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Aberdeen GW, Babischkin JS, Pepe GJ, Albrecht ED. Estrogen stimulates fetal vascular endothelial growth factor expression and microvascularization. J Endocrinol 2024; 262:e230364. [PMID: 38738915 PMCID: PMC11227038 DOI: 10.1530/joe-23-0364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 05/12/2024] [Indexed: 05/14/2024]
Abstract
We recently showed that the ratio of capillaries to myofibers in skeletal muscle, which accounts for 80% of insulin-directed glucose uptake and metabolism, was reduced in baboon fetuses in which estrogen was suppressed by maternal letrozole administration. Since vascular endothelial growth factor (VEGF) promotes angiogenesis, the present study determined the impact of estrogen deprivation on fetal skeletal muscle VEGF expression, capillary development, and long-term vascular and metabolic function in 4- to 8-year-old adult offspring. Maternal baboons were untreated or treated with letrozole or letrozole plus estradiol on days 100-164 of gestation (term = 184 days). Skeletal muscle VEGF protein expression was suppressed by 45% (P < 0.05) and correlated (P = 0.01) with a 47% reduction (P < 0.05) in the number of capillaries per myofiber area in fetuses of baboons in which serum estradiol levels were suppressed 95% (P < 0.01) by letrozole administration. The reduction in fetal skeletal muscle microvascularization was associated with a 52% decline (P = 0.02) in acetylcholine-induced brachial artery dilation and a 23% increase (P = 0.01) in mean arterial blood pressure in adult progeny of letrozole-treated baboons, which was restored to normal by letrozole plus estradiol. The present study indicates that estrogen upregulates skeletal muscle VEGF expression and systemic microvessel development within the fetus as an essential programming event critical for ontogenesis of systemic vascular function and insulin sensitivity/glucose homeostasis after birth in primate offspring.
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Affiliation(s)
- Graham W Aberdeen
- Departments of Obstetrics, Gynecology, Reproductive Sciences and Physiology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Jeffery S Babischkin
- Departments of Obstetrics, Gynecology, Reproductive Sciences and Physiology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Gerald J Pepe
- Department of Physiological Sciences, Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - Eugene D Albrecht
- Departments of Obstetrics, Gynecology, Reproductive Sciences and Physiology, University of Maryland School of Medicine, Baltimore, Maryland, USA
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2
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Evans WS, Pena GS, Gelman B, Kuzmiak-Glancy S, Prior SJ. Unilateral hindlimb ischaemia-induced systemic inflammation is associated with non-ischaemic skeletal muscle inflammation. Exp Physiol 2024. [PMID: 38888281 DOI: 10.1113/ep091901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 06/04/2024] [Indexed: 06/20/2024]
Abstract
Skeletal muscle atrophy and dysfunction commonly accompany cardiovascular diseases such as peripheral arterial disease and may be partially attributable to systemic inflammation. We sought to determine whether acute systemic inflammation in a model of hindlimb ischaemia (HLI) could affect skeletal muscle macrophage infiltration, fibre size, or capillarization, independent of the ischaemia. Eight-week-old C57BL/6 male mice underwent either Sham or HLI surgery, and were killed 1, 3, or 7 days post-surgery. Circulating inflammatory cytokine concentrations were measured, as well as immune cell infiltration and morphology of skeletal muscle from both limbs of HLI and Sham mice. In HLI compared with Sham mice at day 1, plasma interleukin-1β levels were 216% higher (0.48 ± 0.10 vs. 0.15 ± 0.01 pg/μL, P = 0.005) and decreased by day 3. This was followed by increased macrophage presence in muscle from both ischaemic and non-ischaemic limbs of HLI mice by day 7 (7.3- and 2.3-fold greater than Sham, respectively, P < 0.0001). In HLI mice, muscle from the ischaemic limb had 21% lower fibre cross-sectional area than the non-ischaemic limb (724 ± 28 vs. 916 ± 46 μm2, P = 0.01), but the non-ischaemic limb of HLI mice was no different from Sham. This shows that HLI induces acute systemic inflammation accompanied by immune infiltration in both ischaemic and remote skeletal muscle; however, this did not induce skeletal muscle atrophy in remote muscle within the 7-day time course of this study. This effect of local skeletal muscle ischaemia on the inflammatory status of remote skeletal muscle may signal a priming of muscle for subsequent atrophy over a longer time course. HIGHLIGHTS: What is the central question of this study? Does hindlimb ischaemia-induced inflammation cause acute immune, inflammatory and morphological alterations in remote non-ischaemic skeletal muscle? What is the main finding and its importance? Hindlimb ischaemia induced systemic inflammation with subsequent neutrophil and macrophage infiltration in both ischaemic and non-ischaemic skeletal muscle; however, morphological changes did not occur in non-ischaemic muscle within 7 days. These immune alterations may have functional implications that take longer than 7 days to manifest, and subsequent or prolonged systemic inflammation and immune infiltration of muscle could lead to morphological changes and functional decline.
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Affiliation(s)
- William S Evans
- Department of Kinesiology, University of Maryland School of Public Health, College Park, Maryland, USA
| | - Gabriel S Pena
- Department of Kinesiology, University of Maryland School of Public Health, College Park, Maryland, USA
| | - Beata Gelman
- Department of Kinesiology, University of Maryland School of Public Health, College Park, Maryland, USA
| | - Sarah Kuzmiak-Glancy
- Department of Kinesiology, University of Maryland School of Public Health, College Park, Maryland, USA
| | - Steven J Prior
- Department of Kinesiology, University of Maryland School of Public Health, College Park, Maryland, USA
- Baltimore Veterans Affairs Geriatric Research, Education and Clinical Center and Research and Development Service, Baltimore, Maryland, USA
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3
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Noone J, Mucinski JM, DeLany JP, Sparks LM, Goodpaster BH. Understanding the variation in exercise responses to guide personalized physical activity prescriptions. Cell Metab 2024; 36:702-724. [PMID: 38262420 DOI: 10.1016/j.cmet.2023.12.025] [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: 10/25/2023] [Revised: 12/11/2023] [Accepted: 12/20/2023] [Indexed: 01/25/2024]
Abstract
Understanding the factors that contribute to exercise response variation is the first step in achieving the goal of developing personalized exercise prescriptions. This review discusses the key molecular and other mechanistic factors, both extrinsic and intrinsic, that influence exercise responses and health outcomes. Extrinsic characteristics include the timing and dose of exercise, circadian rhythms, sleep habits, dietary interactions, and medication use, whereas intrinsic factors such as sex, age, hormonal status, race/ethnicity, and genetics are also integral. The molecular transducers of exercise (i.e., genomic/epigenomic, proteomic/post-translational, transcriptomic, metabolic/metabolomic, and lipidomic elements) are considered with respect to variability in physiological and health outcomes. Finally, this review highlights the current challenges that impede our ability to develop effective personalized exercise prescriptions. The Molecular Transducers of Physical Activity Consortium (MoTrPAC) aims to fill significant gaps in the understanding of exercise response variability, yet further investigations are needed to address additional health outcomes across all populations.
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Affiliation(s)
- John Noone
- Translational Research Institute, AdventHealth, Orlando, FL 32804, USA
| | | | - James P DeLany
- Translational Research Institute, AdventHealth, Orlando, FL 32804, USA
| | - Lauren M Sparks
- Translational Research Institute, AdventHealth, Orlando, FL 32804, USA
| | - Bret H Goodpaster
- Translational Research Institute, AdventHealth, Orlando, FL 32804, USA.
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Soares RN, Lessard SJ. Low Response to Aerobic Training in Metabolic Disease: Role of Skeletal Muscle. Exerc Sport Sci Rev 2024; 52:47-53. [PMID: 38112622 PMCID: PMC10963145 DOI: 10.1249/jes.0000000000000331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
Aerobic exercise is established to increase cardiorespiratory fitness (CRF), which is linked to reduced morbidity and mortality. However, people with metabolic diseases such as type 1 and type 2 diabetes may be more likely to display blunted improvements in CRF with training. Here, we present evidence supporting the hypothesis that altered skeletal muscle signaling and remodeling may contribute to low CRF with metabolic disease.
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Ashcroft SP, Stocks B, Egan B, Zierath JR. Exercise induces tissue-specific adaptations to enhance cardiometabolic health. Cell Metab 2024; 36:278-300. [PMID: 38183980 DOI: 10.1016/j.cmet.2023.12.008] [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: 07/06/2023] [Revised: 10/06/2023] [Accepted: 12/05/2023] [Indexed: 01/08/2024]
Abstract
The risk associated with multiple cancers, cardiovascular disease, diabetes, and all-cause mortality is decreased in individuals who meet the current recommendations for physical activity. Therefore, regular exercise remains a cornerstone in the prevention and treatment of non-communicable diseases. An acute bout of exercise results in the coordinated interaction between multiple tissues to meet the increased energy demand of exercise. Over time, the associated metabolic stress of each individual exercise bout provides the basis for long-term adaptations across tissues, including the cardiovascular system, skeletal muscle, adipose tissue, liver, pancreas, gut, and brain. Therefore, regular exercise is associated with a plethora of benefits throughout the whole body, including improved cardiorespiratory fitness, physical function, and glycemic control. Overall, we summarize the exercise-induced adaptations that occur within multiple tissues and how they converge to ultimately improve cardiometabolic health.
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Affiliation(s)
- Stephen P Ashcroft
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ben Stocks
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Brendan Egan
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Juleen R Zierath
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Integrative Physiology, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden; Integrative Physiology, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
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Ji LL, Fretwell VS, Escamilla A, Yao W, Zhang T, He M, Zhang JQ. An acute exercise at low to moderate intensity attenuated postprandial lipemia and insulin responses. J Exerc Sci Fit 2024; 22:14-22. [PMID: 38021207 PMCID: PMC10663685 DOI: 10.1016/j.jesf.2023.10.006] [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: 04/06/2023] [Revised: 10/30/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023] Open
Abstract
Objective The purpose of this study was to investigate the effects of different exercise intensities on postprandial lipemia (PHTG) and insulin resistance in healthy individuals. Methods Participants were 10 adult males with normal fasting triglyceride (TG) concentrations (age = 34 ± 2.8 y, body mass = 72.9 ± 2.4 kg, fasting plasma TG = 1.36 ± 0.18 mmol/l, VO2max = 43.7 ± 3.0 ml/kg/min, fasting glucose = 5.2 ± 0.2 mmol/l and fasting Homeostatic Model Assessment for Insulin Resistance (HOMA2-IR) = 1.7 ± 0.3). In this study, each participant performed a control trial (Ctr, no exercise), and 3 exercise trials at 40 % (40%T), 60 % (60%T), and 70 % (70%T) of their VO2max. In the exercise trials, participant jogged on a treadmill for 1 h at a designated intensity. A fat-rich meal was consumed by each participant 12 h after exercise. Blood samples were taken at 0 h (before the meal), and 2 h, 4 h, 6 h, 8 h, and 24 h after the meal. The plasma TG, area score under TG concentration curve over an 8 h-period (TG tAUC) after the meal, and HOMA2-IR were analyzed. Results Our results showed that at 2 h, 4 h, and 6 h after the meal, TG in all exercise trials were lower than Ctr (p < 0.05) but did not differ from each other. All the exercise trials were lower in TG tAUC scores than Ctr (p < 0.02), but differences were not observed among the exercise trials. In comparison to Ctr, a significant difference in HOMA2-IR in both 60 % T and 70 % T (p < 0.05 and p < 0.01, respectively) was observed, but not in 40 % T. Conclusion The results suggest that exercising at low to moderate exercise intensity for 1 h sufficiently attenuates a fat meal induced PHTG. Moderate exercise intensity also effectively mitigates insulin resistance.
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Affiliation(s)
- Lisa L. Ji
- Department of Kinesiology, The University of Texas at San Antonio, USA
| | - Vicki S. Fretwell
- Department of Kinesiology, The University of Texas at San Antonio, USA
| | - Abel Escamilla
- Department of Kinesiology, The University of Texas at San Antonio, USA
| | - Wanxiang Yao
- Department of Kinesiology, The University of Texas at San Antonio, USA
| | - Tianou Zhang
- Department of Kinesiology, The University of Texas at San Antonio, USA
| | - Meizi He
- Department of Public Health, The University of Texas at San Antonio, USA
| | - John Q. Zhang
- Department of Kinesiology, The University of Texas at San Antonio, USA
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Balasekaran G, Mayo M, Ng YC. Effects of large exercise-induced weight loss on insulin sensitivity and metabolic risk factors in young males with obesity. J Sports Med Phys Fitness 2023; 63:1075-1083. [PMID: 37382410 DOI: 10.23736/s0022-4707.23.14846-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
BACKGROUND Obesity around the world is increasing at an alarming rate. One of the issues with obesity is whether exercise with large energy expenditure have any effect on obesity risk factors such as insulin resistance and coronary heart diseases. METHODS Twenty participants (mean age: 19.5±1.09 years) with Body Mass Index (BMI) of >30 kg/m2, and body fat percentage (BF%) of >25% completed an institutionalized regimented training (IRT) for 16 weeks. 12-hour fasting blood samples were collected at least 48 hours after the last exercise session. Glucose and insulin variables were determined through an oral glucose tolerance test. Participants underwent 446 hours of IRT and ate from four standardized meal menus per day with a caloric intake of 3066 kcal. RESULTS IRT resulted in a significant weight loss of 13.48±1.97 kg. Pre- and Post-Training total cholesterol (4.80±0.92 vs. 4.12±0.82 mmol/L) (P<0.01), low-density lipoprotein cholesterol (3.04±0.83 vs. 2.51±0.74 mmol/L) (P<0.01), triglycerides (1.19±0.57 vs. 0.74±0.30 mmol/L) (P<0.01) and apolipoprotein levels (Apo-A: 133.30±13.10 vs. 120.40±14.54 mg/dL; Apo-B: 88.08±25.72 vs. 70.12±18.21 mg/dL) (P<0.01) were significantly reduced, and glucose tolerance and insulin sensitivity were also improved. CONCLUSIONS Large exercise-induced weight loss can be achieved through IRT and may be a solution for weight loss for individuals with obesity to reduce obesity related complications.
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Affiliation(s)
- Govindasamy Balasekaran
- Human Bioenergetics Laboratory, Section of Physical Education and Sports Science, National Institute of Education, Nanyang Technological University, Singapore, Singapore -
| | - Melissa Mayo
- Human Bioenergetics Laboratory, Section of Physical Education and Sports Science, National Institute of Education, Nanyang Technological University, Singapore, Singapore
| | - Yew C Ng
- Human Bioenergetics Laboratory, Section of Physical Education and Sports Science, National Institute of Education, Nanyang Technological University, Singapore, Singapore
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Luo X, Wang Z, Li B, Zhang X, Li X. Effect of resistance vs. aerobic exercise in pre-diabetes: an RCT. Trials 2023; 24:110. [PMID: 36788568 PMCID: PMC9930288 DOI: 10.1186/s13063-023-07116-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 01/28/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND This study aimed to assess the different impacts of aerobic and resistance exercise intervention on pre-diabetes and its possible influencing factor (obesity) to identify which exercise intervention mode was better for pre-diabetes to control their blood glucose levels. METHODS Single-blind randomized controlled trial. Participants were recruited from Southwest Hospital between February 2016 and May 2017 and randomly divided into three groups using stratified randomization: aerobic exercise (A), resistance exercise (R), and control (C). The effects of each group were analyzed, and the relationship with obesity was investigated following a 12-week intervention. RESULTS Eighty participants were enrolled (9 were lost, and 1 was excluded). Finally, 26 participants were included in group A, 23 in group R, and 21 in group C. In groups A and R, FPG, OGTT 2-h PG, and HOMA2-IR decreased by 6.17% (P = 0.001) and 4.81% (P = 0.019), 20.39% (P < 0.001) and 16.50% (P < 0.001), and 8.34% (P = 0.026) and 18.31% (P = 0.001, superior to that in group A), respectively (all P < 0.001 compared with group C, with no significant differences between groups A and R). The ratio of reversal to euglycemia was 69.2% (P = 0.003 compared with group C) in group A and 43.5% (P = 0.213 compared with group C) in group R. The decreased ratio of GSP in group R was greater (65.2%, P = 0.008 compared with group C) compared with group A (38.5%, P = 0.355 compared with group C). Decreases in the parameters BMI (3.1 ± 3.2% P < 0.001, moderately positive correlation with the decreased FPG level, r = 0.498, P = 0.010, two-tailed) and waist circumference (3.1 ± 2.7% P < 0.001) were noted in group A, but no significant correlations were noted between other indicators in group R. CONCLUSIONS Both resistance and aerobic exercise can control and reverse IGR. Compared with aerobic exercise, resistance exercise may be superior in terms of GSP and IR improvement. Aerobic exercise decreases blood glucose levels through weight loss. However, the effect of resistance exercise might not be mediated via weight loss and obesity control. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR2000038304. Registered on September 17, 2020.
