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Schmelzer JS, Kahle-Stephan M, Meier JJ, Nauck MA. Prospective External Validation of an Algorithm Predicting Hourly Basal Insulin Infusion Rates from Characteristics of Patients with Type 1 Diabetes Treated with Insulin Pumps. Exp Clin Endocrinol Diabetes 2023; 131:539-547. [PMID: 37473769 DOI: 10.1055/a-2118-2011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
BACKGROUND We previously published an algorithm predicting 24 h basal insulin infusion profiles in insulin pump-treated subjects with type 1 diabetes profiles from six subject characteristics. This algorithm was to be externally validated in an independent environment and patient population. METHODS Thirty-two patients with pump-treated type diabetes were switched to their individually algorithm-derived basal insulin infusion profile, and the appropriateness of fasting glycemic control was scrutinized by means of a supervised 24 h fast. Primary endpoint was appropriate fasting glycemic control according to pre-defined criteria in at least 80% of the cohort. RESULTS In 24 out of 32 patients switching to the algorithm-derived basal insulin infusion rate and undergoing a 24-h fasting period, appropriate glycemic control was achieved (=75%, lower than the pre-defined threshold of 80%), two patients discontinued the fast due to hyperglycemia, and six finished the fasting period, however, with inappropriate fasting glycemic control (entirely due to hyperglycemic episodes). There were no obvious differences in baseline characteristics between those with appropriate vs. inappropriate fasting glycemic control on the basal insulin infusion rate provided by the algorithm. CONCLUSION In conclusion, when testing fasting glycemic control with an algorithm-derived individual basal insulin infusion profile during a 24 h fasting period in a cohort unrelated in terms of the hospital environment and catchment area, the success rate was lower than a pre-defined threshold for concluding utility of this algorithm. Therefore, applying this algorithm in order to initiate or optimize basal insulin infusion profiles in type 1 diabetes cannot be generally recommended.
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Affiliation(s)
- Jana S Schmelzer
- Diabetes, Endocrinology and Metabolism Section, Medical Department I, Katholisches Klinikum Bochum, St. Josef-Hospital, Klinikum der Ruhr-Universität Bochum, Bochum, Germany
- Department of Internal Medicine, Augusta-Krankenanstalt gGmbH, Bochum, Germany
| | - Melanie Kahle-Stephan
- Diabetes, Endocrinology and Metabolism Section, Medical Department I, Katholisches Klinikum Bochum, St. Josef-Hospital, Klinikum der Ruhr-Universität Bochum, Bochum, Germany
- Diabetes Center Bad Lauterberg, Bad Lauterberg im Harz, Germany
| | - Juris J Meier
- Diabetes, Endocrinology and Metabolism Section, Medical Department I, Katholisches Klinikum Bochum, St. Josef-Hospital, Klinikum der Ruhr-Universität Bochum, Bochum, Germany
- Department of Internal Medicine, Augusta-Krankenanstalt gGmbH, Bochum, Germany
| | - Michael A Nauck
- Diabetes, Endocrinology and Metabolism Section, Medical Department I, Katholisches Klinikum Bochum, St. Josef-Hospital, Klinikum der Ruhr-Universität Bochum, Bochum, Germany
- Diabetes Center Bad Lauterberg, Bad Lauterberg im Harz, Germany
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Associations Between Wearable-Specific Indicators of Physical Activity Behaviour and Insulin Sensitivity and Glycated Haemoglobin in the General Population: Results from the ORISCAV-LUX 2 Study. SPORTS MEDICINE - OPEN 2022; 8:146. [PMID: 36507935 PMCID: PMC9743939 DOI: 10.1186/s40798-022-00541-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 11/23/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Parameters derived from an acceleration signal, such as the time accumulated in sedentary behaviour or moderate to vigorous physical activity (MVPA), may not be sufficient to describe physical activity (PA) which is a complex behaviour. Incorporating more advanced wearable-specific