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McDermott A, Nevin A, Gildea N, Rocha J, O'Shea D, Egaña M. Muscle deoxygenation during ramp incremental cycle exercise in older adults with type 2 diabetes. Eur J Appl Physiol 2024; 124:561-571. [PMID: 37638974 PMCID: PMC10858067 DOI: 10.1007/s00421-023-05297-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 08/03/2023] [Indexed: 08/29/2023]
Abstract
PURPOSE To explore profiles of fractional O2 extraction (using near-infrared spectroscopy) during ramp incremental cycling in older individuals with type 2 diabetes (T2D). METHODS Twelve individuals with T2D (mean ± SD, age: 63 ± 3 years) and 12 healthy controls (mean age: 65 ± 3 years) completed a ramp cycling exercise. Rates of muscle deoxygenation (i.e., deoxygenated haemoglobin and myoglobin, Δ[HHb + Mb]) profiles of the vastus lateralis muscle were normalised to 100% of the response, plotted against absolute (W) and relative (%peak) power output (PO) and fitted with a double linear regression model. RESULTS Peak oxygen uptake (V̇O2peak) was significantly (P < 0.01) reduced in T2D (23.0 ± 4.2 ml.kg-1.min-1) compared with controls (28.3 ± 5.3 ml.kg-1.min-1). The slope of the first linear segment of the model was greater (median (interquartile range)) in T2D (1.06 (1.50)) than controls (0.79 (1.06)) when Δ%[HHb + Mb] was plotted as a function of PO. In addition, the onset of the second linear segment of the Δ%[HHb + Mb]/PO model occurred at a lower exercise intensity in T2D (101 ± 35 W) than controls (140 ± 34 W) and it displayed a near-plateau response in both groups. When the relationship of the Δ%[HHb + Mb] profile was expressed as a function of %PO no differences were observed in any parameters of the double linear model. CONCLUSIONS These findings suggest that older individuals with uncomplicated T2D demonstrate greater fractional oxygen extraction for a given absolute PO compared with older controls. Thus, the reductions in V̇O2peak in older people with T2D are likely influenced by impairments in microvascular O2 delivery.
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Affiliation(s)
- Adam McDermott
- Department of Physiology, School of Medicine, Trinity College Dublin, The University of Dublin, Dublin 2, Ireland
| | - Aaron Nevin
- Department of Physiology, School of Medicine, Trinity College Dublin, The University of Dublin, Dublin 2, Ireland
| | - Norita Gildea
- Department of Physiology, School of Medicine, Trinity College Dublin, The University of Dublin, Dublin 2, Ireland
| | | | - Donal O'Shea
- Endocrinology, St Columcille's and St Vincent's Hospitals, Dublin, Ireland
| | - Mikel Egaña
- Department of Physiology, School of Medicine, Trinity College Dublin, The University of Dublin, Dublin 2, Ireland.
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Zhang J, Tam WWS, Hounsri K, Kusuyama J, Wu VX. Effectiveness of Combined Aerobic and Resistance Exercise on Cognition, Metabolic Health, Physical Function, and Health-related Quality of Life in Middle-aged and Older Adults With Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil 2023:S0003-9993(23)00591-9. [PMID: 37875170 DOI: 10.1016/j.apmr.2023.10.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 09/02/2023] [Accepted: 10/09/2023] [Indexed: 10/26/2023]
Abstract
OBJECTIVES To evaluate the effectiveness of combined aerobic and resistance exercise on cognition, metabolic health, physical function, and health-related quality of life (HRQoL) in middle-aged and older adults with type 2 diabetes mellitus (T2DM). DATA SOURCE AND STUDY SELECTION Systematic search of CINAHL, Cochrane, EMBASE, Scopus, PubMed, ProQuest Dissertation and Thesis, PsycINFO, Web of Science databases, and gray literature from Google Scholar. Pertinent randomized controlled trials (RCTs) were selected. The Protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO CRD42023387336). DATA EXTRACTION The risk of bias was evaluated using the Cochrane Risk of Bias tool by 2 reviewers independently. Outcome data were extracted in a fixed-effect model if heterogeneity test were not significant and I2≤50%; otherwise, the random-effects model was used. DATA SYNTHESIS Sixteen studies with 2426 participants were included in this review. Combined aerobic and resistance exercise had significant positive effects on cognition (SMD=0.34, 95% CI: 0.13 to 0.55), metabolic health on HbA1c (SMD=-0.35, 95% CI: -0.48 to -0.22) and lipid profile (total cholesterol SMD=-0.20, 95% CI: -0.34 to -0.07; low-density lipoprotein SMD=-0.19, 95% CI: -0.33 to -0.05; high-density lipoprotein SMD=0.25, 95% CI: 0.12 to 0.39; and triglycerides SMD=-0.18, 95% CI: -0.31 to -0.04), physical function on aerobic oxygen uptake (SMD=0.58, 95% CI: 0.21 to 0.95) and body mass index (MD=-1.33, 95% CI: -1.84 to -0.82), and physical HRQoL (MD=4.17, 95% CI: 0.86 to 7.48). Our results showed that clinically important effects on cognition may occur in combining the low-moderate intensity of aerobic exercise and progressive intensity of resistance training, the total duration of the exercise needs to be at least 135 minutes per week, among which, resistance training should be at least 60 minutes. CONCLUSION Combined aerobic and resistance exercise effectively improves cognition, ameliorates metabolic health, enhances physical function, and increases physical HRQoL in middle-aged and older adults with T2DM. More RCTs and longitudinal follow-ups are required to provide future evidence of structured combined aerobic and resistance exercise on other domains of cognition.
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Affiliation(s)
- Jinghua Zhang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Clinical Research Centre, Singapore
| | - Wilson Wai San Tam
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Clinical Research Centre, Singapore
| | - Kanokwan Hounsri
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Clinical Research Centre, Singapore
| | - Joji Kusuyama
- Graduate School of Medicine and Dentistry, Tokyo Medical and Dental University, Tokyo, Japan
| | - Vivien Xi Wu
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Clinical Research Centre, Singapore; NUSMED Healthy Longevity Translational Research Programme, National University of Singapore, Singapore.
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Araki N, Hirota T, Hidaka H, Horibe T, Numaguchi R, Takaki J, Nishigawa K, Yoshinaga T, Fukui T. Factors Affecting Recovery of 6-Minute Walk Distance After Coronary Artery Bypass Grafting. Circ Rep 2023; 5:317-322. [PMID: 37564878 PMCID: PMC10411994 DOI: 10.1253/circrep.cr-23-0060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 06/21/2023] [Indexed: 08/12/2023] Open
Abstract
Background: This single-center retrospective analysis investigated the number of days required for postoperative 6-minute walk distance (6MWD) to recover to preoperative values after coronary artery bypass grafting (CABG) and the factors influencing this recovery. Methods and Results: The 6MWD was measured in 101 patients (median age 69 years; 18 women) before and every day after CABG. Univariate and multivariate analyses were performed to identify factors affecting 6MWD recovery to preoperative values after CABG. The median number of days required for recovery of 6MWD after CABG was 9 (interquartile range 7-11 days). Patients were divided into 2 groups based on the median number of days required for recovery of 6MWD; there were 60 patients in the early recovery group (<9 days) and 41 in the "non-early" recovery group (38 who recovered after the median 9 days, and 3 who did not recover during hospitalization). Using univariate logistic regression analysis, diabetes (P=0.01), stroke (P=0.26), left ventricular ejection fraction (P=0.27), and grip strength (P=0.13) were selected for multivariate analysis. Multivariate logistic regression analysis revealed that diabetes (odds ratio 2.955; 95% confidence interval 1.208-7.229; P=0.02) was the only independent predictor of 6MWD recovery. Conclusions: Diabetes was the single factor influencing the recovery of postoperative 6MWD in patients undergoing CABG.