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Affiliation(s)
- Xijuan Luo
- grid.12981.330000 0001 2360 039XDepartment of Sports, Sun Yat-sen University, Guangzhou, 510275 China
| | | | - Bowen Li
- grid.443516.10000 0004 1804 2444School of Sports and Health, Nanjing Sport Institute, Nanjing, 210014 China
| | - Xianbo Zhang
- grid.506261.60000 0001 0706 7839Department of Endocrinology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 100730 China
| | - Xin Li
- grid.443344.00000 0001 0492 8867Center of Academic Journals, Chengdu Sport University, Chengdu, 610041 China
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Ross M, Kargl CK, Ferguson R, Gavin TP, Hellsten Y. Exercise-induced skeletal muscle angiogenesis: impact of age, sex, angiocrines and cellular mediators. Eur J Appl Physiol 2023:10.1007/s00421-022-05128-6. [PMID: 36715739 DOI: 10.1007/s00421-022-05128-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 12/25/2022] [Indexed: 01/31/2023]
Abstract
Exercise-induced skeletal muscle angiogenesis is a well-known physiological adaptation that occurs in humans in response to exercise training and can lead to endurance performance benefits, as well as improvements in cardiovascular and skeletal tissue health. An increase in capillary density in skeletal muscle improves diffusive oxygen exchange and waste extraction, and thus greater fatigue resistance, which has application to athletes but also to the general population. Exercise-induced angiogenesis can significantly contribute to improvements in cardiovascular and metabolic health, such as the increase in muscle glucose uptake, important for the prevention of diabetes. Recently, our understanding of the mechanisms by which angiogenesis occurs with exercise has grown substantially. This review will detail the biochemical, cellular and biomechanical signals for exercise-induced skeletal muscle angiogenesis, including recent work on extracellular vesicles and circulating angiogenic cells. In addition, the influence of age, sex, exercise intensity/duration, as well as recent observations with the use of blood flow restricted exercise, will also be discussed in detail. This review will provide academics and practitioners with mechanistic and applied evidence for optimising training interventions to promote physical performance through manipulating capillarisation in skeletal muscle.
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Affiliation(s)
- Mark Ross
- School of Energy, Geoscience, Infrastructure and Society, Heriot-Watt University, Edinburgh, Scotland, UK.
| | - Christopher K Kargl
- Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, USA.,Department of Health and Kinesiology, Max E. Wastl Human Performance Laboratory, Purdue University, West Lafayette, USA
| | - Richard Ferguson
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Timothy P Gavin
- Department of Health and Kinesiology, Max E. Wastl Human Performance Laboratory, Purdue University, West Lafayette, USA
| | - Ylva Hellsten
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
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Tucker WJ, Fegers-Wustrow I, Halle M, Haykowsky MJ, Chung EH, Kovacic JC. Exercise for Primary and Secondary Prevention of Cardiovascular Disease: JACC Focus Seminar 1/4. J Am Coll Cardiol 2022; 80:1091-1106. [PMID: 36075680 DOI: 10.1016/j.jacc.2022.07.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 07/01/2022] [Accepted: 07/11/2022] [Indexed: 01/09/2023]
Abstract
Regular exercise that meets or exceeds the current physical activity guidelines is associated with a reduced risk of cardiovascular disease (CVD) and mortality. Therefore, exercise training plays an important role in primary and secondary prevention of CVD. In this part 1 of a 4-part focus seminar series, we highlight the mechanisms and physiological adaptations responsible for the cardioprotective effects of exercise. This includes an increase in cardiorespiratory fitness secondary to cardiac, vascular, and skeletal muscle adaptations and an improvement in traditional and nontraditional CVD risk factors by exercise training. This extends to the role of exercise and its prescription in patients with CVDs (eg, coronary artery disease, chronic heart failure, peripheral artery disease, or atrial fibrillation) with special focus on the optimal mode, dosage, duration, and intensity of exercise to reduce CVD risk and improve clinical outcomes in these patients.
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Affiliation(s)
- Wesley J Tucker
- Department of Nutrition and Food Sciences, Texas Woman's University, Houston, Texas, USA; Institute for Women's Health, College of Health Sciences, Houston, Texas, USA
| | - Isabel Fegers-Wustrow
- Department of Prevention and Sports Medicine, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany
| | - Martin Halle
- Department of Prevention and Sports Medicine, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.
| | - Mark J Haykowsky
- College of Health Sciences, Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Eugene H Chung
- Cardiac Electrophysiology Service, Sports Cardiology Clinic, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Jason C Kovacic
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Victor Chang Cardiac Research Institute, Darlinghurst, New South Wales, Australia; St Vincent's Clinical School, University of New South Wales, Sydney, New South Wales, Australia.
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11
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Albrecht ED, Aberdeen GW, Babischkin JS, Prior SJ, Lynch TJ, Baranyk IA, Pepe GJ. Estrogen Promotes Microvascularization in the Fetus and Thus Vascular Function and Insulin Sensitivity in Offspring. Endocrinology 2022; 163:6553898. [PMID: 35325097 PMCID: PMC9272192 DOI: 10.1210/endocr/bqac037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Indexed: 11/19/2022]
Abstract
We have shown that normal weight offspring born to estrogen-deprived baboons exhibited insulin resistance, although liver and adipose function and insulin receptor and glucose transporter expression were unaltered. The blood microvessels have an important role in insulin action by delivering insulin and glucose to target cells. Although little is known about the regulation of microvessel development during fetal life, estrogen promotes capillary proliferation and vascular function in the adult. Therefore, we tested the hypothesis that estrogen promotes fetal microvessel development and thus vascular function and insulin sensitivity in offspring. Capillary/myofiber ratio was decreased 75% (P < 0.05) in skeletal muscle, a major insulin target tissue, of fetal baboons in which estradiol levels were depleted by administration of aromatase inhibitor letrozole. This was sustained after birth, resulting in a 50% reduction (P < 0.01) in microvessel expansion; 65% decrease (P < 0.01) in arterial flow-mediated dilation, indicative of vascular endothelial dysfunction; and 35% increase (P < 0.01) in blood pressure in offspring from estrogen-deprived baboons, changes prevented by letrozole and estradiol administration. Along with vascular dysfunction, peak insulin and glucose levels during a glucose tolerance test were greater (P < 0.05 to P < 0.01) and the homeostasis model of insulin resistance 2-fold higher (P < 0.01) in offspring of letrozole-treated than untreated animals, indicative of insulin resistance. This study makes the novel discovery that estrogen promotes microvascularization in the fetus and thus normal vascular development and function required for eliciting insulin sensitivity in offspring and that placental hormonal secretions, independent from improper fetal growth, are an important determinant of risk of developing insulin resistance.
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Affiliation(s)
- Eugene D Albrecht
- Departments of Obstetrics, Gynecology, Reproductive Sciences and Physiology, University of Maryland School of Medicine, Baltimore, MD, USA
- Correspondence: Eugene Albrecht, PhD, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland School of Medicine, Bressler Research Laboratories 11-045A, 655 West Baltimore St, Baltimore, MD 21201, USA.
| | - Graham W Aberdeen
- Departments of Obstetrics, Gynecology, Reproductive Sciences and Physiology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Jeffery S Babischkin
- Departments of Obstetrics, Gynecology, Reproductive Sciences and Physiology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Steven J Prior
- Department of Kinesiology, University of Maryland School of Public Health, College Park, MD, USA
| | - Terrie J Lynch
- Department of Physiological Sciences, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Irene A Baranyk
- Departments of Obstetrics, Gynecology, Reproductive Sciences and Physiology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Gerald J Pepe
- Department of Physiological Sciences, Eastern Virginia Medical School, Norfolk, VA, USA
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Van Ryckeghem L, Keytsman C, De Brandt J, Verboven K, Verbaanderd E, Marinus N, Franssen WMA, Frederix I, Bakelants E, Petit T, Jogani S, Stroobants S, Dendale P, Bito V, Verwerft J, Hansen D. Impact of continuous vs. interval training on oxygen extraction and cardiac function during exercise in type 2 diabetes mellitus. Eur J Appl Physiol 2022; 122:875-887. [PMID: 35038022 DOI: 10.1007/s00421-022-04884-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 12/28/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE Exercise training improves exercise capacity in type 2 diabetes mellitus (T2DM). It remains to be elucidated whether such improvements result from cardiac or peripheral muscular adaptations, and whether these are intensity dependent. METHODS 27 patients with T2DM [without known cardiovascular disease (CVD)] were randomized to high-intensity interval training (HIIT, n = 15) or moderate-intensity endurance training (MIT, n = 12) for 24 weeks (3 sessions/week). Exercise echocardiography was applied to investigate cardiac output (CO) and oxygen (O2) extraction during exercise, while exercise capacity [([Formula: see text] (mL/kg/min)] was examined via cardiopulmonary exercise testing at baseline and after 12 and 24 weeks of exercise training, respectively. Changes in glycaemic control (HbA1c and glucose tolerance), lipid profile and body composition were also evaluated. RESULTS 19 patients completed 24 weeks of HIIT (n = 10, 66 ± 11 years) or MIT (n = 9, 61 ± 5 years). HIIT and MIT similarly improved glucose tolerance (pTime = 0.001, pInteraction > 0.05), [Formula: see text] (mL/kg/min) (pTime = 0.001, pInteraction > 0.05), and exercise performance (Wpeak) (pTime < 0.001, pInteraction > 0.05). O2 extraction increased to a greater extent after 24 weeks of MIT (56.5%, p1 = 0.009, pTime = 0.001, pInteraction = 0.007). CO and left ventricular longitudinal strain (LS) during exercise remained unchanged (pTime > 0.05). A reduction in HbA1c was correlated with absolute changes in LS after 12 weeks of MIT (r = - 0.792, p = 0.019, LS at rest) or HIIT (r = - 0.782, p = 0.038, LS at peak exercise). CONCLUSION In patients with well-controlled T2DM, MIT and HIIT improved exercise capacity, mainly resulting from increments in O2 extraction capacity, rather than changes in cardiac output. In particular, MIT seemed highly effective to generate these peripheral adaptations. TRIAL REGISTRATION NCT03299790, initially released 09/12/2017.
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Affiliation(s)
- Lisa Van Ryckeghem
- REVAL-Rehabilitation Research Centre, Faculty of Rehabilitation Sciences, Hasselt University, Agoralaan, Building A, 3590, Diepenbeek, Belgium. .,BIOMED-Biomedical Research Centre, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.
| | - Charly Keytsman
- REVAL-Rehabilitation Research Centre, Faculty of Rehabilitation Sciences, Hasselt University, Agoralaan, Building A, 3590, Diepenbeek, Belgium.,BIOMED-Biomedical Research Centre, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium
| | - Jana De Brandt
- REVAL-Rehabilitation Research Centre, Faculty of Rehabilitation Sciences, Hasselt University, Agoralaan, Building A, 3590, Diepenbeek, Belgium.,BIOMED-Biomedical Research Centre, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium
| | - Kenneth Verboven
- REVAL-Rehabilitation Research Centre, Faculty of Rehabilitation Sciences, Hasselt University, Agoralaan, Building A, 3590, Diepenbeek, Belgium.,BIOMED-Biomedical Research Centre, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium
| | - Elvire Verbaanderd
- Physical Activity, Sport and Health Research Group, Faculty of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Nastasia Marinus
- REVAL-Rehabilitation Research Centre, Faculty of Rehabilitation Sciences, Hasselt University, Agoralaan, Building A, 3590, Diepenbeek, Belgium.,BIOMED-Biomedical Research Centre, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium
| | - Wouter M A Franssen
- REVAL-Rehabilitation Research Centre, Faculty of Rehabilitation Sciences, Hasselt University, Agoralaan, Building A, 3590, Diepenbeek, Belgium.,BIOMED-Biomedical Research Centre, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium
| | - Ines Frederix
- BIOMED-Biomedical Research Centre, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.,Department of Cardiology, Virga Jessa Hospital, Heart Centre Hasselt, Hasselt, Belgium.,Faculty of Medicine and Health Sciences, Antwerp University, Antwerp, Belgium.,Department of Cardiology, Antwerp University Hospital, Edegem, Belgium
| | - Elise Bakelants
- Department of Cardiology, Virga Jessa Hospital, Heart Centre Hasselt, Hasselt, Belgium.,Hôpitaux Universitaires de Genève (HUG), Geneva, Switzerland
| | - Thibault Petit
- Department of Cardiology, Virga Jessa Hospital, Heart Centre Hasselt, Hasselt, Belgium.,Department of Cardiology, Hospital Oost-Limburg, Genk, Belgium
| | - Siddharth Jogani
- Department of Cardiology, Virga Jessa Hospital, Heart Centre Hasselt, Hasselt, Belgium
| | - Sarah Stroobants
- Department of Cardiology, Virga Jessa Hospital, Heart Centre Hasselt, Hasselt, Belgium
| | - Paul Dendale
- BIOMED-Biomedical Research Centre, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.,Department of Cardiology, Virga Jessa Hospital, Heart Centre Hasselt, Hasselt, Belgium
| | - Virginie Bito
- BIOMED-Biomedical Research Centre, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium
| | - Jan Verwerft
- Department of Cardiology, Virga Jessa Hospital, Heart Centre Hasselt, Hasselt, Belgium
| | - Dominique Hansen
- REVAL-Rehabilitation Research Centre, Faculty of Rehabilitation Sciences, Hasselt University, Agoralaan, Building A, 3590, Diepenbeek, Belgium.,BIOMED-Biomedical Research Centre, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.,Department of Cardiology, Virga Jessa Hospital, Heart Centre Hasselt, Hasselt, Belgium
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13
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Liu D, Zhang Y, Wu L, Guo J, Yu X, Yao H, Han R, Ma T, Zheng Y, Gao Q, Fang Q, Zhao Y, Zhao Y, Sun B, Jia W, Li H. Effects of Exercise Intervention on Type 2 Diabetes Patients With Abdominal Obesity and Low Thigh Circumference (EXTEND): Study Protocol for a Randomized Controlled Trial. Front Endocrinol (Lausanne) 2022; 13:937264. [PMID: 35903270 PMCID: PMC9317299 DOI: 10.3389/fendo.2022.937264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 06/20/2022] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Type 2 diabetes patients have abdominal obesity and low thigh circumference. Previous studies have mainly focused on the role of exercise in reducing body weight and fat mass, improving glucose and lipid metabolism, with a lack of evaluation on the loss of muscle mass, diabetes complications, energy metabolism, and brain health. Moreover, whether the potential physiological benefit of exercise for diabetes mellitus is related to the modulation of the microbiota-gut-brain axis remains unclear. Multi-omics approaches and multidimensional evaluations may help systematically and comprehensively correlate physical exercise and the metabolic benefits. METHODS AND ANALYSIS This study is a randomized controlled clinical trial. A total of 100 sedentary patients with type 2 diabetes will be allocated to either an exercise or a control group in a 1:1 ratio. Participants in the exercise group will receive a 16-week combined aerobic and resistance exercise training, while those in the control group will maintain their sedentary lifestyle unchanged. Additionally, all participants will receive a diet administration to control the confounding effects of diet. The primary outcome will be the change in body fat mass measured using bioelectrical impedance analysis. The secondary outcomes will include body fat mass change rate (%), and changes in anthropometric indicators (body weight, waist, hip, and thigh circumference), clinical biochemical indicators (glycated hemoglobin, blood glucose, insulin sensitivity, blood lipid, liver enzyme, and renal function), brain health (appetite, mood, and cognitive function), immunologic function, metagenomics, metabolomics, energy expenditure, cardiopulmonary fitness, exercise-related indicators, fatty liver, cytokines (fibroblast growth factor 21, fibroblast growth factor 19, adiponectin, fatty acid-binding protein 4, and lipocalin 2), vascular endothelial function, autonomic nervous function, and glucose fluctuation. DISCUSSION This study will evaluate the effect of a 16-week combined aerobic and resistance exercise regimen on patients with diabetes. The results will provide a comprehensive evaluation of the physiological effects of exercise, and reveal the role of the microbiota-gut-brain axis in exercise-induced metabolic benefits to diabetes. CLINICAL TRIAL REGISTRATION http://www.chictr.org.cn/searchproj.aspx, identifier ChiCTR2100046148.
