Abstract
Aims
The study was designed to compare a combined aerobic and resistance training (ART)
with an aerobic training (AT) over hemodynamic, glucose metabolism and endothelial
factors, adipokines and pro-inflammatory marker release in a population of obese type
2 diabetic patients.
Methods
Forty-seven patients were randomly assigned to aerobic (27 patients) or aerobic plus
resistance (20 patients) exercise trainings, on the top of a diet regime. Anthropometric,
metabolic, hormonal and inflammatory variables were measured at hospitalization and
discharge.
Results
Both exercise programs equally improved body weight and fructosamine levels however
ART only partially decreased HOMA index compared with AT (ART: −25% vs AT: −54%, p < 0.01). Mean blood pressure (AT: −3.6 mmHg vs ART: +0.6 mmHg, p < 0.05) and endothelin-1 (ET-1) incremental areas during walking test (AT: −11% vs ART:
+30%, p < 0.001) decreased after AT while increased after ART. Adiponectin levels increased
by 54% after AT while decreased by 13% after ART (p < 0.0001) and matrix metalloproteinase-2 (MMP-2), tumor necrosis factor-alpha (TNF-alpha)
and monocyte chemoattractan protein-1 (MCP-1) levels significantly decreased in AT
while increased in ART group.
Conclusions
Compared with AT, ART similarly enhanced body weight loss but exerted less positive
effects on insulin sensitivity and endothelial factors, adipokines and pro-inflammatory
marker release.
Abbreviations:
AT (aerobic training), ART (aerobic and resistance training), RT (resistance training), HOMA (homeostasis model assessment), MMP-2 (matrix metalloproteinase-2), TNF-alpha (tumor necrosis factor-alpha), MCP-1 (monocyte chemoattractan protein-1), FM (fat mass), FFM (fat free mass), NO (nitric oxide), FFA (free fatty acids), ET-1 (endothelin-1)Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Diabetes Research and Clinical PracticeAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Influence of physical training on blood glucose control, glucose tolerance, insulin secretion, and insulin action in non-insulin-dependent diabetic patients.Diab Care. 1984; 7: 416-420
- Effects of exercise on glycemic control and body mass in type 2 diabetes mellitus: a meta-analysis of controlled clinical trials.JAMA. 2001; 286: 1218-1227
- Mobilization of visceral adipose tissue related to the improvement in insulin sensitivity in response to physical training in NIDDM. Effects of branched-chain amino acid supplements.Diab Care. 1997; 20: 385-391
- Exercise and type 2 diabetes.Med Sci Sports Exerc. 2000; 32: 1345-1360
- Standards of medical care in diabetes-2006.Diab Care. 2006; 29: S4-S42
- Effects of exercise training modality on glucose tolerance in men with abnormal glucose regulation.Int J Sports Med. 1994; 15: 283-289
- Exercise and physical activity for older adults.Med Sci Sports Exerc. 1998; 30: 992-1008
- Resistance training and intra-abdominal adipose tissue in older men and women.Med Sci Sports Exerc. 2002; 34: 1023-1028
- Progression models in resistance training for healthy adults.Am Coll Sports Med. 2009; 41: 687-708
- Effects of exercise frequency on functional fitness in older adult women.Arc Gerontol Geriatr. 2007; 44: 163-173
- A meta-analysis to determine the dose response for strength development.Med Sci Sports Exerc. 2003; 35: 456-464
- The effect of aerobic versus resistance exercise training on peak cardiac power output and physical functional capacity in patients with chronic heart failure.Int J Cardiol. 2010; 145: 526-528
- Effect of intensive outpatient physical training on gait performance and cardiovascular health in people with hemiparesis after stroke.Phys Ther. 2010; 90: 527-537
- Effects of different modes of exercise training on glucose control and risk factors for complications in type 2 diabetic patients: a meta-analysis.Diab Care. 2006; 29: 2518-2527
- Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III).JAMA. 2001; 285: 2486-2497
- Obesity in older adults: technical review and position statement of the American Society for Nutrition and NAASO, The Obesity Society.Am J Clin Nutr. 2005; 82: 923-934
- Nutrition support in the obese, diabetic patient: the role of hypocaloric feeding.Curr Opin Gastroenterol. 2009; 25: 151-154
- Insulin sensitivity and lipids levels in obese subjects after slimming diets with different complex and simple carbohydrate content.Int J Obes Relat Metab Disord. 1993; 17: 375-381