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Affiliation(s)
- Naoya Araki
- Department of Cardiovascular Surgery, Kumamoto University Hospital Kumamoto Japan
| | - Takafumi Hirota
- Department of Cardiovascular Surgery, Kumamoto University Hospital Kumamoto Japan
| | - Hideaki Hidaka
- Department of Cardiovascular Surgery, Kumamoto University Hospital Kumamoto Japan
| | - Tatsuya Horibe
- Department of Cardiovascular Surgery, Kumamoto University Hospital Kumamoto Japan
| | - Ryosuke Numaguchi
- Department of Cardiovascular Surgery, Kumamoto University Hospital Kumamoto Japan
| | - Jun Takaki
- Department of Cardiovascular Surgery, Kumamoto University Hospital Kumamoto Japan
| | - Kosaku Nishigawa
- Department of Cardiovascular Surgery, Kumamoto University Hospital Kumamoto Japan
| | - Takashi Yoshinaga
- Department of Cardiovascular Surgery, Kumamoto University Hospital Kumamoto Japan
| | - Toshihiro Fukui
- Department of Cardiovascular Surgery, Kumamoto University Hospital Kumamoto Japan
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Goulding RP, Burnley M, Wüst RCI. How Priming Exercise Affects Oxygen Uptake Kinetics: From Underpinning Mechanisms to Endurance Performance. Sports Med 2023; 53:959-976. [PMID: 37010782 PMCID: PMC10115720 DOI: 10.1007/s40279-023-01832-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2023] [Indexed: 04/04/2023]
Abstract
The observation that prior heavy or severe-intensity exercise speeds overall oxygen uptake ([Formula: see text]O2) kinetics, termed the "priming effect", has garnered significant research attention and its underpinning mechanisms have been hotly debated. In the first part of this review, the evidence for and against (1) lactic acidosis, (2) increased muscle temperature, (3) O2 delivery, (4) altered motor unit recruitment patterns and (5) enhanced intracellular O2 utilisation in underpinning the priming effect is discussed. Lactic acidosis and increased muscle temperature are most likely not key determinants of the priming effect. Whilst priming increases muscle O2 delivery, many studies have demonstrated that an increased muscle O2 delivery is not a prerequisite for the priming effect. Motor unit recruitment patterns are altered by prior exercise, and these alterations are consistent with some of the observed changes in [Formula: see text]O2 kinetics in humans. Enhancements in intracellular O2 utilisation likely play a central role in mediating the priming effect, probably related to elevated mitochondrial calcium levels and parallel activation of mitochondrial enzymes at the onset of the second bout. In the latter portion of the review, the implications of priming on the parameters of the power-duration relationship are discussed. The effect of priming on subsequent endurance performance depends critically upon which phases of the [Formula: see text]O2 response are altered. A reduced [Formula: see text]O2 slow component or increased fundamental phase amplitude tend to increase the work performable above critical power (i.e. W´), whereas a reduction in the fundamental phase time constant following priming results in an increased critical power.
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Affiliation(s)
- Richie P Goulding
- Laboratory for Myology, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, De Boelelaan 1108, 1081 HZ, Amsterdam, The Netherlands.
| | - Mark Burnley
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Rob C I Wüst
- Laboratory for Myology, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, De Boelelaan 1108, 1081 HZ, Amsterdam, The Netherlands
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Rocha J, Gildea N, O’Shea D, Green S, Egaña M. Priming exercise accelerates oxygen uptake kinetics during high-intensity cycle exercise in middle-aged individuals with type 2 diabetes. Front Physiol 2022; 13:1006993. [PMID: 36505082 PMCID: PMC9727537 DOI: 10.3389/fphys.2022.1006993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 10/31/2022] [Indexed: 11/19/2022] Open
Abstract
Background: The primary phase time constant of pulmonary oxygen uptake kinetics (V · O 2 τ p) during submaximal efforts is longer in middle-aged people with type 2 diabetes (T2D), partly due to limitations in oxygen supply to active muscles. This study examined if a high-intensity "priming" exercise (PE) would speedV · O 2 τ p during a subsequent high-intensity cycling exercise in T2D due to enhanced oxygen delivery. Methods: Eleven (4 women) middle-aged individuals with type 2 diabetes and 11 (4 women) non-diabetic controls completed four separate cycling bouts each starting at an 'unloaded' baseline of 10 W and transitioning to a high-intensity constant-load. Two of the four cycling bouts were preceded by priming exercise. The dynamics of pulmonaryV · O 2 and muscle deoxygenation (i.e. deoxygenated haemoglobin and myoglobin concentration [HHb + Mb]), were calculated from breath-by-breath and near-infrared spectroscopy data at the vastus lateralis, respectively. Results: At baselineV · O 2 τ p, was slower (p < 0.001) in the type 2 diabetes group (48 ± 6 s) compared to the control group (34 ± 2 s) but priming exercise significantly reducedV · O 2 τ p (p < 0.001) in type 2 diabetes (32 ± 6 s) so that post priming exercise it was not different compared with controls (34 ± 3 s). Priming exercise reduced the amplitude of theV · O 2 slow component (As) in both groups (type 2 diabetes: 0.26 ± 0.11 to 0.16 ± 0.07 L/min; control: 0.33 ± 0.13 to 0.25 ± 0.14 L/min, p < 0.001), while [HHb + Mb] kinetics remained unchanged. Conclusion: These results suggest that in middle-aged men and women with T2D, PE speedsV · O 2 τ p likely by a better matching of O2 delivery to utilisation and reduces theV · O 2 As during a subsequent high-intensity exercise.
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Affiliation(s)
- Joel Rocha
- Division of Sport and Exercise Sciences, Abertay University, Dundee, United Kingdom
| | - Norita Gildea
- Department of Physiology, School of Medicine, Trinity College Dublin, The University of Dublin, Dublin, Ireland
| | - Donal O’Shea
- Endocrinology, St Columcille’s and St Vincent’s Hospitals, Dublin, Ireland
| | - Simon Green
- School of Science and Health, Western Sydney University, Sydney, AU-NSW, Australia
| | - Mikel Egaña
- Department of Physiology, School of Medicine, Trinity College Dublin, The University of Dublin, Dublin, Ireland
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Kominami K, Akino M. Prolonged mean response time in older adults with cardiovascular risk compared to healthy older adults. BMC Sports Sci Med Rehabil 2022; 14:173. [PMID: 36151572 PMCID: PMC9503204 DOI: 10.1186/s13102-022-00565-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 08/25/2022] [Accepted: 09/06/2022] [Indexed: 11/23/2022]
Abstract
Background During incremental exercise (Inc-Ex), the mean response time (MRT) of oxygen uptake (V̇O2) represents the time delay before changes in muscle V̇O2 reflect at the mouth level. MRT calculation by linear regression or monoexponential (τ’) fitting of V̇O2 data are known to be highly variable, and a combination of incremental and constant load exercise (CL-Ex) is more reproducible. Methods We evaluated MRT in older adults using linear regression and combination methods. We recruited 20 healthy adults (male: 9, 69.4 ± 6.8 years) and 10 cardiovascular risk subjects (male: 8, 73.0 ± 8.8 years). On day 1, they performed Inc-Ex using a 10W/min ramp protocol, for determination of the ventilatory anaerobic threshold (VAT) using the V-slope method. On day 2, they performed Inc-Ex to VAT exercise intensity and CL-Ex for 25min total. The MRT was calculated from the CL-Ex V̇O2 average and the time at equivalent V̇O2 in the Inc-Ex. We also assessed the amount of physical activity using the International Physical Activity Questionnaire short form (IPAQ-SF). Results The MRT of healthy participants and those at cardiovascular risk were 49.2 ± 36.3 vs. 83.6 ± 45.4s (p = 0.033). Total physical activity in the IPAQ-SF was inversely correlated with MRT. Conclusion The MRT was significantly prolonged in cardiovascular risk participants compared to healthy participants, possibly related to the amount of daily physical activity. Individual MRT may be useful for adjustment of exercise intensity, but this should also be based on daily physical activity and individual condition during exercise.
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Affiliation(s)
- Kazuyuki Kominami
- Department of Rehabilitation, Sanseikai Kitano Hospital, 6-30, 1-chome, Kitano1-jyo, Kiyota-ku, 004-0861, Sapporo, Hokkaido, Japan.
| | - Masatoshi Akino
- Department of Rehabilitation, Sapporo Kiyota Orthopedic Hospital, 1-50, 4-chome, Kiyota1-jyo, Kiyota-ku, 004-0841, Sapporo, Hokkaido, Japan
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7
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Dantas de Medeiros JL, Carneiro Bezerra B, Araújo Cruz HR, Azevedo de Medeiros K, Cardoso de Melo ME, Sales Craveiro Sarmento A, Abbott Galvão Ururahy M, Fassarella Agnez Lima L, Dos Santos Neto AJ, Gomes Lima J, Resqueti V, Peroni Gualdi L, Fregonezi G, Araújo de Melo Campos JT. Impaired functional exercise capacity and greater cardiovascular response to the 6-min walk test in congenital generalized lipodystrophy. BMC Cardiovasc Disord 2022; 22:384. [PMID: 36008763 PMCID: PMC9414389 DOI: 10.1186/s12872-022-02828-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 08/22/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Congenital Generalized Lipodystrophy (CGL) is an ultra-rare disease characterized by metabolic disorders. However, the evaluation of functional exercise capacity, cardiovascular (CV) response to exercise, and peripheral arterial disease (PAD) in CGL is scarce. Here we evaluated the performance and CV response to exercise and their association with PAD in CGL compared to healthy individuals. METHODS Twelve CGL and 12 healthy subjects matched for age and gender were included. Functional exercise capacity, CV response, and PAD were measured using the six-minute walk test (6MWT) and ankle-brachial index (ABI), respectively. RESULTS At baseline, CGL subjects showed reduced predicted walked distance (6MWD) (p = 0.009) and increased heart rate (HR), systolic (SBP), and diastolic (DBP) pressures compared to healthy subjects (p < 0.05). Most CGL subjects presented normal ABI values (1.0 ≤ ABI ≤ 1.4). Only 25% (n = 3) had ABI ≤ 0.9. CGL subjects did not present changes in ABI and blood pressure 12 months after metreleptin (MLP) replacement, but they walked a greater 6MWD than baseline (p = 0.04). Further, 6MWD and right ABI measurements were positively correlated in CGL subjects (p = 0.03). Right ABI negatively correlated with glucose, triglycerides, and VLDL-c (p < 0.05). CONCLUSIONS We observed that CGL subjects had lower functional exercise capacity and higher cardiovascular effort for similar performance of 6MWT, suggesting that strategies for decreasing exercise effort in this population should be essential. Furthermore, better physical performance was associated with high ABI in CGL. Additional studies are needed to clarify leptin's role in preserving functional exercise capacity in CGL.
