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Kindlovits R, Pereira AMDS, Sousa AC, Viana JL, Teixeira VH. Effects of Acute and Chronic Exercise in Hypoxia on Cardiovascular and Glycemic Parameters in Patients with Type 2 Diabetes: A Systematic Review. High Alt Med Biol 2022; 23:301-312. [PMID: 36036723 DOI: 10.1089/ham.2022.0029] [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: 01/28/2023] Open
Abstract
Kindlovits, Raquel, Alberto Mello da Silva Pereira, Ana Catarina Sousa, João Luís Viana,and Vitor Hugo Teixeira. Effects of acute and chronic exercise in hypoxia on cardiovascular and glycemic parameters in patients with type 2 diabetes: a systematic review. High Alt Med Biol. 23:301-312, 2022. Background: Exercise in hypoxia (EH, decreased oxygen availability) has been proposed as a potential therapeutic intervention to promote angiogenesis and improve glucose metabolism to a greater extent than exercise under normoxia (normal ambient air) in patients with type 2 diabetes (T2D). Currently, there are no studies that systematize the existent evidence. This study aims to systematically review the literature and qualitatively evaluate the effects of acute and chronic EH on cardiovascular and glycemic parameters in T2D patients. Methods: A structured search was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines until March 2021, in the MEDLINE/PubMed, Scopus, and Web of Science databases. The inclusion criteria were as follows: (1) randomized and nonrandomized trials, (2) in complication-free patients with T2D, (3) in which EH was compared with exercise in normoxia or with baseline data, and (4) published in English. Results: Six articles (64 subjects) met the inclusion criteria and were reviewed to data extraction. Four articles investigated the acute effect of EH (33 subjects), and two articles investigated the chronic effect of EH (31 subjects), ranging from 6 to 8 weeks. All studies used a cycle ergometer as exercise. Acute EH benefits insulin sensitivity, blood glucose, vascular endothelial growth factor, and metalloproteinase-9, while chronic EH benefits nitric oxide synthase in erythrocytes, but not brachial artery flow-mediated dilation. Conclusion: Acute EH improves glucose homeostasis in T2D patients, which was not seen with chronic EH. Both acute EH and chronic EH improve angiogenesis regulators, but not vascular function. Despite the putative benefits of EH in patients with T2D, the evidence is still scarce and further research is needed before recommendations can be provided.
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Affiliation(s)
- Raquel Kindlovits
- Faculty of Nutrition and Food Sciences, University of Porto (FCNAUP), Porto, Portugal
| | | | - Ana Catarina Sousa
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), University of Maia, Maia, Portugal
| | - João Luís Viana
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), University of Maia, Maia, Portugal
| | - Vitor Hugo Teixeira
- Faculty of Nutrition and Food Sciences, University of Porto (FCNAUP), Porto, Portugal.,Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sports, University of Porto (FADEUP), Portugal.,Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
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2
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Higashi Y. Roles of Oxidative Stress and Inflammation in Vascular Endothelial Dysfunction-Related Disease. Antioxidants (Basel) 2022; 11:antiox11101958. [PMID: 36290681 PMCID: PMC9598825 DOI: 10.3390/antiox11101958] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 09/27/2022] [Accepted: 09/27/2022] [Indexed: 11/30/2022] Open
Abstract
Oxidative stress and chronic inflammation play an important role in the pathogenesis of atherosclerosis. Atherosclerosis develops as the first step of vascular endothelial dysfunction induced by complex molecular mechanisms. Vascular endothelial dysfunction leads to oxidative stress and inflammation of vessel walls, which in turn enhances vascular endothelial dysfunction. Vascular endothelial dysfunction and vascular wall oxidative stress and chronic inflammation make a vicious cycle that leads to the development of atherosclerosis. Simultaneously capturing and accurately evaluating the association of vascular endothelial function with oxidative stress and inflammation would be useful for elucidating the pathophysiology of atherosclerosis, determining treatment efficacy, and predicting future cardiovascular complications. Intervention in both areas is expected to inhibit the progression of atherosclerosis and prevent cardiovascular complications.
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Affiliation(s)
- Yukihito Higashi
- Department of Regenerative Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima 743-8551, Japan; ; Tel.: +81-82-257-5831
- Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima 734-8553, Japan
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Kajikawa M, Higashi Y. Obesity and Endothelial Function. Biomedicines 2022; 10:biomedicines10071745. [PMID: 35885049 PMCID: PMC9313026 DOI: 10.3390/biomedicines10071745] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/16/2022] [Accepted: 07/16/2022] [Indexed: 02/08/2023] Open
Abstract
Obesity is a major public health problem and is related to increasing rates of cardiovascular morbidity and mortality. Over 1.9 billion adults are overweight or obese worldwide and the prevalence of obesity is increasing. Obesity influences endothelial function through obesity-related complications such as hypertension, dyslipidemia, diabetes, metabolic syndrome, and obstructive sleep apnea syndrome. The excess fat accumulation in obesity causes adipocyte dysfunction and induces oxidative stress, insulin resistance, and inflammation leading to endothelial dysfunction. Several anthropometric indices and imaging modalities that are used to evaluate obesity have demonstrated an association between obesity and endothelial function. In the past few decades, there has been great focus on the mechanisms underlying endothelial dysfunction caused by obesity for the prevention and treatment of cardiovascular events. This review focuses on pathophysiological mechanisms of obesity-induced endothelial dysfunction and therapeutic targets of obesity.
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Affiliation(s)
- Masato Kajikawa
- Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan;
| | - Yukihito Higashi
- Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan;
- Department of Regenerative Medicine, Division of Radiation Medical Science, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
- Correspondence: ; Tel.: +81-82-257-5831
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Garcia LA, Zapata-Bustos R, Day SE, Campos B, Hamzaoui Y, Wu L, Leon AD, Krentzel J, Coletta RL, De Filippis E, Roust LR, Mandarino LJ, Coletta DK. Can Exercise Training Alter Human Skeletal Muscle DNA Methylation? Metabolites 2022; 12:metabo12030222. [PMID: 35323665 PMCID: PMC8953782 DOI: 10.3390/metabo12030222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/28/2022] [Accepted: 02/28/2022] [Indexed: 12/26/2022] Open
Abstract
Skeletal muscle is highly plastic and dynamically regulated by the body’s physical demands. This study aimed to determine the plasticity of skeletal muscle DNA methylation in response to 8 weeks of supervised exercise training in volunteers with a range of insulin sensitivities. We studied 13 sedentary participants and performed euglycemic hyperinsulinemic clamps with basal vastus lateralis muscle biopsies and peak aerobic activity (VO2 peak) tests before and after training. We extracted DNA from the muscle biopsies and performed global methylation using Illumina’s Methylation EPIC 850K BeadChip. Training significantly increased peak aerobic capacity and insulin-stimulated glucose disposal. Fasting serum insulin and insulin levels during the steady state of the clamp were significantly lower post-training. Insulin clearance rates during the clamp increased following the training. We identified 13 increased and 90 decreased differentially methylated cytosines (DMCs) in response to 8 weeks of training. Of the 13 increased DMCs, 2 were within the following genes, FSTL3, and RP11-624M8.1. Of the 90 decreased DMCs, 9 were within the genes CNGA1, FCGR2A, KIF21A, MEIS1, NT5DC1, OR4D1, PRPF4B, SLC26A7, and ZNF280C. Moreover, pathway analysis showed an enrichment in metabolic and actin-cytoskeleton pathways for the decreased DMCs, and for the increased DMCs, an enrichment in signal-dependent regulation of myogenesis, NOTCH2 activation and transmission, and SMAD2/3: SMAD4 transcriptional activity pathways. Our findings showed that 8 weeks of exercise training alters skeletal muscle DNA methylation of specific genes and pathways in people with varying degrees of insulin sensitivity.
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Affiliation(s)
- Luis A. Garcia
- Department of Medicine, Division of Endocrinology, University of Arizona, Tucson, AZ 85724, USA; (L.A.G.); (R.Z.-B.); (B.C.); (A.D.L.); (J.K.); (L.J.M.)
- Center for Disparities in Diabetes Obesity and Metabolism, University of Arizona, Tucson, AZ 85724, USA;
| | - Rocio Zapata-Bustos
- Department of Medicine, Division of Endocrinology, University of Arizona, Tucson, AZ 85724, USA; (L.A.G.); (R.Z.-B.); (B.C.); (A.D.L.); (J.K.); (L.J.M.)
- Center for Disparities in Diabetes Obesity and Metabolism, University of Arizona, Tucson, AZ 85724, USA;
| | - Samantha E. Day
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ 85004, USA;
| | - Baltazar Campos
- Department of Medicine, Division of Endocrinology, University of Arizona, Tucson, AZ 85724, USA; (L.A.G.); (R.Z.-B.); (B.C.); (A.D.L.); (J.K.); (L.J.M.)
- Center for Disparities in Diabetes Obesity and Metabolism, University of Arizona, Tucson, AZ 85724, USA;
| | - Yassin Hamzaoui
- Department of Physiology, University of Arizona, Tucson, AZ 85724, USA; (Y.H.); (L.W.)
| | - Linda Wu
- Department of Physiology, University of Arizona, Tucson, AZ 85724, USA; (Y.H.); (L.W.)
| | - Alma D. Leon
- Department of Medicine, Division of Endocrinology, University of Arizona, Tucson, AZ 85724, USA; (L.A.G.); (R.Z.-B.); (B.C.); (A.D.L.); (J.K.); (L.J.M.)
- Center for Disparities in Diabetes Obesity and Metabolism, University of Arizona, Tucson, AZ 85724, USA;
| | - Judith Krentzel
- Department of Medicine, Division of Endocrinology, University of Arizona, Tucson, AZ 85724, USA; (L.A.G.); (R.Z.-B.); (B.C.); (A.D.L.); (J.K.); (L.J.M.)
- Center for Disparities in Diabetes Obesity and Metabolism, University of Arizona, Tucson, AZ 85724, USA;
| | - Richard L. Coletta
- Center for Disparities in Diabetes Obesity and Metabolism, University of Arizona, Tucson, AZ 85724, USA;
| | - Eleanna De Filippis
- Department of Endocrinology, Metabolism and Diabetes, Mayo Clinic Arizona, Scottsdale, AZ 85259, USA; (E.D.F.); (L.R.R.)
| | - Lori R. Roust
- Department of Endocrinology, Metabolism and Diabetes, Mayo Clinic Arizona, Scottsdale, AZ 85259, USA; (E.D.F.); (L.R.R.)
| | - Lawrence J. Mandarino
- Department of Medicine, Division of Endocrinology, University of Arizona, Tucson, AZ 85724, USA; (L.A.G.); (R.Z.-B.); (B.C.); (A.D.L.); (J.K.); (L.J.M.)
- Center for Disparities in Diabetes Obesity and Metabolism, University of Arizona, Tucson, AZ 85724, USA;
| | - Dawn K. Coletta
- Department of Medicine, Division of Endocrinology, University of Arizona, Tucson, AZ 85724, USA; (L.A.G.); (R.Z.-B.); (B.C.); (A.D.L.); (J.K.); (L.J.M.)
- Center for Disparities in Diabetes Obesity and Metabolism, University of Arizona, Tucson, AZ 85724, USA;
- Department of Physiology, University of Arizona, Tucson, AZ 85724, USA; (Y.H.); (L.W.)
