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Martínez-Ezquerro JD, Ortiz-Ramírez M, García-delaTorre P, González-Covarrubias V, Sánchez-García S. Physical Performance and Telomere Length in Older Adults. Arch Med Res 2024; 55:103046. [PMID: 39013263 DOI: 10.1016/j.arcmed.2024.103046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 06/19/2024] [Accepted: 07/05/2024] [Indexed: 07/18/2024]
Abstract
BACKGROUND The aging population prompts studying risk factors and markers to predict healthy aging. Telomere length is a promising candidate for assessing various age-related traits. AIM OF THE STUDY To investigate the association between physical performance and telomere length. METHODS We enrolled 323 older Mexican adults from the "Cohort of Obesity, Sarcopenia, and Frailty of Older Mexican Adults" affiliated with the Instituto Mexicano del Seguro Social and assessed their physical performance using the Short Physical Performance Battery, dividing participants into low (≤7) and high (>7) groups. Absolute telomere length was determined by qPCR, and individuals were classified into short (≤4.22 kb) and long (>4.22 kb) groups. We calculated the mean and adjusted mean, considering sex and age, among others, with 95% CI. We estimated the effect size between physical performance and telomere length using Cohen's d for unequal group sizes and calculated the odds ratio for physical performance based on telomere length. RESULTS Participants with low physical performance had significantly shorter telomeres (mean 4.14.44.7 kb, adjusted mean 3.54.04.5 kb, p <0.001), while those with high physical performance exhibited longer telomeres (mean 5.55.75.9 kb, adjusted mean 4.75.35.8 kb, p <0.001), with a medium-to-high telomere length effect size (d = 0.762). The odds of low physical activity increased 2.13.66.1-fold per kb of telomere attrition (adjOR 1.73.36.3, p <0.001). CONCLUSION Decreased physical function is associated with shorter telomere length. Absolute telomere length presents a promising biomarker for distinguishing between healthy and unhealthy aging, warranting further investigation.
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Affiliation(s)
- José Darío Martínez-Ezquerro
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Área Envejecimiento, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico; Posgrado en Ciencias Biológicas, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Mauricio Ortiz-Ramírez
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Área Envejecimiento, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Paola García-delaTorre
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Área Envejecimiento, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | | | - Sergio Sánchez-García
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Área Envejecimiento, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
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Jena D, Sahoo J, Barman A, Behera KK, Bhattacharjee S, Kumar S. Type 2 diabetes mellitus, physical activity, and neuromusculoskeletal complications. J Neurosci Rural Pract 2022; 13:705-710. [PMID: 36743753 PMCID: PMC9893944 DOI: 10.25259/jnrp_11_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 09/12/2022] [Indexed: 12/04/2022] Open
Abstract
Objectives The objectives of the study were to investigate the neuromusculoskeletal complications of Type 2 diabetes mellitus (T2DM) and their associated factors, including the level of physical activity (PA) and clinicodemographic characteristics. Materials and Methods In this cross-sectional analysis, we included 370 participants diagnosed with T2DM for no <1 year who satisfied the inclusion and exclusion criteria. Demographic and clinical characteristics were noted and a thorough clinical examination was performed on all the participants. International PA Questionnaire-Short Form was used to evaluate the level of PA of the participants. The continuous data is presented as mean ± SD and the categorical data is presented as the number of participants (n) and percentage (%). A logistic regression model was used to investigate the predictors for the prevalence of the complications. Results The mean duration of T2DM was 7.32 ± 5.53 years and the mean hemoglobin A1C (HbA1c) level (%) was 8.16±1.67. A majority of the participants were having uncontrolled diabetes with an HbA1c level ≥7.5% (n = 190; 51.35%). The level of PA was low in a substantial proportion of the participants (n = 276; 74.59%). A total of 162 (43.78%) participants were diagnosed with neuromusculoskeletal complications. Low back pain was the most common complication and degenerative disk disease was the most common diagnosis overall. Longer duration of diabetes, poor glycemic control, and low PA were associated with the prevalence of neuromusculoskeletal complications (P < 0.05). Conclusion Neuromusculoskeletal complications of T2DM are common and can result in significant disability in this population. Low PA is very common among T2DM patients and an important contributor to the development of complications. Health-care providers should consider PA an integral component of the management protocol for T2DM patients.
