ijcard.2017.01.049] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Revised: 11/30/2016] [Accepted: 01/04/2017] [Indexed: 12/31/2022]
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Wormgoor SG, Dalleck LC, Zinn C, Harris NK. Effects of High-Intensity Interval Training on People Living with Type 2 Diabetes: A Narrative Review. Can J Diabetes 2017; 41:536-547. [PMID: 28366674 DOI: 10.1016/j.jcjd.2016.12.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 10/16/2016] [Accepted: 12/05/2016] [Indexed: 12/17/2022]
Abstract
People with type 2 diabetes typically present with comorbidities, such as elevated blood pressure, high cholesterol, high blood glucose, obesity and decreased fitness, all contributive to increased risk for cardiovascular complications. Determination of effective exercise modalities for the management of such complications is important. One such modality is high-intensity interval training (HIIT). To conduct the review, PubMed and EBSCOHost databases were searched through June 1, 2016, for all HIIT intervention studies conducted in people living with type 2 diabetes. Thereafter, the central characteristics of HIIT were analyzed to obtain a broader understanding of the cardiometabolic benefits achievable by HIIT. Fourteen studies were included for review, but the heterogeneity of the participants with type 2 diabetes, the training equipment and HIIT parameters, accompanied by variations in supervision, dietary advice and medications, prevented direct comparisons. However HIIT, regardless of the specific parameters employed, was a suitable option in pursuing improved glycemic control, body composition, aerobic fitness, blood pressure and lipidemia measures in individuals with type 2 diabetes. HIIT is a therapy with at least equivalent benefit to moderate-intensity continuous training; hence, HIIT should be considered when prescribing exercise interventions for people living with type 2 diabetes.
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Affiliation(s)
- Shohn G Wormgoor
- U-Kinetics Exercise and Wellness Clinic, Faculty of Health and Sciences, Universal College of Learning, Masterton, New Zealand; AUT Millennium Campus, Human Potential Centre, Auckland University of Technology, Rosedale, Auckland, New Zealand
| | - Lance C Dalleck
- High Altitude Exercise Physiology Program, Western State Colorado University, Gunnison, Colorado, United States
| | - Caryn Zinn
- AUT Millennium Campus, Human Potential Centre, Auckland University of Technology, Rosedale, Auckland, New Zealand
| | - Nigel K Harris
- AUT Millennium Campus, Human Potential Centre, Auckland University of Technology, Rosedale, Auckland, New Zealand.
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