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Affiliation(s)
- Jorge Luiz Dantas de Medeiros
- PneumoCardioVascular Lab/HUOL, Hospital Universitário Onofre Lopes, Empresa Brasileira de Serviços Hospitalares and Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - Bruno Carneiro Bezerra
- Faculdade de Ciências da Saúde do Trairi, Universidade Federal do Rio Grande do Norte, Santa Cruz, RN, Brazil
| | - Helen Rainara Araújo Cruz
- Faculdade de Ciências da Saúde do Trairi, Universidade Federal do Rio Grande do Norte, Santa Cruz, RN, Brazil
| | | | - Maria Eduarda Cardoso de Melo
- Laboratório de Biologia Molecular e Genômica, Departamento de Biologia Celular e Genética, Centro de Biociências, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
| | - Aquiles Sales Craveiro Sarmento
- Laboratório de Biologia Molecular e Genômica, Departamento de Biologia Celular e Genética, Centro de Biociências, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
| | - Marcela Abbott Galvão Ururahy
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
| | - Lucymara Fassarella Agnez Lima
- Laboratório de Biologia Molecular e Genômica, Departamento de Biologia Celular e Genética, Centro de Biociências, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
| | | | - Josivan Gomes Lima
- Departamento de Medicina Clínica, Hospital Universitário Onofre Lopes (HUOL)/UFRN, Natal, RN, Brazil
| | - Vanessa Resqueti
- PneumoCardioVascular Lab/HUOL, Hospital Universitário Onofre Lopes, Empresa Brasileira de Serviços Hospitalares and Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, Natal, Brazil.,Laboratório de Inovação Tecnológica em Reabilitação, Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - Lucien Peroni Gualdi
- Faculdade de Ciências da Saúde do Trairi, Universidade Federal do Rio Grande do Norte, Santa Cruz, RN, Brazil
| | - Guilherme Fregonezi
- PneumoCardioVascular Lab/HUOL, Hospital Universitário Onofre Lopes, Empresa Brasileira de Serviços Hospitalares and Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, Natal, Brazil.,Laboratório de Inovação Tecnológica em Reabilitação, Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - Julliane Tamara Araújo de Melo Campos
- Laboratório de Biologia Molecular e Genômica, Departamento de Biologia Celular e Genética, Centro de Biociências, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil.
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Greenman AC, Diffee GM, Power AS, Wilkins GT, Gold OMS, Erickson JR, Baldi JC. Treadmill running increases the calcium sensitivity of myofilaments in diabetic rats. J Appl Physiol (1985) 2022; 132:1350-1360. [PMID: 35482324 DOI: 10.1152/japplphysiol.00785.2021] [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: 11/22/2022] Open
Abstract
The cardiovascular benefits of regular exercise are unequivocal, yet patients with type 2 diabetes respond poorly to exercise due to a reduced cardiac reserve. The contractile response of diabetic cardiomyocytes to beta-adrenergic stimulation is attenuated, which may result in altered myofilament calcium sensitivity and post-translational modifications of cardiac troponin I (cTnI). Treadmill running increases myofilament calcium sensitivity in non‑diabetic rats, and thus we hypothesized that endurance training would increase calcium sensitivity of diabetic cardiomyocytes and alter site-specific phosphorylation of cTnI. Calcium sensitivity, or pCa50, was measured in Zucker Diabetic Fatty (ZDF) non-diabetic (nDM) and diabetic (DM) rat hearts after 8 weeks of either a sedentary (SED) or progressive treadmill running (TR) intervention. Skinned cardiomyocytes were connected to a capacitance-gauge transducer and a torque motor to measure force as a function of pCa (‑log[Ca2+]). Specific phospho-sites on cTnI and O‑GlcNAcylation were quantified by immunoblot and total protein phosphorylation by fluorescent gel staining (ProQ Diamond). The novel finding in this study was that training increased pCa50 in both DM and nDM cardiomyocytes (p = 0.009). Phosphorylation of cTnI amino acid residues Ser23/24, a crucial protein kinase A site, and Threonine (Thr)144, was lower in DM hearts, but there was no effect of training on site-specific phosphorylation. Additionally, total phosphorylation and O-GlcNAcylation levels were not different between SED and TR groups. These findings suggest that regular exercise may benefit the diabetic heart by specifically targeting myofilament contractile function.
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Affiliation(s)
- Angela Claire Greenman
- Department of Medicine, Otago Medical School, University of Otago, Dunedin, New Zealand.,Department of Physiology, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand.,HeartOtago, University of Otago, Dunedin, New Zealand
| | - Gary M Diffee
- Department of Kinesiology, University of Wisconsin-Madison, Madison, WI
| | - Amelia S Power
- Department of Physiology, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand.,HeartOtago, University of Otago, Dunedin, New Zealand
| | - Gerard T Wilkins
- Department of Medicine, Otago Medical School, University of Otago, Dunedin, New Zealand.,HeartOtago, University of Otago, Dunedin, New Zealand
| | - Olivia M S Gold
- Department of Physiology, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand.,HeartOtago, University of Otago, Dunedin, New Zealand
| | - Jeffrey R Erickson
- Department of Physiology, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand.,HeartOtago, University of Otago, Dunedin, New Zealand
| | - James C Baldi
- Department of Medicine, Otago Medical School, University of Otago, Dunedin, New Zealand.,HeartOtago, University of Otago, Dunedin, New Zealand
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9
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Poole DC. Can exercise training help redress sexual dimorphism in type II diabetes outcomes? J Diabetes Complications 2022; 36:108099. [PMID: 34916148 DOI: 10.1016/j.jdiacomp.2021.108099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 11/24/2021] [Indexed: 10/19/2022]
Affiliation(s)
- David C Poole
- Department of Kinesiology and Department of Anatomy and Physiology, Kansas State University, Manhattan, KS 66506, USA.
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10
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Hao X, He H, Tao L, Wang H, Zhao L, Ren Y, Wang P. Analysis of Blood Pressure and Ventilation Efficiency in Different Types of Obesity Aged 40-60 Years by Cardiopulmonary Exercise Test. Diabetes Metab Syndr Obes 2022; 15:3195-3203. [PMID: 36268200 PMCID: PMC9578771 DOI: 10.2147/dmso.s379897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 10/11/2022] [Indexed: 11/18/2022] Open
Abstract
PURPOSE This study investigated blood pressure and ventilation efficiency by cardiopulmonary exercise test (CPX) in different types of obesity aged 40-60 years. MATERIAL AND METHODS The inclusion criteria of this cross-sectional study were adults aged 40-60 years underwent health checks. CPX was measured according to the relevant standards. According to different body mass index (BMI), there were 3 groups, BMI<24 (kg/m2), 24≤BMI<28 (kg/m2) and BMI≥28 (kg/m2). There were two groups in male, waist circumference≥90 (cm) and waist circumference<90 (cm). Similarly, there were two groups in female, waist circumference≥85 (cm) and waist circumference<85 (cm). RESULTS There were 543 individuals (64.6% male and 35.4% female) aged 40-60 years in this study. The resting blood pressure (BP) and peak BP have the significant differences in different BMI groups (p < 0.001) and male or female groups (p < 0.001). However, the resting DBP (77.70±9.45 vs 81.16±8.80, p < 0.001) and peak DBP (85.67±10.21 vs 89.03±9.94, p = 0.002) have the significant differences in different male waist circumference groups, and the resting BP (SBP 113.76±14.29 vs 121.86±15.54, p = 0.001, DBP 71.95±10.83 vs 77.27±11.42, p = 0.005) has the significant differences in different female waist circumference groups. Carbon dioxide Ventilation equivalent (VE/VCO2) has the significant differences in different male waist circumference groups (26.84±3.10 vs 27.68±2.93, p = 0.009), but it has not the significant differences in different BMI groups and different female waist circumference groups. The oxygen pulse (VO2/HR) is slightly higher in female group than male group (0.93±0.15 vs 0.89±0.15, p = 0.001). Breathing reserve has the statistical significance in BMI ≥28 group compared with the BMI <24 group (0.52±0.13 vs 0.46±0.17, ηp2=0.021). CONCLUSION We found that the blood pressure and ventilation efficiency of CPX were different between the obesity and normal. This will provide a basis for accurate cardiopulmonary assessment of obesity.