indicators of PA behaviour (WIPAB) may be useful when characterising PA profiles and investigating associations with health. We investigated the associations of novel objective measures of PA behaviour with glycated haemoglobin (HbA1c) and insulin sensitivity (Quicki index). METHODS This observational study included 1026 adults (55% women) aged 18-79y who were recruited from the general population in Luxembourg. Participants provided ≥ 4 valid days of triaxial accelerometry data which was used to derive WIPAB variables related to the activity intensity, accumulation pattern and the temporal correlation and regularity of the acceleration time series. RESULTS Adjusted general linear models showed that more time spent in MVPA and a higher average acceleration were both associated with a higher insulin sensitivity. More time accumulated in sedentary behaviour was associated with lower insulin sensitivity. With regard to WIPAB variables, parameters that were indicative of higher PA intensity, including a shallower intensity gradient and higher average accelerations registered during the most active 8 h and 15 min of the day, were associated with higher insulin sensitivity. Results for the power law exponent alpha, and the proportion of daily time accumulated in sedentary bouts > 60 min, indicated that activity which was characterised by long sedentary bouts was associated with lower insulin sensitivity. A greater proportion of time spent in MVPA bouts > 10 min was associated with higher insulin sensitivity. A higher scaling exponent alpha at small time scales (< 90 min), which shows greater correlation in the acceleration time series over short durations, was associated with higher insulin sensitivity. When measured over the entirety of the time series, metrics that reflected a more complex, irregular and unpredictable activity profile, such as the sample entropy, were associated with lower HbA1c levels and higher insulin sensitivity. CONCLUSION Our investigation of novel WIPAB variables shows that parameters related to activity intensity, accumulation pattern, temporal correlation and regularity are associated with insulin sensitivity in an adult general population.
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Oliveira CM, Novelli FI, Alves-Santos ÉT, Queiroz MG, Ghezzi AC, Cambri LT. Physical activity influences heart rate variability in young adults, regardless of dextrose ingestion. Blood Press Monit 2022; 27:220-226. [PMID: 35258021 DOI: 10.1097/mbp.0000000000000593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Cardiac autonomic modulation can be altered by carbohydrate ingestion. On the other hand, some of the protective effects of physical activity may be due to its impact on the autonomic nervous system. PURPOSE This cross-sectional study was conducted to evaluate whether physical activity level influences heart rate variability (HRV) under fasting and mainly, after dextrose ingestion. METHODS Healthy adults aged 18-40 years ( n = 92; 54.35 % women) were separated into nonactive ( n = 47) and active groups ( n = 45), based on the physical activity level determined by International Physical Activity Questionnaire (IPAQ) and then compared. RESULTS There were no significant differences ( P > 0.05) for age, body mass, BMI, abdominal circumference, blood pressure, fasting glucose and blood glucose at 60 min after dextrose ingestion between groups. Body fat (%) was lower in the active group ( P = 0.02). The time-domain indices (RMSSD, SDNN and pNN50) were higher in the physically active group compared to the nonactive group (main effect of group, P < 0.01). The SDNN index was higher at 60 min after dextrose ingestion compared to fasting (main effect of time, P ≤ 0.01). However, no HRV indices showed significantly interaction effect (group x time; P > 0.05). CONCLUSION The magnitude of HRV responses to glucose was not influenced by physical activity status. Young adults who met at least the minimum physical activity recommendations showed a higher cardiac autonomic modulation, regardless of dextrose ingestion.