- Correspondence: ; Tel.: +1-(520)-626-9316
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Petersen MH, de Almeida ME, Wentorf EK, Jensen K, Ørtenblad N, Højlund K. High-intensity interval training combining rowing and cycling efficiently improves insulin sensitivity, body composition and VO 2max in men with obesity and type 2 diabetes. Front Endocrinol (Lausanne) 2022; 13:1032235. [PMID: 36387850 PMCID: PMC9664080 DOI: 10.3389/fendo.2022.1032235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 10/17/2022] [Indexed: 11/07/2022] Open
Abstract
AIMS Non-weight-bearing high-intensity interval training (HIIT) involving several muscle groups may efficiently improve metabolic health without compromising adherence in obesity and type 2 diabetes. In a non-randomized intervention study, we examined the effect of a novel HIIT-protocol, recruiting both lower and upper body muscles, on insulin sensitivity, measures of metabolic health and adherence in obesity and type 2 diabetes. METHODS In 15 obese men with type 2 diabetes and age-matched obese (n=15) and lean (n=18) glucose-tolerant men, the effects of 8-weeks supervised HIIT combining rowing and cycling on ergometers (3 sessions/week) were examined by DXA-scan, incremental exercise test and hyperinsulinemic-euglycemic clamp combined with indirect calorimetry. RESULTS At baseline, insulin-stimulated glucose disposal rate (GDR) was ~40% reduced in the diabetic vs the non-diabetic groups (all p<0.01). In response to HIIT, insulin-stimulated GDR increased ~30-40% in all groups (all p<0.01) entirely explained by increased glucose storage. These changes were accompanied by ~8-15% increases in VO2max, (all p<0.01), decreased total fat mass and increased lean body mass in all groups (all p<0.05). There were no correlations between these training adaptations and no group-differences in these responses. HbA1c showed a clinically relevant decrease in men with type 2 diabetes (4±2 mmol/mol; p<0.05). Importantly, adherence was high (>95%) in all groups and no injuries were reported. CONCLUSIONS A novel HIIT-protocol recruiting lower and upper body muscles efficiently improves insulin sensitivity, VO2max and body composition with intact responses in obesity and type 2 diabetes. The high adherence and lack of injuries show that non-weight-bearing HIIT involving several muscle groups is a promising mode of exercise training in obesity and type 2 diabetes.
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Affiliation(s)
| | - Martin Eisemann de Almeida
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Emil Kleis Wentorf
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Kurt Jensen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Niels Ørtenblad
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Kurt Højlund
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
- *Correspondence: Kurt Højlund,
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6
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Love KM, Barrett EJ, Malin SK, Reusch JEB, Regensteiner JG, Liu Z. Diabetes pathogenesis and management: the endothelium comes of age. J Mol Cell Biol 2021; 13:500-512. [PMID: 33787922 PMCID: PMC8530521 DOI: 10.1093/jmcb/mjab024] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/10/2021] [Accepted: 02/25/2021] [Indexed: 12/03/2022] Open
Abstract
Endothelium, acting as a barrier, protects tissues against factors that provoke insulin resistance and type 2 diabetes and itself responds to the insult of insulin resistance inducers with altered function. Endothelial insulin resistance and vascular dysfunction occur early in the evolution of insulin resistance-related disease, can co-exist with and even contribute to the development of metabolic insulin resistance, and promote vascular complications in those affected. The impact of endothelial insulin resistance and vascular dysfunction varies depending on the blood vessel size and location, resulting in decreased arterial plasticity, increased atherosclerosis and vascular resistance, and decreased tissue perfusion. Women with insulin resistance and diabetes are disproportionately impacted by cardiovascular disease, likely related to differential sex-hormone endothelium effects. Thus, reducing endothelial insulin resistance and improving endothelial function in the conduit arteries may reduce atherosclerotic complications, in the resistance arteries lead to better blood pressure control, and in the microvasculature lead to less microvascular complications and more effective tissue perfusion. Multiple diabetes therapeutic modalities, including medications and exercise training, improve endothelial insulin action and vascular function. This action may delay the onset of type 2 diabetes and/or its complications, making the vascular endothelium an attractive therapeutic target for type 2 diabetes and potentially type 1 diabetes.
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MESH Headings
- Age Factors
- Cardiovascular Diseases/epidemiology
- Cardiovascular Diseases/ethnology
- Cardiovascular Diseases/metabolism
- Cardiovascular Diseases/physiopathology
- Comorbidity
- Diabetes Mellitus, Type 1/drug therapy
- Diabetes Mellitus, Type 1/epidemiology
- Diabetes Mellitus, Type 1/metabolism
- Diabetes Mellitus, Type 1/physiopathology
- Diabetes Mellitus, Type 2/drug therapy
- Diabetes Mellitus, Type 2/epidemiology
- Diabetes Mellitus, Type 2/metabolism
- Diabetes Mellitus, Type 2/physiopathology
- Endothelium, Vascular/drug effects
- Endothelium, Vascular/metabolism
- Endothelium, Vascular/physiopathology
- Exercise
- Female
- Humans
- Hypoglycemic Agents/pharmacology
- Hypoglycemic Agents/therapeutic use
- Insulin Resistance
- Male
- Racial Groups
- Risk Factors
- Sex Factors
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Affiliation(s)
- Kaitlin M Love
- Division of Endocrinology and Metabolism, Department of Medicine, University of Virginia Health System, Charlottesville, VA 22908, USA
| | - Eugene J Barrett
- Division of Endocrinology and Metabolism, Department of Medicine, University of Virginia Health System, Charlottesville, VA 22908, USA
| | - Steven K Malin
- Department of Kinesiology and Health, Rutgers University, New Brunswick, NJ, USA
- Division of Endocrinology, Metabolism and Nutrition, Rutgers University, New Brunswick, NJ, USA
- New Jersey Institute for Food, Nutrition and Health, Rutgers University, New Brunswick, NJ, USA
- Institute of Translational Medicine and Research, Rutgers University, New Brunswick, NJ, USA
| | - Jane E B Reusch
- Center for Women’s Health Research, University of Colorado School of Medicine, Aurora, CO, USA
- Department of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
- Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, USA
| | - Judith G Regensteiner
- Center for Women’s Health Research, University of Colorado School of Medicine, Aurora, CO, USA
- Department of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - Zhenqi Liu
- Division of Endocrinology and Metabolism, Department of Medicine, University of Virginia Health System, Charlottesville, VA 22908, USA
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Temel E, Aşikgarip N, Örnek K. Association of choroidal structure and body mass index in an adult population. Eur J Ophthalmol 2021; 32:2375-2381. [PMID: 34463157 DOI: 10.1177/11206721211043751] [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: 11/15/2022]
Abstract
PURPOSE To determine the relation of choroidal structural parameters and body mass index (BMI) in an adult population. METHODS About 144 eyes of 144 healthy individuals were incorporated. There were four groups according to BMI values: Group 1 (⩽18.5), group 2 (18.6-24.9), group 3 (25.0-29.9), and group 4 (30.0-34.9). The enhanced depth imaging optical coherence tomography images were binarized using Image-J software. Choroidal thickness (CT), circumscribed choroidal area (CCA), luminal area (LA), stromal area (SA), and choroidal vascularity index (CVI) were calculated. RESULTS Mean subfoveal, nasal, and temporal CT were lower in group 4 rather than group 1 (p = 0.032, p = 0.001, and p < 0.001, respectively). Mean nasal and temporal CT also showed a decrease in group 4 as compared to group 2 (p = 0.04 and p = 0.039). Mean CCA and LA were decreased in group 4 in comparison to group 3 (p = 0.001 and p = 0.001), group 2 (p < 0.001 and p < 0.001), and group 1 (p = 0.001 and p < 0.001). Mean SA showed a decrease only in group 3 rather than group 2 (p = 0.021) and group 1 (p = 0.008). Mean CVI was decreased in group 3 and group 4 in comparison to group 1 (p < 0.001 and p < 0.001) and group 2 (p = 0.002 and p < 0.001). CONCLUSION Increased BMI percentile was associated with a decrease in CT and structural parameters.
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Affiliation(s)
- Emine Temel
- Kırşehir Training and Research Hospital, Kırşehir, Turkey
| | | | - Kemal Örnek
- Kırşehir Ahi Evran University Medical Faculty, Kırşehir, Turkey
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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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9
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Role of Wnt signaling pathways in type 2 diabetes mellitus. Mol Cell Biochem 2021; 476:2219-2232. [PMID: 33566231 DOI: 10.1007/s11010-021-04086-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 01/27/2021] [Indexed: 01/03/2023]
Abstract
Type 2 diabetes mellitus (T2DM) has become a major global public health issue in the twenty-first century and its incidence has increased each year. Wnt signaling pathways are a set of multi-downstream signaling pathways activated by the binding of Wnt ligands to membrane protein receptors. Wnt signaling pathways regulate protein expression and play important roles in protecting the body's normal physiological metabolism. This review describes Wnt signaling pathways, and then aims to reveal how Wnt signaling pathways participate in the occurrence and development of T2DM. We found that Wnt/c-Jun N-terminal kinase signaling was closely associated with insulin resistance, inflammatory response, and pancreatic β-cell and endothelial dysfunction. β-catenin/transcription factor 7-like 2 (TCF7L2)-mediated and calcineurin/nuclear factor of activated T cells-mediated target genes were involved in insulin synthesis and secretion, insulin degradation, pancreatic β-cell growth and regeneration, and functional application of pancreatic β-cells. In addition, polymorphisms in the TCF7L2 gene could increase risk of T2DM according to previous and the most current results, and the T allele of its variants was a more adverse factor for abnormal pancreatic β-cell function and impaired glucose tolerance in patients with T2DM. These findings indicate a strong correlation between Wnt signaling pathways and T2DM, particularly in terms of pancreatic islet dysfunction and insulin resistance, and new therapeutic targets for T2DM may be identified.
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Madsen NL, Haley JE, Moore RA, Khoury PR, Urbina EM. Increased Arterial Stiffness Is Associated With Reduced Diastolic Function in Youth With Obesity and Type 2 Diabetes. Front Pediatr 2021; 9:781496. [PMID: 34912763 PMCID: PMC8666894 DOI: 10.3389/fped.2021.781496] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 10/29/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Increased arterial stiffness is associated with diastolic dysfunction in adults. Data in youth are lacking, so we examined the impact of arterial stiffness on diastolic function in youth. Methods: We obtained diastolic function and augmentation index, pulse wave velocity, brachial artery distensibility, and carotid stiffness on 612 youth [10-24 years, 65% female, 38% normal weight, 36% obese, and 26% with type 2 diabetes mellitus (T2DM)]. Participants were classified as compliant (C) vs. stiff (S) arteries based on seven arterial stiffness parameters [Global Stiffness Index (GSI), S = GSI > 4). Mean differences in covariates were evaluated by Student's t-tests. A stepwise regression analysis was performed to determine if GSI was an independent predictor of diastolic function. Results: Lower diastolic function and more adverse cardiovascular disease (CVD) risk factors were present in the S group (n = 67) than the C group (n = 545) (p < 0.001). Covariates that were associated with diastolic dysfunction were higher GSI, male sex, higher body mass index (BMI), and systolic blood pressure (SBP) z-score (R 2 = 0.18 to 0.25; p ≤ 0.05). Conclusion: Adverse diastolic function is seen in youth with increased arterial stiffness independent of CVD risk factors. Interventions to improve arterial stiffness prior to clinical onset of diastolic dysfunction are needed to prevent development of heart failure.
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Affiliation(s)
- Nicolas L Madsen
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Jessica E Haley
- Department of Pediatrics, Rady Children's Hospital, San Diego, CA, United States
| | - Ryan A Moore
- The Heart Institute, Cincinnati Children's Hospital Medical Center and the University of Cincinnati, Cincinnati, OH, United States
| | - Philip R Khoury
- The Heart Institute, Cincinnati Children's Hospital Medical Center and the University of Cincinnati, Cincinnati, OH, United States
| | - Elaine M Urbina
- The Heart Institute, Cincinnati Children's Hospital Medical Center and the University of Cincinnati, Cincinnati, OH, United States
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11
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Malin SK, Stewart NR. Metformin May Contribute to Inter-individual Variability for Glycemic Responses to Exercise. Front Endocrinol (Lausanne) 2020; 11:519. [PMID: 32849302 PMCID: PMC7431621 DOI: 10.3389/fendo.2020.00519] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 06/26/2020] [Indexed: 12/20/2022] Open
Abstract
Metformin and exercise independently improve glycemic control. Metformin traditionally is considered to reduce hepatic glucose production, while exercise training is thought to stimulate skeletal muscle glucose disposal. Collectively, combining treatments would lead to the anticipation for additive glucose regulatory effects. Herein, we discuss recent literature suggesting that metformin may inhibit, enhance or have no effect on exercise mediated benefits toward glucose regulation, with particular emphasis on insulin sensitivity. Importantly, we address issues surrounding the impact of metformin on exercise induced glycemic benefit across multiple insulin sensitive tissues (e.g., skeletal muscle, liver, adipose, vasculature, and the brain) in effort to illuminate potential sources of inter-individual glycemic variation. Therefore, the review identifies gaps in knowledge that require attention in order to optimize medical approaches that improve care of people with elevated blood glucose levels and are at risk of cardiovascular disease.