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Affiliation(s)
- Debasish Jena
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Bhubaneswar Odisha, India
| | - Jagannatha Sahoo
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Bhubaneswar Odisha, India
| | - Apurba Barman
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Bhubaneswar Odisha, India
| | - Kishore Kumar Behera
- Department of Endocrinology, All India Institute of Medical Sciences, Bhubaneswar Odisha, India
| | - Souvik Bhattacharjee
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Bhubaneswar Odisha, India
| | - Sanyal Kumar
- Department of Physical Medicine and Rehabilitation, ESIC Medical College and Hospital, Patna, Bihar, India
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Subrata SA. Holistic care of patients with diabetic foot ulcers during the COVID-19 era: integration of Henderson's Need Theory. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2022; 31:S38-S49. [PMID: 35980928 DOI: 10.12968/bjon.2022.31.15.s38] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The COVID-19 pandemic has inhibited the practice of diabetic foot ulcer care, particularly in the community. Comprehensive theory-based nursing care is needed to prevent further complications. Unfortunately, a study combining theory with nursing care in diabetic foot ulcer care has not been explored. When caring for patients with diabetic foot ulcers, who are also at increased risk of severe complications from COVID-19, it is important to take a holistic view of the patient and consider all of their needs and the factors affecting them. Henderson's Need Theory and the 14 basic needs contained within it was chosen to be integrated in the care of patients with diabetic foot ulcers during the pandemic, with the hope that the findings will help nurses to optimise care in both hospital-based and community practice.
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Affiliation(s)
- Sumarno Adi Subrata
- Nursing Lecturer, Center of Research and Community Empowerment (LPPM)/Wound Study Center (WOSCE), Universitas Muhammadiyah Magelang, Indonesia
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The influence of physical activity level on the length of stay in hospital in older men survivors of COVID-19. SPORT SCIENCES FOR HEALTH 2022; 18:1483-1490. [PMID: 35730029 PMCID: PMC9187887 DOI: 10.1007/s11332-022-00948-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 04/06/2022] [Indexed: 12/15/2022]
Abstract
The purpose of this study was to verify the influence of physical activity level on the length of hospital stay in older men recovered from COVID-19. In total, 126 older men diagnosed with COVID-19 were admitted to the hospital between September and December 2020. Among them, 70 survived, of which 39 older men were included in the study. Within 30 days after discharge, patients answered the International Physical Activity Questionnaire to measure their physical activity level through phone contact, with questions corresponding to the week before symptom onset. Clinical and laboratorial data from admission, days between onset of symptoms and admission, length of stay, computed tomography abnormalities, and the need for the intensive care unit were collected. The groups (active × sedentary) were compared using the Student t test or Mann-Whitney test for quantitative data and chi-square test was used for categorical data. There is no difference between the groups in characteristics of admission (p > 0.05), except by potassium level. Active older men had a shorter length of stay (6.50 ± 3.46 vs 11.48 ± 7.63 days; p = 0.03), disease duration (15.71 ± 4.84 vs 21.09 ± 7.69 days; p = 0.02), and lower frequency of lung damage when compared to their sedentary counterparts. In conclusion, being physically active prior to infection can attenuate length of hospital stay in older men with COVID-19.
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Fuji S, Cheng J, Yakushijin K, Wanitpongpun C. Nutritional support in allogeneic hematopoietic stem cell transplantation Asian perspective. BLOOD CELL THERAPY 2022; 5:54-60. [PMID: 36710949 PMCID: PMC9870687 DOI: 10.31547/bct-2021-024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 01/01/2022] [Indexed: 02/01/2023]
Abstract
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an integral part of the treatment strategy for patients with malignant or non-malignant hematological diseases. Clinical outcomes of patients undergoing allo-HSCT have significantly improved in recent decades. However, transplant-related morbidity and mortality remain major issues for allo-HSCT recipients. With regard to nutrition, patients undergoing allo-HSCT are at high risk for malnutrition. It is expected that clinical practice concerning nutritional support in allo-HSCT has been improving in recent decades; however, no data directly support this expectation. One major issue in managing nutritional support during allo-HSCT is the lack of large-scale randomized prospective studies, which leads to a lack of well-established strategies. Accordingly, we need to gather data from studies in non-HSCT and allo-HSCT settings. In some Asia-Pacific countries, a physician's lack of knowledge of nutritional support may impede the application of nutritional support practices recommended by existing guidelines. Another barrier may be the lack of access to an adequately qualified or trained registered dietitian (RD) at allo-HSCT units. Adequate training in the nutritional management of allo-HSCT patients should be provided to all RDs working with HSCT. Herein, we summarize the information on nutritional support in allo-HSCT, focusing on an Asian perspective.