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Affiliation(s)
| | - Fabiula Isoton Novelli
- Physical Education Department, Graduate Program in Physical Education, Federal University of Mato Grosso, Cuiabá
- Medicine Department, Graduate Program in Sciences, University of São Paulo, São Paulo
| | | | - Marilene Gonçalves Queiroz
- Physical Education Department, Graduate Program in Health Sciences, Federal University of Mato Grosso, Cuiabá
| | | | - Lucieli Teresa Cambri
- Nutrition Department, Graduate Program in Nutrition, Foods and Metabolism
- Physical Education Department, Graduate Program in Physical Education, Federal University of Mato Grosso, Cuiabá
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4
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Kufe CN, Goedecke JH, Masemola M, Chikowore T, Soboyisi M, Smith A, Westgate K, Brage S, Micklesfield LK. Physical behaviors and their association with type 2 diabetes mellitus risk markers in urban South African middle-aged adults: an isotemporal substitutionapproach. BMJ Open Diabetes Res Care 2022; 10:e002815. [PMID: 35831028 PMCID: PMC9280902 DOI: 10.1136/bmjdrc-2022-002815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 06/21/2022] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION To examine the associations between physical behaviors and type 2 diabetes mellitus (T2DM) risk markers in middle-aged South African men and women. RESEARCH DESIGN AND METHODS This cross-sectional study included middle-aged men (n=403; age: median (IQR), 53.0 (47.8-58.8) years) and women (n=324; 53.4 (49.1-58.1) years) from Soweto, South Africa. Total movement volume (average movement in milli-g) and time (minutes/day) spent in different physical behaviors, including awake sitting/lying, standing, light intensity physical activity (LPA) and moderate-to-vigorous intensity physical activity (MVPA), were determined by combining the signals from two triaxial accelerometers worn simultaneously on the hip and thigh. All participants completed an oral glucose tolerance test, from which indicators of diabetes risk were derived. Associations between physical behaviors and T2DM risk were adjusted for sociodemographic factors and body composition. RESULTS Total movement volume was inversely associated with measures of fasting and 2-hour glucose and directly associated with insulin sensitivity, basal insulin clearance, and beta-cell function, but these associations were not independent of fat mass, except for basal insulin clearance in women. In men, replacing 30 min of sitting/lying, standing or LPA with the same amount of MVPA time was associated with 1.2-1.4 mmol/L lower fasting glucose and 12.3-13.4 mgl2/mUmin higher insulin sensitivity. In women, substituting sitting/lying with the same amount of standing time or LPA was associated with 0.5-0.8 mmol/L lower fasting glucose. Substituting 30 min sitting/lying with the same amount of standing time was also associated with 3.2 mgl2/mUmin higher insulin sensitivity, and substituting 30 min of sitting/lying, standing or LPA with the same amount of MVPA time was associated with 0.25-0.29 ng/mIU higher basal insulin clearance in women. CONCLUSION MVPA is important in reducing T2DM risk in men and women, but LPA appears to be important in women only. Longitudinal and intervention studies warranted to provide more specific PA recommendations.
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Affiliation(s)
- Clement N Kufe
- Department of Paediatrics, Faculty of Health Sciences University of the Witwatersrand, Johannesburg, Gauteng, South Africa
- Epidemiology and Surveillance Section, National Institute for Occupational Health (NIOH), National Health Laboratory Service (NHLS), Johannesburg, Gauteng, South Africa
| | - Julia H Goedecke
- Department of Paediatrics, Faculty of Health Sciences University of the Witwatersrand, Johannesburg, Gauteng, South Africa
- Non-communicable Disease Unit (NCDU), South African Medical Research Council (SAMRC), Tygerberg, South Africa
| | - Maphoko Masemola
- Department of Paediatrics, Faculty of Health Sciences University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Tinashe Chikowore
- Department of Paediatrics, Faculty of Health Sciences University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Melikhaya Soboyisi
- Department of Paediatrics, Faculty of Health Sciences University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Antonia Smith
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Kate Westgate
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Lisa K Micklesfield
- Department of Paediatrics, Faculty of Health Sciences University of the Witwatersrand, Johannesburg, Gauteng, South Africa
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Llavero-Valero M, Escalada-San Martín J, Martínez-González MA, Basterra-Gortari FJ, Gea A, Bes-Rastrollo M. Physical Activity Intensity and Type 2 Diabetes: Isotemporal Substitution Models in the "Seguimiento Universidad de Navarra" (SUN) Cohort. J Clin Med 2021; 10:jcm10132744. [PMID: 34206360 PMCID: PMC8267904 DOI: 10.3390/jcm10132744] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 06/07/2021] [Accepted: 06/17/2021] [Indexed: 11/24/2022] Open
Abstract
Which intensity of physical activity (PA) is associated with type 2 diabetes (T2D) prevention remains unclear. Isotemporal substitution models assess the relationship of replacing the amount of time spent in one activity for another. We aimed to assess T2D incidence associated with light-to-moderate physical activity (LMPA) and vigorous physical activity (VPA) using isotemporal substitution models of one hour (1 h) sitting by 1 h of LMPA or VPA. Furthermore, we evaluated the effect on T2D of an isotemporal substitution of 1 h sitting by 1 h of slow (light physical activity) or brisk–very brisk walking (moderate physical activity). In total, 20,060 participants (both sexes) of the SUN cohort (Spain) initially free of T2D followed-up during a median of 12 years were included. Cox regression models were fitted to assess the association between the substitution of 1 h LMPA, VPA, slow and brisk–very brisk pace by 1 h sitting and T2D. The replacement of 1 h sitting time by 1 h of VPA was associated with an adjusted HR of 0.52 (95% CI: 0.34–0.80), not observed for the substitution by 1 h of LMPA (HR 0.93; 95% CI: 0.73–1.20). An apparent inverse association was observed for the replacement of 1 h sitting time by 1 h of brisk/very brisk walking (HR: 0.69; 95% CI: 0.46–1.04), not observed by 1 h of slow pace. From equal conditions of duration and frequency of PA, the higher the intensity of PA, the greater the T2D prevention.
