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Gene Networks of Hyperglycemia, Diabetic Complications, and Human Proteins Targeted by SARS-CoV-2: What Is the Molecular Basis for Comorbidity? Int J Mol Sci 2022; 23:ijms23137247. [PMID: 35806251 PMCID: PMC9266766 DOI: 10.3390/ijms23137247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 06/25/2022] [Accepted: 06/27/2022] [Indexed: 12/10/2022] Open
Abstract
People with diabetes are more likely to have severe COVID-19 compared to the general population. Moreover, diabetes and COVID-19 demonstrate a certain parallelism in the mechanisms and organ damage. In this work, we applied bioinformatics analysis of associative molecular networks to identify key molecules and pathophysiological processes that determine SARS-CoV-2-induced disorders in patients with diabetes. Using text-mining-based approaches and ANDSystem as a bioinformatics tool, we reconstructed and matched networks related to hyperglycemia, diabetic complications, insulin resistance, and beta cell dysfunction with networks of SARS-CoV-2-targeted proteins. The latter included SARS-CoV-2 entry receptors (ACE2 and DPP4), SARS-CoV-2 entry associated proteases (TMPRSS2, CTSB, and CTSL), and 332 human intracellular proteins interacting with SARS-CoV-2. A number of genes/proteins targeted by SARS-CoV-2 (ACE2, BRD2, COMT, CTSB, CTSL, DNMT1, DPP4, ERP44, F2RL1, GDF15, GPX1, HDAC2, HMOX1, HYOU1, IDE, LOX, NUTF2, PCNT, PLAT, RAB10, RHOA, SCARB1, and SELENOS) were found in the networks of vascular diabetic complications and insulin resistance. According to the Gene Ontology enrichment analysis, the defined molecules are involved in the response to hypoxia, reactive oxygen species metabolism, immune and inflammatory response, regulation of angiogenesis, platelet degranulation, and other processes. The results expand the understanding of the molecular basis of diabetes and COVID-19 comorbidity.
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Freitas-Dias R, Lima TI, Costa-Junior JM, Gonçalves LM, Araujo HN, Paula FMM, Santos GJ, Branco RCS, Ou K, Kaestner KH, Silveira LR, Oliveira CAM, Boschero AC, Zoppi CC, Carneiro EM. Offspring from trained male mice inherit improved muscle mitochondrial function through PPAR co-repressor modulation. Life Sci 2021; 291:120239. [PMID: 34942163 DOI: 10.1016/j.lfs.2021.120239] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 12/03/2021] [Accepted: 12/11/2021] [Indexed: 10/19/2022]
Abstract
Aim Investigate whether inheritance of improved skeletal muscle mitochondrial function and its association with glycemic control are multigenerational benefits of exercise. MAIN METHODS Male Swiss mice were subjected to 8 weeks of endurance training and mated with untrained females. KEY FINDINGS Trained fathers displayed typical endurance training-induced adaptations. Remarkably, offspring from trained fathers also exhibited higher endurance performance, mitochondrial oxygen consumption, glucose tolerance and insulin sensitivity. However, PGC-1α expression was not increased in the offspring. In the offspring, the expression of the co-repressor NCoR1 was reduced, increasing activation of PGC-1α target genes. These effects correlated with higher DNA methylation at the NCoR1 promoter in both, the sperm of trained fathers and in the skeletal muscle of their offspring. SIGNIFICANCE Higher skeletal muscle mitochondrial function is inherited by epigenetic de-activation of a key PGC-1α co-repressor.