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Affiliation(s)
- Shigeo Fuji
- Department of Hematology, Osaka International Cancer Institute, Osaka, Japan,Nutrition Support WG, Asia-Pacific Blood and Marrow Transplantation group
| | - Jessica Cheng
- Nutrition Support WG, Asia-Pacific Blood and Marrow Transplantation group,Bone Marrow Transplant & Haematology, St Vincent's Public Hospital Sydney, Sydney, Australia
| | - Kimikazu Yakushijin
- Nutrition Support WG, Asia-Pacific Blood and Marrow Transplantation group,Department of Medical Oncology and Hematology, Kobe University Hospital, Kobe, Japan
| | - Chinadol Wanitpongpun
- Nutrition Support WG, Asia-Pacific Blood and Marrow Transplantation group,Hematology Unit, Department of Internal Medicine, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand
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Diesel M, Heberle I, Juchem G, de Barcelos GT, Cavestré Coneglian J, Gerage AM, Delevatti RS. Blood Pressure and Blood Glucose Responses to Combined Exercise Sessions of Different Intensities in Individuals with Cardiovascular Risk Factors. Clin Exp Hypertens 2022; 44:436-441. [PMID: 35420926 DOI: 10.1080/10641963.2022.2065289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE The purpose of the present study was to verify the acute effects of blood pressure and blood glucose after two sessions of combined exercise sessions performed at two levels of intensity in trained individuals with cardiovascular risk factors. METHODS Eighteen individuals (66.22 ± 8.61 years) of both sexes (6 women/12 men) with cardiovascular risk factors performed two sessions of combined exercises at different levels of intensity: moderate (MOD) and high (HI). To control the intensity of the aerobic training, the Borg Rating of Perceived Exertion (RPE) Scale was used. For the strength training, the maximum number of repetitions was carried out within a predetermined duration of sets. Blood pressure and blood glucose measurements were collected before and 20 minutes after the sessions. The data were analyzed using Generalized Estimating Equations, α 5%. RESULTS Reductions were observed in systolic blood pressure (MOD - Δ = -4.95 mmHg; HI - Δ = -3.31 mmHg) and blood glucose (MOD - Δ = -16.06 mg/dL; HI - Δ = -29.45 mg/dL) after the two sessions, with no difference between sessions. Diastolic blood pressure did not change (p < .05). CONCLUSION Combined exercises sessions of moderate or high intensity can promote an acute reduction in systolic blood pressure and glycemia in individuals with cardiovascular risk factors.