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Affiliation(s)
- Xiaoyan Hao
- Medical Examination Center, Peking University, Third Hospital, Beijing, People’s Republic of China
| | - Honghai He
- Medical Examination Center, Peking University, Third Hospital, Beijing, People’s Republic of China
| | - Liyuan Tao
- Medical Examination Center, Peking University, Third Hospital, Beijing, People’s Republic of China
| | - Hongli Wang
- Medical Examination Center, Peking University, Third Hospital, Beijing, People’s Republic of China
| | - Lili Zhao
- Medical Examination Center, Peking University, Third Hospital, Beijing, People’s Republic of China
| | - Yi Ren
- Medical Examination Center, Peking University, Third Hospital, Beijing, People’s Republic of China
| | - Peng Wang
- Medical Examination Center, Peking University, Third Hospital, Beijing, People’s Republic of China
- Correspondence: Peng Wang, Medical Examination Center, Peking University, Third Hospital, North Garden Road & 49, Beijing, People’s Republic of China, Tel +86-10-82266969, Fax +86-21-82265999, Email
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11
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Liu BB, Niu ZR, Jia XJ, Liu XL, Lu Q. A Correlational Study on Cardiopulmonary Endurance in Male Patients with New-Onset Type 2 Diabetes. Diabetes Metab Syndr Obes 2022; 15:1365-1373. [PMID: 35528721 PMCID: PMC9075895 DOI: 10.2147/dmso.s352798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 04/01/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Cardiopulmonary exercise tests (CPETs) are widely used non-invasive and reliable functional evaluation methods. This study investigated the correlation between cardiopulmonary endurance indices and plasma glucose levels and abdominal visceral fat in males with new-onset type 2 diabetes. METHODS A total of 136 male individuals, who had been treated in the First Hospital of Qinhuangdao City, were selected to form a new-onset type 2 diabetes group (66 cases) and a control group (70 cases); individuals were divided into three groups (Q1, Q2, and Q3) from low to high according to their anaerobic threshold (AT) oxygen uptake (VO2), AT VO2/kg (VO2 per kg of body weight), peak VO2, peak VO2/kg, AT heart rate (HR), peak HR, and HR recovery after 1 minute. A cardiopulmonary exercise test was used to determine the VO2 of each group of subjects for VO2 max and AT VO2/kg, HR, and HR recovery after 1 minute. The differences in fat areas and plasma glucose levels were compared under different cardiorespiratory endurance indicators. RESULTS Compared with the control group, the abdominal visceral fat (AVF) area, fasting plasma glucose (FPG), and postprandial plasma glucose (PPG) levels increased in the new-onset type 2 diabetes group. Concurrently, AT VO2, AT VO2/kg, peak VO2, peak VO2/kg, AT HR, peak HR, and 1-minute HR recovery all decreased, and the difference between the groups was statistically significant (P<0.05). The higher the AT VO2 and peak VO2 values, the lower the PPG level (P<0.05) and the smaller the area of abdominal visceral fat (P<0.05). The AT VO2/kg and peak VO2/kg values were negatively correlated with the abdominal visceral fat area, while other indicators had no obvious relationship with either plasma glucose levels or the area of fat. CONCLUSION The levels of blood glucose and visceral fat are correlated with cardiopulmonary function. With the increase in blood glucose levels and visceral fat, the indices of cardiopulmonary function gradually decrease. The correlation between different cardiopulmonary function indices and blood glucose levels and visceral fat was different.
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Affiliation(s)
- Bin-Bin Liu
- Department of Functional Inspection, Qinhuangdao First Hospital, Qinhuangdao, 066000, People’s Republic of China
| | - Zi-Ru Niu
- Department of Endocrinology and Metabolic Diseases, Hebei Medical University, Shijiazhuang, 050000, People’s Republic of China
| | - Xiao-Jiao Jia
- Department of Endocrinology, Qinhuangdao First Hospital, Qinhuangdao, 066000, People’s Republic of China
| | - Xiao-Li Liu
- Department of Endocrinology, Qinhuangdao First Hospital, Qinhuangdao, 066000, People’s Republic of China
| | - Qiang Lu
- Department of Endocrinology, Qinhuangdao First Hospital, Qinhuangdao, 066000, People’s Republic of China
- Correspondence: Qiang Lu, Department of Endocrinology, Qinhuangdao First Hospital, No. 258 of Wenhua Road, Haigang District, Qinhuangdao, 066000, People’s Republic of China, Tel +86-0335-5908385, Fax: +86-0335-3032042, Email
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12
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Green S, Kiely C, O'Connor E, Gildea N, O'Shea D, Egaña M. Differential effects of sex on adaptive responses of skeletal muscle vasodilation to exercise training in type 2 diabetes. J Diabetes Complications 2022; 36:108098. [PMID: 34887186 DOI: 10.1016/j.jdiacomp.2021.108098] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 11/14/2021] [Accepted: 11/21/2021] [Indexed: 01/07/2023]
Abstract
AIMS We tested the hypotheses that exercise training improves the peak and dynamic responses of leg vascular conductance (LVC) in males and females with type 2 diabetes (T2DM). METHODS Forty-one males and females with T2DM were assigned to two training groups and two control groups. Twelve weeks of aerobic/resistance training was performed three times per week, 60-90 min per session. Responses of calf muscle blood flow and systemic arterial pressure during incremental and constant-load (30% maximal voluntary contraction) intermittent plantar-flexion protocols in the supine position were recorded. RESULTS Training significantly increased peak LVC in males (4.86 ± 1.88 to 6.06 ± 2.06 ml·min-1·mm Hg-1) and females (3.91 ± 1.13 to 5.40 ± 1.38 ml·min-1·mm Hg-1) with no changes in control groups. For dynamic responses, training significantly increased the amplitude of the fast growth phase of LVC (1.81 ± 1.12 to 2.68 ± 1.01 ml·min-1·mm Hg-1) and decreased the time constant of the slow growth phase (43.6 ± 46.4 s to 16.1 14.0 s) in females, but no improvements were observed in control females or in any of the two male groups. CONCLUSIONS These data suggest that training increases the peak vasodilatory response in males and females, whereas the speed of the dynamic response of vasodilation is improved in females but not males.
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Affiliation(s)
- Simon Green
- School of Health Sciences, Western Sydney University, Sydney, Australia; School of Medicine, Western Sydney University, Sydney, Australia
| | - Catherine Kiely
- School of Medicine, Department of Physiology, Trinity College Dublin, Dublin 2, Ireland
| | - Eamonn O'Connor
- School of Medicine, Department of Physiology, Trinity College Dublin, Dublin 2, Ireland
| | - Norita Gildea
- School of Medicine, Department of Physiology, Trinity College Dublin, Dublin 2, Ireland
| | - 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
| | - Mikel Egaña
- School of Medicine, Department of Physiology, Trinity College Dublin, Dublin 2, Ireland.
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13
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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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14
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Grotle AK, Kaur J, Stone AJ, Fadel PJ. Neurovascular Dysregulation During Exercise in Type 2 Diabetes. Front Physiol 2021; 12:628840. [PMID: 33927637 PMCID: PMC8076798 DOI: 10.3389/fphys.2021.628840] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 03/05/2021] [Indexed: 12/12/2022] Open
Abstract
Emerging evidence suggests that type 2 diabetes (T2D) may impair the ability to properly adjust the circulation during exercise with augmented blood pressure (BP) and an attenuated contracting skeletal muscle blood flow (BF) response being reported. This review provides a brief overview of the current understanding of these altered exercise responses in T2D and the potential underlying mechanisms, with an emphasis on the sympathetic nervous system and its regulation during exercise. The research presented support augmented sympathetic activation, heightened BP, reduced skeletal muscle BF, and impairment in the ability to attenuate sympathetically mediated vasoconstriction (i.e., functional sympatholysis) as potential drivers of neurovascular dysregulation during exercise in T2D. Furthermore, emerging evidence supporting a contribution of the exercise pressor reflex and central command is discussed along with proposed future directions for studies in this important area of research.