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Affiliation(s)
- Dan Liu
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China
- Department of Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ying Zhang
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China
- Department of Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Liang Wu
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China
| | - Jingyi Guo
- Clinical Research Center, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Xiangtian Yu
- Clinical Research Center, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Huasheng Yao
- School of Sports Science and Physical Education, Nanjing Normal University, Nanjing, China
| | - Rui Han
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China
- Department of Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tianshu Ma
- Department of Kinesiology, Nanjing Sport Institute, Nanjing, China
| | - Yuchan Zheng
- Department of Sports and Health Science, Nanjing Sport Institute, Nanjing, China
| | - Qiongmei Gao
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China
| | - Qichen Fang
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China
| | - Yan Zhao
- Department of Sports and Health Science, Nanjing Sport Institute, Nanjing, China
| | - Yanan Zhao
- School of Sports Science and Physical Education, Nanjing Normal University, Nanjing, China
- *Correspondence: Huating Li, ; Weiping Jia, ; Biao Sun, ; Yanan Zhao,
| | - Biao Sun
- Department of Kinesiology, Nanjing Sport Institute, Nanjing, China
- *Correspondence: Huating Li, ; Weiping Jia, ; Biao Sun, ; Yanan Zhao,
| | - Weiping Jia
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China
- *Correspondence: Huating Li, ; Weiping Jia, ; Biao Sun, ; Yanan Zhao,
| | - Huating Li
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China
- *Correspondence: Huating Li, ; Weiping Jia, ; Biao Sun, ; Yanan Zhao,
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14
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Gilloteaux J, Nicaise C, Sprimont L, Bissler J, Finkelstein JA, Payne WR. Leptin receptor defect with diabetes causes skeletal muscle atrophy in female obese Zucker rats where peculiar depots networked with mitochondrial damages. Ultrastruct Pathol 2021; 45:346-375. [PMID: 34743665 DOI: 10.1080/01913123.2021.1983099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Tibialis anterior muscles of 45-week-old female obese Zucker rats with defective leptin receptor and non-insulin dependent diabetes mellitus (NIDDM) showed a significative atrophy compared to lean muscles, based on histochemical-stained section's measurements in the sequence: oxidative slow twitch (SO, type I) < oxidative fast twitch (FOG, type IIa) < fast glycolytic (FG, type IIb). Both oxidative fiber's outskirts resembled 'ragged' fibers and, in these zones, ultrastructure revealed small clusters of endoplasm-like reticulum filled with unidentified electron contrasted compounds, contiguous and continuous with adjacent mitochondria envelope. The linings appeared crenated stabbed by circular patterns resembling those found of ceramides. The same fibers contained scattered degraded mitochondria that tethered electron contrasted droplets favoring larger depots while mitoptosis were widespread in FG fibers. Based on other interdisciplinary investigations on the lipid depots of diabetes 2 muscles made us to propose these accumulated contrasted contents to be made of peculiar lipids, including acyl-ceramides, as those were only found while diabetes 2 progresses in aging obese rats. These could interfere in NIDDM with mitochondrial oxidative energetic demands and muscle functions.
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Affiliation(s)
- Jacques Gilloteaux
- Department of Anatomical Sciences, St George's University School of Medicine, K B Taylor Global Scholar's Program at the University of Northumbria, School of Health and Life Sciences, Newcastle upon Tyne, UK.,Unité de Recherches de Physiologie Moleculaire (URPHyM) - Narilis, Département de Médecine, Université de Namur, Namur, Belgium.,Department of Anatomy, Northeast Ohio Medical University (Neomed), Rootstown, OH, USA
| | - Charles Nicaise
- Unité de Recherches de Physiologie Moleculaire (URPHyM) - Narilis, Département de Médecine, Université de Namur, Namur, Belgium
| | - Lindsay Sprimont
- Unité de Recherches de Physiologie Moleculaire (URPHyM) - Narilis, Département de Médecine, Université de Namur, Namur, Belgium
| | - John Bissler
- Department of Anatomy, Northeast Ohio Medical University (Neomed), Rootstown, OH, USA.,Division of Nephrology at St. Jude Children's Research Hospital and Le Bonheur Children's Hospital, The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Judith A Finkelstein
- Department of Anatomy, Northeast Ohio Medical University (Neomed), Rootstown, OH, USA
| | - Warren R Payne
- Institute for Sport and Health, Footscray Park Campus, Victoria University, Melbourne, VIC, Australia
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15
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Saldiran TÇ, Mutluay FK, Yağci I, Yilmaz Y. Comparison of aerobic and combined aerobic and whole-body vibration training effects on physical fitness in non-alcoholic fatty liver patients. COMPARATIVE EXERCISE PHYSIOLOGY 2021. [DOI: 10.3920/cep200075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The aim of this study was to evaluate the effectiveness of exercises with whole-body vibration which was added to aerobic training on the physical fitness of patients with non-alcoholic fatty liver disease. Thirty-two patients diagnosed with non-alcoholic fatty liver (age 44.39±8.74 years) were randomly divided into an aerobic training + vibration group and an aerobic training + sham vibration group. The aerobic training was continued at 60-80% heart rate workload, 40 min per day during 3 days per week, for 8 weeks. Vibration were performed with dynamic and static exercises at 30 Hz, with a 2 mm amplitude, for 15 min. The energy expenditure responses were carried out by an exercise tolerance test system. Lower limb isometric muscle strength assessment was made with a calibrated handheld dynamometer from bilaterally knee extensors. The sit to stand test, and the time up and go test were used for physical performance evaluation. At eight weeks, both groups showed a significant reduction in the sit to stand (-1.62±1.00 vs -0.37±1.52), the time up and go test (-1.43±0.99 vs -1.39±1.06), the right lower extremity muscle strength (1.01±1.61 vs 1.22±2.82), and the energy expenditure scores (MET; 1.88 ml/kg/min, 95% confidence interval (CI) 1.19; 2.57, d=0.55, minimal clinically important difference (McID) = 0.69 vs 2.01 ml/kg/min, 95% CI 0.76; 3.24, d=0.26, McID = 1.54, respectively), however no significant differences emerged between groups (P≥0.05). The addition of vibration exercises to an aerobic program did not provide additional benefits to physical fitness in patients with non-alcoholic fatty liver.
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Affiliation(s)
- T. Çevik Saldiran
- Bitlis Eren University, School of Health Sciences, Department of Physiotherapy and Rehabilitation, Bitlis 13000, Turkey
| | - F. Karantay Mutluay
- Istanbul Medipol University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul 34000, Turkey
| | - I. Yağci
- Marmara University, Physical Therapy and Rehabilitation Department of Medicine, Istanbul 34000, Turkey
| | - Y. Yilmaz
- Marmara University, Gastroenterology Department of Medicine, Istanbul 34000, Turkey
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16
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Tucker WJ, Angadi SS, Haykowsky MJ, Nelson MD, Sarma S, Tomczak CR. Pathophysiology of Exercise Intolerance and Its Treatment With Exercise-Based Cardiac Rehabilitation in Heart Failure With Preserved Ejection Fraction. J Cardiopulm Rehabil Prev 2021; 40:9-16. [PMID: 31764536 DOI: 10.1097/hcr.0000000000000481] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Heart failure with preserved ejection fraction (HFpEF) is the fastest growing form of heart failure in the United States. The cardinal feature of HFpEF is reduced exercise tolerance (peak oxygen uptake, (Equation is included in full-text article.)O2peak) secondary to impaired cardiac, vascular, and skeletal muscle function. There are currently no evidence-based drug therapies to improve clinical outcomes in patients with HFpEF. In contrast, exercise training is a proven effective intervention for improving (Equation is included in full-text article.)O2peak, aerobic endurance, and quality of life in HFpEF patients. This brief review discusses the pathophysiology of exercise intolerance and the role of exercise training to improve (Equation is included in full-text article.)O2peak in clinically stable HFpEF patients. It also discusses the mechanisms responsible for the exercise training-mediated improvements in (Equation is included in full-text article.)O2peak in HFpEF. Finally, it provides evidence-based exercise prescription guidelines for cardiac rehabilitation specialists to assist them with safely implementing exercise-based cardiac rehabilitation programs for HFpEF patients.
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Affiliation(s)
- Wesley J Tucker
- Department of Kinesiology (Drs Tucker and Nelson) and College of Nursing and Health Innovation (Drs Tucker and Haykowsky), University of Texas at Arlington, Arlington; Department of Nutrition & Food Sciences, Texas Woman's University, Houston (Dr Tucker); College of Health Solutions, Arizona State University, and Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Phoenix, Arizona (Dr Angadi); Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, and Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (Dr Sarma); and College of Kinesiology, University of Saskatchewan, Saskatoon, Canada (Dr Tomczak)
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17
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Evans WS, Blumenthal JB, Heilman JM, Ryan AS, Prior SJ. Effects of exercise training with weight loss on skeletal muscle expression of angiogenic factors in overweight and obese older men. J Appl Physiol (1985) 2021; 131:56-63. [PMID: 34013746 DOI: 10.1152/japplphysiol.00084.2021] [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] [Indexed: 01/21/2023] Open
Abstract
Low skeletal muscle capillarization is associated with impaired glucose tolerance (IGT); however, aerobic exercise training with weight loss (AEX + WL) increases skeletal muscle capillarization and improves glucose tolerance in adults with IGT. Given that the expression of angiogenic growth factors mediates skeletal muscle capillarization, we sought to determine whether angiogenic growth factor levels are associated with low capillarization in those with IGT versus normal glucose tolerance (NGT) or to the benefits of AEX + WL in both groups. Sixteen overweight or obese men 50-75 yr of age completed 6 mo of AEX + WL with oral glucose tolerance tests and vastus lateralis muscle biopsies for measurement of muscle vascular endothelial growth factor (VEGF), placental growth factor (PlGF), soluble fms-like tyrosine kinase receptor-1 (sFlt-1), and basic fibroblast growth factor (bFGF). At baseline, all growth factor levels were numerically lower in IGT than NGT, but these did not reach statistical significance (P = 0.06-0.33). Following AEX + WL, aerobic capacity [maximal oxygen consumption (V̇o2max)] increased by 16%, whereas body weight and 120-min postprandial glucose levels decreased by 10% and 15%, respectively (P ≤ 0.001 for all). There was a main effect of AEX + WL to increase VEGF (0.095 ± 0.016 vs. 0.114 ± 0.018 ng/µg, P < 0.05), PlGF (0.004 ± 0.001 vs. 0.005 ± 0.001 ng/µg, P < 0.05), and sFlt-1 (0.216 ± 0.029 vs. 0.264 ± 0.036 ng/µg, P < 0.01), with overall increases driven by the IGT group. These results suggest that 6 mo of AEX + WL increases skeletal muscle angiogenic growth factor levels in obese older adults with IGT and NGT, which may contribute to our previous findings that AEX + WL increases capillarization to improve glucose tolerance in those with IGT.NEW & NOTEWORTHY Skeletal muscle capillarization is lower in adults with impaired glucose tolerance than normal controls. This may, in part, be attributable to differential expression of angiogenic growth factors in skeletal muscle. Using a 6-mo aerobic exercise intervention with ∼10% body weight loss (AEX + WL), we show that the expression of angiogenic growth factors tends to be lower in adults with impaired glucose tolerance compared with normal controls and that AEX + WL increased expression of angiogenic growth factors in all participants.
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Affiliation(s)
- William S Evans
- Department of Kinesiology, University of Maryland School of Public Health, College Park, Maryland
| | - Jacob B Blumenthal
- Baltimore Veterans Affairs Geriatric Research, Education and Clinical Center and Research and Development Service, Baltimore, Maryland.,Division of Geriatrics and Palliative Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland
| | - James M Heilman
- Department of Kinesiology, University of Maryland School of Public Health, College Park, Maryland
| | - Alice S Ryan
- Baltimore Veterans Affairs Geriatric Research, Education and Clinical Center and Research and Development Service, Baltimore, Maryland.,Division of Geriatrics and Palliative Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland
| | - Steven J Prior
- Department of Kinesiology, University of Maryland School of Public Health, College Park, Maryland.,Baltimore Veterans Affairs Geriatric Research, Education and Clinical Center and Research and Development Service, Baltimore, Maryland.,Division of Geriatrics and Palliative Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland
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18
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Paquin J, Lagacé JC, Brochu M, Dionne IJ. Exercising for Insulin Sensitivity - Is There a Mechanistic Relationship With Quantitative Changes in Skeletal Muscle Mass? Front Physiol 2021; 12:656909. [PMID: 34054574 PMCID: PMC8149906 DOI: 10.3389/fphys.2021.656909] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 04/14/2021] [Indexed: 12/29/2022] Open
Abstract
Skeletal muscle (SM) tissue has been repetitively shown to play a major role in whole-body glucose homeostasis and overall metabolic health. Hence, SM hypertrophy through resistance training (RT) has been suggested to be favorable to glucose homeostasis in different populations, from young healthy to type 2 diabetic (T2D) individuals. While RT has been shown to contribute to improved metabolic health, including insulin sensitivity surrogates, in multiple studies, a universal understanding of a mechanistic explanation is currently lacking. Furthermore, exercised-improved glucose homeostasis and quantitative changes of SM mass have been hypothesized to be concurrent but not necessarily causally associated. With a straightforward focus on exercise interventions, this narrative review aims to highlight the current level of evidence of the impact of SM hypertrophy on glucose homeostasis, as well various mechanisms that are likely to explain those effects. These mechanistic insights could provide a strengthened rationale for future research assessing alternative RT strategies to the current classical modalities, such as low-load, high repetition RT or high-volume circuit-style RT, in metabolically impaired populations.