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Affiliation(s)
- Mabel Diesel
- Grupo de Pesquisa em Exercício Clínico (GPEC), Centro de Desportos (CDS), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
| | - Isabel Heberle
- Grupo de Pesquisa em Exercício Clínico (GPEC), Centro de Desportos (CDS), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
| | - Gabriel Juchem
- Grupo de Pesquisa em Exercício Clínico (GPEC), Centro de Desportos (CDS), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
| | - Guilherme Tadeu de Barcelos
- Grupo de Pesquisa em Exercício Clínico (GPEC), Centro de Desportos (CDS), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
| | - Juliana Cavestré Coneglian
- Grupo de Pesquisa em Exercício Clínico (GPEC), Centro de Desportos (CDS), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
| | - Aline Mendes Gerage
- Grupo de Pesquisa em Exercício Clínico (GPEC), Centro de Desportos (CDS), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
| | - Rodrigo Sudatti Delevatti
- Grupo de Pesquisa em Exercício Clínico (GPEC), Centro de Desportos (CDS), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
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Beyond the Calorie Paradigm: Taking into Account in Practice the Balance of Fat and Carbohydrate Oxidation during Exercise? Nutrients 2022; 14:nu14081605. [PMID: 35458167 PMCID: PMC9027421 DOI: 10.3390/nu14081605] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 04/07/2022] [Accepted: 04/08/2022] [Indexed: 02/04/2023] Open
Abstract
Recent literature shows that exercise is not simply a way to generate a calorie deficit as an add-on to restrictive diets but exerts powerful additional biological effects via its impact on mitochondrial function, the release of chemical messengers induced by muscular activity, and its ability to reverse epigenetic alterations. This review aims to summarize the current literature dealing with the hypothesis that some of these effects of exercise unexplained by an energy deficit are related to the balance of substrates used as fuel by the exercising muscle. This balance of substrates can be measured with reliable techniques, which provide information about metabolic disturbances associated with sedentarity and obesity, as well as adaptations of fuel metabolism in trained individuals. The exercise intensity that elicits maximal oxidation of lipids, termed LIPOXmax, FATOXmax, or FATmax, provides a marker of the mitochondrial ability to oxidize fatty acids and predicts how much fat will be oxidized over 45–60 min of low- to moderate-intensity training performed at the corresponding intensity. LIPOXmax is a reproducible parameter that can be modified by many physiological and lifestyle influences (exercise, diet, gender, age, hormones such as catecholamines, and the growth hormone-Insulin-like growth factor I axis). Individuals told to select an exercise intensity to maintain for 45 min or more spontaneously select a level close to this intensity. There is increasing evidence that training targeted at this level is efficient for reducing fat mass, sparing muscle mass, increasing the ability to oxidize lipids during exercise, lowering blood pressure and low-grade inflammation, improving insulin secretion and insulin sensitivity, reducing blood glucose and HbA1c in type 2 diabetes, and decreasing the circulating cholesterol level. Training protocols based on this concept are easy to implement and accept in very sedentary patients and have shown an unexpected efficacy over the long term. They also represent a useful add-on to bariatric surgery in order to maintain and improve its weight-lowering effect. Additional studies are required to confirm and more precisely analyze the determinants of LIPOXmax and the long-term effects of training at this level on body composition, metabolism, and health.
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Chen Y, Su J, Qin Y, Luo P, Shen C, Pan E, Lu Y, Miao D, Zhang N, Zhou J, Yu X, Wu M. Fresh fruit consumption, physical activity, and five-year risk of mortality among patients with type 2 diabetes: A prospective follow-up study. Nutr Metab Cardiovasc Dis 2022; 32:878-888. [PMID: 35078677 DOI: 10.1016/j.numecd.2021.10.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 10/19/2021] [Accepted: 10/27/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND AND AIMS We explored the associations among fruit consumption, physical activity, and their dose-response relationship with all-cause and cardiovascular disease (CVD) mortality in type 2 diabetic patients. METHODS AND RESULTS We prospectively followed 20,340 community-dwelling type 2 diabetic patients aged 21-94 years. Information on diets and physical activity was collected using standardized questionnaires. All-cause and CVD mortality were assessed. Hazard ratios (HRs) for all-cause mortality were estimated with Cox regression models, and HRs for CVD mortality were derived from a competing risk model. Restricted cubic spline regression was used to analyze dose-response relationships. We identified 1362 deaths during 79,844 person-years. Compared to non-consumption, fruit consumption >42.9 g/d was inversely associated with all-cause mortality (HR 0.76; 95% CI 0.64-0.88), CVD mortality (HR 0.69, 0.51-0.94) and stroke mortality (HR 0.57, 0.36-0.89), but not with heart disease mortality (HR 0.93, 0.56-1.52). The HRs comparing the top vs bottom physical activity quartiles were 0.44 (0.37-0.53) for all-cause mortality, 0.46 (0.33-0.64) for CVD mortality, 0.46 (0.29-0.74) for stroke mortality and 0.51 (0.29-0.88) for heart disease mortality. Lower fruit consumption combined with a lower physical activity level was associated with a greater mortality risk. A nonlinear threshold of 80 g fruit/day was identified; all-cause mortality risk was reduced by approximately 24% at this value. A physical activity threshold of eight metabolic equivalents (MET) h/day was also identified, after which the risk of mortality did not decrease. CONCLUSIONS Fruit consumption and physical activity may reduce all-cause, CVD, and stroke mortality in type 2 diabetic patients.