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Affiliation(s)
- Ricardo Freitas-Dias
- Obesity and Comorbidities Research Center (OCRC), Department of Functional and Structural Biology, Institute of Biology, University of Campinas (UNICAMP), Campinas, SP, Brazil; Department of Physical Therapy, Laboratory of Exercise Physiology, University of Pernambuco, Petrolina, PE, Brazil
| | - Tanes I Lima
- Obesity and Comorbidities Research Center (OCRC), Department of Functional and Structural Biology, Institute of Biology, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Jose Maria Costa-Junior
- Obesity and Comorbidities Research Center (OCRC), Department of Functional and Structural Biology, Institute of Biology, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Luciana M Gonçalves
- Obesity and Comorbidities Research Center (OCRC), Department of Functional and Structural Biology, Institute of Biology, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Hygor N Araujo
- Obesity and Comorbidities Research Center (OCRC), Department of Functional and Structural Biology, Institute of Biology, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Flavia M M Paula
- Obesity and Comorbidities Research Center (OCRC), Department of Functional and Structural Biology, Institute of Biology, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Gustavo J Santos
- Obesity and Comorbidities Research Center (OCRC), Department of Functional and Structural Biology, Institute of Biology, University of Campinas (UNICAMP), Campinas, SP, Brazil; Department of Physiological Sciences, Center of Biological Sciences, Federal University of Santa Catarina (UFSC), Florianopolis, SC, Brazil
| | - Renato Chaves Souto Branco
- Obesity and Comorbidities Research Center (OCRC), Department of Functional and Structural Biology, Institute of Biology, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Kristy Ou
- Department of Genetics and Institute for Diabetes, Obesity and Metabolism, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Klaus H Kaestner
- Department of Genetics and Institute for Diabetes, Obesity and Metabolism, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Leonardo R Silveira
- Obesity and Comorbidities Research Center (OCRC), Department of Functional and Structural Biology, Institute of Biology, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Camila A M Oliveira
- Department of Biosciences, Federal University of Sao Paulo, Santos, SP, Brazil
| | - Antonio C Boschero
- Obesity and Comorbidities Research Center (OCRC), Department of Functional and Structural Biology, Institute of Biology, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Claudio C Zoppi
- Obesity and Comorbidities Research Center (OCRC), Department of Functional and Structural Biology, Institute of Biology, University of Campinas (UNICAMP), Campinas, SP, Brazil.
| | - Everardo M Carneiro
- Obesity and Comorbidities Research Center (OCRC), Department of Functional and Structural Biology, Institute of Biology, University of Campinas (UNICAMP), Campinas, SP, Brazil.
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Ferreira SM, Costa-Júnior JM, Kurauti MA, Leite NC, Ortis F, Rezende LF, Barbosa HC, Boschero AC, Santos GJ. ARHGAP21 Acts as an Inhibitor of the Glucose-Stimulated Insulin Secretion Process. Front Endocrinol (Lausanne) 2020; 11:599165. [PMID: 33324349 PMCID: PMC7726208 DOI: 10.3389/fendo.2020.599165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 10/26/2020] [Indexed: 12/17/2022] Open
Abstract
ARHGAP21 is a RhoGAP protein implicated in the modulation of insulin secretion and energy metabolism. ARHGAP21 transient-inhibition increase glucose-stimulated insulin secretion (GSIS) in neonatal islets; however, ARHGAP21 heterozygote mice have a reduced insulin secretion. These discrepancies are not totally understood, and it might be related to functional maturation of beta cells and peripheral sensitivity. Here, we investigated the real ARHGAP21 role in the insulin secretion process using an adult mouse model of acute ARHGAP21 inhibition, induced by antisense. After ARHGAP21 knockdown induction by antisense injection in 60-day old male mice, we investigated glucose and insulin tolerance test, glucose-induced insulin secretion, glucose-induced intracellular calcium dynamics, and gene expression. Our results showed that ARHGAP21 acts negatively in the GSIS of adult islet. This effect seems to be due to the modulation of important points of insulin secretion process, such as the energy metabolism (PGC1α), Ca2+ signalization (SYTVII), granule-extrusion (SNAP25), and cell-cell interaction (CX36). Therefore, based on these finds, ARHGAP21 may be an important target in Diabetes Mellitus (DM) treatment.