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Affiliation(s)
- Jasmine Paquin
- Research Centre on Aging, Affiliated With CIUSSS de l'Estrie-CHUS, Sherbrooke, QC, Canada.,Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Jean-Christophe Lagacé
- Research Centre on Aging, Affiliated With CIUSSS de l'Estrie-CHUS, Sherbrooke, QC, Canada.,Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Martin Brochu
- Research Centre on Aging, Affiliated With CIUSSS de l'Estrie-CHUS, Sherbrooke, QC, Canada.,Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Isabelle J Dionne
- Research Centre on Aging, Affiliated With CIUSSS de l'Estrie-CHUS, Sherbrooke, QC, Canada.,Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, QC, Canada
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19
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Beneficial Effects of Physical Activity in Diabetic Patients. J Funct Morphol Kinesiol 2020; 5:jfmk5030070. [PMID: 33467285 PMCID: PMC7739324 DOI: 10.3390/jfmk5030070] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/30/2020] [Accepted: 09/01/2020] [Indexed: 12/14/2022] Open
Abstract
One of the main goals of diabetic therapy is to achieve the best metabolic control to prevent the development and progression of potential complications. A multidisciplinary approach characterized by the combination of diet, physical activity (PA) and drug therapy with oral and injectable (non-insulin) pharmacological agents, is desirable to optimize metabolic control. The aim of this review is to explain the contribution of PA and its beneficial effects on patients affected by type 1 (T1D) and type 2 diabetes (T2D). We provide an overview of evidence on the effects of PA for the main two types of diabetes mellitus (DM) to identify the right level of PA to be recommended. We discuss the physiological and clinical role of PA in people with DM. It can be concluded that the objective of antidiabetic therapy should be the achievement and optimization of metabolic control through a multidisciplinary approach involving non-pharmacological therapy such as diet and PA, which has a crucial role.
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20
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Çevik Saldiran T, Mutluay FK, Yağci İ, Yilmaz Y. Impact of aerobic training with and without whole-body vibration training on metabolic features and quality of life in non-alcoholic fatty liver disease patients. ANNALES D'ENDOCRINOLOGIE 2020; 81:493-499. [PMID: 32768394 DOI: 10.1016/j.ando.2020.05.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 04/23/2020] [Accepted: 05/05/2020] [Indexed: 01/28/2023]
Abstract
The present study examined the effectiveness of adding exercises with whole-body vibration (WBV) to aerobic training in terms of metabolic features and quality of life. Patients with non-alcoholic fatty liver disease (NAFLD), confirmed on imaging, underwent an 8-week individualized exercise program randomized between aerobic training with and without WBV. Training was performed at 60-80% heart rate workload for 165 min/week. The WBV amplitude was 2-4mm and the training frequency was 30Hz, for 15min. Assessments were carried out on surrogate scores of steatosis and fibrosis including transient elastography (FibroScan), metabolic features (biochemical analysis) and quality of life (SF-36). Insulin resistance was markedly reduced (-2.36; 95% CI: -4.96 to -0.24; P: 0.049) in aerobic training with WBV. The decrease in serum aspartate transaminase was significantly greater in aerobic training without WBV (-14.81; 95% CI: -23.36 to -6.25; P: 0.029). There were no significant differences between groups for the other metabolic features (P<0.05). All quality of life well-being domains improved in both groups (P<0.05). Given this reduction in insulin resistance, WBV can usefully be added to aerobic training. However, WBV did not provide further benefits in improving metabolic properties or quality of life.
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Affiliation(s)
- Tülay Çevik Saldiran
- Department of physiotherapy and rehabilitation, faculty of health science, Bitlis Eren University, Ahmet-Eren boulevard, Rahva street, 13000 Bitlis, Turkey.
| | - Fatma Karantay Mutluay
- Department of physiotherapy and rehabilitation, Istanbul Medipol University, Istanbul, Turkey
| | - İlker Yağci
- Department of physical therapy and rehabilitation medicine, Marmara University, Istanbul, Istanbul, Turkey
| | - Yusuf Yilmaz
- Department of gastroenterology medicine, Marmara University, Istanbul, Istanbul, Turkey
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21
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Iaccarino G, Franco D, Sorriento D, Strisciuglio T, Barbato E, Morisco C. Modulation of Insulin Sensitivity by Exercise Training: Implications for Cardiovascular Prevention. J Cardiovasc Transl Res 2020; 14:256-270. [PMID: 32737757 PMCID: PMC8043859 DOI: 10.1007/s12265-020-10057-w] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 06/28/2020] [Indexed: 12/11/2022]
Abstract
The beneficial effects of physical activity on the cardiovascular system nowadays have achieved the relevance of clinical evidence. In fact, several studies have documented the benefits of exercise training in the prevention of the cardiovascular risk. Abnormalities of insulin signaling transduction account for the impairment of insulin sensitivity and development of insulin resistance, which, in turn, is responsible for the enhancement of cardiovascular risk. Insulin sensitivity is related to the degree of physical activity, and physical training has been shown to ameliorate insulin action in insulin-resistant subjects. This effect is mediated by the improvement of the molecular abnormalities that are responsible of the insulin resistance, contributing in this way to restore the physiological insulin sensitivity. However, it should be underlined that mechanisms that account for this phenomenon are extremely complex and still unclear. Further studies are required to better clarify the molecular basis of the exercise-evoked improvement of insulin signal. Graphical abstract ![]()
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Affiliation(s)
- Guido Iaccarino
- Department of Advanced Biomedical Science, Federico II University, Via S. Pansini n. 5, 80131, Naples, Italy
| | - Danilo Franco
- Department of Advanced Biomedical Science, Federico II University, Via S. Pansini n. 5, 80131, Naples, Italy
| | - Daniela Sorriento
- Department of Advanced Biomedical Science, Federico II University, Via S. Pansini n. 5, 80131, Naples, Italy
| | - Teresa Strisciuglio
- Department of Advanced Biomedical Science, Federico II University, Via S. Pansini n. 5, 80131, Naples, Italy
| | - Emanuele Barbato
- Department of Advanced Biomedical Science, Federico II University, Via S. Pansini n. 5, 80131, Naples, Italy
| | - Carmine Morisco
- Department of Advanced Biomedical Science, Federico II University, Via S. Pansini n. 5, 80131, Naples, Italy.
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22
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Abushamat LA, McClatchey PM, Scalzo RL, Schauer I, Huebschmann AG, Nadeau KJ, Liu Z, Regensteiner JG, Reusch JEB. Mechanistic Causes of Reduced Cardiorespiratory Fitness in Type 2 Diabetes. J Endocr Soc 2020; 4:bvaa063. [PMID: 32666009 PMCID: PMC7334033 DOI: 10.1210/jendso/bvaa063] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 06/04/2020] [Indexed: 02/06/2023] Open
Abstract
Type 2 diabetes (T2D) has been rising in prevalence in the United States and worldwide over the past few decades and contributes to significant morbidity and premature mortality, primarily due to cardiovascular disease (CVD). Cardiorespiratory fitness (CRF) is a modifiable cardiovascular (CV) risk factor in the general population and in people with T2D. Young people and adults with T2D have reduced CRF when compared with their peers without T2D who are similarly active and of similar body mass index. Furthermore, the impairment in CRF conferred by T2D is greater in women than in men. Various factors may contribute to this abnormality in people with T2D, including insulin resistance and mitochondrial, vascular, and cardiac dysfunction. As proof of concept that understanding the mediators of impaired CRF in T2D can inform intervention, we previously demonstrated that an insulin sensitizer improved CRF in adults with T2D. This review focuses on how contributing factors influence CRF and why they may be compromised in T2D. Functional exercise capacity is a measure of interrelated systems biology; as such, the contribution of derangement in each of these factors to T2D-mediated impairment in CRF is complex and varied. Therefore, successful approaches to improve CRF in T2D should be multifaceted and individually designed. The current status of this research and future directions are outlined.
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Affiliation(s)
- Layla A Abushamat
- Department of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colorado
| | | | - Rebecca L Scalzo
- Department of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colorado.,Rocky Mountain Regional VA, Aurora, Colorado.,Center for Women's Health Research, University of Colorado, Anschutz Medical Campus, Aurora, Colorado
| | - Irene Schauer
- Department of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colorado.,Rocky Mountain Regional VA, Aurora, Colorado.,Center for Women's Health Research, University of Colorado, Anschutz Medical Campus, Aurora, Colorado
| | - Amy G Huebschmann
- Department of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colorado.,Center for Women's Health Research, University of Colorado, Anschutz Medical Campus, Aurora, Colorado
| | - Kristen J Nadeau
- Center for Women's Health Research, University of Colorado, Anschutz Medical Campus, Aurora, Colorado.,Department of Pediatrics, University of Colorado, Anschutz Medical Campus, Aurora, Colorado
| | - Zhenqi Liu
- Department of Medicine, University of Virginia, Charlottesville, Virginia
| | - Judith G Regensteiner
- Department of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colorado.,Center for Women's Health Research, University of Colorado, Anschutz Medical Campus, Aurora, Colorado
| | - Jane E B Reusch
- Department of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colorado.,Rocky Mountain Regional VA, Aurora, Colorado.,Center for Women's Health Research, University of Colorado, Anschutz Medical Campus, Aurora, Colorado
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23
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Wade M, Delawder V, Reneau P, Dos Santos JM. The effect of BPA exposure on insulin resistance and type 2 diabetes - The impact of muscle contraction. Med Hypotheses 2020; 140:109675. [PMID: 32200183 DOI: 10.1016/j.mehy.2020.109675] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 02/23/2020] [Accepted: 03/10/2020] [Indexed: 12/19/2022]
Abstract
Type 2 diabetes (T2D) is considered one of the leading causes of death worldwide. In addition to physical inactivity and obesity, established risk factors for T2D, chemical contaminants consumed in industrialized food such as BPA might also be a contributor to the development of T2D. Epidemiological studies have shown that BPA concentrations are higher in human specimens of T2D when compared to healthy subjects, while experimental studies suggested that bisphenol A (BPA) impairs the pathway by which insulin stimulates glucose uptake. In skeletal muscle and adipocytes, insulin resistance is developed by the impairment of the insulin pathway to stimulate the translocation of glucose transporter, GLUT4, to the cell membrane. Recent results demonstrated that BPA impairs several components of insulin-induced glucose uptake pathway and affect the expression of GLUT4. Regular physical exercise delays or inhibits the development of T2D due to the physiologic processes taking place during muscle contraction, and the fact that skeletal muscle is the site for almost 80% of the glucose transported under insulin stimulation. In fact, the mechanism by which contraction induces glucose uptake in skeletal muscle is partially independent of the insulin pathway, therefore, the effect of BPA on this mechanism is unknown. We hypothesize that during the development of insulin resistance, BPA contributes to the impairment of the molecular pathway by which insulin induces glucose uptake while contraction-induced glucose uptake is not impaired. At the late stages of T2D, BPA may affect GLUT4 expression that will decrease the ability of muscle contraction to induce glucose uptake.
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Affiliation(s)
- Madison Wade
- School of Education, Health and Human Performance, Fairmont State University, Fairmont, WV, United States
| | - Virginia Delawder
- School of Education, Health and Human Performance, Fairmont State University, Fairmont, WV, United States
| | - Paul Reneau
- School of Education, Health and Human Performance, Fairmont State University, Fairmont, WV, United States
| | - Julia M Dos Santos
- School of Education, Health and Human Performance, Fairmont State University, Fairmont, WV, United States; Detroit R&D, Inc, Detroit, MI, United States.
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24
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Moro T, Brightwell CR, Phalen DE, McKenna CF, Lane SJ, Porter C, Volpi E, Rasmussen BB, Fry CS. Low skeletal muscle capillarization limits muscle adaptation to resistance exercise training in older adults. Exp Gerontol 2019; 127:110723. [PMID: 31518665 DOI: 10.1016/j.exger.2019.110723] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 08/06/2019] [Accepted: 09/03/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Adequate muscle perfusion supports the transport of nutrients, oxygen and hormones into muscle fibers. Aging is associated with a substantial decrease in skeletal muscle capillarization, fiber size and oxidative capacity, which may be improved with regular physical activity. The aim of this study was to investigate the relationship between muscle capillarization and indices of muscle hypertrophy (i.e. lean mass; fiber cross sectional area (CSA)) in older adults before and after 12 weeks of progressive resistance exercise training (RET). DESIGN Interventional study SETTING AND PARTICIPANTS: 19 subjects (10 male and 9 female; 71.1 ± 4.3 years; 27.6 ± 3.2 BMI) were enrolled in the study and performed a whole body RET program for 12 weeks. Subjects where then retrospectively divided into a LOW or HIGH group, based on their pre-RET capillary-to-fiber perimeter exchange index (CFPE). Physical activity level, indices of capillarization (capillaries-to-fiber ratio, C:Fi; CFPE index and capillary-to-fiber interface, LC-PF index), muscle hypertrophy, muscle protein turnover and mitochondrial function were assessed before and after RET. RESULTS Basal capillarization (C:Fi; CFPE and LP-CF index) correlates with daily physical activity level (C:Fi, r = 0.57, p = 0.019; CFPE index, r = 0.55, p = 0.024; LC-PF index, r = 0.56, p = 0.022) and CFPE and LC-PF indices were also positively associated with oxidative capacity (respectively r = 0.45, p = 0.06; r = 0.67, p = 0.004). Following RET, subjects in the HIGH group underwent hypertrophy with significant improvements in muscle protein synthesis and muscle fiber CSA (p < 0.05). However, RET did not promote muscle hypertrophy in the LOW group, but RET significantly increased muscle capillary density (p < 0.05). CONCLUSION/IMPLICATIONS Muscle fiber capillarization before starting an exercise training program may be predictive of the muscle hypertrophic response to RET in older adults. Increases in muscle fiber size following RET appear to be blunted when muscle capillarization is low, suggesting that an adequate initial capillarization is critical to achieve a meaningful degree of muscle adaptation to RET.
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Affiliation(s)
- Tatiana Moro
- Department of Nutrition & Metabolism, School of Health Professions, University of Texas Medical Branch, Galveston, TX, USA; Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, USA
| | - Camille R Brightwell
- Department of Nutrition & Metabolism, School of Health Professions, University of Texas Medical Branch, Galveston, TX, USA
| | - Danielle E Phalen
- Department of Nutrition & Metabolism, School of Health Professions, University of Texas Medical Branch, Galveston, TX, USA
| | - Colleen F McKenna
- Department of Nutrition & Metabolism, School of Health Professions, University of Texas Medical Branch, Galveston, TX, USA
| | - Samantha J Lane
- Department of Nutrition & Metabolism, School of Health Professions, University of Texas Medical Branch, Galveston, TX, USA
| | - Craig Porter
- Metabolism Unit, Shriners Hospitals for Children, Galveston, TX, USA; Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA
| | - Elena Volpi
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, USA; Department of Internal Medicine/Geriatrics, University of Texas Medical Branch, Galveston, TX, USA
| | - Blake B Rasmussen
- Department of Nutrition & Metabolism, School of Health Professions, University of Texas Medical Branch, Galveston, TX, USA; Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, USA
| | - Christopher S Fry
- Department of Nutrition & Metabolism, School of Health Professions, University of Texas Medical Branch, Galveston, TX, USA; Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, USA.