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Affiliation(s)
- Yijia Chen
- Department of Non-communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing, 210003, China
| | - Jian Su
- Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China
| | - Yu Qin
- Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China
| | - Pengfei Luo
- Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China
| | - Chong Shen
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Enchun Pan
- Department of Chronic Disease Prevention and Control, Huai'an City Center for Disease Control and Prevention, Huai'an, 223001, China
| | - Yan Lu
- Department of Chronic Disease Prevention and Control, Suzhou City Center for Disease Control and Prevention, Suzhou, 215003, China
| | - Dandan Miao
- Department of Chronic Disease Prevention and Control, Huai'an City Center for Disease Control and Prevention, Huai'an, 223001, China
| | - Ning Zhang
- Changshu County Center for Disease Control and Prevention, Suzhou, 215500, China
| | - Jinyi Zhou
- Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China
| | - Xiaojin Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing, 210009, China
| | - Ming Wu
- Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China.
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Pellinger TK, Emhoff CAW. Skeletal Muscle Hyperemia: A Potential Bridge Between Post-exercise Hypotension and Glucose Regulation. Front Physiol 2022; 12:821919. [PMID: 35173625 PMCID: PMC8841576 DOI: 10.3389/fphys.2021.821919] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 12/28/2021] [Indexed: 11/16/2022] Open
Abstract
For both healthy individuals and patients with type 2 diabetes (T2D), the hemodynamic response to regular physical activity is important for regulating blood glucose, protecting vascular function, and reducing the risk of cardiovascular disease. In addition to these benefits of regular physical activity, evidence suggests even a single bout of dynamic exercise promotes increased insulin-mediated glucose uptake and insulin sensitivity during the acute recovery period. Importantly, post-exercise hypotension (PEH), which is defined as a sustained reduction in arterial pressure following a single bout of exercise, appears to be blunted in those with T2D compared to their non-diabetic counterparts. In this short review, we describe research that suggests the sustained post-exercise vasodilation often observed in PEH may sub-serve glycemic regulation following exercise in both healthy individuals and those with T2D. Furthermore, we discuss the interplay of enhanced perfusion, both macrovascular and microvascular, and glucose flux following exercise. Finally, we propose future research directions to enhance our understanding of the relationship between post-exercise hemodynamics and glucose regulation in healthy individuals and in those with T2D.
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Affiliation(s)
- Thomas K. Pellinger
- Department of Physical Therapy, University of Maryland Eastern Shore, Princess Anne, MD, United States
- *Correspondence: Thomas K. Pellinger,
| | - Chi-An W. Emhoff
- Department of Kinesiology, Saint Mary’s College of California, Moraga, CA, United States
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Deng MG, Cui HT, Lan YB, Nie JQ, Liang YH, Chai C. Physical activity, sedentary behavior, and the risk of type 2 diabetes: A two-sample Mendelian Randomization analysis in the European population. Front Endocrinol (Lausanne) 2022; 13:964132. [PMID: 36407298 PMCID: PMC9670309 DOI: 10.3389/fendo.2022.964132] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022] Open
Abstract
Physical activity (PA) and sedentary behaviors (SB) have been linked to the risk of type 2 diabetes (T2DM) in observational studies; however, it is unclear whether these associations are causative or confounded. This study intends to use summary genetic data from the UK Biobank and other consortiums in conjunction with the two-sample Mendelian Randomization (MR) approach to solve this problem. The inverse variance weighted (IVW) technique was utilized as the primary analysis, with sensitivity analyses using the MR-Egger, weighted-median, and MR-Pleiotropy RESidual Sum and Outlier (PRESSO) techniques. Inverse associations between self-reported moderate PA (OR: 0.3096, 95% CI: 0.1782-0.5380) and vigorous PA (OR: 0.2747, 95% CI: 0.1390-0.5428) with T2DM risk were found, respectively. However, accelerometer-based PA measurement (average acceleration) was not associated with T2DM risk (OR: 1.0284, 95% CI: 0.9831-1.0758). The time (hours/day) spent watching TV was associated with T2DM risk (OR: 2.3490, 95% CI: 1.9084-2.8915), while the time (hours/day) spent using the computer (OR: 0.8496, 95% CI: 0.7178-1.0056), and driving (OR: 3.0679, 95% CI: 0.8448-11.1415) were not associated with T2DM risk. The sensitivity analysis revealed relationships of a similar magnitude. Our study revealed that more PA and less TV viewing were related to a decreased T2DM risk, and provided genetic support for a causal relationship between PA, TV viewing, and T2DM risk.