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Affiliation(s)
- Sandra M. Ferreira
- Obestity and Comorbidities Research Center/Biology Institute, University State of Campinas (UNICAMP), Campinas, Brazil
| | - José M. Costa-Júnior
- Obestity and Comorbidities Research Center/Biology Institute, University State of Campinas (UNICAMP), Campinas, Brazil
| | - Mirian A. Kurauti
- Departament Physiological Sciences, University State of Maringá (UEM), Maringá, Brazil
| | - Nayara C. Leite
- Obestity and Comorbidities Research Center/Biology Institute, University State of Campinas (UNICAMP), Campinas, Brazil
| | - Fernanda Ortis
- Department of Cellular Biology and Development, Institute of Biomedical Sciences, University State of São Paulo (USP), São Paulo, Brazil
| | - Luiz F. Rezende
- Departament of Physiopathology, University State of Montes Claros (UNIMONTES), Montes Claros, Brazil
| | - Helena C. Barbosa
- Obestity and Comorbidities Research Center/Biology Institute, University State of Campinas (UNICAMP), Campinas, Brazil
| | - Antonio C. Boschero
- Obestity and Comorbidities Research Center/Biology Institute, University State of Campinas (UNICAMP), Campinas, Brazil
| | - Gustavo J. Santos
- Departament of Physiological Sciences, Center for Biological Sciences, University Federal of Santa Catarina (UFSC), Florianópolis, Brazil
- *Correspondence: Gustavo J. Santos,
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Asare-Bediako I, Paszkiewicz RL, Kim SP, Woolcott OO, Kolka CM, Burch M, Kabir M, Piccinini F, Bergman RN. Assessment of hepatic insulin extraction from in vivo surrogate methods of insulin clearance measurement. Am J Physiol Endocrinol Metab 2018; 315:E605-E612. [PMID: 29509434 PMCID: PMC6230713 DOI: 10.1152/ajpendo.00344.2017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Hyperinsulinemia, accompanied by reduced first-pass hepatic insulin extraction (FPE) and increased secretion, is a primary response to insulin resistance. Different in vivo methods are used to estimate the clearance of insulin, which is assumed to reflect FPE. We compared two methodologically different but commonly used indirect estimates with directly measured FPE in healthy dogs ( n = 9). The indirect methods were 1) metabolic clearance rate of insulin (MCR) during the hyperinsulinemic-euglycemic clamp (EGC), a steady-state method, and 2) fractional clearance rate of insulin (FCR) during the frequently sampled intravenous glucose tolerance test (FSIGT), a dynamic method. MCR was calculated as the ratio of insulin infusion rate to steady-state plasma insulin. FCR was calculated as the exponential decay rate constant of the injected insulin. Directly measured FPE is based on the difference in insulin measurements during intraportal vs. peripheral vein insulin infusions. We found a strong correlation between indirect FCR (min-1) and FPE (%). In contrast, we observed a poor association between MCR (ml·min-1·kg-1) and FPE (%). Our findings in canines suggest that FCR measured during FSIGT can be used to estimate FPE. However, MCR calculated during EGC appears to be a poor surrogate for FPE.
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Affiliation(s)
- Isaac Asare-Bediako
- Cedars-Sinai Diabetes and Obesity Research Institute , Los Angeles, California
| | | | - Stella P Kim
- Cedars-Sinai Diabetes and Obesity Research Institute , Los Angeles, California
| | - Orison O Woolcott
- Cedars-Sinai Diabetes and Obesity Research Institute , Los Angeles, California
| | - Cathryn M Kolka
- Cedars-Sinai Diabetes and Obesity Research Institute , Los Angeles, California
| | - Miguel Burch
- Cedars-Sinai Medical Center, Department of Surgery , Los Angeles, California
| | - Morvarid Kabir
- Cedars-Sinai Diabetes and Obesity Research Institute , Los Angeles, California
| | - Francesca Piccinini
- Cedars-Sinai Diabetes and Obesity Research Institute , Los Angeles, California
| | - Richard N Bergman
- Cedars-Sinai Diabetes and Obesity Research Institute , Los Angeles, California
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Lin X, Shi H, Cui Y, Wang X, Zhang J, Yu W, Wei M. Dendrobium mixture regulates hepatic gluconeogenesis in diabetic rats via the phosphoinositide-3-kinase/protein kinase B signaling pathway. Exp Ther Med 2018; 16:204-212. [PMID: 29896241 PMCID: PMC5995077 DOI: 10.3892/etm.2018.6194] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 01/22/2018] [Indexed: 01/07/2023] Open
Abstract
The present study aimed to evaluate the impact of dendrobium mixture (DMix) on the gene and protein expression of insulin signaling pathway-associated factors in the livers of diabetic rats. The molecular mechanisms by which DMix inhibits gluconeogenesis were also investigated. A total of 47 female Wistar rats were used in the present study. Of these, 11 rats were randomly selected as healthy controls and diabetes was induced in the remaining 36 rats by administering a high-fat and high-sugar diet for 6 weeks, followed by two intraperitoneal injections of streptozotocin. The 36 rats were screened for diabetes and then randomly divided into three groups: Model, metformin and DMix groups. Following 12 weeks of treatment, the fasting blood glucose (FBG), glycosylated serum protein (GSP), serum insulin, blood lipids [total cholesterol (Tch) and triglycerides (TG)], alanine transaminase (ALT) and aspartate transaminase (AST) were assessed. In addition, hematoxylin and eosin staining was used for histomorphological examination of the liver tissues. The mRNA expression of insulin receptor (InsR), forkhead box protein O1 (FoxO1), phosphoenolpyruvate carboxykinase (PEPCK) and glucose 6-phosphatase (G6Pase) in the liver was measured with reverse transcription-quantitative polymerase chain reaction and the protein expression of InsR, phosphoinositide-3-kinase (PI3K), phosphorylated (p)-PI3K, protein kinase B (Akt), p-Akt, FoxO1, PEPCK and G6Pase in the liver was measured by western blot analysis. The FBG, GSP, InsR, Tch, TG, ALT and AST levels were significantly lower in the DMix-treated group compared with the model group (P<0.05). In addition, DMix treatment notably improved liver histopathology and significantly increased the gene and protein expression of InsR, PI3K and Akt (P<0.05). DMix treatment also significantly reduced the gene and protein expression of FoxO1, PEPCK and G6Pase (P<0.05). DMix effectively reduced FBG and blood lipids and significantly improved liver function and insulin resistance in diabetic rats, possibly by regulating the gene and protein expression of molecules associated with the PI3K/Akt signaling pathway.