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Affiliation(s)
- Steven K. Malin
- Department of Kinesiology, University of Virginia, Charlottesville, VA, United States
- Division of Endocrinology and Metabolism, University of Virginia, Charlottesville, VA, United States
- Robert M. Berne Cardiovascular Research Center, University of Virginia, Charlottesville, VA, United States
| | - Nathan R. Stewart
- Department of Kinesiology, University of Virginia, Charlottesville, VA, United States
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12
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Moccia F, Negri S, Faris P, Berra-Romani R. Targeting the Endothelial Ca2+ Toolkit to Rescue Endothelial Dysfunction in Obesity Associated-Hypertension. Curr Med Chem 2020; 27:240-257. [PMID: 31486745 DOI: 10.2174/0929867326666190905142135] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 06/03/2019] [Accepted: 07/16/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Obesity is a major cardiovascular risk factor which dramatically impairs endothelium- dependent vasodilation and leads to hypertension and vascular damage. The impairment of the vasomotor response to extracellular autacoids, e.g., acetylcholine, mainly depends on the reduced Nitric Oxide (NO) bioavailability, which hampers vasorelaxation in large conduit arteries. In addition, obesity may affect Endothelium-Dependent Hyperpolarization (EDH), which drives vasorelaxation in small resistance arteries and arterioles. Of note, endothelial Ca2+ signals drive NO release and trigger EDH. METHODS A structured search of bibliographic databases was carried out to retrieve the most influential, recent articles on the impairment of vasorelaxation in animal models of obesity, including obese Zucker rats, and on the remodeling of the endothelial Ca2+ toolkit under conditions that mimic obesity. Furthermore, we searched for articles discussing how dietary manipulation could be exploited to rescue Ca2+-dependent vasodilation. RESULTS We found evidence that the endothelial Ca2+ could be severely affected by obese vessels. This rearrangement could contribute to endothelial damage and is likely to be involved in the disruption of vasorelaxant mechanisms. However, several Ca2+-permeable channels, including Vanilloid Transient Receptor Potential (TRPV) 1, 3 and 4 could be stimulated by several food components to stimulate vasorelaxation in obese individuals. CONCLUSION The endothelial Ca2+ toolkit could be targeted to reduce vascular damage and rescue endothelium- dependent vasodilation in obese vessels. This hypothesis remains, however, to be probed on truly obese endothelial cells.
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Affiliation(s)
- Francesco Moccia
- Laboratory of General Physiology, Department of Biology and Biotechnology "Lazzaro Spallanzani", University of Pavia, Pavia, Italy
| | - Sharon Negri
- Laboratory of General Physiology, Department of Biology and Biotechnology "Lazzaro Spallanzani", University of Pavia, Pavia, Italy
| | - Pawan Faris
- Laboratory of General Physiology, Department of Biology and Biotechnology "Lazzaro Spallanzani", University of Pavia, Pavia, Italy
| | - Roberto Berra-Romani
- Department of Biomedicine, School of Medicine, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
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13
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Scheer AS, Naylor LH, Gan SK, Charlesworth J, Benjanuvatra N, Green DJ, Maiorana AJ. The Effects of Water-based Exercise Training in People with Type 2 Diabetes. Med Sci Sports Exerc 2019; 52:417-424. [PMID: 31469709 DOI: 10.1249/mss.0000000000002133] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
PURPOSE To investigate the effects of 8 wk of upright water-based exercise training in people with type 2 diabetes. METHODS Thirteen participants with type 2 diabetes (54% male; 60.9 ± 9.6 yr, mean ± standard deviation) completed 8 wk of upright water-based exercise training at a moderate intensity (60%-80% of exercise test-derived maximum HR), for 1 h, three times a week (TG). Fourteen participants (64% male; 63.9 ± 9.8 yr) acted as a control group (CG) who maintained their usual activities. Preintervention and postintervention, participants performed cardiopulmonary exercise testing to determine V˙O2peak and one-repetition maximum testing to assess muscular strength. Blood profiles were assessed with standard assays. Body mass index and waist/hip ratio were employed as measures of anthropometry. Endothelium-dependent (brachial artery flow-mediated dilation) and independent (glyceryl trinitrate-mediated) function were assessed using vascular ultrasound. RESULTS Water-based training increased V˙O2peak (18.5 ± 4.3 mL·kg·min to 21.5 ± 5.4 mL·kg·min) (P = 0.002), overall muscle strength (123 ± 44 kg to 139 ± 43 kg) and leg strength (92 ± 28 kg to 104 ± 29 kg), compared with the CG (P = 0.001). The effect on pectoral strength (31 ± 17 kg to 35 ± 16 kg) was not significantly different to the CG (24 ± 12 kg to 26 ± 14 kg) (P = 0.08). No change was observed in anthropometry, blood profiles, or glyceryl trinitrate-mediated vascular function. Flow-mediated dilation was increased after training (6.1% ± 2.4% to 6.5% ± 3.0%), compared with controls who demonstrated a slight decrease (6.2% ± 1.6% to 5.4% ± 1.6%) (P = 0.002). CONCLUSIONS Water-based circuit training was well tolerated and appears to be an effective exercise modality for improving aerobic fitness, strength, and vascular function in people with type 2 diabetes.
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Affiliation(s)
- Anna S Scheer
- School of Physiotherapy and Exercise Science, Faculty of Health Science, Curtin University, Perth, Western Australia, AUSTRALIA
| | | | - Seng K Gan
- Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Crawley, Western Australia, AUSTRALIA
| | | | - Nat Benjanuvatra
- School of Human Sciences, Faculty of Science, University of Western Australia, Crawley, Western Australia, AUSTRALIA
| | - Daniel J Green
- School of Human Sciences, Faculty of Science, University of Western Australia, Crawley, Western Australia, AUSTRALIA
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14
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Meza CA, La Favor JD, Kim DH, Hickner RC. Endothelial Dysfunction: Is There a Hyperglycemia-Induced Imbalance of NOX and NOS? Int J Mol Sci 2019; 20:ijms20153775. [PMID: 31382355 PMCID: PMC6696313 DOI: 10.3390/ijms20153775] [Citation(s) in RCA: 175] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 07/29/2019] [Accepted: 07/31/2019] [Indexed: 02/07/2023] Open
Abstract
NADPH oxidases (NOX) are enzyme complexes that have received much attention as key molecules in the development of vascular dysfunction. NOX have the primary function of generating reactive oxygen species (ROS), and are considered the main source of ROS production in endothelial cells. The endothelium is a thin monolayer that lines the inner surface of blood vessels, acting as a secretory organ to maintain homeostasis of blood flow. The enzymatic production of nitric oxide (NO) by endothelial NO synthase (eNOS) is critical in mediating endothelial function, and oxidative stress can cause dysregulation of eNOS and endothelial dysfunction. Insulin is a stimulus for increases in blood flow and endothelium-dependent vasodilation. However, cardiovascular disease and type 2 diabetes are characterized by poor control of the endothelial cell redox environment, with a shift toward overproduction of ROS by NOX. Studies in models of type 2 diabetes demonstrate that aberrant NOX activation contributes to uncoupling of eNOS and endothelial dysfunction. It is well-established that endothelial dysfunction precedes the onset of cardiovascular disease, therefore NOX are important molecular links between type 2 diabetes and vascular complications. The aim of the current review is to describe the normal, healthy physiological mechanisms involved in endothelial function, and highlight the central role of NOX in mediating endothelial dysfunction when glucose homeostasis is impaired.
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Affiliation(s)
- Cesar A Meza
- Department of Nutrition, Food & Exercise Sciences, Florida State University, Tallahassee, FL 32306, USA
| | - Justin D La Favor
- Department of Nutrition, Food & Exercise Sciences, Florida State University, Tallahassee, FL 32306, USA
| | - Do-Houn Kim
- Department of Nutrition, Food & Exercise Sciences, Florida State University, Tallahassee, FL 32306, USA
| | - Robert C Hickner
- Department of Nutrition, Food & Exercise Sciences, Florida State University, Tallahassee, FL 32306, USA.
- Institute of Sports Sciences and Medicine, College of Human Sciences, Florida State University, Tallahassee, FL 32306, USA.
- Department of Biokinetics, Exercise and Leisure Sciences, School of Health Sciences, University of KwaZulu-Natal, Westville 4041, South Africa.
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15
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Landers-Ramos RQ, Sapp RM, Shill DD, Hagberg JM, Prior SJ. Exercise and Cardiovascular Progenitor Cells. Compr Physiol 2019; 9:767-797. [PMID: 30892694 DOI: 10.1002/cphy.c180030] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Autologous stem/progenitor cell-based methods to restore blood flow and function to ischemic tissues are clinically appealing for the substantial proportion of the population with cardiovascular diseases. Early preclinical and case studies established the therapeutic potential of autologous cell therapies for neovascularization in ischemic tissues. However, trials over the past ∼15 years reveal the benefits of such therapies to be much smaller than originally estimated and a definitive clinical benefit is yet to be established. Recently, there has been an emphasis on improving the number and function of cells [herein generally referred to as circulating angiogenic cells (CACs)] used for autologous cell therapies. CACs include of several subsets of circulating cells, including endothelial progenitor cells, with proangiogenic potential that is largely exerted through paracrine functions. As exercise is known to improve CV outcomes such as angiogenesis and endothelial function, much attention is being given to exercise to improve the number and function of CACs. Accordingly, there is a growing body of evidence that acute, short-term, and chronic exercise have beneficial effects on the number and function of different subsets of CACs. In particular, recent studies show that aerobic exercise training can increase the number of CACs in circulation and enhance the function of isolated CACs as assessed in ex vivo assays. This review summarizes the roles of different subsets of CACs and the effects of acute and chronic exercise on CAC number and function, with a focus on the number and paracrine function of circulating CD34+ cells, CD31+ cells, and CD62E+ cells. © 2019 American Physiological Society. Compr Physiol 9:767-797, 2019.
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Affiliation(s)
- Rian Q Landers-Ramos
- University of Maryland School of Public Health, Department of Kinesiology, College Park, Maryland, USA.,Education and Clinical Center, Baltimore Veterans Affairs Geriatric Research, Baltimore, Maryland, USA.,University of Maryland School of Medicine, Department of Medicine, Baltimore, Maryland, USA
| | - Ryan M Sapp
- University of Maryland School of Public Health, Department of Kinesiology, College Park, Maryland, USA
| | - Daniel D Shill
- University of Maryland School of Public Health, Department of Kinesiology, College Park, Maryland, USA
| | - James M Hagberg
- University of Maryland School of Public Health, Department of Kinesiology, College Park, Maryland, USA
| | - Steven J Prior
- University of Maryland School of Public Health, Department of Kinesiology, College Park, Maryland, USA.,Education and Clinical Center, Baltimore Veterans Affairs Geriatric Research, Baltimore, Maryland, USA.,University of Maryland School of Medicine, Department of Medicine, Baltimore, Maryland, USA
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16
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Barreira E, Novo A, Vaz JA, Pereira AMG. Dietary program and physical activity impact on biochemical markers in patients with type 2 diabetes: A systematic review. Aten Primaria 2017; 50:590-610. [PMID: 29061310 PMCID: PMC6836882 DOI: 10.1016/j.aprim.2017.06.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 05/26/2017] [Accepted: 06/13/2017] [Indexed: 02/07/2023] Open
Abstract
Objectives Evaluate the effectiveness of the implementation of independently or combined dietary and physical activity programs on the blood glucose values and lipid profile in patients with type 2 diabetes, including participants aged 60 years and over. Design Systematic review. Data source PubMed/Medline database, with language restrictions. Papers published between 2010 and 2016 were included. Study selection A total of 30 randomised controlled trials were included that focused on physical activity and dietary interventions in patients with type 2 diabetes mellitus and include participants aged 60 years and over. Results The selected articles have shown that the implementation of physical activity programs (aerobic, resistance, flexibility and combined exercises), and programs based on a higher intake of vegetables, grains, legumes, fruits, unsaturated fatty acids, as well as consumption of foods with low glycaemic index, calorie restriction, intake of probiotics, vitamin D supplementation and educational sessions about diabetes improves blood glucose levels, as well as the lipid profile, in patients with type 2 diabetes. Conclusions Physical activity and dietary programs are fundamental in the treatment and metabolic control of type 2 diabetes mellitus.