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Affiliation(s)
- Ann-Katrin Grotle
- Department of Kinesiology, The University of Texas at Arlington, Arlington, TX, United States
| | - Jasdeep Kaur
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, United States
| | - Audrey J Stone
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, United States
| | - Paul J Fadel
- Department of Kinesiology, The University of Texas at Arlington, Arlington, TX, United States
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15
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Gildea N, McDermott A, Rocha J, O'Shea D, Green S, Egaña M. Time-course of V̇o 2 kinetics responses during moderate-intensity exercise subsequent to HIIT versus moderate-intensity continuous training in type 2 diabetes. J Appl Physiol (1985) 2021; 130:1646-1659. [PMID: 33792400 DOI: 10.1152/japplphysiol.00952.2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We assessed the time-course of changes in oxygen uptake (V̇o2) and muscle deoxygenation (i.e., deoxygenated hemoglobin and myoglobin, [HHb + Mb]) kinetics during transitions to moderate-intensity cycling following 12 wk of low-volume high-intensity interval training (HIIT) vs. moderate-intensity continuous training (MICT) in adults with type 2 diabetes (T2D). Participants were randomly assigned to MICT (n = 10, 50 min of moderate-intensity cycling), HIIT (n = 9, 10 × 1 min at ∼90% maximal heart rate), or nonexercising control (n = 9) groups. Exercising groups trained three times per week, and measurements were taken every 3 wk. [HHb + Mb] kinetics were measured by near-infrared spectroscopy at the vastus lateralis muscle. The local matching of O2 delivery to O2 utilization was assessed by the Δ[HHb + Mb]/ΔV̇o2 ratio. The pretraining time constant of the primary phase of V̇o2 (τV̇o2p) decreased (P < 0.05) at wk 3 of training in both MICT (from 44 ± 12 to 32 ± 5 s) and HIIT (from 42 ± 8 to 32 ± 4 s) with no further changes thereafter, whereas no changes were reported in controls. The pretraining overall dynamic response of muscle deoxygenation (τ'[HHb + Mb]) was faster than τV̇o2p in all groups, resulting in Δ[HHb + Mb]/V̇o2p showing a transient "overshoot" relative to the subsequent steady-state level. After 3 wk, the Δ[HHb + Mb]/V̇o2p overshoot was eliminated only in the training groups, so that τ'[HHb + Mb] was not different to τV̇o2p in MICT and HIIT. The enhanced V̇o2 kinetics response consequent to both MICT and HIIT in T2D was likely attributed to a training-induced improvement in matching of O2 delivery to utilization.NEW & NOTEWORTHY High-intensity interval training and moderate-intensity continuous training elicited faster pulmonary oxygen uptake (V̇o2) kinetics during moderate-intensity cycling within 3 wk of training with no further changes thereafter in individuals with type 2 diabetes. These adaptations were accompanied by unaltered near-infrared spectroscopy-derived muscle deoxygenation (i.e. deoxygenated hemoglobin and myoglobin concentration, [HHb+Mb]) kinetics and transiently reduced Δ[HHb+Mb]-to-ΔV̇o2 ratio, suggesting an enhanced blood flow distribution within the active muscles subsequent to both training interventions.
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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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16
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Gildea N, Rocha J, O'Shea D, Green S, Egaña M. Priming exercise accelerates pulmonary oxygen uptake kinetics during "work-to-work" cycle exercise in middle-aged individuals with type 2 diabetes. Eur J Appl Physiol 2020; 121:409-423. [PMID: 33084929 DOI: 10.1007/s00421-020-04518-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 09/25/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE The time constant of phase II pulmonary oxygen uptake kinetics ([Formula: see text]) is increased when high-intensity exercise is initiated from an elevated baseline (work-to-work). A high-intensity priming exercise (PE), which enhances muscle oxygen supply, does not reduce this prolonged [Formula: see text] in healthy active individuals, likely because [Formula: see text] is limited by metabolic inertia (rather than oxygen delivery) in these individuals. Since [Formula: see text] is more influenced by oxygen delivery in type 2 diabetes (T2D), this study tested the hypothesis that PE would reduce [Formula: see text] in T2D during work-to-work cycle exercise. METHODS Nine middle-aged individuals with T2D and nine controls (ND) performed four bouts of constant-load, high-intensity work-to-work transitions, each commencing from a baseline of moderate-intensity. Two bouts were completed without PE and two were preceded by PE. The rate of muscle deoxygenation ([HHb + Mb]) and surface integrated electromyography (iEMG) were measured at the right and left vastus lateralis, respectively. RESULTS Subsequent to PE, [Formula: see text] was reduced (P = 0.001) in T2D (from 59 ± 17 to 37 ± 20 s) but not (P = 0.24) in ND (44 ± 10 to 38 ± 7 s). The amplitude of the [Formula: see text] slow component ([Formula: see text]2 As) was reduced (P = 0.001) in both groups (T2D: 0.16 ± 0.09 to 0.11 ± 0.04 l/min; ND: 0.21 ± 0.13 to 0.13 ± 0.09 l/min). This was accompanied by a reduction in ΔiEMG from the onset of [Formula: see text] slow component to end-exercise in both groups (P < 0.001), while [HHb + Mb] kinetics remained unchanged. CONCLUSIONS PE accelerates [Formula: see text] in T2D, likely by negating the O2 delivery limitation extant in the unprimed condition, and reduces the [Formula: see text]As possibly due to changes in muscle fibre activation.
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Affiliation(s)
- Norita Gildea
- Department of Physiology, School of Medicine, Trinity College Dublin, Dublin 2, Ireland
| | - Joel Rocha
- Division of Sport and Exercise Sciences, Abertay University, Dundee, UK
| | - 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 2, Ireland.
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17
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Fittipaldi EODS, Dornelas de Andrade A, Santos ACO, Campos SL, Souza HCMD, Fernandes J, Catanho MTJDA. Cardiorespiratory Performance and Acute Effect of High-intensity Exercise on Lipid Profile in Hypertensive Sedentary Older Adults with and without Diabetes Mellitus. Arch Gerontol Geriatr 2020; 89:104061. [PMID: 32325307 DOI: 10.1016/j.archger.2020.104061] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/20/2020] [Accepted: 03/28/2020] [Indexed: 12/29/2022]
Abstract
PURPOSE The aim of this study was to verify if the association of hypertension and diabetes mellitus could lead to the differences on cardiorespiratory fitness and lipid profile in older adults. METHODS 40 older adults were divided into two groups: Hypertensive (HTN) and Hypertensive-diabetic (HTN + T2DM). Maximum exercise test on a treadmill was conducted. Lipid profiles assessment was conducted before and after exercise. The cardiorespiratory fitness (CRF) variables were peak oxygen consumption (VO2peak), time to reach peak oxygen consumption (TVO2peak), carbon dioxide ventilatory equivalent (VE/VCO2) and carbon dioxide production (VCO2). To test intergroup and intragroup analyses independent and paired t-tests were used before and after acute exercise. Multiple linear regression was performed to test the influence of coexistence of HTN and T2DM on CRF. RESULTS CRF measures such as VO2peak (β = -3.90), VCO2 (β = -3.87) and TVO2peak (β= -115.79) were significantly (p-value <0.01) lower in HTN + T2DM group. After acute exercise, there was an increase in the levels of lipid profile variables, however without differences between groups. CONCLUSION HTN + T2DM older adults had poorer CRF. Acute changes in lipemia were similar in both groups.
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Affiliation(s)
| | | | | | - Shirley Lima Campos
- Postgraduate Program of Physiotherapy, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
| | - Helga Cecília Muniz de Souza
- Laboratory of Cardiopulmonary Physiotherapy, Department of Physiotherapy, Universidade Federal de Pernambuco, Recife, Brazil
| | - Juliana Fernandes
- Laboratory of Cardiopulmonary Physiotherapy, Department of Physiotherapy, Universidade Federal de Pernambuco, Recife, Brazil
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18
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Green S, Kiely C, O'Connor E, Gildea N, O'Shea D, Egaña M. Effects of exercise training and sex on dynamic responses of O 2 uptake in type 2 diabetes. Appl Physiol Nutr Metab 2020; 45:865-874. [PMID: 32134683 DOI: 10.1139/apnm-2019-0636] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Effects of training and sex on oxygen uptake dynamics during exercise in type 2 diabetes mellitus (T2DM) are not well established. We tested the hypotheses that exercise training improves the time constant of the primary phase of oxygen uptake (τp oxygen uptake) and with greater effect in males than females. Forty-one subjects with T2DM were assigned to 2 training groups (Tmale, Tfemale) and 2 control groups (Cmale, Cfemale), and were assessed before and after a 12-week intervention period. Twelve weeks of aerobic/resistance training was performed 3 times per week, 60-90 min per session. Assessments included ventilatory threshold (VT), peak oxygen uptake, τp oxygen uptake (80%VT), and dynamic responses of cardiac output, mean arterial pressure and systemic vascular conductance (80%VT). Training significantly decreased τp oxygen uptake in males by a mean of 20% (Tmale = 42.7 ± 6.2 to 34.3 ± 7.2 s) and females by a mean of 16% (Tfemale = 42.2 ± 9.3 to 35.4 ± 8.6 s); whereas τp oxygen uptake was not affected in controls (Cmale = 41.6 ± 9.8 to 42.9 ± 7.6 s; Cfemale = 40.4 ± 12.2 to 40.6 ± 13.4 s). Training increased peak oxygen uptake in both sexes (12%-13%) but did not alter systemic cardiovascular dynamics in either sex. Training improved oxygen uptake dynamics to a similar extent in males and females in the absence of changes in systemic cardiovascular dynamics. Novelty Similar training improvements in oxygen uptake dynamics were observed in males and females with T2DM. In both sexes these improvements occurred without changes in systemic cardiovascular dynamics.