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Affiliation(s)
- María Llavero-Valero
- Department of Preventive Medicine and Public Health, University of Navarra, 31008 Pamplona, Spain; (M.L.-V.); (M.A.M.-G.); (F.J.B.-G.); (A.G.)
- Department of Endocrinology and Nutrition, University of Navarra, 31008 Pamplona, Spain;
| | - Javier Escalada-San Martín
- Department of Endocrinology and Nutrition, University of Navarra, 31008 Pamplona, Spain;
- Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain
- IDISNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
| | - Miguel A. Martínez-González
- Department of Preventive Medicine and Public Health, University of Navarra, 31008 Pamplona, Spain; (M.L.-V.); (M.A.M.-G.); (F.J.B.-G.); (A.G.)
- Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain
- IDISNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Francisco Javier Basterra-Gortari
- Department of Preventive Medicine and Public Health, University of Navarra, 31008 Pamplona, Spain; (M.L.-V.); (M.A.M.-G.); (F.J.B.-G.); (A.G.)
- IDISNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
- Department of Endocrinology and Nutrition, Complejo Hospitalario de Navarra, 31008 Pamplona, Spain
| | - Alfredo Gea
- Department of Preventive Medicine and Public Health, University of Navarra, 31008 Pamplona, Spain; (M.L.-V.); (M.A.M.-G.); (F.J.B.-G.); (A.G.)
- Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain
| | - Maira Bes-Rastrollo
- Department of Preventive Medicine and Public Health, University of Navarra, 31008 Pamplona, Spain; (M.L.-V.); (M.A.M.-G.); (F.J.B.-G.); (A.G.)
- Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain
- IDISNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
- Correspondence: ; Tel.: +34-948-425-600
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Alves JM, Angelo BC, Zink J, Chow T, Yunker AG, Clark K, Luo S, Belcher BR, Herting MM, Dieli-Conwright CM, Xiang AH, Page KA. Child physical activity as a modifier of the relationship between prenatal exposure to maternal overweight/obesity and neurocognitive outcomes in offspring. Int J Obes (Lond) 2021; 45:1310-1320. [PMID: 33731834 PMCID: PMC8164988 DOI: 10.1038/s41366-021-00794-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 01/04/2021] [Accepted: 02/11/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND/OBJECTIVES With rising obesity rates among pregnant women, more children are exposed in utero to maternal obesity. In prior epidemiological studies, exposure to maternal obesity was associated with lower intelligence quotient (IQ) scores and worse cognitive abilities in offspring. Further studies have shown that offspring exposed to maternal obesity, exhibit differences in the white matter microstructure properties, fractional anisotropy (FA) and mean diffusivity (MD). In contrast, physical activity was shown to improve cognition and white matter microstructure during childhood. We examined if child physical activity levels modify the relationship between prenatal exposure to maternal obesity with IQ and white matter microstructure in offspring. SUBJECTS/METHODS One hundred children (59% girls) age 7-11 years underwent brain magnetic resonance imaging and IQ testing. Maternal pre-pregnancy BMI was abstracted from electronic medical records. White matter was assessed using diffusion tensor imaging with the measures, global FA, MD. The 3-day physical activity recall was used to measure moderate-to-vigorous physical activity and vigorous physical activity (VPA). Linear regression was used to test for interactions between prenatal exposure to maternal overweight/obesity and child PA levels on child IQ and global FA/MD. RESULTS The relationship between prenatal exposure to maternal overweight/obesity and child IQ and global FA varied by child VPA levels. Children exposed to mothers with overweight/obesity who engaged in more VPA had higher IQ scores and global FA compared to exposed children who engaged in less VPA. Associations were independent of child age, sex, BMI Z-score and socioeconomic status. Children born to normal-weight mothers did not differ in either IQ or global FA by time in VPA. CONCLUSIONS Our findings support findings in rodent models and suggest that VPA during childhood modifies the relationship between prenatal exposure to maternal obesity and child IQ and white matter microstructure.