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Affiliation(s)
- Eduarda Barreira
- Health School, Polytechnic Institute of Bragança, Bragança, Portugal.
| | - André Novo
- Health School, Polytechnic Institute of Bragança, Bragança, Portugal; CINTESIS-Research Center on Health Technologies and Services, Porto, Portugal
| | - Josiana A Vaz
- Health School, Polytechnic Institute of Bragança, Bragança, Portugal; CIMO-Mountain Research Centre, Polytechnic Institute of Bragança, Campus de Santa Apolónia, Bragança, Portugal
| | - Ana M G Pereira
- Health School, Polytechnic Institute of Bragança, Bragança, Portugal
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17
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Rezaei S, Shamsi MM, Mahdavi M, Jamali A, Prestes J, Tibana RA, Navalta JW, Voltarelli FA. Endurance exercise training decreased serum levels of surfactant protein D and improved aerobic fitness of obese women with type-2 diabetes. Diabetol Metab Syndr 2017; 9:74. [PMID: 29021828 PMCID: PMC5613319 DOI: 10.1186/s13098-017-0273-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 09/18/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Surfactant protein D (SP-D) is a member of the collectin family and is an important component of the pulmonary innate host defense. To find the relationship between exercise training and SP-D in diabetes, we examined the possible effects of a 10-week endurance exercise-training program on serum levels of SP-D, leptin, lipid profile and insulin resistance in obese women with type-2 diabetes mellitus (T2DM). METHODS Twenty-two obese women with T2DM were randomly assigned to either exercise training (ET) or control (C) group. A subject dropped from ET group due to personal reasons and 1 subject dropped from C group due to commitment to experiments conditions. A total of twenty obese women with T2DM were randomly assigned into endurance exercise training (ET = 10) and control (C = 10) groups. The training group underwent a progressive endurance-training program for 10 weeks (running on a treadmill for 30-55 min/day at 50-75% heart rate reserve) and the control group did not participate in any exercise program. Venous blood samples were collected from both groups before and 72 h after the last session of exercise training for analysis of serum SP-D, leptin, lipid profile, glucose and insulin. Data were analyzed using 2 (group: control, endurance training) × 2 (time: pre, post) ANOVA with repeated measures on the second factor. Absolute changes from rest (∆ baseline) values were calculated according to the following formula: ((measure-baseline)·baseline-1)·100. Percent change between groups was analyzed using independent t-tests (p < 0.05). All analyses were completed using SPSS 19. RESULTS The serum SP-D levels were decreased after exercise training in ET (∆ = - 78.78 ± 17.14%, p = 0.001) when compare to C (∆ = 9.41 ± 4.75%). Obese diabetic women in the ET group showed significantly lower serum leptin levels (8053.27 ± 878.7 pg/ml, ∆ = - 26.97 ± 16.41%) when compared with women in the control group (9885.5 ± 696 pg/ml, ∆ = 7.02 ± 3.46%, p = 0.003). Fasting glucose was favorably and significantly affected by the intervention (ET ∆ = - 17.01 ± 12.74%, Control ∆ = 15.47 ± 7.32%, p = 0.011). VO2max as an index of aerobic fitness was significantly increased after 10-weeks of endurance exercise training (ET ∆ = 19.29 ± 6.18%). CONCLUSIONS Endurance exercise training with improvement in aerobic fitness induced a significant reduction of serum SP-D levels in obese women with T2DM.
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Affiliation(s)
- Sajjad Rezaei
- Physical Education and Sport Sciences Department, Faculty of Humanities, Tarbiat Modares University, Jala Ale Ahmad Exp. Tehran, P.O.Box: 14117-13116, Tehran, Iran
| | - Mahdieh Molanouri Shamsi
- Physical Education and Sport Sciences Department, Faculty of Humanities, Tarbiat Modares University, Jala Ale Ahmad Exp. Tehran, P.O.Box: 14117-13116, Tehran, Iran
| | - Mehdi Mahdavi
- Immunology Department, Pasteur Institute of Iran, Tehran, Iran
| | - Azadeh Jamali
- Department of Physical Education, Taft Branch, Islamic Azad University, Taft, Iran
| | - Jonato Prestes
- Graduate Program in Health Sciences and Technologies, University of Brasilia, Brasilia, Brazil
| | - Ramires Alsamir Tibana
- Graduate Program in Health Sciences and Technologies, University of Brasilia, Brasilia, Brazil
| | - James Wilfred Navalta
- Department of Kinesiology and Nutrition Sciences, University of Nevada, Las Vegas, NV USA
| | - Fabrício Azevedo Voltarelli
- Graduation Program of Physical Education, Faculty of Physical Education, Federal University of Mato Grosso, Cuiabá, Brazil
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18
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Dow CA, Stauffer BL, Brunjes DL, Greiner JJ, DeSouza CA. Regular aerobic exercise reduces endothelin-1-mediated vasoconstrictor tone in overweight and obese adults. Exp Physiol 2017. [DOI: 10.1113/ep086454] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Caitlin A. Dow
- Integrative Vascular Biology Laboratory; Department of Integrative Physiology; University of Colorado; Boulder CO 80309 USA
| | - Brian L. Stauffer
- Integrative Vascular Biology Laboratory; Department of Integrative Physiology; University of Colorado; Boulder CO 80309 USA
- Department of Medicine; University of Colorado Anschutz Medical Center; Aurora CO 80045 USA
- Denver Health Medical Center; Denver CO 80204 USA
| | - Danielle L. Brunjes
- Integrative Vascular Biology Laboratory; Department of Integrative Physiology; University of Colorado; Boulder CO 80309 USA
| | - Jared J. Greiner
- Integrative Vascular Biology Laboratory; Department of Integrative Physiology; University of Colorado; Boulder CO 80309 USA
| | - Christopher A. DeSouza
- Integrative Vascular Biology Laboratory; Department of Integrative Physiology; University of Colorado; Boulder CO 80309 USA
- Department of Medicine; University of Colorado Anschutz Medical Center; Aurora CO 80045 USA
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19
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The Relative Efficacy of Land-Based and Water-Based Exercise Training on Macro- and Microvascular Functions in Older Patients With Type 2 Diabetes. J Aging Phys Act 2017; 25:446-452. [DOI: 10.1123/japa.2016-0193] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Microvascular and macrovascular dysfunction plays an important role in the pathogenesis of diabetic vascular disease. Twenty-nine older patients with type 2 diabetes were randomly assigned into the land-based (LB; n = 14) or water-based (WB; n = 15) groups. Both groups completed supervised aerobic cycling exercises three times per week for 12 weeks. The WB group performed cycling exercise training in warm water (36 °C) immersed to the hip level. After 12 weeks, blood glucose concentration and insulin resistance did not change but hemoglobin A1c levels decreased (P < .05) in both groups. Plasma nitric oxide concentrations increased (P < .05) in both groups. Flow-mediated dilation in the popliteal artery increased and arterial stiffness decreased (P < .05) in both exercise groups. Indices of microvascular reactivity improved (P < .05) only in the WB group. The benefits of warm water-based training were similar in general, and superior in some measures, to the more established land-based cycling exercise.
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20
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Malin SK, Rynders CA, Weltman JY, Roberts LJ, Barrett EJ, Weltman A. Endothelial function following glucose ingestion in adults with prediabetes: Role of exercise intensity. Obesity (Silver Spring) 2016; 24:1515-21. [PMID: 27221649 PMCID: PMC4925188 DOI: 10.1002/oby.21522] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 03/11/2016] [Accepted: 03/17/2016] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To determine whether high intensity exercise (HIE) would improve endothelial function more than an isocaloric bout of moderate intensity exercise (MIE) following glucose ingestion in adults with prediabetes. METHODS Twelve subjects with prediabetes completed all three conditions: time-course matched control and isocaloric exercise (∼200 kcal) at moderate (MIE; at lactate threshold) and high intensity (HIE; 75% of difference between lactate threshold and VO2 peak). Brachial artery flow-mediated dilation (FMD) was measured before exercise (baseline), within 30 min postexercise, and 1 and 2 hr following a 75 g oral glucose tolerance test (OGTT). Plasma F2-isoprostanes were also assessed during the protocol (i.e., baseline to 2 hr OGTT) as a biomarker of oxidative stress. RESULTS MIE reduced postexercise F2-isoprostanesAUC compared with time-course matched control and HIE. Although exercise had no statistical effect on FMD postexercise or during the OGTT, elevations in FMDAUC after MIE and HIE were associated with reduced postexercise F2-isoprostanesAUC . CONCLUSIONS Exercise at either intensity had no effect on FMD immediately postexercise following glucose administration. However, individuals with reduced oxidative stress responses to exercise had greater exercise-induced improvement in FMD. Further work is required to identify the mechanism by which exercise alters oxidative stress to enhance endothelial function.
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Affiliation(s)
- Steven K. Malin
- Department of Kinesiology, University of Virginia, Charlottesville VA
- Division of Endocrinology and Metabolism, University of Virginia, Charlottesville VA
- Exercise Physiology Core Laboratory, University of Virginia, Charlottesville VA
| | - Corey A. Rynders
- Division of Geriatric Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Judy Y. Weltman
- Exercise Physiology Core Laboratory, University of Virginia, Charlottesville VA
| | - L. Jackson Roberts
- Department of Pharmacology and Medicine, Vanderbilt University, Nashville TN
| | - Eugene J. Barrett
- Division of Endocrinology and Metabolism, University of Virginia, Charlottesville VA
| | - Arthur Weltman
- Department of Kinesiology, University of Virginia, Charlottesville VA
- Division of Endocrinology and Metabolism, University of Virginia, Charlottesville VA
- Exercise Physiology Core Laboratory, University of Virginia, Charlottesville VA
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21
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Hwang MH, Lee S. Insulin resistance: vascular function and exercise. Integr Med Res 2016; 5:198-203. [PMID: 28462118 PMCID: PMC5390417 DOI: 10.1016/j.imr.2016.06.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 05/30/2016] [Accepted: 06/02/2016] [Indexed: 12/19/2022] Open
Abstract
Insulin resistance associated with metabolic syndrome and Type 2 diabetes mellitus is an epidemic metabolic disorder, which increases the risk of cardiovascular complications. Impaired vascular endothelial function is an early marker for atherosclerosis, which causes cardiovascular complications. Both experimental and clinical studies indicate that endothelial dysfunction in vasculatures occurs with insulin resistance. The associated physiological mechanisms are not fully appreciated yet, however, it seems that augmented oxidative stress, a physiological imbalance between oxidants and antioxidants, in vascular cells is a possible mechanism involved in various vascular beds with insulin resistance and hyperglycemia. Regardless of the inclusion of resistance exercise, aerobic exercise seems to be beneficial for vascular endothelial function in both large conduit and small resistance vessels in both clinical and experimental studies with insulin resistance. In clinical cases, aerobic exercise over 8 weeks with higher intensity seems more beneficial than the cases with shorter duration and lower intensity. However, more studies are needed in the future to elucidate the physiological mechanisms by which vascular endothelial function is impaired in insulin resistance and improved with aerobic exercise.