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Affiliation(s)
- Simon Green
- School of Science and Health, Western Sydney University, Sydney 2567, Australia.,School of Medicine, Western Sydney University, Sydney 2567, Australia
| | - Catherine Kiely
- Department of Physiology, School of Medicine, Trinity College Dublin, Dublin 2, Ireland
| | - Eamonn O'Connor
- Department of Physiology, School of Medicine, Trinity College Dublin, Dublin 2, Ireland
| | - Norita Gildea
- Department of Physiology, School of Medicine, Trinity College Dublin, Dublin 2, Ireland
| | - Donal O'Shea
- Endocrinology, St Columcille's and St Vincent's Hospitals, Dublin, Dublin 18, Ireland
| | - Mikel Egaña
- Department of Physiology, School of Medicine, Trinity College Dublin, Dublin 2, Ireland
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19
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Senefeld JW, D’Astice SE, Harmer AR, Hunter SK. Increased Cardiovascular Response to a 6-Minute Walk Test in People With Type 2 Diabetes. Diabetes Spectr 2020; 33:104-110. [PMID: 32116462 PMCID: PMC7026755 DOI: 10.2337/ds19-0002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND AND OBJECTIVE Exercise is a cornerstone of management for type 2 diabetes; however, little is known about the cardiovascular (CV) response to submaximal functional exercise in people with type 2 diabetes. The aim of this study was to compare performance and CV response during a 6-minute walk test (6MWT) between people with type 2 diabetes and matched control subjects. METHODS CV response and distance walked during the 6MWT were assessed in 30 people with type 2 diabetes, matched for age, body composition, physical activity, and estimated aerobic capacity with 34 control subjects (type 2 diabetes group: 16 men, 59.8 ± 8.8 years of age, 33.3 ± 10.9% body fat, physical activity of 7,968 ± 3,236 steps·day-1, estimated aerobic capacity 31.9 ± 11.1 mLO2·kg-1·min-1; control group: 19 men, 59.3 ± 8.8 years of age, 32.7 ± 8.5% body fat, physical activity 8,228 ± 2,941 steps·day-1, estimated aerobic capacity 34.9 ± 15.4 mLO2·kg-1·min-1). RESULTS People with type 2 diabetes walked a similar distance (590 ± 75 vs. 605 ± 69 m; P = 0.458) compared with control subjects during the 6MWT and had similar ratings of perceived exertion (RPE) after the 6MWT (4.19 ± 1.56 vs. 3.65 ± 1.54, P = 0.147). However, at the end of the 6MWT, people with type 2 diabetes had a higher heart rate (108 ± 23 vs. 95 ± 18 beats·min-1; P = 0.048), systolic blood pressure (169 ± 26 vs. 147 ± 22 mmHg, P = 0.003), and rate-pressure product (18,762 ± 5,936 vs. 14,252 ± 4,330, P = 0.009) than control subjects. CONCLUSION Although people with type 2 diabetes had similar performance and RPE during the 6MWT compared with control subjects, the CV response was greater for people with type 2 diabetes, indicating greater cardiac effort for similar perceived effort and performance of 6MWT. These data suggest that observation and prescription of exercise intensity should include both perceived effort and CV response.
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Affiliation(s)
- Jonathon W. Senefeld
- Exercise Science Program, Department of Physical Therapy, Marquette University, Milwaukee, WI
| | - Sarah E. D’Astice
- Exercise Science Program, Department of Physical Therapy, Marquette University, Milwaukee, WI
| | - Alison R. Harmer
- Musculoskeletal Health Research Group, Faculty of Health Sciences, The University of Sydney, Lidcombe, Australia
| | - Sandra K. Hunter
- Exercise Science Program, Department of Physical Therapy, Marquette University, Milwaukee, WI
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20
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Vranish JR, Holwerda SW, Kaur J, Fadel PJ. Augmented pressor and sympathoexcitatory responses to the onset of isometric handgrip in patients with type 2 diabetes. Am J Physiol Regul Integr Comp Physiol 2019; 318:R311-R319. [PMID: 31823673 DOI: 10.1152/ajpregu.00109.2019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Patients with type 2 diabetes (T2D) exhibit greater daytime blood pressure (BP) variability, increasing their cardiovascular risk. Given the number of daily activities that incorporate short-duration isometric muscle contractions (e.g., carrying groceries), herein we investigated BP and muscle sympathetic nerve activity (MSNA) responses at the onset of isometric handgrip (HG). We tested the hypothesis that, relative to control subjects, patients with T2D would exhibit exaggerated pressor and MSNA responses to the immediate onset of HG. Mean arterial pressure (MAP) and MSNA were quantified during the first 30 s of isometric HG at 30% and 40% of maximal voluntary contraction (MVC) and during a cold pressor test (CPT), a nonexercise sympathoexcitatory stimulus. The onset of 30% MVC HG evoked similar increases in MAP between groups (P = 0.17); however, the increase in MSNA was significantly greater in patients with T2D versus control subjects with the largest group difference at 20 s (P < 0.001). At the onset of 40% MVC HG, patients with T2D demonstrated greater increases in MAP (e.g., 10 s, T2D: 9 ± 1 mmHg, controls: 5 ± 2 mmHg; P = 0.04). MSNA was also greater in patients with T2D at 40% MVC onset but differences were only significant at the 20-30 s timepoint (T2D: 15 ± 3 bursts/min, controls: -2 ± 4 bursts/min; P < 0.001). Similarly, MAP and MSNA responses were augmented during the onset of CPT in T2D patients. These findings demonstrate exaggerated pressor and MSNA reactivity in patients with T2D, with rapid and robust responses to both isometric contractions and cold stress. This hyper-responsiveness may contribute to daily surges in BP in patients with T2D, increasing their short-term and long-term cardiovascular risk.
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Affiliation(s)
- Jennifer R Vranish
- Department of Integrative Physiology and Health Science, Alma College, Alma, Michigan
| | - Seth W Holwerda
- Department of Health and Human Physiology, University of Iowa, Iowa City, Iowa
| | - Jasdeep Kaur
- Department of Kinesiology, University of Texas at Arlington, Texas
| | - Paul J Fadel
- Department of Kinesiology, University of Texas at Arlington, Texas
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Rocha J, Gildea N, O’Shea D, Green S, Egaña M. Influence of priming exercise on oxygen uptake and muscle deoxygenation kinetics during moderate-intensity cycling in type 2 diabetes. J Appl Physiol (1985) 2019; 127:1140-1149. [DOI: 10.1152/japplphysiol.00344.2019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The pulmonary oxygen uptake (V̇o2) kinetics during the transition to moderate-intensity exercise is slowed in individuals with type 2 diabetes (T2D), at least in part because of limitations in O2 delivery. The present study tested the hypothesis that a prior heavy-intensity warm-up or “priming” exercise (PE) bout would accelerate V̇o2 kinetics in T2D, because of a better matching of O2 delivery to utilization. Twelve middle-aged individuals with T2D and 12 healthy controls (ND) completed moderate-intensity constant-load cycling bouts either without (Mod A) or with (Mod B) prior PE. The rates of muscle deoxygenation (i.e., deoxygenated hemoglobin and myoglobin concentration, [HHb+Mb]) and oxygenation (i.e., tissue oxygenation index) were continuously measured by near-infrared spectroscopy at the vastus lateralis muscle. The local matching of O2 delivery to O2 utilization was assessed by the Δ[HHb+Mb]-to-ΔV̇o2 ratio. Both groups demonstrated an accelerated V̇O2 kinetics response during Mod B compared with Mod A (T2D, 32 ± 9 vs. 42 ± 12 s; ND, 28 ± 9 vs. 34 ± 8 s; means ± SD) and an elevated muscle oxygenation throughout Mod B, whereas the [HHb+Mb] amplitude was greater during Mod B only in individuals with T2D. The [HHb+Mb] kinetics remained unchanged in both groups. In T2D, Mod B was associated with a decrease in the “overshoot” relative to steady state in the Δ[HHb+Mb]-to-ΔV̇o2 ratio (1.17 ± 0.17 vs. 1.05 ± 0.15), whereas no overshoot was observed in the control group before (1.04 ± 0.12) or after (1.01 ± 0.12) PE. Our findings support a favorable priming-induced acceleration of the V̇o2 kinetics response in middle-aged individuals with uncomplicated T2D attributed to an enhanced matching of microvascular O2 delivery to utilization. NEW & NOTEWORTHY Heavy-intensity “priming” exercise (PE) elicited faster pulmonary oxygen uptake (V̇o2) kinetics during moderate-intensity cycling exercise in middle-aged individuals with type 2 diabetes (T2D). This was accompanied by greater near-infrared spectroscopy-derived muscle deoxygenation (i.e., deoxygenated hemoglobin and myoglobin concentration, [HHb+Mb]) responses and a reduced Δ[HHb+Mb]-to-ΔV̇o2 ratio. This suggests that the PE-induced acceleration in oxidative metabolism in T2D is a result of greater O2 extraction and better matching between O2 delivery and utilization.
