Journal
NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES
Volume 20, Issue 8, Pages 608-617Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.numecd.2009.04.015
Keywords
Type 2 diabetes; Cardiovascular disease; Exercise; Inflammation; Insulin resistance; Physical fitness
Funding
- Metabolic Fitness Organization, Rome, Italy
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Background and aims: We investigated the effect of different exercise modalities on high sensitivity-C reactive protein (hs-CRP) and other inflammatory markers in patients with type 2 diabetes and the metabolic syndrome. Methods and results: Eighty-two patients were randomized into 4 groups: sedentary control (A); receiving counseling to perform low-intensity physical activity (B); performing prescribed and supervised high-intensity aerobic (C) or aerobic + resistance (D) exercise (with the same caloric expenditure) for 12 months. Evaluation of leisure-time physical activity and assessment of physical fitness, cardiovascular risk factors and inflammatory biomarkers was performed at baseline and every 3 months. Volume of physical activity increased and HbA(1c) decreased in Groups B-D. VO2max, HOMA-IR index, HDL-cholesterol, waist circumference and albuminuria improved in Groups C and D, whereas strength and flexibility improved only in Group D. Levels of hs-CRP decreased in all three exercising groups, but the reduction was significant only in Groups C and D, and particularly in Group D. Changes in VO2max and the exercise modalities were strong predictors of hs-CRP reduction, independent of body weight. Leptin, resistin and interleukin-6 decreased, whereas adiponectin increased in Groups C and D. Interleukin-1 beta, tumor necrosis factor-alpha and interferon-gamma decreased, whereas anti-inflammatory interleukin-4 and 10 increased only in Group D. Conclusion: Physical exercise in type 2 diabetic patients with the metabolic syndrome is associated with a significant reduction of hs-CRP and other inflammatory and insulin resistance biomarkers, independent of weight loss. Long-term high-intensity (preferably mixed) training, in addition to daytime physical activity, is required to obtain a significant anti-inflammatory effect. (C) 2009 Elsevier B.V. All rights reserved.
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