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Affiliation(s)
- Moon-Hyon Hwang
- Division of Health and Exercise Science, Incheon National University, Incheon, Korea.,Sport Science Institute, Incheon National University, Incheon, Korea
| | - Sewon Lee
- Sport Science Institute, Incheon National University, Incheon, Korea.,Division of Sport Science, Incheon National University, Incheon, Korea
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22
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Campia U, Barac A. Exercise and Aerobic Fitness to Reduce Cancer-Related Cardiovascular Toxicity. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2016; 18:44. [DOI: 10.1007/s11936-016-0465-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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23
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Lim SL, Lam CSP. Breakthrough in heart failure with preserved ejection fraction: are we there yet? Korean J Intern Med 2016; 31:1-14. [PMID: 26767852 PMCID: PMC4712413 DOI: 10.3904/kjim.2016.31.1.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 10/13/2015] [Indexed: 01/09/2023] Open
Abstract
Heart failure with preserved ejection fraction (HFPEF) is a global health problem of considerable socioeconomic burden. It is projected to worsen with the aging population worldwide. The lack of effective therapies underscores our incomplete understanding of this complex heterogeneous syndrome. A novel paradigm has recently emerged, in which central roles are ascribed to systemic inflammation and generalized endothelial dysfunction in the pathophysiology of HFPEF. In this review, we discuss the role of the endothelium in cardiovascular homeostasis and how deranged endothelial-related signaling pathways contribute to the development of HFPEF. We also review the novel therapies in various stages of research and development that target different components of this signaling pathway.
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Affiliation(s)
- Shir Lynn Lim
- Department of Cardiology, National University Heart Center, Singapore
| | - Carolyn Su Ping Lam
- Department of Cardiology, National Heart Center Singapore, Singapore
- Cardiovascular and Metabolic Disorders Program, Duke-NUS Graduate Medical School, Singapore
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24
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van Haare J, Kooi ME, Vink H, Post MJ, van Teeffelen JWGE, Slenter J, Munts C, Cobelens H, Strijkers GJ, Koehn D, van Bilsen M. Early impairment of coronary microvascular perfusion capacity in rats on a high fat diet. Cardiovasc Diabetol 2015; 14:150. [PMID: 26576929 PMCID: PMC4650915 DOI: 10.1186/s12933-015-0312-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 11/06/2015] [Indexed: 02/05/2023] Open
Abstract
Background It remains to be established if, and to what extent, the coronary microcirculation becomes compromised during the development of obesity and insulin resistance. Recent studies suggest that changes in endothelial glycocalyx properties contribute to microvascular dysfunction under (pre-)diabetic conditions. Accordingly, early effects of diet-induced obesity on myocardial perfusion and function were studied in rats under baseline and hyperaemic conditions. Methods Rats were fed a high fat diet (HFD) for 6 weeks and myocardial microvascular perfusion was determined using first-pass perfusion MRI before and after adenosine infusion. The effect of HFD on microcirculatory properties was also assessed by sidestream darkfield (SDF) imaging of the gastrocnemius muscle. Results HFD-fed rats developed central obesity and insulin sensitivity was reduced as evidenced by the marked reduction in insulin-induced phosphorylation of Akt in both cardiac and gastrocnemius muscle. Early diet-induced obesity did not lead to hypertension or cardiac hypertrophic remodeling. In chow-fed, control rats a robust increase in cardiac microvascular perfusion was observed upon adenosine infusion (+40 %; p < 0.05). In contrast, the adenosine response was abrogated in rats on a HFD (+8 %; N.S.). HFD neither resulted in rarefaction or loss of glycocalyx integrity in skeletal muscle, nor reduced staining intensity of the glycocalyx of cardiac capillaries. Conclusions Alterations in coronary microcirculatory function as assessed by first-pass perfusion MRI represent one of the earliest obesity-related cardiac adaptations that can be assessed non-invasively. In this early stage of insulin resistance, disturbances in glycocalyx barrier properties appeared not to contribute to the observed changes in coronary microvascular function.
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Affiliation(s)
- Judith van Haare
- Department of Physiology, CARIM School for Cardiovascular Diseases, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
| | - M Eline Kooi
- Department of Radiology, CARIM School for Cardiovascular Diseases, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Hans Vink
- Department of Physiology, CARIM School for Cardiovascular Diseases, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Mark J Post
- Department of Physiology, CARIM School for Cardiovascular Diseases, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Jurgen W G E van Teeffelen
- Department of Physiology, CARIM School for Cardiovascular Diseases, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Jos Slenter
- Department of Radiology, CARIM School for Cardiovascular Diseases, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Chantal Munts
- Department of Physiology, CARIM School for Cardiovascular Diseases, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Hanneke Cobelens
- Department of Physiology, CARIM School for Cardiovascular Diseases, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Gustav J Strijkers
- Biomedical Engineering and Physics, Academic Medical Center, P.O. Box 22700, 1100 DE, Amsterdam, The Netherlands.
| | - Dennis Koehn
- Pie Medical Imaging, P.O. Box 1132, 6201 BC, Maastricht, The Netherlands.
| | - Marc van Bilsen
- Department of Physiology, CARIM School for Cardiovascular Diseases, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands. .,Department of Cardiology, CARIM School for Cardiovascular Diseases, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
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Prior SJ, Goldberg AP, Ortmeyer HK, Chin ER, Chen D, Blumenthal JB, Ryan AS. Increased Skeletal Muscle Capillarization Independently Enhances Insulin Sensitivity in Older Adults After Exercise Training and Detraining. Diabetes 2015; 64:3386-95. [PMID: 26068543 PMCID: PMC4587640 DOI: 10.2337/db14-1771] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 05/23/2015] [Indexed: 01/04/2023]
Abstract
Intramuscular signaling and glucose transport mechanisms contribute to improvements in insulin sensitivity after aerobic exercise training. This study tested the hypothesis that increases in skeletal muscle capillary density (CD) also contribute to exercise-induced improvements in whole-body insulin sensitivity (insulin-stimulated glucose uptake per unit plasma insulin [M/I]) independent of other mechanisms. The study design included a 6-month aerobic exercise training period followed by a 2-week detraining period to eliminate short-term effects of exercise on intramuscular signaling and glucose transport. Before and after exercise training and detraining, 12 previously sedentary older (65 ± 3 years) men and women underwent research tests, including hyperinsulinemic-euglycemic clamps and vastus lateralis biopsies. Exercise training increased Vo2max (2.2 ± 0.2 vs. 2.5 ± 0.2 L/min), CD (313 ± 13 vs. 349 ± 18 capillaries/mm(2)), and M/I (0.041 ± 0.005 vs. 0.051 ± 0.007 μmol/kg fat-free mass/min) (P < 0.05 for all). Exercise training also increased the insulin activation of glycogen synthase by 60%, GLUT4 expression by 16%, and 5' AMPK-α1 expression by 21%, but these reverted to baseline levels after detraining. Conversely, CD and M/I remained 15% and 18% higher after detraining, respectively (P < 0.05), and the changes in M/I (detraining minus baseline) correlated directly with changes in CD in regression analysis (partial r = 0.70; P = 0.02). These results suggest that an increase in CD is one mechanism contributing to sustained improvements in glucose metabolism after aerobic exercise training.
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Affiliation(s)
- Steven J Prior
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD Baltimore Veterans Affairs Geriatric Research Education and Clinical Center and Research and Development Service, Baltimore, MD
| | - Andrew P Goldberg
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD Baltimore Veterans Affairs Geriatric Research Education and Clinical Center and Research and Development Service, Baltimore, MD
| | - Heidi K Ortmeyer
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD Baltimore Veterans Affairs Geriatric Research Education and Clinical Center and Research and Development Service, Baltimore, MD
| | - Eva R Chin
- Department of Kinesiology, University of Maryland School of Public Health, College Park, MD
| | - Dapeng Chen
- Department of Kinesiology, University of Maryland School of Public Health, College Park, MD
| | - Jacob B Blumenthal
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD Baltimore Veterans Affairs Geriatric Research Education and Clinical Center and Research and Development Service, Baltimore, MD
| | - Alice S Ryan
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD Baltimore Veterans Affairs Geriatric Research Education and Clinical Center and Research and Development Service, Baltimore, MD
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Wethal T, Røysland R, Torbjørn O, Kjekshus J. Exercise-induced vasodilation in healthy males: A marker of reduced endothelial function. SCAND CARDIOVASC J 2015; 49:123-9. [PMID: 25752356 DOI: 10.3109/14017431.2015.1021708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Reduced arterial vasodilatatory capacity is a marker of coronary heart disease. The aim was to investigate if the difference between the vasodilatory response before and after exercise, as assessed by non-invasive methodology, is related to endothelial and inflammatory biomarkers. DESIGN Post-ischemic hyperemia after 5 min of arterial occlusion was examined before and after a bicycle test with strain-gauge plethysmography (measuring peak reactive hyperemia in the forearm) and peripheral arterial tonometry (PAT hyperemia ratio: measuring pulse waves in the index finger relative to the contra-lateral index finger) in 30 healthy males. A low PAT hyperemia ratio or a low peak reactive hyperemia reflects endothelial dysfunction. Inflammatory and endothelial biomarkers were assessed. RESULTS A low peak reactive hyperemia and a low PAT hyperemia ratio before the bicycle test was associated with a high percentage increase in peak reactive hyperemia after exercise (r = - 0.68, p < 0.001; r = - 0.35, p = 0.06, respectively). Asymmetric dimethylarginine and interleukin-10 were associated with the percentage increase in peak reactive hyperemia in multiple linear regression analyses (β: 165 (confidence interval [CI], 34-296), p = 0.02; β: 19 (CI, - 0.5-39), p = 0.06, respectively). CONCLUSIONS The difference in the vasodilatory response before and after exercise, as assessed by non-invasive methodology, is related to endothelial and inflammatory biomarkers in healthy males.
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Affiliation(s)
- Torgeir Wethal
- Institute of Clinical Medicine , University of Oslo , Norway
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Hwang MH, Kim S. Type 2 Diabetes: Endothelial dysfunction and Exercise. J Exerc Nutrition Biochem 2014; 18:239-47. [PMID: 25566460 PMCID: PMC4241901 DOI: 10.5717/jenb.2014.18.3.239] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 09/16/2014] [Accepted: 09/26/2014] [Indexed: 01/22/2023] Open
Abstract
PURPOSE Vascular endothelial dysfunction is an early marker of atherosclerosis characterized by decreased nitric oxide bioavailability in the vascular endothelium and smooth muscle cells. Recently, some animal models and in vitro trials demonstrated that excessive superoxide production from mitochondria within vascular endothelial cells played a role in the pathogenesis of atherosclerosis in type 2 diabetes. This review provides a systematic assessment of the effectiveness of exercise to identify effective approaches to recognize diabetes risk and prevent progression to heart disease. METHODS A systematic literature search was conducted to retrieve articles from 1979 to 2013 using the following databases: the MEDLINE, PubMed. Articles had to describe an intervention that physical activity and exercise to identify effective approaches to heart and vascular endothelium. RESULTS Currently, physical activity and exercise guidelines aimed to improve cardiovascular health in patients with type 2 diabetes are nonspecific. Benefit of aerobic exercise training on vascular endothelial function in type 2 diabetic patients is still controversial. CONCLUSION it is necessary to demonstrate the mechanism of endothelial dysfunction from live human tissues so that we can provide more specific exercise training regimens to enhance cardiovascular health in type 2 diabetic patients.
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Affiliation(s)
- Moon-Hyon Hwang
- Division of Clinical and Translational Science, Georgia Regents University, Georgia, USA
| | - Sangho Kim
- School of Global Sport Studies, Korea University, Sejong, Korea
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Schreuder THA, Duncker DJ, Hopman MTE, Thijssen DHJ. Randomized controlled trial using bosentan to enhance the impact of exercise training in subjects with type 2 diabetes mellitus. Exp Physiol 2014; 99:1538-47. [PMID: 25172889 DOI: 10.1113/expphysiol.2014.081182] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In type 2 diabetes patients, endothelin (ET) receptor blockade may enhance blood flow responses to exercise training. The combination of exercise training and ET receptor blockade may represent a more potent stimulus than training alone to improve vascular function, physical fitness and glucose homeostasis. We assessed the effect of an 8 week exercise training programme combined with either ET blockade or placebo on vasculature, fitness and glucose homeostasis in people with type 2 diabetes. In a double-blind randomized controlled trial, brachial endothelium-dependent and ‑independent dilatation (using flow-mediated dilatation and glyceryl trinitrate, respectively), glucose homeostasis (using Homeostasis Model Assessment for Insulin Resistance (HOMA-IR)) and physical fitness (maximal cycling test) were assessed in 18 men with type 2 diabetes (60 ± 6 years old). Subjects underwent an 8 week exercise training programme, with half of the subjects receiving ET receptor blockade (bosentan) and the other half a placebo, followed by reassessment of the tests above. Exercise training improved physical fitness to a similar extent in both groups, but we did not detect changes in vascular function in either group. This study suggests that there is no adaptation in brachial and femoral artery endothelial function after 8 weeks of training in type 2 diabetes patients. Endothelin receptor blockade combined with exercise training does not additionally alter conduit artery endothelial function or physical fitness in type 2 diabetes.