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Affiliation(s)
- Joel Rocha
- Division of Sport and Exercise Sciences, Abertay University, Dundee, United Kingdom
| | - Norita Gildea
- Department of Physiology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - 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
- School of Science and Health, Western Sydney University, Sydney, New South Wales, Australia
| | - Mikel Egaña
- Department of Physiology, School of Medicine, Trinity College Dublin, Dublin, Ireland
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22
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Gildea N, Rocha J, McDermott A, O'Shea D, Green S, Egaña M. Influence of type 2 diabetes on muscle deoxygenation during ramp incremental cycle exercise. Respir Physiol Neurobiol 2019; 269:103258. [PMID: 31349019 DOI: 10.1016/j.resp.2019.103258] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 07/04/2019] [Accepted: 07/23/2019] [Indexed: 11/18/2022]
Abstract
We tested the hypothesis that type 2 diabetes (T2D) alters the profile of muscle fractional oxygen (O2) extraction (near-infrared spectroscopy) during incremental cycle exercise. Seventeen middle-aged individuals with uncomplicated T2D and 17 controls performed an upright ramp test to exhaustion. The rate of muscle deoxygenation (i.e. deoxygenated haemoglobin and myoglobin concentration, Δ[HHb+Mb]) profiles of the vastus lateralis muscle were normalised to 100% of the response, plotted against % power output (PO) and fitted with a double linear regression model. Peak oxygen uptake was significantly (P < 0.05) reduced in individuals with T2D. The %Δ[HHb+Mb]/%PO slope of the first linear segment of the double linear regression function was significantly (P < 0.05) steeper in T2D than controls (1.59 (1.14) vs 1.23 (0.51)). Both groups displayed a near-plateau in Δ[HHb+Mb] at an exercise intensity (%PO) not different amongst them. Such findings suggest that a reduced O2 delivery to active muscles is an important underlying cause of exercise intolerance during a maximum graded test in middle-aged individuals with T2D.
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Affiliation(s)
- Norita Gildea
- Department of Physiology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Joel Rocha
- Division of Sport and Exercise Sciences, Abertay University, Dundee, UK
| | - Adam McDermott
- Department of Physiology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Donal O'Shea
- Endocrinology, St Columcille's and St Vincent's Hospitals, Dublin, Ireland
| | - Simon Green
- School of Science and Health, Western Sydney University, Sydney, Australia
| | - Mikel Egaña
- Department of Physiology, School of Medicine, Trinity College Dublin, Dublin, Ireland.
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23
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Green S, O'Connor E, Kiely C, O'Shea D, Egaña M. Effect of obesity on oxygen uptake and cardiovascular dynamics during whole-body and leg exercise in adult males and females. Physiol Rep 2019; 6:e13705. [PMID: 29756296 PMCID: PMC5949330 DOI: 10.14814/phy2.13705] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 04/13/2018] [Indexed: 12/02/2022] Open
Abstract
Obesity has been associated with a slowing of V˙O2 dynamics in children and adolescents, but this problem has not been studied in adults. Cardiovascular mechanisms underlying this effect are not clear. In this study, 48 adults (18 males, 30 females) grouped according to body mass index (BMI) (lean < 25 kg·m−2, overweight = 25–29.9 kg·m−2, obese ≥30 kg·m−2) provided a fasting blood sample, completed a maximal graded exercise test and six bouts of submaximal exercise on a cycle ergometer, and performed two protocols of calf exercise. Dynamic response characteristics of V˙O2 and leg vascular conductance (LVC) were assessed during cycling (80% ventilatory threshold) and calf exercise (30% MVC), respectively. Dynamic responses of cardiac output, mean arterial pressure and total systemic vascular conductance were also assessed during cycling based on measurements at 30 and 240 sec. The time constant of the second phase of the V˙O2 response was significantly greater in obese than lean subjects (39.4 (9.2) vs. 29.1 (7.6) sec); whereas dynamic responses of cardiac output and systemic vascular conductance were not affected by BMI. For calf exercise, the time constant of the second growth phase of LVC was slowed significantly in obese subjects (22.1 (12.7) sec) compared with lean and overweight subjects (11.6 (4.5) sec and 13.4 (6.7) sec). These data show that obesity slows dynamic responses of V˙O2 during cycling and the slower phase of vasodilation in contracting muscles of male and female adults.
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Affiliation(s)
- Simon Green
- School of Science and Health, Western Sydney University, Sydney, Australia
| | - Eamon O'Connor
- School of Medicine, Department of Physiology, Trinity College Dublin, Dublin, Ireland
| | - Catherine Kiely
- School of Medicine, Department of Physiology, Trinity College Dublin, Dublin, Ireland
| | - Donal O'Shea
- Endocrinology, St. Columcille's and St. Vincent's Hospitals, Dublin, Ireland
| | - Mikel Egaña
- School of Medicine, Department of Physiology, Trinity College Dublin, Dublin, Ireland
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Im S, Jin G, Jeong J, Yeom J, Jekal J, Lee SI, Cho JA, Lee S, Lee Y, Kim DH, Bae M, Heo J, Moon C, Lee CH. Gender Differences in Aggression-related Responses on EEG and ECG. Exp Neurobiol 2019; 27:526-538. [PMID: 30636903 PMCID: PMC6318556 DOI: 10.5607/en.2018.27.6.526] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 10/30/2018] [Accepted: 11/08/2018] [Indexed: 01/03/2023] Open
Abstract
Gender differences in aggression viewed from an evolutionary and sociocultural perspective have traditionally explained why men engage in more direct and physical aggression, and women engage in more indirect and relational aggression. However, psychological and behavioral studies offer inconsistent support for this theory due to personal or social factors, and little is known about the gender-based neurobiological mechanisms of aggression. This study investigates gender differences in aggression through an analysis of electroencephalography (EEG) and electrocardiography (ECG) based neurobiological responses to commonly encountered stimuli, as well as psychological approaches in healthy Korean youth. Our results from self-reports indicate that overall aggression indices, including physical and reactive/overt aggression, were stronger in men. This agrees with the results of previous studies. Furthermore, our study reveals prominent gender-related patterns in γ signals from the right ventrolateral frontal cortex and changes in heart rate through stimulation by aggressive videos. In particular, gender differences in EEG and ECG responses were observed in response to different scenes, as simple aversion and situation-dependent aggression, respectively. In addition, we discovered decisive gender-distinct EEG signals during stimulation of the situation-dependent aggression regions within the right ventromedial prefrontal and ventrolateral frontal regions. Our findings provide evidence of a psychological propensity for aggression and neurobiological mechanisms of oscillation underlying gender differences in aggression. Further studies of oscillatory responses to aggression and provocation will expand the objective understanding of the different emotional worlds between men and women.