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Affiliation(s)
- Jasmin M Alves
- Division of Endocrinology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, USA
- Diabetes and Obesity Research Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, USA
| | - Brendan C Angelo
- Division of Endocrinology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, USA
- Diabetes and Obesity Research Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, USA
| | - Jennifer Zink
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, 90032, USA
| | - Ting Chow
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, 91101, USA
| | - Alexandra G Yunker
- Division of Endocrinology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, USA
- Diabetes and Obesity Research Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, USA
| | - Kristi Clark
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, USA
| | - Shan Luo
- Division of Endocrinology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, USA
- Diabetes and Obesity Research Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, USA
| | - Britni Ryan Belcher
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, 90032, USA
| | - Megan M Herting
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, 90032, USA
| | - Christina M Dieli-Conwright
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Institute, Harvard Medical School, Boston, MA, 02215, USA
| | - Anny H Xiang
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, 91101, USA
| | - Kathleen A Page
- Division of Endocrinology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, USA.
- Diabetes and Obesity Research Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, USA.
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7
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Oliveira CM, Ghezzi AC, Cambri LT. Higher blood glucose impairs cardiac autonomic modulation in fasting and after carbohydrate overload in adults. Appl Physiol Nutr Metab 2020; 46:221-228. [PMID: 32898425 DOI: 10.1139/apnm-2020-0473] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
This study aimed to assess whether the blood glucose levels influence cardiac autonomic modulation under fasting and after carbohydrate overload conditions. Participants (n = 108) were separated into lower blood glucose and higher blood glucose groups, based on the median (90.5 mg·dL-1) of fasting glucose assessed. The SD2, SDNN, LF indices, and LF/HF increased, and HF decreased after dextrose overload compared with fasting (p < 0.05). Body mass (78.9 vs 69.7 kg), abdominal circumference (90.2 vs 82.2 cm), systolic (113 vs 108 mm Hg) and diastolic (72 vs 67 mm Hg) blood pressure were higher (p < 0.05) in the higher blood glucose group. Heart rate variability (HRV) indices (SD1: 21.0 vs 26.5; SD2: 76.8: vs 86.1; RMSSD: 28.7 vs 37.5; SDNN: 56.1 vs 62.5 ms; pNN50: 10.6 vs 18.9%, HF: 328.4 vs 506.0; LF: 982.8 vs 1259.0 ms2), and the area under the curve of these indices after dextrose overload were lower in the higher blood glucose group (p < 0.05). Additionally, glycemia after dextrose overload was correlated with HRV indices (ρ = -0.216 to -0.273, p < 0.05). Individuals with higher blood glucose, even in the normality range, showed impairment in the cardiac autonomic modulation both at fasting and after carbohydrate overload. Novelty: Higher fasting blood glucose impairs cardiac autonomic modulation. Carbohydrate overload impairs cardiac autonomic modulation.