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Affiliation(s)
- Tim H A Schreuder
- Department of Physiology, Radboud University Nijmegen Medical Centre, The Netherlands
| | - Dirk J Duncker
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Maria T E Hopman
- Department of Physiology, Radboud University Nijmegen Medical Centre, The Netherlands
| | - Dick H J Thijssen
- Department of Physiology, Radboud University Nijmegen Medical Centre, The Netherlands Division of Experimental Cardiology, Department of Cardiology, Erasmus University Medical Centre, Rotterdam, The Netherlands
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29
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Prior SJ, Blumenthal JB, Katzel LI, Goldberg AP, Ryan AS. Increased skeletal muscle capillarization after aerobic exercise training and weight loss improves insulin sensitivity in adults with IGT. Diabetes Care 2014; 37:1469-75. [PMID: 24595633 PMCID: PMC3994928 DOI: 10.2337/dc13-2358] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Transcapillary transport of insulin is one determinant of glucose uptake by skeletal muscle; thus, a reduction in capillary density (CD) may worsen insulin sensitivity. Skeletal muscle CD is lower in older adults with impaired glucose tolerance (IGT) compared with those with normal glucose tolerance and may be modifiable through aerobic exercise training and weight loss (AEX+WL). We tested the hypothesis that 6-month AEX+WL would increase CD to improve insulin sensitivity and glucose tolerance in older adults with IGT. RESEARCH DESIGN AND METHODS Sixteen sedentary, overweight-obese (BMI 27-35 kg/m2), older (63 ± 2 years) men and women with IGT underwent hyperinsulinemic-euglycemic clamps to measure insulin sensitivity, oral glucose tolerance tests, exercise and body composition testing, and vastus lateralis muscle biopsies to determine CD before and after 6-month AEX+WL. RESULTS Insulin sensitivity (M) and 120-min postprandial glucose (G120) correlated with CD at baseline (r = 0.58 and r = -0.60, respectively, P < 0.05). AEX+WL increased maximal oxygen consumption (VO2max) 18% (P = 0.02) and reduced weight and fat mass 8% (P < 0.02). CD increased 15% (264 ± 11 vs. 304 ± 14 capillaries/mm(2), P = 0.01), M increased 21% (42.4 ± 4.0 vs. 51.4 ± 4.3 µmol/kg FFM/min, P < 0.05), and G120 decreased 16% (9.35 ± 0.5 vs. 7.85 ± 0.5 mmol/L, P = 0.008) after AEX+WL. Regression analyses showed that the AEX+WL-induced increase in CD independently predicted the increase in M (r = 0.74, P < 0.01) as well as the decrease in G120 (r = -0.55, P < 0.05). CONCLUSIONS Six-month AEX+WL increases skeletal muscle CD in older adults with IGT. This represents one mechanism by which AEX+WL improves insulin sensitivity in older adults with IGT.
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Mitranun W, Deerochanawong C, Tanaka H, Suksom D. Continuous vs interval training on glycemic control and macro- and microvascular reactivity in type 2 diabetic patients. Scand J Med Sci Sports 2013; 24:e69-76. [DOI: 10.1111/sms.12112] [Citation(s) in RCA: 184] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2013] [Indexed: 12/29/2022]
Affiliation(s)
- W. Mitranun
- Faculty of Sports Science; Chulalongkorn University; Bangkok Thailand
| | - C. Deerochanawong
- Rajvithi Hospital; Bangkok Thailand
- Rangsit Medical School; Bangkok Thailand
| | - H. Tanaka
- Department of Kinesiology and Health Education; The University of Texas at Austin; Austin Texas USA
| | - D. Suksom
- Faculty of Sports Science; Chulalongkorn University; Bangkok Thailand
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31
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Blood flow restricted exercise and vascular function. Int J Vasc Med 2012; 2012:543218. [PMID: 23133756 PMCID: PMC3485988 DOI: 10.1155/2012/543218] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2012] [Revised: 08/03/2012] [Accepted: 08/06/2012] [Indexed: 11/18/2022] Open
Abstract
It is established that regular aerobic training improves vascular function, for example, endothelium-dependent vasodilatation and arterial stiffness or compliance and thereby constitutes a preventative measure against cardiovascular disease. In contrast, high-intensity resistance training impairs vascular function, while the influence of moderate-intensity resistance training on vascular function is still controversial. However, aerobic training is insufficient to inhibit loss in muscular strength with advancing age; thus, resistance training is recommended to prevent sarcopenia. Recently, several lines of study have provided compelling data showing that exercise and training with blood flow restriction (BFR) leads to muscle hypertrophy and strength increase. As such, BFR training might be a novel means of overcoming the contradiction between aerobic and high-intensity resistance training. Although it is not enough evidence to obtain consensus about impact of BFR training on vascular function, available evidences suggested that BFR training did not change coagulation factors and arterial compliance though with inconsistence results in endothelial function. This paper is a review of the literature on the impact of BFR exercise and training on vascular function, such as endothelial function, arterial compliance, or other potential factors in comparison with those of aerobic and resistance training.
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32
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Park Y, Booth FW, Lee S, Laye MJ, Zhang C. Physical activity opposes coronary vascular dysfunction induced during high fat feeding in mice. J Physiol 2012; 590:4255-68. [PMID: 22674721 DOI: 10.1113/jphysiol.2012.234856] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
The study's purpose was to investigate if physical activity initiated with the start of high-fat feeding would oppose development of endothelial dysfunction, and if it does, then to determine some potential mechanisms. C57BL/6 female mice were randomly divided into three groups: (1) control low-fat diet (LF-SED; 15% of calories from fat), (2) high-fat diet (HF-SED; 45% of calories from fat), and (3) HF diet given access to a voluntary running wheel (HF-RUN). Our hypothesis was that HF-RUN would differ in multiple markers of endothelial dysfunction from HF-SED after 10 weeks of 45%-fat diet, but would not differ from LF-SED. HF-RUN differed from HF-SED in nine determinations in which HF-SED either had decreases in (1) acetylcholine (ACh)-induced and flow-induced vasodilatations in isolated, pressurized coronary arterioles, (2) heart phosphorylated endothelial nitric oxide synthase (p-eNOS/eNOS) protein, (3) coronary arteriole leptin (ob) receptor protein, (4) phosphorylated signal transducer and activator of transcription 3 (p-STAT3/STAT3) protein, and (5) coronary arteriole superoxide dismutase 1 protein; or had increases in (6) percentage body fat, (7) serum leptin, (8) coronary arteriole suppressor of cytokine signalling 3 (SOCS3) protein, and (9) coronary arteriole gp91(phox) protein. Higher endothelium-dependent vasodilatation by ACh or leptin was abolished with incubation of NOS inhibitor N(G)-nitro-l-arginine-methyl ester (l-NAME) in LF-SED and HF-RUN groups. Further, impaired ACh-induced vasodilatation in HF-SED was normalized by apocynin or TEMPOL to LF-SED and HF-RUN. These findings demonstrate multiple mechanisms (eNOS, leptin and redox balance) by which voluntary running opposes the development of impaired coronary arteriolar vasodilatation during simultaneous high-fat feeding.
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Affiliation(s)
- Yoonjung Park
- Internal Medicine, University of Missouri, Columbia, MO 65211, USA.
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Berwick ZC, Dick GM, Tune JD. Heart of the matter: coronary dysfunction in metabolic syndrome. J Mol Cell Cardiol 2012; 52:848-56. [PMID: 21767548 PMCID: PMC3206994 DOI: 10.1016/j.yjmcc.2011.06.025] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2011] [Revised: 06/16/2011] [Accepted: 06/30/2011] [Indexed: 12/14/2022]
Abstract
Metabolic syndrome (MetS) is a collection of risk factors including obesity, dyslipidemia, insulin resistance/impaired glucose tolerance, and/or hypertension. The incidence of obesity has reached pandemic levels, as ~20-30% of adults in most developed countries can be classified as having MetS. This increased prevalence of MetS is critical as it is associated with a two-fold elevated risk for cardiovascular disease. Although the pathophysiology underlying this increase in disease has not been clearly defined, recent evidence indicates that alterations in the control of coronary blood flow could play an important role. The purpose of this review is to highlight current understanding of the effects of MetS on regulation of coronary blood flow and to outline the potential mechanisms involved. In particular, the role of neurohumoral modulation via sympathetic α-adrenoceptors and the renin-angiotensin-aldosterone system (RAAS) are explored. Alterations in the contribution of end-effector K(+), Ca(2+), and transient receptor potential (TRP) channels are also addressed. Finally, future perspectives and potential therapeutic targeting of the microcirculation in MetS are discussed. This article is part of a Special Issue entitled "Coronary Blood Flow".
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Affiliation(s)
- Zachary C. Berwick
- Department of Cellular and Integrative Physiology, Indiana University School of Medicine, Indianapolis, IN 46202
| | - Gregory M. Dick
- Department of Exercise Physiology Center for Cardiovascular and Respiratory Sciences West Virginia University School of Medicine
| | - Johnathan D. Tune
- Department of Cellular and Integrative Physiology, Indiana University School of Medicine, Indianapolis, IN 46202
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Perivascular Fat and the Microcirculation: Relevance to Insulin Resistance, Diabetes, and Cardiovascular Disease. CURRENT CARDIOVASCULAR RISK REPORTS 2011; 6:80-90. [PMID: 22247785 PMCID: PMC3251783 DOI: 10.1007/s12170-011-0214-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Type 2 diabetes and its major risk factor, obesity, are a growing burden for public health. The mechanisms that connect obesity and its related disorders, such as insulin resistance, type 2 diabetes, and hypertension, are still undefined. Microvascular dysfunction may be a pathophysiologic link between insulin resistance and hypertension in obesity. Many studies have shown that adipose tissue-derived substances (adipokines) interact with (micro)vascular function and influence insulin sensitivity. In the past, research focused on adipokines from perivascular adipose tissue (PVAT). In this review, we focus on the interactions between adipokines, predominantly from PVAT, and microvascular function in relation to the development of insulin resistance, diabetes, and cardiovascular disease.
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35
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Markelic M, Velickovic K, Golic I, Otasevic V, Stancic A, Jankovic A, Vucetic M, Buzadzic B, Korac B, Korac A. Endothelial cell apoptosis in brown adipose tissue of rats induced by hyperinsulinaemia: the possible role of TNF-α. Eur J Histochem 2011; 55:e34. [PMID: 22297440 PMCID: PMC3284236 DOI: 10.4081/ejh.2011.e34] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2011] [Revised: 06/20/2011] [Accepted: 06/21/2011] [Indexed: 12/11/2022] Open
Abstract
The aim of the present study was to investigate whether hyperinsulinaemia, which frequently precedes insulin resistance syndrome (obesity, diabetes), induces apoptosis of endothelial cells (ECs) in brown adipose tissue (BAT) and causes BAT atrophy and also, to investigate the possible mechanisms underlying ECs death. In order to induce hyperinsuli-naemia, adult male rats of Wistar strain were treated with high dose of insulin (4 U/kg, intraperitonely) for one or three days. Examinations at ultrastructural level showed apoptotic changes of ECs, allowing us to point out that changes mainly but not exclusively, occur in nuclei. Besides different stages of condensation and alterations of the chromatin, nuclear fragmentation was also observed. Higher number of ECs apoptotic nuclei in the BAT of hyperinsulinaemic rats was also confirmed by propidium iodide staining. Immunohistochemical localization of tumor necrosis factor-alpha (TNF-α) revealed increased expression in ECs of BAT of hyperinsulinaemic animals, indicating its possible role in insulin-induced apoptotic changes. These results suggest that BAT atrophy in hyperinsulinaemia is a result of endothelial and adipocyte apoptosis combined, rather than any of functional components alone.