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25
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Randolph AC, Markofski MM, Rasmussen BB, Volpi E. Effect of essential amino acid supplementation and aerobic exercise on insulin sensitivity in healthy older adults: A randomized clinical trial. Clin Nutr 2019; 39:1371-1378. [PMID: 31307843 DOI: 10.1016/j.clnu.2019.06.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 06/18/2019] [Accepted: 06/21/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND & AIMS The combination of prolonged essential amino acid (EAA) supplementation and aerobic exercise training (Ex) improves muscle protein metabolism, strength and function in healthy older adults. However, excess EAA intake may worsen insulin sensitivity. Here we report the effects of EAA supplementation (EAA, n = 11), placebo (PLA, n = 10), aerobic exercise with placebo (Ex + PLA, n = 11) or Ex with EAA supplementation (Ex + EAA, n = 10) for 22 weeks on insulin sensitivity in non-diabetic older adults. METHODS A 2 × 2 design with block randomization and double blinding for supplement or placebo was used. Subjects ingested EAA (15 g) or placebo daily. Exercising subjects participated in supervised progressive vigorous treadmill walking 3 times weekly. Measures of insulin sensitivity by oral glucose tolerance testing were collected at baseline and 22 weeks. Dietary intakes of protein and specific amino acids were determined in a subset of subjects. RESULTS Overall, exercise improved insulin sensitivity, while EAA supplementation had no effect. In the dietary subset, post-intervention insulin sensitivity did not correlate significantly with the total intake of EAA, anti-angiogenic amino acids (cysteine, methionine), or branched-chain amino acids (isoleucine, leucine, valine). CONCLUSIONS Overall, we conclude that in healthy older adults with moderate protein intake, EAA supplementation is metabolically safe as it does not decrease insulin sensitivity regardless of its combination with aerobic exercise. Thus, daily protein intake should be controlled for when modeling insulin sensitivity. Future studies should explore the role of increased blood flow as a potential explanatory factor for the observed interaction between aerobic exercise and supplementation. CLINICAL TRIAL REGISTRATION NUMBER NCT00872911.
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Affiliation(s)
- Amanda C Randolph
- Sealy Center on Aging, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555, USA
| | - Melissa M Markofski
- Sealy Center on Aging, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555, USA
| | - Blake B Rasmussen
- Sealy Center on Aging, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555, USA; Department of Nutrition and Metabolism, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555, USA
| | - Elena Volpi
- Sealy Center on Aging, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555, USA; Department of Internal Medicine, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555, USA.
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26
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Olver TD, Laughlin MH, Padilla J. Exercise and Vascular Insulin Sensitivity in the Skeletal Muscle and Brain. Exerc Sport Sci Rev 2019; 47:66-74. [PMID: 30883470 DOI: 10.1249/jes.0000000000000182] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
We present the hypothesis that exercise-induced hyperemia, perhaps through vascular shear stress, represents an important factor responsible for the effects of physical activity (PA) on vascular insulin sensitivity. Specifically, we postulate PA involving the greatest amount of skeletal muscle mass and the greatest central neural recruitment maximizes perfusion and consequently enhances vascular insulin sensitivity in the skeletal muscle and brain.
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Affiliation(s)
- T Dylan Olver
- Department of Biomedical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - M Harold Laughlin
- Department of Biomedical Sciences.,Dalton Cardiovascular Research Center
| | - Jaume Padilla
- Dalton Cardiovascular Research Center.,Department of Nutrition and Exercise Physiology, and.,Department of Child Health, University of Missouri, Columbia, MO
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27
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Diaz EC, Børsheim E, Shankar K, Cleves MA, Andres A. Prepregnancy Fat Free Mass and Associations to Glucose Metabolism Before and During Pregnancy. J Clin Endocrinol Metab 2019; 104:1394-1403. [PMID: 30496579 PMCID: PMC7296201 DOI: 10.1210/jc.2018-01381] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 11/21/2018] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Our aim was to quantify the individual contribution of prepregnancy (PP) fat-free mass (FFM), expressed as [PP-FFM index (PP-FFMI) = FFM (kg)/height (m2)], on markers of glucose homeostasis before and during pregnancy. METHODS Body composition was assessed in 43 women before pregnancy using air-displacement plethysmography. Blood was drawn at PP and gestational weeks ∼8 and 30. Relationships between body composition (independent) variables and glucose homeostasis (dependent) variables were assessed using adjusted correlations and simple and multiple linear regression analyses. RESULTS PP-FFMI was the strongest predictor of plasma insulin concentration [squared partial correlation (Pr2) = 17, P = 0.007] and homeostasis model assessment of insulin resistance (HOMA2-IR) (Pr2 = 16, P = 0.010). At gestation week 30, PP-FFMI and gestational weight gain (GWG) were the strongest predictors of insulin concentration (PP-FFMI: Pr2 = 20, P = 0.010; GWG: Pr2 = 12, P = 0.052) and HOMA2-IR (PP-FFMI: Pr2 = 19, P = 0.012; GWG: Pr2 = 13, P = 0.045). After accounting for PP fat mass index (PP-FMI), PP-FFMI and GWG were independently associated with first-phase insulin response (PP-FFMI: Pr2 = 20, P = 0.009; GWG: Pr2 = 15, P = 0.025) and second-phase insulin response (PP-FFMI: Pr2 = 19, P = 0.011; GWG: Pr2 = 17, P = 0.016). PP-FMI was the strongest predictor of an oral glucose tolerance test‒derived estimated metabolic clearance rate of glucose (PP-FMI: Pr2 = 14, P = 0.037) and estimated insulin sensitivity index (PP-FMI: Pr2 = 13, P = 0.047). CONCLUSIONS PP-FFMI was a predictor of markers of glucose homeostasis before and during pregnancy. Studies assessing the effect of skeletal muscle quality on metabolic regulation during pregnancy are warranted.
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Affiliation(s)
- Eva Carolina Diaz
- Arkansas Children’s Nutrition Center, University of Arkansas for Medical Sciences, Little Rock, Arkansas
- Arkansas Children’s Research Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
- Correspondence and Reprint Requests: Eva Carolina Diaz, MD, Arkansas Children’s Nutrition Center, 15 Children’s Way, Slot 317, Little Rock, Arkansas 72202. E-mail:
| | - Elisabet Børsheim
- Arkansas Children’s Nutrition Center, University of Arkansas for Medical Sciences, Little Rock, Arkansas
- Arkansas Children’s Research Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Kartik Shankar
- Arkansas Children’s Nutrition Center, University of Arkansas for Medical Sciences, Little Rock, Arkansas
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Mario Alberto Cleves
- Arkansas Children’s Nutrition Center, University of Arkansas for Medical Sciences, Little Rock, Arkansas
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Aline Andres
- Arkansas Children’s Nutrition Center, University of Arkansas for Medical Sciences, Little Rock, Arkansas
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
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28
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Yang W, Liu L, Wei Y, Fang C, Zhou F, Chen J, Han Q, Huang M, Tan X, Liu Q, Pan Q, Zhang L, Lei X, Li L. Exercise ameliorates the FGF21-adiponectin axis impairment in diet-induced obese mice. Endocr Connect 2019; 8:596-604. [PMID: 30978696 PMCID: PMC6510890 DOI: 10.1530/ec-19-0034] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Accepted: 04/11/2019] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The protective effects of exercise against glucose dysmetabolism have been generally reported. However, the mechanism by which exercise improves glucose homeostasis remains poorly understood. The FGF21-adiponectin axis participates in the regulation of glucose metabolism. Elevated levels of FGF21 and decreased levels of adiponectin in obesity indicate FGF21-adiponectin axis dysfunction. Hence, we investigated whether exercise could improve the FGF21-adiponectin axis impairment and ameliorate disturbed glucose metabolism in diet-induced obese mice. METHODS Eight-week-old C57BL/6J mice were randomly assigned to three groups: low-fat diet control group, high-fat diet group and high-fat diet plus exercise group. Glucose metabolic parameters, the ability of FGF21 to induce adiponectin, FGF21 receptors and co-receptor levels and adipose tissue inflammation were evaluated after 12 weeks of intervention. RESULTS Exercise training led to reduced levels of fasting blood glucose and insulin, improved glucose tolerance and better insulin sensitivity in high-fat diet-induced obese mice. Although serum FGF21 levels were not significantly changed, both total and high-molecular-weight adiponectin concentrations were markedly enhanced by exercise. Importantly, exercise protected against high-fat diet-induced impaired ability of FGF21 to stimulate adiponectin secretion. FGF21 co-receptor, β-klotho, as well as receptors, FGFR1 and FGFR2, were upregulated by exercise. We also found that exercise inhibited adipose tissue inflammation, which may contribute to the improvement in the FGF21-adiponectin axis impairment. CONCLUSIONS Our data indicate exercise protects against high-fat diet-induced FGF21-adiponectin axis impairment, and may thereby exert beneficial effects on glucose metabolism.
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Affiliation(s)
- Wenqi Yang
- Center for Scientific Research and Institute of Exercise and Health, Guangzhou Sports University, Guangzhou, China
- Key Laboratory of Sports Technique, Tactics and Physical Function of General Administration of Sport of China, Scientific Research Center, Guangzhou Sport University, Guangzhou, China
| | - Ling Liu
- Key Laboratory of Sports Technique, Tactics and Physical Function of General Administration of Sport of China, Scientific Research Center, Guangzhou Sport University, Guangzhou, China
| | - Yuan Wei
- Center for Scientific Research and Institute of Exercise and Health, Guangzhou Sports University, Guangzhou, China
- Key Laboratory of Sports Technique, Tactics and Physical Function of General Administration of Sport of China, Scientific Research Center, Guangzhou Sport University, Guangzhou, China
| | - Chunlu Fang
- Center for Scientific Research and Institute of Exercise and Health, Guangzhou Sports University, Guangzhou, China
- Key Laboratory of Sports Technique, Tactics and Physical Function of General Administration of Sport of China, Scientific Research Center, Guangzhou Sport University, Guangzhou, China
| | - Fu Zhou
- Key Laboratory of Sports Technique, Tactics and Physical Function of General Administration of Sport of China, Scientific Research Center, Guangzhou Sport University, Guangzhou, China
| | - Jinbao Chen
- Key Laboratory of Sports Technique, Tactics and Physical Function of General Administration of Sport of China, Scientific Research Center, Guangzhou Sport University, Guangzhou, China
| | - Qinghua Han
- Key Laboratory of Sports Technique, Tactics and Physical Function of General Administration of Sport of China, Scientific Research Center, Guangzhou Sport University, Guangzhou, China
| | - Meifang Huang
- Key Laboratory of Sports Technique, Tactics and Physical Function of General Administration of Sport of China, Scientific Research Center, Guangzhou Sport University, Guangzhou, China
| | - Xuan Tan
- Key Laboratory of Sports Technique, Tactics and Physical Function of General Administration of Sport of China, Scientific Research Center, Guangzhou Sport University, Guangzhou, China
| | - Qiuyue Liu
- Key Laboratory of Sports Technique, Tactics and Physical Function of General Administration of Sport of China, Scientific Research Center, Guangzhou Sport University, Guangzhou, China
| | - Qiang Pan
- Key Laboratory of Sports Technique, Tactics and Physical Function of General Administration of Sport of China, Scientific Research Center, Guangzhou Sport University, Guangzhou, China
| | - Lu Zhang
- Key Laboratory of Sports Technique, Tactics and Physical Function of General Administration of Sport of China, Scientific Research Center, Guangzhou Sport University, Guangzhou, China
| | - Xiaojuan Lei
- Key Laboratory of Sports Technique, Tactics and Physical Function of General Administration of Sport of China, Scientific Research Center, Guangzhou Sport University, Guangzhou, China
| | - Liangming Li
- Center for Scientific Research and Institute of Exercise and Health, Guangzhou Sports University, Guangzhou, China
- Key Laboratory of Sports Technique, Tactics and Physical Function of General Administration of Sport of China, Scientific Research Center, Guangzhou Sport University, Guangzhou, China
- Correspondence should be addressed to L Li:
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29
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Brightwell CR, Markofski MM, Moro T, Fry CS, Porter C, Volpi E, Rasmussen BB. Moderate-intensity aerobic exercise improves skeletal muscle quality in older adults. TRANSLATIONAL SPORTS MEDICINE 2019; 2:109-119. [PMID: 31123725 PMCID: PMC6518946 DOI: 10.1002/tsm2.70] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 01/16/2019] [Accepted: 01/22/2019] [Indexed: 12/12/2022]
Abstract
Sarcopenia, age-associated involuntary loss of muscle and strength, can progress to clinically relevant functional decline. Resistance exercise attenuates muscle and strength loss but may not be feasible for some older adults. Aerobic exercise training (AET) improves cardiopulmonary health; however, effects on protein turnover, muscle mass, and strength are less clear. We aimed to determine whether AET improves basal myofibrillar protein synthesis (MPS) and capillarization, promoting hypertrophy and strength. We hypothesized that AET improves strength with increased MPS and capillarization. Older adults were randomized to non-exercise (NON; n = 11, 71.4 ± 4.18 years) or exercise (EX; n = 12, 73.7 ± 4.05 years). EX completed 24 weeks of AET (walking 3×/week, 45 minutes, 70% heart rate reserve); NON remained sedentary. A stable isotope tracer was infused. MPS and capillarization were analyzed from vastus lateralis muscle biopsies. Strength was measured via isokinetic dynamometry. Lean mass was determined with dual-energy X-ray absorptiometry. Basal MPS increased in EX (+50.7%, P = 0.01) along with capillary density (+66.4%, P = 0.03), peak oxygen consumption (+15.8%, P = 0.01), quadriceps strength (+15.1%, P = 0.01), and muscle quality (peak torque divided by leg lean mass, +15.5%, P = 0.01). Lean mass did not change (P > 0.05). AET increases muscle protein turnover and capillarization in older adults, improving muscle quality.
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Affiliation(s)
- Camille R. Brightwell
- Department of Nutrition and MetabolismUniversity of Texas Medical BranchGalvestonTexas
- Division of Neuroscience, Cell Biology and AnatomyUniversity of Texas Medical BranchGalvestonTexas
| | | | - Tatiana Moro
- Department of Nutrition and MetabolismUniversity of Texas Medical BranchGalvestonTexas
- Sealy Center on AgingUniversity of Texas Medical BranchGalvestonTexas
- Center for RecoveryPhysical Activity, and NutritionUniversity of Texas Medical BranchGalvestonTexas
| | - Christopher S. Fry
- Department of Nutrition and MetabolismUniversity of Texas Medical BranchGalvestonTexas
- Center for RecoveryPhysical Activity, and NutritionUniversity of Texas Medical BranchGalvestonTexas
| | - Craig Porter
- Center for RecoveryPhysical Activity, and NutritionUniversity of Texas Medical BranchGalvestonTexas
- Metabolism UnitShriners Hospitals for ChildrenGalvestonTexas
| | - Elena Volpi
- Sealy Center on AgingUniversity of Texas Medical BranchGalvestonTexas
- Center for RecoveryPhysical Activity, and NutritionUniversity of Texas Medical BranchGalvestonTexas
| | - Blake B. Rasmussen
- Department of Nutrition and MetabolismUniversity of Texas Medical BranchGalvestonTexas
- Sealy Center on AgingUniversity of Texas Medical BranchGalvestonTexas
- Center for RecoveryPhysical Activity, and NutritionUniversity of Texas Medical BranchGalvestonTexas
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30
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Landers-Ramos RQ, Sapp RM, Shill DD, Hagberg JM, Prior SJ. Exercise and Cardiovascular Progenitor Cells. Compr Physiol 2019; 9:767-797. [PMID: 30892694 DOI: 10.1002/cphy.c180030] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Autologous stem/progenitor cell-based methods to restore blood flow and function to ischemic tissues are clinically appealing for the substantial proportion of the population with cardiovascular diseases. Early preclinical and case studies established the therapeutic potential of autologous cell therapies for neovascularization in ischemic tissues. However, trials over the past ∼15 years reveal the benefits of such therapies to be much smaller than originally estimated and a definitive clinical benefit is yet to be established. Recently, there has been an emphasis on improving the number and function of cells [herein generally referred to as circulating angiogenic cells (CACs)] used for autologous cell therapies. CACs include of several subsets of circulating cells, including endothelial progenitor cells, with proangiogenic potential that is largely exerted through paracrine functions. As exercise is known to improve CV outcomes such as angiogenesis and endothelial function, much attention is being given to exercise to improve the number and function of CACs. Accordingly, there is a growing body of evidence that acute, short-term, and chronic exercise have beneficial effects on the number and function of different subsets of CACs. In particular, recent studies show that aerobic exercise training can increase the number of CACs in circulation and enhance the function of isolated CACs as assessed in ex vivo assays. This review summarizes the roles of different subsets of CACs and the effects of acute and chronic exercise on CAC number and function, with a focus on the number and paracrine function of circulating CD34+ cells, CD31+ cells, and CD62E+ cells. © 2019 American Physiological Society. Compr Physiol 9:767-797, 2019.