- Behavioural treatments for chronic systemic inflammation: effects of dietary weight loss and exercise training.CMAJ. 2005; 172: 1199-1209
- Age-predicted maximal heart rate revisited.J Am Coll Cardiol. 2001; 37: 153-156
- Weight loss, exercise, or both and physical function in obese older adults.N Engl J Med. 2011; 364: 1218-1229
- New bioimpedance analysis system: improved phenotyping with whole-body analysis.Eur J Clin Nutr. 2004; 58: 1479-1484
- Reliability and intensity of the six-minute walk test in healthy elderly subjects.Med Sci Sports Exerc. 2003; 35: 169-174
- ATS statement: guidelines for the six-minute walk test.Am J Respir Crit Care Med. 2002; 166: 111-117
- Homeostasis model assessment as a clinical index of insulin resistance in type 2 diabetic patients treated with sulfonylureas.Diab Care. 1999; 22: 818-822
- Protein nutrition, exercise and aging.J Am Coll Nutr. 2004; 23: 601S-609S
- Decrease in Akt/PKB signalling in human skeletal muscle by resistance exercise.Eur J Appl Physiol. 2008; 104: 57-65
- Adipose tissue lipolysis is upregulated in lean and obese men during acute resistance exercise.Diab Care. 2008; 31: 1397-1399
- Associations between physical fitness and HbA(1c) in type 2 diabetes mellitus on behalf of the Diabetes Aerobic and Resistance Exercise (DARE) trial investigators.Diabetologia. 2011; 54: 93-102
- Effect of exercise training on physical fitness in type II diabetes mellitus.Med Sci Sports Exerc. 2010; 42: 1439-1447
- Effects of aerobic and resistance training on hemoglobin A1c levels in patients with type 2 diabetes.JAMA. 2010; 304: 2253-2262
- Combined aerobic and resistance exercise for patients with type 2 diabetes.JAMA. 2010; 304: 2298-2299
- Unfavorable effects of resistance training on central arterial compliance: a randomized intervention study.Circulation. 2004; 110: 2858-2863
- Low-intensity resistance exercise with slow lifting and lowering does not increase noradrenalin and cardiovascular responses.Clin Physiol Funct Imaging. 2009; 29: 32-37
- Circulating soluble transferrin receptor concentration decreases after exercise-induced improvement of insulin sensitivity in obese individuals.Int J Obes. 2009; 33: 768-774
- The adipose triglyceride lipase, adiponectin and visfatin are downregulated by tumor necrosis factor-alpha (TNF-alpha) in vivo.Cytokine. 2009; 45: 12-19
- Anti-inflammatory effect of exercise training in subjects with type 2 diabetes and the metabolic syndrome is dependent on exercise modalities and independent of weight loss.Nutr Metab Cardiovasc Dis. 2010; 20: 608-617
- Effects of exercise combined with caloric restriction on inflammatory cytokines.Appl Physiol Nutr Metab. 2010; 35: 573-582
- Changes in inflammatory mediators following eccentric exercise of the elbow flexors.Exerc Immunol Rev. 2004; 10: 75-90
- Aerobic exercise, but not flexibility/resistance exercise, reduces serum IL-18, CRP, and IL-6 independent of beta-blockers, BMI, and psychosocial factors in older adults.Brain Behav Immun. 2006; 20: 201-209
- Effect of high-frequency resistance exercise on adaptive responses in skeletal muscle.Med Sci Sports Exerc. 2007; 39: 2135-2144
- Improved endothelial function following a 14-month resistance exercise training program in adults with type 2 diabetes.Diab Res Clin Pract. 2008; 79: 405-411
- Twice-weekly progressive resistance training decreases abdominal fat and improves insulin sensitivity in older men with type 2 diabetes.Diab Care. 2005; 28: 662-667
- The impact of training modalities on the clinical benefits of exercise intervention in patients with cardiovascular disease risk or type 2 diabetes mellitus.Sports Med. 2010; 40: 921-940
- Discriminated benefits of a Mediterranean dietary pattern within a hypocaloric diet program on plasma RBP4 concentrations and other inflammatory markers in obese subjects.Endocrine. 2009; 36: 445-451
- Effects of adiposity and 30 days of caloric restriction upon protein metabolism in moderately vs. severely obese women.Obesity. 2010; 18: 1135-1142
Article info
Publication history
Published online: September 05, 2011
Accepted:
August 1,
2011
Received in revised form:
July 20,
2011
Received:
June 9,
2011
Identification
Copyright
© 2011 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