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Affiliation(s)
- M Markelic
- Faculty of Biology, Centre for Electron Microscopy, University of Belgrade, Serbia
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36
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Mikus CR, Fairfax ST, Libla JL, Boyle LJ, Vianna LC, Oberlin DJ, Uptergrove GM, Deo SH, Kim A, Kanaley JA, Fadel PJ, Thyfault JP. Seven days of aerobic exercise training improves conduit artery blood flow following glucose ingestion in patients with type 2 diabetes. J Appl Physiol (1985) 2011; 111:657-64. [PMID: 21737826 DOI: 10.1152/japplphysiol.00489.2011] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
The vasodilatory effects of insulin account for up to 40% of insulin-mediated glucose disposal; however, insulin-stimulated vasodilation is impaired in individuals with type 2 diabetes, limiting perfusion and delivery of glucose and insulin to target tissues. To determine whether exercise training improves conduit artery blood flow following glucose ingestion, a stimulus for increasing circulating insulin, we assessed femoral blood flow (FBF; Doppler ultrasound) during an oral glucose tolerance test (OGTT; 75 g glucose) in 11 overweight or obese (body mass index, 34 ± 1 kg/m²), sedentary (peak oxygen consumption, 23 ± 1 ml·kg⁻¹·min⁻¹) individuals (53 ± 2 yr) with non-insulin-dependent type 2 diabetes (HbA1c, 6.63 ± 0.18%) before and after 7 days of supervised treadmill and cycling exercise (60 min/day, 60-75% heart rate reserve). Fasting glucose, insulin, and FBF were not significantly different after 7 days of exercise, nor were glucose or insulin responses to the OGTT. However, estimates of whole body insulin sensitivity (Matsuda insulin sensitivity index) increased (P < 0.05). Before exercise training, FBF did not change significantly during the OGTT (1 ± 7, -7 ± 5, 0 ± 6, and 0 ± 5% of fasting FBF at 75, 90, 105, and 120 min, respectively). In contrast, after exercise training, FBF increased by 33 ± 9, 39 ± 14, 34 ± 7, and 48 ± 18% above fasting levels at 75, 90, 105, and 120 min, respectively (P < 0.05 vs. corresponding preexercise time points). Additionally, postprandial glucose responses to a standardized breakfast meal consumed under "free-living" conditions decreased during the final 3 days of exercise (P < 0.05). In conclusion, 7 days of aerobic exercise training improves conduit artery blood flow during an OGTT in individuals with type 2 diabetes.
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Affiliation(s)
- Catherine R Mikus
- Dept. of Nutrition and Exercise Physiology, Univ. of Missouri, Columbia, MO 65211, USA
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Sanchez OA, Copenhaver EA, Chance MA, Fowler MJ, Towse TF, Kent-Braun JA, Damon BM. Postmaximal contraction blood volume responses are blunted in obese and type 2 diabetic subjects in a muscle-specific manner. Am J Physiol Heart Circ Physiol 2011; 301:H418-27. [PMID: 21572006 DOI: 10.1152/ajpheart.00060.2011] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The purpose of this study was to determine whether there are differences in postisometric contraction blood volume and oxygenation responses among groups of type 2 diabetes mellitus (T2DM), obese, and lean individuals detectable using MRI. Eight T2DM patients were individually matched by age, sex, and race to non-T2DM individuals with similar body mass index (obese) and lean subjects. Functional MRI was performed using a dual-gradient-recalled echo, echo-planar imaging sequence with a repetition time of 1 s and at two echo times (TE = 6 and 46 ms). Data were acquired before, during, and after 10-s isometric dorsiflexion contractions performed at 50 and 100% of maximal voluntary contraction (MVC) force. MRI signal intensity (SI) changes from the tibialis anterior and extensor digitorum longus muscles were plotted as functions of time for each TE. From each time course, the difference between the minimum and the maximum postcontraction SI (ΔSI) were determined for TE = 6 ms (ΔSI(6)) and TE = 46 ms (ΔSI(46)), reflecting variations in blood volume and oxyhemoglobin saturation, respectively. Following 50% MVC contractions, the mean postcontraction ΔSI(6) values were similar in the three groups. Following MVC only, and in the EDL muscle only, T2DM and obese participants had ∼56% lower ΔSI(6) than the lean individuals. Also following MVC only, the ΔSI(46) response in the EDL was lower in T2DM subjects than in lean individuals. These data suggest that skeletal muscle small vessel impairment occurs in T2DM and body mass index-matched subjects, in muscle-specific and contraction intensity-dependent manners.
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Affiliation(s)
- Otto A Sanchez
- Institute of Imaging Science, Department of Medicine, Vanderbilt University, Nashville, Tennessee, USA
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Gaesser GA, Angadi SS, Sawyer BJ. Exercise and diet, independent of weight loss, improve cardiometabolic risk profile in overweight and obese individuals. PHYSICIAN SPORTSMED 2011; 39:87-97. [PMID: 21673488 DOI: 10.3810/psm.2011.05.1898] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Diet and/or exercise are routinely advised as methods for weight loss in overweight/obese individuals, particularly those who are at high risk for cardiovascular disease and type 2 diabetes mellitus. However, physical activity and structured exercise programs rarely result in significant loss of body weight or body fat, and weight-loss diets have extraordinarily high recidivism rates. Despite only modest effects on body weight, exercise and ad libitum nutrient-dense diets for overweight/obese individuals have many health benefits, including skeletal muscle adaptations that improve fat and glucose metabolism, and insulin action; enhance endothelial function; have favorable changes in blood lipids, lipoproteins, and hemostatic factors; and reduce blood pressure, postprandial lipemia and glycemia, and proinflammatory markers. These lifestyle-induced adaptations occur independently of changes in body weight or body fat. Thus, overweight/obese men and women who are at increased risk for cardiovascular disease and type 2 diabetes as a result of sedentary lifestyle, poor diet, and excess body weight should be encouraged to engage in regular physical activity and improve their diet, regardless of whether the healthier lifestyle leads to weight loss.
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Affiliation(s)
- Glenn A Gaesser
- Healthy Lifestyles Research Center, Arizona State University, Mesa, AZ, USA.
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39
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Francischetti EA, Tibirica E, da Silva EG, Rodrigues E, Celoria BM, de Abreu VG. Skin capillary density and microvascular reactivity in obese subjects with and without metabolic syndrome. Microvasc Res 2011; 81:325-30. [PMID: 21236266 DOI: 10.1016/j.mvr.2011.01.002] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Accepted: 01/05/2011] [Indexed: 10/18/2022]
Abstract
Obesity is associated with increased cardiovascular morbidity and mortality. We hypothesized that microvascular function may be impaired in obese subjects with metabolic syndrome (OB-MetSnd) compared to obese subjects without MetSnd (OB) and healthy subjects (HS). In this cross-sectional study, we evaluated skin capillary density (SCD) in OB-MetSnd (n=20, 12 women, BMI=36.5±1.1kg/m(2)), OB (n=25, 16 women, BMI=34.5±0.7kg/m(2)), and HS (n=30, 22 women, BMI=22.8±0.3kg/m(2)) groups. SCD was evaluated by intravital video-microscopy at rest and after post-occlusive reactive hyperemia (PORH) and venous congestion (VC). OB-MetSnd subjects exhibited significant differences in the values of MetSnd components and in leptin and HOMA-IR levels compared to OB and HS individuals. There were no differences in SCD among groups in resting conditions. The OB-MetSnd group failed to show a significant increase in the number of recruited capillaries during PORH and VC compared to the SCD evaluated at rest. A negative correlation of SCD with waist circumference, BMI, blood pressure, and HOMA-IR was observed after PORH and VC. When obese subjects were analyzed according to their HOMA-IR quartiles, a significant decrease in SCD was observed during POHR (P=0.02). Our findings showed that obese subjects have structural and functional alterations in skin microcirculation that are proportional to the increase in the degree of global and central obesity. In addition, in OB-MetSnd subjects, the cutaneous capillaries at rest are already maximally recruited, indicating an absence of functional capillary reserve. This may be related to the insulin resistance observed in OB-MetSnd individuals.
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Affiliation(s)
- Emilio A Francischetti
- Hypertension Clinic, Laboratory of Clinical and Experimental Pathophysiology, (CLINEX), School of Medicine, Rio de Janeiro State University, Brazil
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MacAnaney O, Reilly H, O'Shea D, Egaña M, Green S. Effect of type 2 diabetes on the dynamic response characteristics of leg vascular conductance during exercise. Diab Vasc Dis Res 2011; 8:12-21. [PMID: 21262866 DOI: 10.1177/1479164110389625] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
In this study we tested the hypothesis that type 2 diabetes impairs the dynamic response of leg vascular conductance (LVC) during exercise. LVC (leg blood flow/mean arterial pressure) responses were studied during intermittent contractions of the calf muscle in subjects with type 2 diabetes (n = 9), heavy controls (n = 10) and lean controls (n = 8) using a biexponential function and an estimate of the mean response time (MRT). The time constant of the second phase of LVC was significantly greater in type 2 diabetes (66.4 ± 29.2 s) than the heavy (22.2 ± 13.4 s) and lean (21.8 ± 9.3 s) controls, resulting in a significantly greater MRT in the diabetic group (median [IQR] = 30.7 [24.6-46.5] s versus 16.3 [4.3-23.2] s and 18.4 [13.7-19.3] s). These data support the hypothesis and suggest that a slowed hyperaemic response in the exercising limb might contribute to exercise intolerance in diabetic subjects.
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Affiliation(s)
- Oscar MacAnaney
- Department of Physiology, Trinity College Dublin, Dublin, Ireland
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41
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Ivey FM, Hafer-Macko CE, Ryan AS, Macko RF. Impaired leg vasodilatory function after stroke: adaptations with treadmill exercise training. Stroke 2010; 41:2913-7. [PMID: 20966405 DOI: 10.1161/strokeaha.110.599977] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Resting and reactive hyperemic leg blood flows are significantly reduced in the paretic compared with the nonparetic limb after disabling stroke. Our objective was to compare the effects of regular treadmill exercise (TM) with an active control regimen of supervised stretching (CONTROL) on peripheral hemodynamic function. METHODS This intervention study used a randomized, controlled design, in which participants were randomized with stratification according to age and baseline walking capacity to ensure approximate balance between the 2 groups. Fifty-three chronic, ischemic stroke participants (29 TM and 24 CONTROL) with mild to moderate hemiparetic gait completed bilateral measurements of lower leg resting and reactive hyperemic blood flow using venous occlusion strain gauge plethysmography before and after the 6-month intervention period. Participants also underwent testing to track changes in peak aerobic fitness across time. RESULTS Resting and reactive hyperemic blood flows were significantly reduced in the paretic compared with the nonparetic limb at baseline before any intervention (-28% and -34%, respectively, P<0.01). TM increased both resting and reactive hyperemic blood flow in the paretic limb by 25% compared with decreases in CONTROL (P<0.001, between groups). Similarly, nonparetic leg blood flow was significantly improved with TM compared with controls (P<0.001). Peak aerobic fitness improved by 18% in TM and decreased by 4% in CONTROL (P<0.01, between groups), and there was a significant relationship between blood flow change and peak fitness change for the group as a whole (r=.30, P<0.05). CONCLUSIONS Peripheral hemodynamic function improves with regular aerobic exercise training after disabling stroke.
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Affiliation(s)
- Frederick M Ivey
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD 21201-1524, USA.