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Affiliation(s)
- Caroline Maria Oliveira
- Graduate Program in Nutrition, Foods and Metabolism, Federal University of Mato Grosso, Cuiabá, MT 78060-900, Brazil
| | - Ana Carolina Ghezzi
- Department of Pharmacology, State University of Campinas, Campinas, SP 13083-887, Brazil
| | - Lucieli Teresa Cambri
- Graduate Program in Nutrition, Foods and Metabolism, Federal University of Mato Grosso, Cuiabá, MT 78060-900, Brazil.,Graduate Program in Physical Education, Federal University of Mato Grosso, Cuiabá, MT 78060-900, Brazil
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Rowlands AV, Fairclough SJ, Yates T, Edwardson CL, Davies M, Munir F, Khunti K, Stiles VH. Activity Intensity, Volume, and Norms: Utility and Interpretation of Accelerometer Metrics. Med Sci Sports Exerc 2020; 51:2410-2422. [PMID: 31318713 DOI: 10.1249/mss.0000000000002047] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE The physical activity profile can be described from accelerometer data using two population-independent metrics: average acceleration (ACC, volume) and intensity gradient (IG, intensity). This article aims 1) to demonstrate how these metrics can be used to investigate the relative contributions of volume and intensity of physical activity for a range of health markers across data sets and 2) to illustrate the future potential of the metrics for generation of age and sex-specific percentile norms. METHODS Secondary data analyses were conducted on five diverse data sets using wrist-worn accelerometers (ActiGraph/GENEActiv/Axivity): children (n = 145), adolescent girls (n = 1669), office workers (n = 114), premenopausal (n = 1218) and postmenopausal (n = 1316) women, and adults with type 2 diabetes (n = 475). Open-source software (GGIR) was used to generate ACC and IG. Health markers were (a) zBMI (children), (b) %fat (adolescent girls and adults), (c) bone health (pre- and postmenopausal women), and (d) physical function (adults with type 2 diabetes). RESULTS Multiple regression analyses showed that IG, but not ACC, was independently associated with zBMI/%fat in children and adolescents. In adults, associations were stronger and the effects of ACC and IG were additive. For bone health and physical function, interactions showed associations were strongest if IG was high, largely irrespective of ACC. Exemplar illustrative percentile "norms" showed the expected age-related decline in physical activity, with greater drops in IG across age than ACC. CONCLUSION The ACC and the IG accelerometer metrics facilitate the investigation of whether volume and intensity of physical activity have independent, additive, or interactive effects on health markers. In future studies, the adoption of data-driven metrics would facilitate the generation of age- and sex-specific norms that would be beneficial to researchers.
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Affiliation(s)
- Alex V Rowlands
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UNITED KINGDOM.,NIHR Leicester Biomedical Research Centre, Leicester, UNITED KINGDOM.,Division of Health Sciences, Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research, University of South Australia, Adelaide, AUSTRALIA
| | - Stuart J Fairclough
- Movement Behaviours, Health, and Wellbeing Research Group, Department of Sport and Physical Activity, Edge Hill University, Ormskirk, UNITED KINGDOM
| | - Tom Yates
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UNITED KINGDOM.,NIHR Leicester Biomedical Research Centre, Leicester, UNITED KINGDOM
| | - Charlotte L Edwardson
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UNITED KINGDOM.,NIHR Leicester Biomedical Research Centre, Leicester, UNITED KINGDOM
| | - Melanie Davies
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UNITED KINGDOM.,NIHR Leicester Biomedical Research Centre, Leicester, UNITED KINGDOM
| | - Fehmidah Munir
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UNITED KINGDOM
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UNITED KINGDOM.,NIHR Leicester Biomedical Research Centre, Leicester, UNITED KINGDOM.,NIHR Collaboration for Leadership in Applied Health Research and Care East Midlands, Leicester General Hospital, UNITED KINGDOM
| | - Victoria H Stiles
- Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UNITED KINGDOM
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9
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Henson J, Edwardson CL, Davies MJ, Gill JMR, Heaney LM, Khunti K, Ng L, Sattar N, Zaccardi F, Yates T. Physical activity and lipidomics in a population at high risk of type 2 diabetes mellitus. J Sports Sci 2020; 38:1150-1160. [PMID: 32228122 DOI: 10.1080/02640414.2020.1744836] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The aim was to investigate how measurements of the lipidome differ according to the level and intensity of physical activity in a population at high risk of type 2 diabetes (T2DM). A targeted metabolomics platform provided quantitative molecular data on lipid species. Linear regression examined the associations between plasma lipid concentrations, particle size and time spent in objectively measured physical activity intensity domains, in increments of 500 counts per minute (cpm) (up to >4500 cpm (~>5.6METs)). Results are presented as % difference in the concentration (lower/higher) or particle size (smaller/larger) per 10 min of activity within each intensity. Five hundred and nine participants were included. Time spent in the lowest physical activity intensity domain (<500 cpm) was unfavourably associated with VLDL (2%), HDL (-2%) and Apolipoprotein A-1 particle concentrations (-2%) and HDL diameter (-2%). Conversely, time spent in intensities ≥1000 cpm were favourably associated with HDL subclass concentrations; with stronger associations seen at moderate intensities (2000-3999 cpm (~4.5METs)). For Apolipoprotein-B concentration and VLDL particle concentration and size, a negative association was consistently observed at the highest physical activity intensity only. If these associations are causal, HDL subclasses appear sensitive to light-intensities whereas only the high category of physical activity intensity was consistently associated with VLDL subclasses.