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Affiliation(s)
- Rian Q Landers-Ramos
- University of Maryland School of Public Health, Department of Kinesiology, College Park, Maryland, USA.,Education and Clinical Center, Baltimore Veterans Affairs Geriatric Research, Baltimore, Maryland, USA.,University of Maryland School of Medicine, Department of Medicine, Baltimore, Maryland, USA
| | - Ryan M Sapp
- University of Maryland School of Public Health, Department of Kinesiology, College Park, Maryland, USA
| | - Daniel D Shill
- University of Maryland School of Public Health, Department of Kinesiology, College Park, Maryland, USA
| | - James M Hagberg
- University of Maryland School of Public Health, Department of Kinesiology, College Park, Maryland, USA
| | - Steven J Prior
- University of Maryland School of Public Health, Department of Kinesiology, College Park, Maryland, USA.,Education and Clinical Center, Baltimore Veterans Affairs Geriatric Research, Baltimore, Maryland, USA.,University of Maryland School of Medicine, Department of Medicine, Baltimore, Maryland, USA
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31
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Yaribeygi H, Atkin SL, Simental‐Mendía LE, Sahebkar A. Molecular mechanisms by which aerobic exercise induces insulin sensitivity. J Cell Physiol 2019; 234:12385-12392. [DOI: 10.1002/jcp.28066] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 12/18/2018] [Indexed: 12/14/2022]
Affiliation(s)
- Habib Yaribeygi
- Chronic Kidney Disease Research Center, Shahid Beheshti University of Medical Sciences Tehran Iran
| | | | | | - Amirhossein Sahebkar
- Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences Mashhad Iran
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences Mashhad Iran
- School of Pharmacy, Mashhad University of Medical Sciences Mashhad Iran
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32
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Landers-Ramos RQ, Prior SJ. The Microvasculature and Skeletal Muscle Health in Aging. Exerc Sport Sci Rev 2018; 46:172-179. [PMID: 29652695 DOI: 10.1249/jes.0000000000000151] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Aging and aging-related declines in physical activity are associated with physical and metabolic impairments. Skeletal muscle capillarization is reduced in sedentary older adults, may contribute to impairments in skeletal muscle, and is modifiable by exercise training. This article examines the hypothesis that preservation of skeletal muscle capillarization is essential to maintain metabolism, fitness, and function with aging.
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Affiliation(s)
- Rian Q Landers-Ramos
- Baltimore Veterans Affairs Geriatric Research, Education and Clinical Center.,Department of Medicine, University of Maryland School of Medicine, Baltimore
| | - Steven J Prior
- Baltimore Veterans Affairs Geriatric Research, Education and Clinical Center.,Department of Medicine, University of Maryland School of Medicine, Baltimore.,Department of Kinesiology, University of Maryland School of Public Health, College Park, MD
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Cree-Green M, Scalzo RL, Harrall K, Newcomer BR, Schauer IE, Huebschmann AG, McMillin S, Brown MS, Orlicky D, Knaub L, Nadeau KJ, McClatchey PM, Bauer TA, Regensteiner JG, Reusch JEB. Supplemental Oxygen Improves In Vivo Mitochondrial Oxidative Phosphorylation Flux in Sedentary Obese Adults With Type 2 Diabetes. Diabetes 2018; 67:1369-1379. [PMID: 29643061 PMCID: PMC6463751 DOI: 10.2337/db17-1124] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 03/29/2018] [Indexed: 12/11/2022]
Abstract
Type 2 diabetes is associated with impaired exercise capacity. Alterations in both muscle perfusion and mitochondrial function can contribute to exercise impairment. We hypothesized that impaired muscle mitochondrial function in type 2 diabetes is mediated, in part, by decreased tissue oxygen delivery and would improve with oxygen supplementation. Ex vivo muscle mitochondrial content and respiration assessed from biopsy samples demonstrated expected differences in obese individuals with (n = 18) and without (n = 17) diabetes. Similarly, in vivo mitochondrial oxidative phosphorylation capacity measured in the gastrocnemius muscle via 31P-MRS indicated an impairment in the rate of ADP depletion with rest (27 ± 6 s [diabetes], 21 ± 7 s [control subjects]; P = 0.008) and oxidative phosphorylation (P = 0.046) in type 2 diabetes after isometric calf exercise compared with control subjects. Importantly, the in vivo impairment in oxidative capacity resolved with oxygen supplementation in adults with diabetes (ADP depletion rate 5.0 s faster, P = 0.012; oxidative phosphorylation 0.046 ± 0.079 mmol/L/s faster, P = 0.027). Multiple in vivo mitochondrial measures related to HbA1c These data suggest that oxygen availability is rate limiting for in vivo mitochondrial oxidative exercise recovery measured with 31P-MRS in individuals with uncomplicated diabetes. Targeting muscle oxygenation could improve exercise function in type 2 diabetes.
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Affiliation(s)
- Melanie Cree-Green
- Center for Women's Health Research, Anschutz Medical Campus, Aurora, CO
- Division of Pediatric Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Rebecca L Scalzo
- Center for Women's Health Research, Anschutz Medical Campus, Aurora, CO
- Division of Endocrinology and Metabolism, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Kylie Harrall
- Center for Women's Health Research, Anschutz Medical Campus, Aurora, CO
- School of Pharmacy, University of Colorado Anschutz Medical Campus, Aurora, CO
| | | | - Irene E Schauer
- Center for Women's Health Research, Anschutz Medical Campus, Aurora, CO
- Division of Endocrinology and Metabolism, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
- Veterans Affairs Medical Center, Denver, CO
| | - Amy G Huebschmann
- Center for Women's Health Research, Anschutz Medical Campus, Aurora, CO
- Division of General Internal Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Shawna McMillin
- Division of General Internal Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Mark S Brown
- Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - David Orlicky
- Division of Pathology, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Leslie Knaub
- Division of Endocrinology and Metabolism, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Kristen J Nadeau
- Center for Women's Health Research, Anschutz Medical Campus, Aurora, CO
- Division of Pediatric Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - P Mason McClatchey
- Division of Endocrinology and Metabolism, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Timothy A Bauer
- Division of General Internal Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Judith G Regensteiner
- Center for Women's Health Research, Anschutz Medical Campus, Aurora, CO
- Division of General Internal Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
- Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Jane E B Reusch
- Center for Women's Health Research, Anschutz Medical Campus, Aurora, CO
- Veterans Affairs Medical Center, Denver, CO
- Division of General Internal Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
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Schütten MTJ, Kusters YHAM, Houben AJHM, Scheijen JLJM, van de Waarenburg MPH, Schalkwijk CG, Joris PJ, Plat J, Mensink RP, de Leeuw PW, Stehouwer CDA. Aldosterone Is Not Associated With Metabolic and Microvascular Insulin Sensitivity in Abdominally Obese Men. J Clin Endocrinol Metab 2018; 103:759-767. [PMID: 29211893 DOI: 10.1210/jc.2017-01541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 11/28/2017] [Indexed: 11/19/2022]
Abstract
CONTEXT Impaired insulin-mediated muscle microvascular recruitment (IMMR) may add to the development of insulin resistance and hypertension. Increased aldosterone levels have been linked to these obesity-related complications in severely to morbidly obese individuals and to impaired microvascular function in experimental studies. OBJECTIVES To investigate whether aldosterone levels are associated with IMMR, insulin sensitivity, and blood pressure in lean and moderately abdominally obese men, and to study the effect of weight loss. DESIGN, SETTING, PARTICIPANTS, INTERVENTION, MAIN OUTCOME MEASURES In 25 lean and 53 abdominally obese men, 24-hour blood pressure measurement was performed, and aldosterone levels were measured using ultra-performance liquid chromatography tandem mass spectrometry. Insulin sensitivity was assessed by determining whole-body glucose disposal during a hyperinsulinemic clamp. IMMR in forearm skeletal muscle was measured with contrast-enhanced ultrasonography. These assessments were repeated in the abdominally obese men following an 8-week weight loss or weight stable period. RESULTS Sodium excretion and aldosterone levels were similar in lean and abdominally obese participants, but sodium excretion was inversely associated with aldosterone concentration only in the lean individuals [lean, β/100 mmol sodium excretion (adjusted for age and urinary potassium excretion) = -0.481 (95% confidence interval, -0.949 to -0.013); abdominally obese, β/100 mmol sodium excretion = -0.081 (95% confidence interval, -0.433 to 0.271); P for interaction = 0.02]. Aldosterone was not associated with IMMR, insulin sensitivity, or blood pressure and was unaffected by weight loss. CONCLUSION In moderately abdominally obese men, the inverse relationship between sodium excretion and aldosterone concentration is less than that in lean men but does not translate into higher aldosterone levels. The absolute aldosterone level does not explain differences in microvascular and metabolic insulin sensitivity and blood pressure between lean and moderately abdominally obese men.
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Affiliation(s)
- Monica T J Schütten
- Department of Internal Medicine, School for Cardiovascular Diseases, CARIM, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Yvo H A M Kusters
- Department of Internal Medicine, School for Cardiovascular Diseases, CARIM, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Alfons J H M Houben
- Department of Internal Medicine, School for Cardiovascular Diseases, CARIM, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Jean L J M Scheijen
- Department of Internal Medicine, School for Cardiovascular Diseases, CARIM, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Marjo P H van de Waarenburg
- Department of Internal Medicine, School for Cardiovascular Diseases, CARIM, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Casper G Schalkwijk
- Department of Internal Medicine, School for Cardiovascular Diseases, CARIM, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Peter J Joris
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Jogchum Plat
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Ronald P Mensink
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Peter W de Leeuw
- Department of Internal Medicine, School for Cardiovascular Diseases, CARIM, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Coen D A Stehouwer
- Department of Internal Medicine, School for Cardiovascular Diseases, CARIM, Maastricht University Medical Center, Maastricht, The Netherlands
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Laughlin MH, Yang HT, Tharp DL, Rector RS, Padilla J, Bowles DK. Vascular cell transcriptomic changes to exercise training differ directionally along and between skeletal muscle arteriolar trees. Microcirculation 2018; 24. [PMID: 27889934 DOI: 10.1111/micc.12336] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 11/14/2016] [Indexed: 01/10/2023]
Abstract
EXT-induced arteriolar adaptations in skeletal muscle are heterogeneous because of spatial variations in muscle fiber type composition and fiber recruitment patterns during exercise. The purpose of this report is to summarize a series of experiments conducted to test the hypothesis that changes in vascular gene expression are signaled by alterations in shear stress resulting from increases in blood flow, muscle fiber type composition, and fiber recruitment patterns. We also report results from a follow-up study of Ankrd23, one gene whose expression was changed by EXT. We expected to see differences in magnitude of changes in gene expression along arteriolar trees and between/among arteriolar trees but similar directional changes. However, transcriptional profiles of arterioles/arteries from OLETF rats exposed to END or SIT reveal that EXT does not lead to similar directional changes in the transcriptome among arteriolar trees of different skeletal muscles or along arteriolar trees within a particular muscle. END caused the most changes in gene expression in 2A arterioles of soleus and white gastrocnemius with little to no changes in the FAs. Ingenuity Pathway Analysis across vessels revealed significant changes in gene expression in 18 pathways. EXT increased expression of some genes (Shc1, desert hedgehog protein (Dhh), adenylate cyclase 4 (Adcy4), G protein-binding protein, alpha (Gnat1), and Bcl2l1) in all arterioles examined, but decreased expression of ubiquitin D (Ubd) and cAMP response element modulator (Crem). Many contractile and/or structural protein genes were increased by SIT in the gastrocnemius FA, but the same genes exhibited decreased expression in red gastrocnemius arterioles. Ankrd23 mRNA levels increased with increasing branch order in the gastrocnemius arteriolar tree and were increased 19-fold in gastrocnemius muscle FA by SIT. Follow-up experiments indicate that Ankrd23 mRNA level was increased 14-fold in cannulated gastrocnemius FA when intraluminal pressure was increased from 90 and 180 cm H2O for 4 hours. Also, Ankrd23-/- mice exhibit limited ability to form collateral arteries following femoral artery occlusion compared to WT mice (angioscore WT=0.18±0.03; Ankrd23-/- =0.04±0.01). Further research will be required to determine whether Ankrd23 plays an important role in mechanically induced vascular remodeling of the arterial tree in skeletal muscle.
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Affiliation(s)
- M Harold Laughlin
- Department of Biomedical Sciences, College of Veterinary Medicine, Columbia, MO, USA
| | - Hsiao T Yang
- Department of Biomedical Sciences, College of Veterinary Medicine, Columbia, MO, USA
| | - Darla L Tharp
- Department of Biomedical Sciences, College of Veterinary Medicine, Columbia, MO, USA
| | - R Scott Rector
- Department of Nutrition & Exercise Physiology, University of Missouri, Columbia, MO, USA.,Harry S Truman Memorial VA Hospital, Columbia, MO, USA
| | - Jaume Padilla
- Department of Nutrition & Exercise Physiology, University of Missouri, Columbia, MO, USA
| | - Douglas K Bowles
- Department of Biomedical Sciences, College of Veterinary Medicine, Columbia, MO, USA
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36
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Medical Nutrition Therapy and Weight Loss Questions for the Evidence Analysis Library Prevention of Type 2 Diabetes Project: Systematic Reviews. J Acad Nutr Diet 2017; 117:1578-1611. [DOI: 10.1016/j.jand.2017.06.361] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 06/20/2017] [Indexed: 01/03/2023]
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Bird SR, Hawley JA. Update on the effects of physical activity on insulin sensitivity in humans. BMJ Open Sport Exerc Med 2017; 2:e000143. [PMID: 28879026 PMCID: PMC5569266 DOI: 10.1136/bmjsem-2016-000143] [Citation(s) in RCA: 289] [Impact Index Per Article: 41.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2016] [Indexed: 01/04/2023] Open
Abstract
PURPOSE AND METHODS This review presents established knowledge on the effects of physical activity (PA) on whole-body insulin sensitivity (SI) and summarises the findings of recent (2013-2016) studies. DISCUSSION AND CONCLUSIONS Recent studies provide further evidence to support the notion that regular PA reduces the risk of insulin resistance, metabolic syndrome and type 2 diabetes, and SI improves when individuals comply with exercise and/or PA guidelines. Many studies indicate a dose response, with higher energy expenditures and higher exercise intensities, including high intensity interval training (HIIT), producing greater benefits on whole-body SI, although these findings are not unanimous. Aerobic exercise interventions can improve SI without an associated increase in cardiorespiratory fitness as measured by maximal or peak oxygen consumption. Both aerobic and resistance exercise can induce improvements in glycaemic regulation, with some suggestions that exercise regimens including both may be more efficacious than either exercise mode alone. Some studies report exercise-induced benefits to SI that are independent of habitual diet and weight loss, while others indicate an association with fat reduction, hence the debate over the relative importance of PA and weight loss continues. During exercise, muscle contraction stimulated improvements in SI are associated with increases in AMPK activity, which deactivates TCB1D1, promoting GLUT4 translocation to the cell membrane and thereby increasing glucose uptake. Postexercise, increases in Akt deactivate TCB1D4 and thereby increase GLUT4 translocation to the cell membrane. The reduction in intramuscular saturated fatty acids and concomitant reductions in ceramides, but not diacylglycerols, provide a potential link between intramuscular lipid content and SI. Increased skeletal muscle capillarisation provides another independent adaptation through which SI is improved, as does enhanced β cell activity. Recent studies are combining exercise interventions with dietary and feeding manipulations to investigate the potential for augmenting the exercise-induced improvements in SI and glycaemic control.