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Affiliation(s)
- Xinjun Lin
- Institute of Integrated Chinese and Western Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Hong Shi
- Institute of Integrated Chinese and Western Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Yi Cui
- Department of Ophthalmology, Fujian Medical University Union Hospital, Fuzhou, Fujian 350001, P.R. China
| | - Xiaoning Wang
- Institute of Integrated Chinese and Western Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Jieping Zhang
- Institute of Integrated Chinese and Western Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Wenzhen Yu
- Institute of Integrated Chinese and Western Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Min Wei
- Institute of Integrated Chinese and Western Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
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Acute Exercise Improves Insulin Clearance and Increases the Expression of Insulin-Degrading Enzyme in the Liver and Skeletal Muscle of Swiss Mice. PLoS One 2016; 11:e0160239. [PMID: 27467214 PMCID: PMC4965115 DOI: 10.1371/journal.pone.0160239] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 07/15/2016] [Indexed: 11/19/2022] Open
Abstract
The effects of exercise on insulin clearance and IDE expression are not yet fully elucidated. Here, we have explored the effect of acute exercise on insulin clearance and IDE expression in lean mice. Male Swiss mice were subjected to a single bout of exercise on a speed/angle controlled treadmill for 3-h at approximately 60-70% of maximum oxygen consumption. As expected, acute exercise reduced glycemia and insulinemia, and increased insulin tolerance. The activity of AMPK-ACC, but not of IR-Akt, pathway was increased in the liver and skeletal muscle of trained mice. In an apparent contrast to the reduced insulinemia, glucose-stimulated insulin secretion was increased in isolated islets of these mice. However, insulin clearance was increased after acute exercise and was accompanied by increased expression of the insulin-degrading enzyme (IDE), in the liver and skeletal muscle. Finally, C2C12, but not HEPG2 cells, incubated at different concentrations of 5-aminoimidazole-4-carboxamide-1-β-d-ribofuranoside (AICAR) for 3-h, showed increased expression of IDE. In conclusion, acute exercise increases insulin clearance, probably due to an augmentation of IDE expression in the liver and skeletal muscle. The elevated IDE expression, in the skeletal muscle, seems to be mediated by activation of AMPK-ACC pathway, in response to exercise. We believe that the increase in the IDE expression, comprise a safety measure to maintain glycemia at or close to physiological levels, turning physical exercise more effective and safe.
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Kurauti MA, Costa-Júnior JM, Ferreira SM, Dos Santos GJ, Protzek AOP, Nardelli TR, de Rezende LF, Boschero AC. Acute exercise restores insulin clearance in diet-induced obese mice. J Endocrinol 2016; 229:221-32. [PMID: 27000684 DOI: 10.1530/joe-15-0483] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 03/21/2016] [Indexed: 01/19/2023]
Abstract
The aim of this study was to investigate the insulin clearance in diet-induced obese (DIO) mice submitted to acute endurance exercise (3h of treadmill exercise at 60-70% VO2max). Glucose-stimulated insulin secretion in isolated islets; ipGTT; ipITT; ipPTT; in vivo insulin clearance; protein expression in liver, skeletal muscle, and adipose tissue (insulin degrading enzyme (IDE), insulin receptor subunitβ(IRβ), phospho-Akt (p-Akt) and phospho-AMPK (p-AMPK)), and the activity of IDE in the liver and skeletal muscle were accessed. In DIO mice, acute exercise reduced fasting glycemia and insulinemia, improved glucose and insulin tolerance, reduced hepatic glucose production, and increased p-Akt protein levels in liver and skeletal muscle and p-AMPK protein levels in skeletal muscle. In addition, insulin secretion was reduced, whereas insulin clearance and the expression of IDE and IRβ were increased in liver and skeletal muscle. Finally, IDE activity was increased only in skeletal muscle. In conclusion, we propose that the increased insulin clearance and IDE expression and activity, primarily, in skeletal muscle, constitute an additional mechanism, whereby physical exercise reduces insulinemia in DIO mice.