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Affiliation(s)
- Joseph Henson
- NIHR Leicester Biomedical Research Centre, UK and Diabetes Research Centre, College of Life Sciences, University of Leicester , Leicester, UK
| | - Charlotte L Edwardson
- NIHR Leicester Biomedical Research Centre, UK and Diabetes Research Centre, College of Life Sciences, University of Leicester , Leicester, UK
| | - Melanie J Davies
- NIHR Leicester Biomedical Research Centre, UK and Diabetes Research Centre, College of Life Sciences, University of Leicester , Leicester, UK
| | - Jason M R Gill
- Institute of Cardiovascular and Medical Sciences, University of Glasgow , Glasgow, UK
| | - Liam M Heaney
- School of Sport, Exercise and Health Sciences, Loughborough University , Loughborough, UK
| | - Kamlesh Khunti
- NIHR Applied Research Collaboration (ARC) East Midlands, UK and Diabetes Research Centre, College of Life Sciences, University of Leicester , Leicester, UK
| | - Leong Ng
- NIHR Leicester Biomedical Research Centre, UK and Department of Cardiovascular Sciences, University of Leicester , Leicester, UK
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow , Glasgow, UK
| | - Francesco Zaccardi
- NIHR Leicester Biomedical Research Centre, UK and Diabetes Research Centre, College of Life Sciences, University of Leicester , Leicester, UK
| | - Thomas Yates
- NIHR Leicester Biomedical Research Centre, UK and Diabetes Research Centre, College of Life Sciences, University of Leicester , Leicester, UK
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10
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Exercise training attenuates insulin resistance and improves β-cell function in patients with systemic autoimmune myopathies: a pilot study. Clin Rheumatol 2019; 38:3435-3442. [PMID: 31401791 DOI: 10.1007/s10067-019-04738-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 07/29/2019] [Accepted: 08/04/2019] [Indexed: 01/07/2023]
Abstract
INTRODUCTION/OBJECTIVES To assess the effects of exercise training on insulin resistance and β-cell function in patients with systemic autoimmune myopathies (SAMs). METHOD This quasi-experimental, prospective study includes 9 patients with SAMs (six with dermatomyositis, two with antisynthetase syndrome, and one with polymyositis). Patients were submitted to a 12-week, twice a week, exercise training program comprising aerobic and resistance exercises. Baseline and after the intervention, we evaluated disease status, aerobic capacity, muscle strength, body composition, insulin resistance, and β-cell function parameters. RESULTS The patients have a mean age of 46.7 years and stable disease. No clinical or laboratory parameter impairment was observed after the intervention. Compared with baseline, aerobic capacity, muscle strength, and function increased after 12 weeks (P < 0.05), while no changes were observed for body composition. Data from the oral glucose tolerance test showed that exercise did not change glucose area under the curve (AUC), whereas insulin and C-peptide AUC decreased significantly (P < 0.05). Furthermore, Matsuda index and HOMA2 percentage (both surrogates of insulin resistance) also improved (P < 0.05). CONCLUSION Exercise training improved aerobic capacity, muscle strength, and muscle function in patients with SAMs. In addition, exercise training led to an attenuation of insulin resistance and improvements in β-cell function parameters. These data indicate that exercise training can mitigate metabolic impairments, attenuating the cardiovascular risk in SAMs.Key Points• Exercise training improved aerobic capacity, muscle strength, and function without disease impairment• Exercise training was capable of improve insulin resistance and β-cell function in patients with SAM• These results suggest that exercise can mitigate metabolic impairments in patients with SAM, attenuating the cardiovascular risk.