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Affiliation(s)
| | - Han-Tao Cui
- School of Public Health, Wuhan University, Wuhan, China
| | - Yong-Bing Lan
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Jia-Qi Nie
- School of Public Health, Wuhan University, Wuhan, China
| | - Yue-Hui Liang
- School of Public Health, Wuhan University, Wuhan, China
| | - Chen Chai
- Emergency Center, Hubei Clinical Research Center for Emergency and Resuscitation, Zhongnan Hospital of Wuhan University, Wuhan, China
- *Correspondence: Chen Chai,
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Hacke C, Schreiber J, Weisser B. Application of the Templates TIDieR and CERT Reveal Incomplete Reporting and Poor Replicability of Exercise Interventions for Type 2 Diabetes Mellitus. Curr Diabetes Rev 2022; 18:e250821195838. [PMID: 34433402 DOI: 10.2174/1871525719666210825150957] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/16/2021] [Accepted: 07/16/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Exercise is strongly recommended for the management of type 2 diabetes mellitus (T2DM). However, incomplete intervention reporting in clinical trials limits the replication of exercise protocols. As previously demonstrated by us for exercise and hypertension, the reporting quality might also be insufficient in studies with respect to T2DM and exercise. OBJECTIVE The aim of the study was to assess the completeness of exercise intervention reporting in randomized controlled trials (RCTs) for T2DM. METHODS Two independent reviewers applied the Consensus on Exercise Reporting Template (CERT) and the template for intervention description and replication (TIDieR) to 23 exercise trials obtained from the most recent and frequently cited meta-analysis in current guidelines. The completeness of reporting was evaluated, focusing on the F.I.T.T. components (frequency, intensity, time, type). Interrater agreement and associations with publication year and journal impact factor were examined. RESULTS Mean CERT score was 11/19 (range 5-17), and 8/12 (range 4-12) for TIDieR. F.I.T.T. components were almost completely described, whereas overall completeness of exercise reporting was 60% and 68% (CERT and TIDieR). Replication of each exercise of the respective program was not possible in 52% of interventions. The majority of items had shown excellent agreement. No associations with publication year or impact factor were found. CONCLUSION Exercise interventions were not found to be sufficiently reported in RCTs that currently guide clinical practice in T2DM. Replication in further studies or clinical practice is limited due to poor exercise description. We suggest the use of more specific CERT for reporting results of exercise interventions. Further refinement for internal diseases is needed to better describe exercise interventions.