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Affiliation(s)
- Mirian A Kurauti
- Department of Structural and Functional BiologyInstitute of Biology, State University of Campinas (UNICAMP), Campinas, Brazil
| | - José M Costa-Júnior
- Department of Structural and Functional BiologyInstitute of Biology, State University of Campinas (UNICAMP), Campinas, Brazil
| | - Sandra M Ferreira
- Department of Structural and Functional BiologyInstitute of Biology, State University of Campinas (UNICAMP), Campinas, Brazil
| | - Gustavo J Dos Santos
- Department of Structural and Functional BiologyInstitute of Biology, State University of Campinas (UNICAMP), Campinas, Brazil
| | - André O P Protzek
- Department of Structural and Functional BiologyInstitute of Biology, State University of Campinas (UNICAMP), Campinas, Brazil
| | - Tarlliza R Nardelli
- Department of Structural and Functional BiologyInstitute of Biology, State University of Campinas (UNICAMP), Campinas, Brazil
| | - Luiz F de Rezende
- Department of Structural and Functional BiologyInstitute of Biology, State University of Campinas (UNICAMP), Campinas, Brazil
| | - Antonio C Boschero
- Department of Structural and Functional BiologyInstitute of Biology, State University of Campinas (UNICAMP), Campinas, Brazil
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Cho K, Song Y, Kwon D. Conjugated linoleic acid supplementation enhances insulin sensitivity and peroxisome proliferator-activated receptor gamma and glucose transporter type 4 protein expression in the skeletal muscles of rats during endurance exercise. IRANIAN JOURNAL OF BASIC MEDICAL SCIENCES 2016; 19:20-7. [PMID: 27096060 PMCID: PMC4823612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVES This study examined whether conjugated linoleic acid (CLA) supplementation affects insulin sensitivity and peroxisome proliferator-activated receptor gamma (PPAR-γ) and glucose transporter type 4 (GLUT-4) protein expressions in the skeletal muscles of rats during endurance exercise. MATERIALS AND METHODS Sprague-Dawley male rats were randomly divided into HS (high-fat diet (HFD) sedentary group, n = 8), CS (1.0% CLA supplemented HFD sedentary group, n = 8), and CE (1.0% CLA supplemented HFD exercise group, n = 8). The rats in the CE swam for 60 min a day, 5 days a week for 8 weeks. RESULTS The serum glucose and insulin contents and homeostasis model assessment of insulin resistance (HOMA-IR) value of the CS and CE were significantly decreased compared to those of the HS. The PPAR-γ protein expressions in the soleus muscle (SOM) and extensor digitorum longus muscle (EDL) were significantly higher in the CE than in the HS. In addition, the PPAR-γ protein expression in the SOM of the CS was significantly higher than that in the HS. On the other hand, the GLUT-4 protein expression of the SOM in the CE was significantly higher compared to that in the HS. However, there was no significant difference in GLUT-4 protein expression in the EDL among the groups. CONCLUSION CLA supplementation with/without endurance exercise has role in improvement of insulin sensitivity. Moreover, when CLA supplementation was accompanied by endurance exercise, the PPAR-γ protein expression in SOM and EDL and the GLUT-4 protein expression in SOM were enhanced compared with the control group.
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Affiliation(s)
- Kangok Cho
- Institute of Sports Health Science, Sunmoon University, Asan city, Chung Nam, 380-701, S. Korea
| | - Youngju Song
- Institute of Sports Health Science, Sunmoon University, Asan city, Chung Nam, 380-701, S. Korea
| | - Daekeun Kwon
- Institute of Sports Health Science, Sunmoon University, Asan city, Chung Nam, 380-701, S. Korea,Corresponding author: Daekeun Kwon. Institute of Sports Health Science, Sunmoon University, Asan city, Chung Nam, 380-701, S. Korea. Tel: +82-41-530-2239; Fax: +82-41-530-2810;
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