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Affiliation(s)
- Stephen R Bird
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
| | - John A Hawley
- Mary MaKillop Institute for Health Research, Centre for Exercise and Nutrition, Australian Catholic University, Melbourne, Victoria, Australia.,Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
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38
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Sové RJ, Goldman D, Fraser GM. A computational model of the effect of capillary density variability on oxygen transport, glucose uptake, and insulin sensitivity in prediabetes. Microcirculation 2017; 24. [DOI: 10.1111/micc.12342] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Accepted: 12/09/2016] [Indexed: 12/23/2022]
Affiliation(s)
- Richard J. Sové
- Department of Medical Biophysics; Schulich School of Medicine and Dentistry; Western University; London ON Canada
| | - Daniel Goldman
- Department of Medical Biophysics; Schulich School of Medicine and Dentistry; Western University; London ON Canada
| | - Graham M. Fraser
- Cardiovascular Research Group; Division of BioMedical Sciences; Faculty of Medicine; Memorial University of Newfoundland; St. John's NL Canada
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Blumenthal JB, Gitterman A, Ryan AS, Prior SJ. Effects of Exercise Training and Weight Loss on Plasma Fetuin-A Levels and Insulin Sensitivity in Overweight Older Men. J Diabetes Res 2017; 2017:1492581. [PMID: 28770230 PMCID: PMC5523541 DOI: 10.1155/2017/1492581] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 05/17/2017] [Indexed: 11/18/2022] Open
Abstract
Aerobic exercise training and weight loss (AEX+WL) improves insulin sensitivity in overweight adults; however, the underlying pathways are incompletely understood. Fetuin-A, a hepatokine that inhibits insulin signaling, may be involved in the salutary effects of AEX+WL. Therefore, we examined the effects of 6-month AEX+WL on plasma fetuin-A levels (36-48 hours after the last bout of exercise), aerobic capacity (VO2max), body composition, glucose tolerance, and insulin sensitivity (M) in 16 sedentary, overweight-obese older men (age = 60 ± 2 years, BMI = 31 ± 1 kg/m2) with no history of cardiovascular disease or diabetes. At baseline, fetuin-A levels correlated directly with adiposity and had a borderline inverse correlation with M. After AEX+WL, body weight decreased by ~10 kg, while both VO2max and M increased by 16% (P < 0.005 for all). Contrary to our hypothesis, plasma fetuin-A levels increased after AEX+WL (1.16 ± 0.10 g/L versus 1.70 ± 0.19 g/L, P = 0.006). This increase was unrelated to changes in body composition or glucose metabolism, but directly correlated with changes in VO2max (r = 0.57, P < 0.05). Thus, in overweight-to-obese older men, AEX+WL appears to increase plasma fetuin-A levels. Although not associated with improvements in insulin sensitivity, this increase in fetuin-A was related to improvements in aerobic capacity and could be representative of the cardioprotective effects of AEX+WL in older men.
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Affiliation(s)
- Jacob B. Blumenthal
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
- Baltimore Veterans Affairs Geriatric Research, Education and Clinical Center and Research and Development Service, Baltimore, MD, USA
- *Jacob B. Blumenthal:
| | - Anna Gitterman
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
- Baltimore Veterans Affairs Geriatric Research, Education and Clinical Center and Research and Development Service, Baltimore, MD, USA
| | - Alice S. Ryan
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
- Baltimore Veterans Affairs Geriatric Research, Education and Clinical Center and Research and Development Service, Baltimore, MD, USA
| | - Steven J. Prior
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
- Baltimore Veterans Affairs Geriatric Research, Education and Clinical Center and Research and Development Service, Baltimore, MD, USA
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40
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Berger AL. Insulin resistance and reduced brain glucose metabolism in the aetiology of Alzheimer’s disease. JOURNAL OF INSULIN RESISTANCE 2016. [DOI: 10.4102/jir.v1i1.15] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Significant epidemiological and clinical evidence has emerged that suggests Alzheimer’s disease (AD) can be added to the list of chronic illnesses that are primarily caused by modern diets and lifestyles at odds with human physiology. High intakes of refined carbohydrates insufficient physical activity, suboptimal sleep quantity and quality, and other factors that may contribute to insulin resistance combine to create a perfect storm of glycation and oxidative stress in the brain. Specific neurons lose the ability to metabolise and harness energy from glucose, ultimately resulting in neuronal degeneration and death. Simultaneously, chronic peripheral hyperinsulinaemia prevents ketogenesis, thus depriving struggling neurons of a highly efficient alternative fuel substrate. The intimate association between type 2 diabetes and AD suggests that they have common underlying causes, namely insulin resistance and perturbed glucose metabolism. Preclinical evidence of AD is detectable decades before over symptoms appear, indicating that AD progresses over time, with observable signs manifesting only after the brain’s compensatory mechanisms have failed and widespread neuronal atrophy begins to interfere with cognition and performance of daily life tasks. That dietary and environmental triggers play pivotal roles in causing AD suggests that nutrition and lifestyle based interventions may hold the key to ameliorating or preventing this debilitating condition for which conventional pharmaceutical treatments are largely ineffective. Results from small scale clinical studies indicate that dietary and lifestyle strategies may be effective for reversing dementia and cognitive impairment. Increased research efforts should be dedicated towards this promising avenue in the future.
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Wang T, Huang T, Zheng Y, Rood J, Bray GA, Sacks FM, Qi L. Genetic variation of fasting glucose and changes in glycemia in response to 2-year weight-loss diet intervention: the POUNDS LOST trial. Int J Obes (Lond) 2016; 40:1164-9. [PMID: 27113490 PMCID: PMC4935586 DOI: 10.1038/ijo.2016.41] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Revised: 01/14/2016] [Accepted: 01/28/2016] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Weight-loss intervention through diet modification has been widely used to improve obesity-related hyperglycemia; however, little is known about whether genetic variation modifies the intervention effect. We examined the interaction between weight-loss diets and genetic variation of fasting glucose on changes in glycemic traits in a dietary intervention trial. RESEARCH DESIGN AND METHODS The Preventing Overweight Using Novel Dietary Strategies (POUNDS LOST) trial is a randomized, controlled 2-year weight-loss trial. We assessed overall genetic variation of fasting glucose by calculating a genetic risk score (GRS) based on 14 fasting glucose-associated single nucleotide polymorphisms, and examined the progression in fasting glucose and insulin levels, and insulin resistance and insulin sensitivity in 733 adults from this trial. RESULTS The GRS was associated with 6-month changes in fasting glucose (P<0.001), fasting insulin (P=0.042), homeostasis model assessment of insulin resistance (HOMA-IR, P=0.009) and insulin sensitivity (HOMA-S, P=0.043). We observed significant interaction between the GRS and dietary fat on 6-month changes in fasting glucose, HOMA-IR and HOMA-S after multivariable adjustment (P-interaction=0.007, 0.045 and 0.028, respectively). After further adjustment for weight loss, the interaction remained significant on change in fasting glucose (P=0.015). In the high-fat diet group, participants in the highest GRS tertile showed increased fasting glucose, whereas participants in the lowest tertile showed decreased fasting glucose (P-trend <0.001); in contrast, the genetic association was not significant in the low-fat diet group (P-trend=0.087). CONCLUSIONS Our data suggest that participants with a higher genetic risk may benefit more by eating a low-fat diet to improve glucose metabolism.
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Affiliation(s)
- Tiange Wang
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tao Huang
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Yan Zheng
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jennifer Rood
- Pennington Biomedical Research Center of the Louisiana State University System, Baton Rouge, LA, USA
| | - George A. Bray
- Pennington Biomedical Research Center of the Louisiana State University System, Baton Rouge, LA, USA
| | - Frank M. Sacks
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Lu Qi
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
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Landers-Ramos RQ, Corrigan KJ, Guth LM, Altom CN, Spangenburg EE, Prior SJ, Hagberg JM. Short-term exercise training improves flow-mediated dilation and circulating angiogenic cell number in older sedentary adults. Appl Physiol Nutr Metab 2016; 41:832-41. [PMID: 27441589 DOI: 10.1139/apnm-2015-0637] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Cardiovascular disease risk increases with age due, in part, to impaired endothelial function and decreased circulating angiogenic cell (CAC) number and function. We sought to determine if 10 days of aerobic exercise training improves endothelial function, CAC number, and intracellular redox balance in older sedentary adults. Eleven healthy subjects (4 men, 7 women), 61 ± 2 years of age participated in 60 min of aerobic exercise at 70% maximal oxygen consumption for 10 consecutive days while maintaining body weight. Before and after training, endothelial function was measured as flow-mediated dilation of the brachial artery and fasting blood was drawn to enumerate 3 CAC subtypes. Intracellular reactive oxygen species (ROS) and nitric oxide (NO) in CD34+ CACs were measured using fluorescent probes and reinforced via real-time quantitative polymerase chain reaction. Flow-mediated dilation improved significantly following training (10% ± 1.3% before vs. 16% ± 1.4% after training; P < 0.05). Likewise, CD34+/KDR+ number increased 104% and KDR+ number increased 151% (P < 0.05 for both), although CD34+ number was not significantly altered (P > 0.05). Intracellular NO and ROS levels in CD34+ CACs were not different after training (P > 0.05 for both). Messenger RNA expression of SOD1, endothelial nitric oxide synthase, and NADPH oxidase 2 and neutrophil cytosolic factor 1 in CD34+ CACs was not significantly altered with training (P > 0.05). In conclusion, 10 consecutive days of aerobic exercise increased flow-mediated dilation and CAC number in older, previously sedentary adults, but did not affect intracellular redox balance in CD34+ CACs. Overall, these data indicate that even short-term aerobic exercise training can have a significant impact on cardiovascular disease risk factors.
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Affiliation(s)
- Rian Q Landers-Ramos
- a Department of Kinesiology, University of Maryland, College Park, MD 20742-2611, USA
| | - Kelsey J Corrigan
- a Department of Kinesiology, University of Maryland, College Park, MD 20742-2611, USA
| | - Lisa M Guth
- a Department of Kinesiology, University of Maryland, College Park, MD 20742-2611, USA
| | - Christine N Altom
- a Department of Kinesiology, University of Maryland, College Park, MD 20742-2611, USA
| | - Espen E Spangenburg
- a Department of Kinesiology, University of Maryland, College Park, MD 20742-2611, USA
| | - Steven J Prior
- b University of Maryland School of Medicine and Baltimore VA GRECC, Baltimore, MD 21201, USA
| | - James M Hagberg
- a Department of Kinesiology, University of Maryland, College Park, MD 20742-2611, USA
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Böhm A, Weigert C, Staiger H, Häring HU. Exercise and diabetes: relevance and causes for response variability. Endocrine 2016; 51:390-401. [PMID: 26643313 PMCID: PMC4762932 DOI: 10.1007/s12020-015-0792-6] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 10/28/2015] [Indexed: 12/31/2022]
Abstract
Exercise as a key prevention strategy for diabetes and obesity is commonly accepted and recommended throughout the world. Unfortunately, not all individuals profit to the same extent, some exhibit exercise resistance. This phenomenon of non-response to exercise is found for several endpoints, including glucose tolerance and insulin sensitivity. Since these non-responders are of notable quantity, there is the need to understand the underlying mechanisms and to identify predictors of response. This displays the basis to develop personalized training intervention regimes. In this review, we summarize the current knowledge on response variability, with focus on human studies and improvement of glucose homeostasis as outcome.
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Affiliation(s)
- Anja Böhm
- Department of Internal Medicine IV, Division of Endocrinology, Diabetology, Angiology, Nephrology, and Clinical Chemistry, University Hospital Tübingen, Eberhard Karls University Tübingen, 72076, Tübingen, Germany
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the Eberhard Karls University Tübingen, Tübingen, Germany
- German Center for Diabetes Research (DZD), 85764, München-Neuherberg, Germany
| | - Cora Weigert
- Department of Internal Medicine IV, Division of Endocrinology, Diabetology, Angiology, Nephrology, and Clinical Chemistry, University Hospital Tübingen, Eberhard Karls University Tübingen, 72076, Tübingen, Germany
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the Eberhard Karls University Tübingen, Tübingen, Germany
- German Center for Diabetes Research (DZD), 85764, München-Neuherberg, Germany
| | - Harald Staiger
- Department of Internal Medicine IV, Division of Endocrinology, Diabetology, Angiology, Nephrology, and Clinical Chemistry, University Hospital Tübingen, Eberhard Karls University Tübingen, 72076, Tübingen, Germany
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the Eberhard Karls University Tübingen, Tübingen, Germany
- German Center for Diabetes Research (DZD), 85764, München-Neuherberg, Germany
| | - Hans-Ulrich Häring
- Department of Internal Medicine IV, Division of Endocrinology, Diabetology, Angiology, Nephrology, and Clinical Chemistry, University Hospital Tübingen, Eberhard Karls University Tübingen, 72076, Tübingen, Germany.
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the Eberhard Karls University Tübingen, Tübingen, Germany.
- German Center for Diabetes Research (DZD), 85764, München-Neuherberg, Germany.
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Montero D. Comment on Prior et al. Increased Skeletal Muscle Capillarization Independently Enhances Insulin Sensitivity in Older Adults After Exercise Training and Detraining. Diabetes 2015;64:3386-3395. Diabetes 2016; 65:e11-2. [PMID: 26908909 DOI: 10.2337/db15-1461] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- David Montero
- Zurich Center for Integrative Human Physiology, Institute of Physiology, University of Zurich, Zurich, Switzerland
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Prior SJ, Ryan AS, Blumenthal JB, Watson JM, Katzel LI, Goldberg AP. Sarcopenia Is Associated With Lower Skeletal Muscle Capillarization and Exercise Capacity in Older Adults. J Gerontol A Biol Sci Med Sci 2016; 71:1096-101. [PMID: 26888434 DOI: 10.1093/gerona/glw017] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 01/24/2016] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Skeletal muscle capillary rarefaction limits the transcapillary transport of nutrients and oxygen to muscle and may contribute to sarcopenia and functional impairment in older adults. We tested the hypothesis that skeletal muscle capillarization and exercise capacity (VO2max) are lower in sarcopenic than in nonsarcopenic older adults and that the degree of sarcopenia is related to lower skeletal muscle capillarization. METHODS Body composition, VO2max, and vastus lateralis capillarization were determined in 76 middle-aged and older men and women (age = 61±1 years, body mass index [BMI] = 30.7±0.5kg/m(2) [mean ± SEM]). Participants were classified as sarcopenic if appendicular lean mass divided by BMI (ALMBMI) was less than 0.789 for men or less than 0.512 for women. RESULTS Sarcopenic subjects (ALMBMI = 0.65±0.04, n = 16) had 20% lower capillary-to-fiber ratio, as well as 13% and 15% lower VO2max expressed as mL/kg/min or L/min, respectively, compared with sex-, race-, and age-matched participants without sarcopenia (ALMBMI = 0.81±0.05, n = 16; p < .05). In all 76 subjects, ALMBMI, thigh muscle cross-sectional area, and VO2max correlated directly with capillarization (r = .30-.37, p ≤ .05), after accounting for age, sex, and race. CONCLUSIONS These findings suggest that low skeletal muscle capillarization is one factor that may contribute to sarcopenia and reduced exercise capacity in older adults by limiting diffusion of substrates, oxygen, hormones, and nutrients. Strategies to prevent the aging-related decline in skeletal muscle capillarization may help to prevent or slow the progression of sarcopenia and its associated functional declines in generally healthy older adults.