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Affiliation(s)
- Claudia Hacke
- Department of Sports Medicine, Institute of Sports Science, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Janika Schreiber
- Department of Sports Medicine, Institute of Sports Science, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Burkhard Weisser
- Department of Sports Medicine, Institute of Sports Science, Christian-Albrechts-University Kiel, Kiel, Germany
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Janssen JAMJL. Hyperinsulinemia and Its Pivotal Role in Aging, Obesity, Type 2 Diabetes, Cardiovascular Disease and Cancer. Int J Mol Sci 2021; 22:ijms22157797. [PMID: 34360563 PMCID: PMC8345990 DOI: 10.3390/ijms22157797] [Citation(s) in RCA: 73] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/11/2021] [Accepted: 07/13/2021] [Indexed: 01/10/2023] Open
Abstract
For many years, the dogma has been that insulin resistance precedes the development of hyperinsulinemia. However, recent data suggest a reverse order and place hyperinsulinemia mechanistically upstream of insulin resistance. Genetic background, consumption of the “modern” Western diet and over-nutrition may increase insulin secretion, decrease insulin pulses and/or reduce hepatic insulin clearance, thereby causing hyperinsulinemia. Hyperinsulinemia disturbs the balance of the insulin–GH–IGF axis and shifts the insulin : GH ratio towards insulin and away from GH. This insulin–GH shift promotes energy storage and lipid synthesis and hinders lipid breakdown, resulting in obesity due to higher fat accumulation and lower energy expenditure. Hyperinsulinemia is an important etiological factor in the development of metabolic syndrome, type 2 diabetes, cardiovascular disease, cancer and premature mortality. It has been further hypothesized that nutritionally driven insulin exposure controls the rate of mammalian aging. Interventions that normalize/reduce plasma insulin concentrations might play a key role in the prevention and treatment of age-related decline, obesity, type 2 diabetes, cardiovascular disease and cancer. Caloric restriction, increasing hepatic insulin clearance and maximizing insulin sensitivity are at present the three main strategies available for managing hyperinsulinemia. This may slow down age-related physiological decline and prevent age-related diseases. Drugs that reduce insulin (hyper) secretion, normalize pulsatile insulin secretion and/or increase hepatic insulin clearance may also have the potential to prevent or delay the progression of hyperinsulinemia-mediated diseases. Future research should focus on new strategies to minimize hyperinsulinemia at an early stage, aiming at successfully preventing and treating hyperinsulinemia-mediated diseases.
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Affiliation(s)
- Joseph A M J L Janssen
- Department of internal Medicine, Division of Endocrinology, Erasmus Medical Center, 40, 3015 GD Rotterdam, The Netherlands
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Li Y, Li R, Li X, Liu L, Zhu J, Li D. Effects of different aerobic exercise training on glycemia in patients with type 2 diabetes: A protocol for systematic review and meta analysis. Medicine (Baltimore) 2021; 100:e25615. [PMID: 33950940 PMCID: PMC8104194 DOI: 10.1097/md.0000000000025615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 04/04/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Type 2 diabetes is an emergent worldwide health crisis, and rates are growing globally. Aerobic exercise is an essential measure for patients with diabetes, which has the advantages of flexible time and low cost. Aerobic exercise is a popular method to reduce blood glucose. Due to the lack of randomized trials to compare the effects of various aerobic exercises, it is difficult to judge the relative efficacy. Therefore, we intend to conduct a network meta-analysis to evaluate these aerobic exercises. METHODS According to the retrieval strategies, randomized controlled trials on different aerobic exercise training will be obtained from China National Knowledge Infrastructure, WanFang, SinoMed, PubMed, Web of Science, EMBASE, and Cochrane Library, regardless of publication date or language. Studies were screened based on inclusion and exclusion criteria, and the Cochrane risk bias assessment tool will be used to evaluate the quality of the literature. The network meta-analysis will be performed in Markov Chain Monte Carlo method and carried out with Stata14 and OpenBUGS software. Ultimately, the evidentiary grade for the results will be evaluated. RESULTS Eighteen literatures with a total of 1134 patients were included for the meta-analysis. In glycemia assessment, Tennis (standard mean difference = 3.59, credible interval 1.52, 5.65), had significantly better effects than the named control group. Tennis (standard mean difference = 3.50, credible interval 1.05, 5.59), had significantly better effects than the named Taiji group. CONCLUSION All together, these results suggest that tennis may be the best way to improve blood glucose in patients with type 2 diabetes. This study may provide an excellent resource for future control glycemia and may also serve as a springboard for creative undertakings as yet unknown.
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Affiliation(s)
- Ying Li
- Intensive Care Unit, The Second Affiliated Hospital of Nanchang University, Nanchang City, Jiangxi Province, Nanchang
| | - Runmin Li
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan
| | - Xianhuang Li
- School of Nursing, Nanchang University, Jiangxi, People's Republic of China
| | - Liping Liu
- School of Nursing, Nanchang University, Jiangxi, People's Republic of China
| | - Jianting Zhu
- School of Nursing, Nanchang University, Jiangxi, People's Republic of China
| | - Dongying Li
- Intensive Care Unit, The Second Affiliated Hospital of Nanchang University, Nanchang City, Jiangxi Province, Nanchang
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