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42
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Segerström AB, Glans F, Eriksson KF, Holmbäck AM, Groop L, Thorsson O, Wollmer P. Impact of exercise intensity and duration on insulin sensitivity in women with T2D. Eur J Intern Med 2010; 21:404-8. [PMID: 20816594 DOI: 10.1016/j.ejim.2010.05.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2010] [Revised: 04/28/2010] [Accepted: 05/10/2010] [Indexed: 11/16/2022]
Abstract
BACKGROUND Clinical guidelines seldom provide in depth information about the most suitable type and intensity of exercise to obtain optimal benefit in different subgroups of T2D individuals. The aim of this study was to examine the effect of group exercise training on exercise capacity, insulin sensitivity and HbA1c in women with diabetes. METHODS Twenty-two women with T2D participated in a supervised group exercise program for six months. The program combined endurance and resistance exercise. The duration and intensity of exercise for each subject was recorded. The volume of exercise was calculated as the product of exercise duration and intensity. Exercise capacity, insulin sensitivity and HbA1c were measured at baseline and after six months of training. The subjects were dichotomized with respect to training volume in a high training volume group and a low training volume group. RESULTS Exercise capacity did not change significantly during the training period. Insulin sensitivity increased significantly and HbA1c decreased significantly from baseline in the high volume group but not in the low volume group. The increase in insulin sensitivity was explained with the intensity of exercise by 30%. The reduction in HbA1c was explained with exercise by 25%. CONCLUSION Improvement in insulin sensitivity after six months combined supervised group training in female diabetic subjects is related to exercise intensity, whereas the reduction in HbA1c is related mainly to training volume. Metabolic effects of training may be seen in the absence of improved exercise capacity.
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Affiliation(s)
- Asa B Segerström
- Department of Health Sciences, Division of Physiotherapy, Lund University, Lund, Sweden.
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Mikus CR, Rector RS, Arce-Esquivel AA, Libla JL, Booth FW, Ibdah JA, Laughlin MH, Thyfault JP. Daily physical activity enhances reactivity to insulin in skeletal muscle arterioles of hyperphagic Otsuka Long-Evans Tokushima Fatty rats. J Appl Physiol (1985) 2010; 109:1203-10. [PMID: 20634354 DOI: 10.1152/japplphysiol.00064.2010] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Insulin-mediated glucose disposal is dependent on the vasodilator effects of insulin. In type 2 diabetes, insulin-stimulated vasodilation is impaired as a result of an imbalance in NO and ET-1 production. We tested the hypothesis that chronic voluntary wheel running (RUN) prevents impairments in insulin-stimulated vasodilation associated with obesity and type 2 diabetes independent of the effects of RUN on adiposity by randomizing Otsuka Long Evans Tokushima Fatty (OLETF) rats, a model of hyperphagia-induced obesity and type 2 diabetes, to 1) RUN, 2) caloric restriction (CR; diet adjusted to match body weights of RUN group), or 3) sedentary control (SED) groups (n = 8/group) at 4 wk. At 40 wk, NO- and ET-1-mediated vasoreactivity to insulin (1-1,000 μIU/ml) was assessed in the presence of a nonselective ET-1 receptor blocker (tezosentan) or a NO synthase (NOS) inhibitor [N(G)-nitro-L-arginine methyl ester (L-NAME)], respectively, in second-order arterioles isolated from the white portion of the gastrocnemius muscle. Body weight, fasting plasma glucose, and hemoglobin A1c were lower in RUN and CR than SED (P < 0.05); however, the glucose area under the curve (AUC) following the intraperitoneal glucose tolerance test was lower only in the RUN group (P < 0.05). Vasodilator responses to all doses of insulin were greater in RUN than SED or CR in the presence of a tezosentan (P < 0.05), but group differences in vasoreactivity to insulin with coadministration of L-NAME were not observed. We conclude daily wheel running prevents obesity and type 2 diabetes-associated declines in insulin-stimulated vasodilation in skeletal muscle arterioles through mechanisms that appear to be NO mediated and independent of attenuating excess adiposity in hyperphagic rats.
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Affiliation(s)
- Catherine R Mikus
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, USA
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Burr JF, Rowan CP, Jamnik VK, Riddell MC. The role of physical activity in type 2 diabetes prevention: physiological and practical perspectives. PHYSICIAN SPORTSMED 2010; 38:72-82. [PMID: 20424404 DOI: 10.3810/psm.2010.04.1764] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Lifestyle changes that include a nutritionally balanced diet and increased physical activity (PA) are effective intervention options for persons with prediabetes who want to prevent progression to type 2 diabetes mellitus. Although nutritional counseling is standard practice for patients in a clinical setting, an individualized PA prescription, including recommendations on the type, frequency, duration, and intensity, is much less likely to occur. This is surprising because lifestyle modifications including a PA program are at least as effective in diabetes prevention as any single pharmacological agent. The success of regular PA in improving glycemic control in persons with either prediabetes or type 2 diabetes likely results from adaptations that occur in several organs and tissues, including adipose, skeletal muscle, liver, and pancreas. Increased insulin sensitivity is an important link between increased PA, body composition, and metabolic health, and it is at this link where increases in PA and energy expenditure exert much of their effect on preventing metabolic disorders and improving symptoms of existing disease. In addition to improving insulin sensitivity, regular PA has several cardioprotective effects, especially for persons with metabolic dysfunction, and has been shown to elicit minimal adverse events in these populations. Effective PA prescription is contingent on an understanding of the underlying physiological adaptations and the differing responses to diverse modes and intensities of PA. This article highlights recent findings on the beneficial role of regular PA for improving and/or maintaining insulin sensitivity in persons with prediabetes. We also provide an evidence-informed prescription for the type, intensity, and duration of both resistance and aerobic PA in persons with prediabetes.
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Affiliation(s)
- Jamie F Burr
- Physical Activity and Chronic Disease Unit, School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, Ontario, M3J 1P3, Canada
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Villela NR, Kramer-Aguiar LG, Bottino DA, Wiernsperger N, Bouskela E. Metabolic disturbances linked to obesity: the role of impaired tissue perfusion. ACTA ACUST UNITED AC 2010; 53:238-45. [PMID: 19466216 DOI: 10.1590/s0004-27302009000200015] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2009] [Accepted: 02/17/2009] [Indexed: 01/17/2023]
Abstract
Associated with elevated risk of cardiovascular events and cancer, obesity is a worldwide problem affecting developed and developing countries. Microcirculatory vessels, represented by arterioles, capillaries and venules (mean internal diameter < 100 microm), are the place where blood/tissue nutrition and exchange effectively take place. Microvascular dysfunction is an early event in obesity probably secondary to endothelial dysfunction and capillaries rarefaction. New research techniques allow the investigation of the microcirculation in different vascular beds in humans. Studies suggest a link between endothelial dysfunction and visceral obesity. Oxidative stress, inflammation and renin-angiotensin system are among factors considered to be involved on microvascular dysfunction in obesity. Microcirculatory impairment present in obesity suggests that it could be an important causal factor in obesity-related disorders such as insulin resistance and hypertension.
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Affiliation(s)
- Nivaldo Ribeiro Villela
- Laboratório de Pesquisas Clínicas e Experimentais em Biologia Vascular, Centro Biomédico, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524, Rio de Janeiro, RJ, Brazil
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46
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Olsen DB, Scheede-Bergdahl C, Reving D, Boushel R, Dela F. The effect of rowing on endothelial function and insulin action in healthy controls and in patients with type 2 diabetes. Scand J Med Sci Sports 2010; 21:420-30. [DOI: 10.1111/j.1600-0838.2009.01012.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Borbouse L, Dick GM, Payne GA, Berwick ZC, Neeb ZP, Alloosh M, Bratz IN, Sturek M, Tune JD. Metabolic syndrome reduces the contribution of K+ channels to ischemic coronary vasodilation. Am J Physiol Heart Circ Physiol 2010; 298:H1182-9. [PMID: 20118408 DOI: 10.1152/ajpheart.00888.2009] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
This investigation tested the hypothesis that metabolic syndrome decreases the relative contribution of specific K(+) channels to coronary reactive hyperemia. Ca(2+)-activated (BK(Ca)), voltage-activated (K(V)), and ATP-dependent (K(ATP)) K(+) channels were investigated. Studies were conducted in anesthetized miniature Ossabaw swine fed a normal maintenance diet (11% kcal from fat) or an excess calorie atherogenic diet (43% kcal from fat, 2% cholesterol, 20% kcal from fructose) for 20 wk. The latter diet induces metabolic syndrome, increasing body weight, fasting glucose, total cholesterol, and triglyceride levels. Ischemic vasodilation was determined by the coronary flow response to a 15-s occlusion before and after cumulative administration of antagonists for BK(Ca) (penitrem A; 10 microg/kg iv), K(V) (4-aminopyridine; 0.3 mg/kg iv) and K(ATP) (glibenclamide; 1 mg/kg iv) channels. Coronary reactive hyperemia was diminished by metabolic syndrome as the repayment of flow debt was reduced approximately 30% compared with lean swine. Inhibition of BK(Ca) channels had no effect on reactive hyperemia in either lean or metabolic syndrome swine. Subsequent inhibition of K(V) channels significantly reduced the repayment of flow debt ( approximately 25%) in both lean and metabolic syndrome swine. Additional blockade of K(ATP) channels further diminished ( approximately 45%) the repayment of flow debt in lean but not metabolic syndrome swine. These data indicate that the metabolic syndrome impairs coronary vasodilation in response to cardiac ischemia via reductions in the contribution of K(+) channels to reactive hyperemia.
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Affiliation(s)
- Léna Borbouse
- Dept. of Cellular and Integrative Physiology, Indiana Univ. School of Medicine, Indianapolis, 46202, USA
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Sixt S, Beer S, Blüher M, Korff N, Peschel T, Sonnabend M, Teupser D, Thiery J, Adams V, Schuler G, Niebauer J. Long- but not short-term multifactorial intervention with focus on exercise training improves coronary endothelial dysfunction in diabetes mellitus type 2 and coronary artery disease. Eur Heart J 2009; 31:112-9. [PMID: 19793768 DOI: 10.1093/eurheartj/ehp398] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIMS Patients with type 2 diabetes mellitus (T2DM) suffer from accelerated coronary artery disease. We assessed the effects of a multifactorial intervention with focus on exercise training on coronary endothelial function, vascular structure, and inflammation in serum and skeletal muscle biopsies, including mRNA expression of diabetes candidate genes. METHODS AND RESULTS Twenty-three patients were randomized to either 4 weeks in-hospital exercise training (6 x 15 min bicycle/day, 5 days/week) and a hypocaloric diet, followed by a 5 months ambulatory program (30 min ergometer/day, 5 days/week, plus 1 h group exercise/week), or a control group. At the beginning of the study, at 4 weeks, and after 6 months changes in diameter of coronary arteries in response to acetylcholine and mean peak flow velocity were invasively measured; intramural plaques were assessed by intravascular ultrasound. Six months of intervention led to significant improvement of coronary endothelial function, whereas intramural plaque burden remained unchanged. After 4 weeks, endothelial function remained unchanged, however, lowest values for fasting glucose, HbA1c, high-sensitive C-reactive protein, total and LDL-cholesterol, and highest values for mRNA expression in skeletal muscle of p22, gp91, haem oxygenase 1, peroxisome proliferator activator receptor (PPAR) alpha and gamma were observed. There was a continuous increase for AdipoR1, AdipoR2, Glut4, interleukin-6, endothelial nitric oxide synthase, and PPARgamma-coactivator-1alpha mRNA expression in skeletal muscle. CONCLUSION This is the first study to demonstrate improvement in coronary endothelial function by a multifactorial intervention which focused on exercise training in patients with T2DM. This coincided with improved markers of hyperglycaemia, insulin sensitivity, and inflammation both in serum and skeletal muscle biopsies.
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Affiliation(s)
- Sebastian Sixt
- Department of Cardiology, Heart Centre, University of Leipzig, Leipzig, Germany
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49
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Weltman NY, Saliba SA, Barrett EJ, Weltman A. The Use of Exercise in the Management of Type 1 and Type 2 Diabetes. Clin Sports Med 2009; 28:423-39. [DOI: 10.1016/j.csm.2009.02.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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50
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Owens DR, Schalkwyk CV, Smith P, Beer S, Goenka N, Bain SC, Bootle S, Robertson D, Robinson A, Shaw JAM. Algorithm for the introduction of rapid-acting insulin analogues in patients with type 2 diabetes on basal insulin therapy. ACTA ACUST UNITED AC 2009. [DOI: 10.1002/pdi.1339] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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