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Affiliation(s)
- Steven J Prior
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore. Baltimore Veterans Affairs Geriatric Research, Education and Clinical Center, and Research and Development Service, Baltimore, Maryland.
| | - Alice S Ryan
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore. Baltimore Veterans Affairs Geriatric Research, Education and Clinical Center, and Research and Development Service, Baltimore, Maryland
| | - Jacob B Blumenthal
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore. Baltimore Veterans Affairs Geriatric Research, Education and Clinical Center, and Research and Development Service, Baltimore, Maryland
| | - Jonathan M Watson
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore. Baltimore Veterans Affairs Geriatric Research, Education and Clinical Center, and Research and Development Service, Baltimore, Maryland
| | - Leslie I Katzel
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore. Baltimore Veterans Affairs Geriatric Research, Education and Clinical Center, and Research and Development Service, Baltimore, Maryland
| | - Andrew P Goldberg
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore. Baltimore Veterans Affairs Geriatric Research, Education and Clinical Center, and Research and Development Service, Baltimore, Maryland
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Kitzman DW, Brubaker P, Morgan T, Haykowsky M, Hundley G, Kraus WE, Eggebeen J, Nicklas BJ. Effect of Caloric Restriction or Aerobic Exercise Training on Peak Oxygen Consumption and Quality of Life in Obese Older Patients With Heart Failure With Preserved Ejection Fraction: A Randomized Clinical Trial. JAMA 2016; 315:36-46. [PMID: 26746456 PMCID: PMC4787295 DOI: 10.1001/jama.2015.17346] [Citation(s) in RCA: 538] [Impact Index Per Article: 67.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
IMPORTANCE More than 80% of patients with heart failure with preserved ejection fraction (HFPEF), the most common form of heart failure among older persons, are overweight or obese. Exercise intolerance is the primary symptom of chronic HFPEF and a major determinant of reduced quality of life (QOL). OBJECTIVE To determine whether caloric restriction (diet) or aerobic exercise training (exercise) improves exercise capacity and QOL in obese older patients with HFPEF. DESIGN, SETTING, AND PARTICIPANTS Randomized, attention-controlled, 2 × 2 factorial trial conducted from February 2009 through November 2014 in an urban academic medical center. Of 577 initially screened participants, 100 older obese participants (mean [SD]: age, 67 years [5]; body mass index, 39.3 [5.6]) with chronic, stable HFPEF were enrolled (366 excluded by inclusion and exclusion criteria, 31 for other reasons, and 80 declined participation). INTERVENTIONS Twenty weeks of diet, exercise, or both; attention control consisted of telephone calls every 2 weeks. MAIN OUTCOMES AND MEASURES Exercise capacity measured as peak oxygen consumption (V̇O2, mL/kg/min; co-primary outcome) and QOL measured by the Minnesota Living with Heart Failure (MLHF) Questionnaire (score range: 0-105, higher scores indicate worse heart failure-related QOL; co-primary outcome). RESULTS Of the 100 enrolled participants, 26 participants were randomized to exercise; 24 to diet; 25 to exercise + diet; 25 to control. Of these, 92 participants completed the trial. Exercise attendance was 84% (SD, 14%) and diet adherence was 99% (SD, 1%). By main effects analysis, peak V̇O2 was increased significantly by both interventions: exercise, 1.2 mL/kg body mass/min (95% CI, 0.7 to 1.7), P < .001; diet, 1.3 mL/kg body mass/min (95% CI, 0.8 to 1.8), P < .001. The combination of exercise + diet was additive (complementary) for peak V̇O2 (joint effect, 2.5 mL/kg/min). There was no statistically significant change in MLHF total score with exercise and with diet (main effect: exercise, -1 unit [95% CI, -8 to 5], P = .70; diet, -6 units [95% CI, -12 to 1], P = .08). The change in peak V̇O2 was positively correlated with the change in percent lean body mass (r = 0.32; P = .003) and the change in thigh muscle:intermuscular fat ratio (r = 0.27; P = .02). There were no study-related serious adverse events. Body weight decreased by 7% (7 kg [SD, 1]) in the diet group, 3% (4 kg [SD, 1]) in the exercise group, 10% (11 kg [SD, 1] in the exercise + diet group, and 1% (1 kg [SD, 1]) in the control group. CONCLUSIONS AND RELEVANCE Among obese older patients with clinically stable HFPEF, caloric restriction or aerobic exercise training increased peak V̇O2, and the effects may be additive. Neither intervention had a significant effect on quality of life as measured by the MLHF Questionnaire. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00959660.
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Affiliation(s)
- Dalane W. Kitzman
- Cardiology Section, Department of Internal Medicine, Wake Forest School of Medicine
| | - Peter Brubaker
- Department of Health and Exercise Science, Wake Forest University
| | - Timothy Morgan
- Department of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC
| | - Mark Haykowsky
- College of Nursing and Health Innovation, University of Texas at Arlington
| | - Gregory Hundley
- Cardiology Section, Department of Internal Medicine, Wake Forest School of Medicine
| | | | | | - Barbara J. Nicklas
- Geriatrics and Gerontology Section, Department of Internal Medicine, Wake Forest School of Medicine
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47
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Julian V, Thivel D, Pereira B, Costes F, Richard R, Duclos M. Improving Peripheral and Central Vascular Adjustments during Exercise through a Training Program in Adolescents with Obesity. Obes Facts 2016; 9:321-331. [PMID: 27701156 PMCID: PMC5644802 DOI: 10.1159/000447456] [Citation(s) in RCA: 4] [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: 02/10/2016] [Accepted: 06/01/2016] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The effects of a training program (TP) on muscle microvascularization during exercise remained to be explored in adolescents with obesity. We hypothesized that a TP would lead to better microvascular adaptations to exercise in skeletal muscle. METHODS 15 inactive adolescents followed a 12-week TP where both peripheral (muscular microvascularization) and central (cardiac) adaptations to exercise (40 min exercise set at 70% V̇O2peak) were assessed before and after intervention. Microvascular adaptations were evaluated in the Musculus vastus lateralis with near-infrared spectroscopy, by measurement of muscular blood volume (IR-BV) and tissue oxygen saturation (IR-SO2). Central adaptations were evaluated using thoracic impedance. RESULTS The TP favored lower BMI (p < 0.001), lower total and abdominal fat (p < 0.001), and a trend for the decrease in insulin resistance index (p = 0.07). V̇O2peak relative to weight (p = 0.008) and maximum power output increased (p = 0.0003). A smaller initial drop in IR-BV and IR-SO2 (p < 0.001), a prompter return of these parameters to their base values, and a higher IR-BV and IR-SO2 all times taken together (p < 0.001) were observed after completing the TP. Concerning central adaptation, cardiac output decreased (p < 0.001). CONCLUSION We demonstrate for the first time by noninvasive techniques that a training program induces peripheral and central vascular adaptations to exercise in adolescents with obesity.
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Affiliation(s)
- Valérie Julian
- Department of Sport Medicine and Functional Explorations, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
- Department of Pediatrics, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
- *Dr. Valérie Julian, Department of Sport Medicine and Functional Explorations, University Hospital of Clermont-Ferrand, 58, rue Montalembert, 63000 Clermont-Ferrand, France,
| | - David Thivel
- AME2P Laboratory, Bat Bio B, Campus Universitaire des Cezeaux, Aubiere Cedex. France
| | - Bruno Pereira
- Biostatistics Unit (Department of Clinical Research and Innovation), University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Frédéric Costes
- Department of Sport Medicine and Functional Explorations, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Ruddy Richard
- Department of Sport Medicine and Functional Explorations, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Martine Duclos
- Department of Sport Medicine and Functional Explorations, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
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48
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Tucker WJ, Nelson MD, Beaudry RI, Halle M, Sarma S, Kitzman DW, Gerche AL, Haykowksy MJ. Impact of Exercise Training on Peak Oxygen Uptake and its Determinants in Heart Failure with Preserved Ejection Fraction. Card Fail Rev 2016; 2:95-101. [PMID: 28785460 DOI: 10.15420/cfr.2016:16:2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Heart failure with preserved ejection (HFpEF) accounts for over 50 % of all HF cases, and the proportion is higher among women and older individuals. A hallmark feature of HFpEF is dyspnoea on exertion and reduced peak aerobic power (VO2peak) secondary to central and peripheral abnormalities that result in reduced oxygen delivery to and/or utilisation by exercising skeletal muscle. The purpose of this brief review is to discuss the role of exercise training to improve VO2peak and the central and peripheral adaptations that reduce symptoms following physical conditioning in patients with HFpEF.
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Affiliation(s)
- Wesley J Tucker
- College of Nursing and Health Innovation, University of Texas at Arlington, Arlington,Texas, USA
| | - Michael D Nelson
- College of Nursing and Health Innovation, University of Texas at Arlington, Arlington,Texas, USA
| | - Rhys I Beaudry
- College of Nursing and Health Innovation, University of Texas at Arlington, Arlington,Texas, USA
| | | | - Satyam Sarma
- Institute for Exercise and Environmental Medicine,Texas Health Presbyterian Hospital, Dallas.,University of Texas Southwestern Medical Center,Dallas, Texas, USA
| | - Dalane W Kitzman
- Wake Forest School of MedicineWinston-Salem, North Carolina, USA
| | - Andre La Gerche
- Sport Cardiology, Baker IDI Heart Institute,Melbourne, Victoria, Australia
| | - Mark J Haykowksy
- College of Nursing and Health Innovation, University of Texas at Arlington, Arlington,Texas, USA.,Sport Cardiology, Baker IDI Heart Institute,Melbourne, Victoria, Australia
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49
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Laughlin MH. Physical activity-induced remodeling of vasculature in skeletal muscle: role in treatment of type 2 diabetes. J Appl Physiol (1985) 2015; 120:1-16. [PMID: 26472876 DOI: 10.1152/japplphysiol.00789.2015] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 10/08/2015] [Indexed: 01/15/2023] Open
Abstract
This manuscript summarizes and discusses adaptations of skeletal muscle vasculature induced by physical activity and applies this understanding to benefits of exercise in prevention and treatment of type 2 diabetes (T2D). Arteriolar trees of skeletal muscle are heterogeneous. Exercise training increases capillary exchange and blood flow capacities. The distribution of vascular adaptation to different types of exercise training are influenced by muscle fiber type composition and fiber recruitment patterns that produce different modes of exercise. Thus training-induced adaptations in vascular structure and vascular control in skeletal muscle are not homogeneously distributed throughout skeletal muscle or along the arteriolar tree within a muscle. Results summarized indicate that similar principles apply to vascular adaptation in skeletal muscle in T2D. It is concluded that exercise training-induced changes in vascular gene expression differ along the arteriolar tree and by skeletal muscle fiber type composition. Results suggest that it is unlikely that hemodynamic forces are the only exercise-induced signals mediating the regulation of vascular gene expression. In patients with T2D, exercise training is perhaps the most effective treatment of the many related symptoms. Training-induced changes in the vasculature and in insulin signaling in the muscle fibers and vasculature augment glucose and insulin delivery as well as glucose uptake. If these adaptations occur in a sufficient amount of muscle mass, exposure to hyperglycemia and hyperinsulinemia will decrease along with the risk of microvascular complications throughout the body. It is postulated that exercise sessions in programs of sufficient duration, that engage as much skeletal muscle mass as possible, and that recruit as many muscle fibers within each muscle as possible will produce the greatest benefit. The added benefit of combined resistance and aerobic training programs and of high-intensity exercise programs is not simply "more exercise is better".
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Affiliation(s)
- M Harold Laughlin
- Department of Biomedical Sciences, Department of Medical Pharmacology & Physiology, and Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri
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50
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Prior SJ, Goldberg AP, Ortmeyer HK, Chin ER, Chen D, Blumenthal JB, Ryan AS. Increased Skeletal Muscle Capillarization Independently Enhances Insulin Sensitivity in Older Adults After Exercise Training and Detraining. Diabetes 2015; 64:3386-95. [PMID: 26068543 PMCID: PMC4587640 DOI: 10.2337/db14-1771] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 05/23/2015] [Indexed: 01/04/2023]
Abstract
Intramuscular signaling and glucose transport mechanisms contribute to improvements in insulin sensitivity after aerobic exercise training. This study tested the hypothesis that increases in skeletal muscle capillary density (CD) also contribute to exercise-induced improvements in whole-body insulin sensitivity (insulin-stimulated glucose uptake per unit plasma insulin [M/I]) independent of other mechanisms. The study design included a 6-month aerobic exercise training period followed by a 2-week detraining period to eliminate short-term effects of exercise on intramuscular signaling and glucose transport. Before and after exercise training and detraining, 12 previously sedentary older (65 ± 3 years) men and women underwent research tests, including hyperinsulinemic-euglycemic clamps and vastus lateralis biopsies. Exercise training increased Vo2max (2.2 ± 0.2 vs. 2.5 ± 0.2 L/min), CD (313 ± 13 vs. 349 ± 18 capillaries/mm(2)), and M/I (0.041 ± 0.005 vs. 0.051 ± 0.007 μmol/kg fat-free mass/min) (P < 0.05 for all). Exercise training also increased the insulin activation of glycogen synthase by 60%, GLUT4 expression by 16%, and 5' AMPK-α1 expression by 21%, but these reverted to baseline levels after detraining. Conversely, CD and M/I remained 15% and 18% higher after detraining, respectively (P < 0.05), and the changes in M/I (detraining minus baseline) correlated directly with changes in CD in regression analysis (partial r = 0.70; P = 0.02). These results suggest that an increase in CD is one mechanism contributing to sustained improvements in glucose metabolism after aerobic exercise training.
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Affiliation(s)
- Steven J Prior
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD Baltimore Veterans Affairs Geriatric Research Education and Clinical Center and Research and Development Service, Baltimore, MD
| | - Andrew P Goldberg
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD Baltimore Veterans Affairs Geriatric Research Education and Clinical Center and Research and Development Service, Baltimore, MD
| | - Heidi K Ortmeyer
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD Baltimore Veterans Affairs Geriatric Research Education and Clinical Center and Research and Development Service, Baltimore, MD
| | - Eva R Chin
- Department of Kinesiology, University of Maryland School of Public Health, College Park, MD
| | - Dapeng Chen
- Department of Kinesiology, University of Maryland School of Public Health, College Park, MD
| | - Jacob B Blumenthal
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD Baltimore Veterans Affairs Geriatric Research Education and Clinical Center and Research and Development Service, Baltimore, MD
| | - Alice S Ryan
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD Baltimore Veterans Affairs Geriatric Research Education and Clinical Center and Research and Development Service, Baltimore, MD
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