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Abstract
This commentary highlights 23 noteworthy publications from 2018, selected by leading scientists in pediatric exercise science. These publications have been deemed as significant or exciting in the field as they (a) reveal a new mechanism, (b) highlight a new measurement tool, (c) discuss a new concept or interpretation/application of an existing concept, or (d) describe a new therapeutic approach or clinical tool in youth. In some cases, findings in adults are highlighted, as they may have important implications in youth. The selected publications span the field of pediatric exercise science, specifically focusing on: aerobic exercise and training; neuromuscular physiology, exercise, and training; endocrinology and exercise; resistance training; physical activity and bone strength; growth, maturation, and exercise; physical activity and cognition; childhood obesity, physical activity, and exercise; pulmonary physiology or diseases, exercise, and training; immunology and exercise; cardiovascular physiology and disease; and physical activity, inactivity, and health.
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Henson J, Edwardson CL, Bodicoat DH, Bakrania K, Davies MJ, Khunti K, Talbot DCS, Yates T. Reallocating sitting time to standing or stepping through isotemporal analysis: associations with markers of chronic low-grade inflammation. J Sports Sci 2017; 36:1586-1593. [PMID: 29157133 DOI: 10.1080/02640414.2017.1405709] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Although high levels of sitting time are adversely related to health, it is unclear whether moving from sitting to standing provides a sufficient stimulus to elicit benefits upon markers of chronic low-grade inflammation in a population at high risk of type 2 diabetes (T2DM). Three hundred and seventy two participants (age = 66.8 ± 7.5years; body mass index (BMI) = 31.7 ± 5.5kg/m2; Male = 61%) were included. Sitting, standing and stepping was determined using the activPAL3TM device. Linear regression modelling employing an isotemporal substitution approach was used to quantify the association of theoretically substituting 60 minutes of sitting per day for standing or stepping on interleukin-6 (IL-6), C-reactive protein (CRP) and leptin. Reallocating 60 minutes of sitting time per day for standing was associated with a -4% (95% CI -7%, -1%) reduction in IL-6 (p = 0.048). Reallocating 60 minutes of sitting time for light stepping was also associated with lower IL-6 levels (-28% (-46%, -4%; p = 0.025)). Substituting sitting for moderate-to-vigorous (MVPA) stepping was associated with lower CRP (-41% (-75%, -8%; p = 0.032)), leptin (-24% (-34%, -12%; p ≤ 0.001)) and IL-6 (-16% (-28%, 10%; p = 0.036). Theoretically replacing 60 minutes of sitting per day with an equal amount of either standing or stepping yields beneficial associations upon markers of chronic-low grade inflammation.
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Affiliation(s)
- Joseph Henson
- a Diabetes Research Centre , University of Leicester , Leicester , UK.,b NIHR Leicester Biomedical Research Centre , Leicester , UK
| | - Charlotte L Edwardson
- a Diabetes Research Centre , University of Leicester , Leicester , UK.,b NIHR Leicester Biomedical Research Centre , Leicester , UK
| | - Danielle H Bodicoat
- a Diabetes Research Centre , University of Leicester , Leicester , UK.,b NIHR Leicester Biomedical Research Centre , Leicester , UK.,c Diabetes Research Centre, NIHR Collaborations for Leadership in Applied Health Research and Care (CLAHRC) , East Midlands , UK
| | - Kishan Bakrania
- a Diabetes Research Centre , University of Leicester , Leicester , UK.,b NIHR Leicester Biomedical Research Centre , Leicester , UK.,c Diabetes Research Centre, NIHR Collaborations for Leadership in Applied Health Research and Care (CLAHRC) , East Midlands , UK
| | - Melanie J Davies
- a Diabetes Research Centre , University of Leicester , Leicester , UK.,b NIHR Leicester Biomedical Research Centre , Leicester , UK
| | - Kamlesh Khunti
- a Diabetes Research Centre , University of Leicester , Leicester , UK.,c Diabetes Research Centre, NIHR Collaborations for Leadership in Applied Health Research and Care (CLAHRC) , East Midlands , UK
| | | | - Thomas Yates
- a Diabetes Research Centre , University of Leicester , Leicester , UK.,b NIHR Leicester Biomedical Research Centre , Leicester , UK
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