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Affiliation(s)
- SeungYeong Im
- School of Undergraduate Studies, DGIST, Daegu 42988, Korea.,Department of Brain and Cognitive Sciences, Graduate School, DGIST, Daegu 42988, Korea
| | - Gwonhyu Jin
- School of Undergraduate Studies, DGIST, Daegu 42988, Korea
| | - Jinju Jeong
- Undergraduate School Administration Team, DGIST, Daegu 42988, Korea.,Well Aging Research Center, DGIST, Daegu 42988, Korea
| | - Jiwoo Yeom
- School of Undergraduate Studies, DGIST, Daegu 42988, Korea
| | - Janghwan Jekal
- School of Undergraduate Studies, DGIST, Daegu 42988, Korea
| | - Sang-Im Lee
- School of Undergraduate Studies, DGIST, Daegu 42988, Korea
| | - Jung Ah Cho
- School of Undergraduate Studies, DGIST, Daegu 42988, Korea
| | - Sukkyoo Lee
- School of Undergraduate Studies, DGIST, Daegu 42988, Korea
| | - Youngmi Lee
- School of Undergraduate Studies, DGIST, Daegu 42988, Korea
| | - Dae-Hwan Kim
- School of Undergraduate Studies, DGIST, Daegu 42988, Korea
| | - Mijeong Bae
- School of Undergraduate Studies, DGIST, Daegu 42988, Korea
| | - Jinhwa Heo
- School of Undergraduate Studies, DGIST, Daegu 42988, Korea
| | - Cheil Moon
- Department of Brain and Cognitive Sciences, Graduate School, DGIST, Daegu 42988, Korea
| | - Chang-Hun Lee
- School of Undergraduate Studies, DGIST, Daegu 42988, Korea
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25
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Verma S, Moiz JA, Anwer S, Alghadir AH, Hussain ME. A dose-response study of aerobic training for oxygen uptake, oxidative stress and cardiac autonomic function in type 2 diabetes mellitus: study protocol for a randomized controlled trial. Trials 2018; 19:289. [PMID: 29793518 PMCID: PMC5968520 DOI: 10.1186/s13063-018-2671-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 05/04/2018] [Indexed: 02/02/2023] Open
Abstract
Background Cardiac autonomic neuropathy is a commonly overlooked complication of type 2 diabetes mellitus (T2DM) characterized by an imbalance between sympathetic and parasympathetic supply to the heart, which contributes to cardiovascular morbidity and mortality. T2DM has also been shown to negatively influence oxygen kinetics and increase oxidative stress, which may be linked to the development of various chronic complications. Aerobic training has been reported to improve oxygen uptake, antioxidant defense, and cardiac autonomic function in T2DM; however, the effects of varying doses of exercise on these variables are not known. Therefore, the aim of the present study is to explore the effects of manipulating training variables (volume and intensity) on the regulation of oxygen uptake response, oxidative stress, and cardiac autonomic function in patients with T2DM. Methods We will recruit 60 patients with T2DM, who will be randomly allocated into one of the three aerobic training groups: low-intensity, low-volume training; low-intensity, high volume-training; high-intensity, high-volume training; or to the control group receiving no supervised exercise. All participants will be assessed for the rate of oxygen uptake, levels of antioxidant enzymes and cardiac autonomic function at baseline and after 12 weeks of training. Secondary outcome measures will include cardiometabolic risk factors and body composition. Discussion Despite a large body of evidence on the efficacy of aerobic training in the prevention and treatment of T2DM, there is no unequivocal exercise prescription for the same. Oxygen kinetics and oxidative stress are highly sensitive to the magnitude of physical activity. It would therefore, be interesting to study their interaction with chronic exposure to various doses of exercises and explore the optimal volume and intensity to bring about improvements in these parameters. Trial registration Clinical Trials Registry – India, CTRI2017/08/009459. Registered on 23 August 2017. Retrospectively registered. Electronic supplementary material The online version of this article (10.1186/s13063-018-2671-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Shalini Verma
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (Central University), New Delhi, 110025, India
| | - Jamal Ali Moiz
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (Central University), New Delhi, 110025, India
| | - Shahnawaz Anwer
- Department of Rehabilitation, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Ahmad H Alghadir
- Department of Rehabilitation, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed Ejaz Hussain
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (Central University), New Delhi, 110025, India.
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26
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Wilson GA, Wilkins GT, Cotter JD, Lamberts RR, Lal S, Baldi JC. Impaired ventricular filling limits cardiac reserve during submaximal exercise in people with type 2 diabetes. Cardiovasc Diabetol 2017; 16:160. [PMID: 29258502 PMCID: PMC5735887 DOI: 10.1186/s12933-017-0644-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 12/12/2017] [Indexed: 01/22/2023] Open
Abstract
Background Attenuated increases in ventricular stroke volume during exercise are common in type 2 diabetes and contribute to reduced aerobic capacity. The purpose of this study was to determine whether impaired ventricular filling or reduced systolic ejection were responsible for the attenuated stroke volume reserve in people with uncomplicated type 2 diabetes. Methods Peak aerobic capacity and total blood volume were measured in 17 people with diabetes and 16 non-diabetic controls with no evidence of cardiovascular disease. Left ventricular volumes and other systolic and diastolic functional parameters were measured with echocardiography at rest and during semi-recumbent cycle ergometry at 40 and 60% of maximal aerobic power and compared between groups. Results People with diabetes had reduced peak aerobic capacity and heart rate reserve, and worked at lower workloads than non-diabetic controls. Cardiac output, stroke volume and ejection fraction were not different at rest, but increased less in people with diabetes during exercise. Left ventricular end systolic volume was not different between groups in any condition but end diastolic volume, although not different at rest, was smaller in people with diabetes during exercise. Total blood volume was not different between the groups, and was only moderately associated with left ventricular volumes. Conclusions People with type 2 diabetes exhibit an attenuated increase in stroke volume during exercise attributed to an inability to maintain/increase left ventricular filling volumes at higher heart rates. This study is the first to determine the role of filling in the blunted cardiac reserve in adults with type 2 diabetes. Electronic supplementary material The online version of this article (10.1186/s12933-017-0644-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Genevieve A Wilson
- Department of Medicine, HeartOtago, University of Otago, Dunedin, New Zealand
| | - Gerard T Wilkins
- Department of Medicine, HeartOtago, University of Otago, Dunedin, New Zealand
| | - Jim D Cotter
- School of Physical Education, Sports and Exercises Sciences, University of Otago, Dunedin, New Zealand
| | - Regis R Lamberts
- Department of Physiology, School of Biomedical Sciences, HeartOtago, University of Otago, Dunedin, New Zealand
| | - Sudish Lal
- Department of Medicine, HeartOtago, University of Otago, Dunedin, New Zealand
| | - James C Baldi
- Department of Medicine, HeartOtago, University of Otago, Dunedin, New Zealand.
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De Sá C, Grudka Heizen P, Corralo V, Gonzaga dos Santos G, Moura Soares N. Chronic effect of aerobic exercise on anthropometric, biochemical and hemodynamic variables in individuals with type 2 diabetes mellitus: A systematic review. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.ramd.2015.09.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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28
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The Type 2 Diabetic Heart: Its Role in Exercise Intolerance and the Challenge to Find Effective Exercise Interventions. Sports Med 2016; 46:1605-1617. [DOI: 10.1007/s40279-016-0542-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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29
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Kiely C, Rocha J, O'Connor E, O'Shea D, Green S, Egaña M. Influence of menopause and Type 2 diabetes on pulmonary oxygen uptake kinetics and peak exercise performance during cycling. Am J Physiol Regul Integr Comp Physiol 2015; 309:R875-83. [PMID: 26269520 DOI: 10.1152/ajpregu.00258.2015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 08/11/2015] [Indexed: 02/02/2023]
Abstract
We investigated if the magnitude of the Type 2 diabetes (T2D)-induced impairments in peak oxygen uptake (V̇O2) and V̇O2 kinetics was affected by menopausal status. Twenty-two women with T2D (8 premenopausal, 14 postmenopausal), and 22 nondiabetic (ND) women (11 premenopausal, 11 postmenopausal) matched by age (range = 30-59 yr) were recruited. Participants completed four bouts of constant-load cycling at 80% of their ventilatory threshold for the determination of V̇O2 kinetics. Cardiac output (CO) (inert gas rebreathing) was recorded at rest and at 30 s and 240 s during two additional bouts. Peak V̇O2 was significantly (P < 0.05) reduced in both groups with T2D compared with ND counterparts (premenopausal, 1.79 ± 0.16 vs. 1.55 ± 0.32 l/min; postmenopausal, 1.60 ± 0.30 vs. 1.45 ± 0.24 l/min). The time constant of phase II of the V̇O2 response was slowed (P < 0.05) in both groups with T2D compared with healthy counterparts (premenopausal, 29.1 ± 11.2 vs. 43.0 ± 12.2 s; postmenopausal, 33.0 ± 9.1 vs. 41.8 ± 17.7 s). At rest and during submaximal exercise absolute CO responses were lower, but the "gains" in CO larger (both P < 0.05) in both groups with T2D. Our results suggest that the magnitude of T2D-induced impairments in peak V̇O2 and V̇O2 kinetics is not affected by menopausal status in participants younger than 60 yr of age.
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Affiliation(s)
- Catherine Kiely
- School of Medicine, Department of Physiology, Trinity College Dublin, Dublin, Ireland
| | - Joel Rocha
- School of Medicine, Department of Physiology, Trinity College Dublin, Dublin, Ireland
| | - Eamonn O'Connor
- School of Medicine, Department of Physiology, Trinity College Dublin, Dublin, Ireland
| | - Donal O'Shea
- Endocrinology, St. Columcille's and St. Vincent's Hospitals, Dublin, Ireland; and
| | - Simon Green
- School of Science and Health and School of Medicine, University of Western Sydney, Sydney, Australia
| | - Mikel Egaña
- School of Medicine, Department of Physiology, Trinity College Dublin, Dublin, Ireland;
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