The effect of 8 weeks aerobic exercise training on cardiovascular risk factors in men with type 2 diabetes mellitus
محورهای موضوعی : Report of Health CareSeyyed Zoheir Rabei 1 , Mohsen Salesi 2
1 - MSc in Physical Education, Department of Physical Education, Shiraz University, Shiraz, Iran
2 - Associated Professor, Department of Physical Education, Shiraz University, Shiraz, Iran
کلید واژه: aerobic exercise, Cardiovascular risk factors, Type 2 diabetes mellitus,
چکیده مقاله :
Introduction: Individuals with diabetes are often diagnosed with low high-density lipoprotein cholesterol (HDL-C) concentration, hypertriglyceridemia and development of cardiovascular disease (CVD). The purpose of this study was to determine the impact of aerobic training on blood profile and inflammatory marker (CRP) of type 2 diabetes mellitus (T2DM) people.
Methods: Thirty diabetic males were recruited (age: 50.34 ± 10.28 years) and randomly assigned to 8 weeks aerobic exercise training (n = 15) and control groups (n = 15). Before and after training blood pressure, weight, lipid profile (Total cholesterol [TC], triglyceride [TG], low-density lipoprotein cholesterol (LDL-C), HDL-C) and high-sensitivity C-reactive protein (hs-CRP) were measured. Exercise training was in mode of walking and consisted of 5 exercise sessions/week at 50%–70% heart rate maximum and began with 25 minutes of walking. Training increased each week by 5 minutes until 60 minutes of walking was reached. Each exercise session included approximately 10 minutes of warm-up and cool-down periods.
Results: Resting systolic blood pressure decreased following 8 weeks of aerobic training (pre 139 ± 16 vs post 121 ± 11 mm Hg, P = 0.04). Also, TG significantly decreased (pre 210.19 ± 9.31 vs 191.12 ± 7.25, P = 0.03) and HDL-C significantly increased (pre 42.37 ± 3.15 vs 47.56 ± 2.19, P = 0.01) after exercise training. However, there was no difference between groups in TC, LDL-C, body mass index (BMI) and weight. In addition, a decrease in fasting blood glucose levels showed a significant difference between groups (pre 142.43 ± 7.96 vs 121.17 ± 8.32, P = 0.04).
Conclusion: Regular aerobic exercise training can improve the lipid profile and reduce the cardiovascular risk factors in T2DM patients. Exercise, like walking, is inexpensive and has relatively few negative side effects when performed properly.
1. Whiting DR, Guariguata L, Weil C, Shaw J. IDF diabetes atlas: global estimates of the prevalence of diabetes for 2011 and 2030. Diabetes Res Clin Pract 2011; 94(3): 311-21.
2. Sicree R, Shaw J, Zimmet P. Diabetes and Impaired Glucose Tolerance. In: Gan D, ed. Diabetes Atlas. 3rd ed. Belgium: International Diabetes Federation; 2007.
3. Yach D, Stuckler D, Brownell KD. Epidemiologic and economic consequences of the global epidemics of obesity and diabetes. Nat Med 2006; 12(1): 62-6.
4. Kara MT, Levi M, Choudhury D. Diabetes and chronic kidney disease. In: Arici M, ed. Management of Chronic Kidney Disease: A Clinician’s Guide. Berlin, Heidelberg: Springer; 2014. p. 43-55.
5. Kaizu S, Kishimoto H, Iwase M, Fujii H, Ohkuma T, Ide H, et al. Impact of leisure-time physical activity on glycemic control and cardiovascular risk factors in Japanese patients with type 2 diabetes mellitus: the Fukuoka Diabetes Registry. PLoS One 2014; 9(6): e98768.
6. Gadi R, Samaha FF. Dyslipidemia in type 2 diabetes mellitus. Curr Diab Rep 2007; 7(3): 228-34.
7. Wang X, Bao W, Liu J, Ouyang YY, Wang D, Rong S, et al. Inflammatory markers and risk of type 2 diabetes: a systematic review and meta-analysis. Diabetes care 2013; 36(1): 166-75.
8. Doi Y, Kiyohara Y, Kubo M, Ninomiya T, Wakugawa Y, Yonemoto K, et al. Elevated C-reactive protein is a predictor of the development of diabetes in a general Japanese population: the Hisayama Study. Diabetes Care 2005; 28(10): 2497-500.
9. Donath MY, Shoelson SE. Type 2 diabetes as an inflammatory disease. Nat Rev Immunol 2011; 11(2): 98-107.
10. Pontiroli AE. Type 2 diabetes mellitus is becoming the most common type of diabetes in school children. Acta Diabetol 2004; 41(3): 85-90.
11. Bailes BK. Diabetes mellitus and its chronic complications. AORN J 2002; 76(2): 266-76.
12. Madden KM. Evidence for the benefit of exercise therapy in patients with type 2 diabetes. Diabetes Metab Syndr Obes 2013; 6: 233-9.
13. Kodama S, Tanaka S, Saito K, Shu M, Sone Y, Onitake F, et al. Effect of aerobic exercise training on serum levels of high-density lipoprotein cholesterol: a meta-analysis. Arch Intern Med 2007; 167(10): 999-1008.
14. Alam S, Stolinski M, Pentecost C, Boroujerdi MA, Jones RH, Sonksen PH. The effect of a six-month exercise program on very low-density lipoprotein apolipoprotein B secretion in type 2 diabetes. J Clin Endocrinol Metab 2004; 89(2): 688-94.
15. Gordon LA, Morrison EY, McGrowder DA, Young R, Fraser YT, Zamora EM, et al. Effect of exercise therapy on lipid profile and oxidative stress indicators in patients with type 2 diabetes. BMC Complement Altern Med 2008; 8: 21.
16. Di Loreto C, Fanelli C, Lucidi P, Murdolo G, De Cicco A, Parlanti N, et al. Make your diabetic patients walk: long-term impact of different amounts of physical activity on type 2 diabetes. Diabetes Care 2005; 28(6): 1295-302.
17. Lira FS, Yamashita AS, Uchida MC, Zanchi NE, Gualano B, Martins E Jr, et al. Low and moderate, rather than high intensity strength exercise induces benefit regarding plasma lipid profile. Diabetol Metab Syndr 2010; 2: 31.
18. Santiago M, Leon A, Serfass R. Failure of 40 weeks of brisk walking to alter blood lipids in normolipemic women. Can J Appl Physiol 1995; 20(4): 417-28
19. Kelley GA, Kelley KS. Effects of aerobic exercise on lipids and lipoproteins in adults with type 2 diabetes: a meta-analysis of randomized-controlled trials. Public Health 2007; 121(9): 643-55.
20. Zhang JQ, Thomas TR, Ball SD. Effect of exercise timing on postprandial lipemia and HDL cholesterol sub fractions. J Appl Physiol (1985) 1998; 85(4): 1516-22.
21. Annuzzi G, Jansson E, Kaijser L, Holmquist L, Carlson LA. Increased removal rate of exogenous triglycerides after prolonged exercise in man: time course and effect of exercise duration. Metabolism 1987; 36(5): 438-43.
22. Kiens B, Lithell H, Mikines KJ, Richter EA. Effects of insulin and exercise on muscle lipoprotein lipase activity in man and its relation to insulin action. J Clin Invest 1989; 84(4): 1124-9.
23. Thompson PD, Crouse SF, Goodpaster B, Kelley D, Moyna N, Pescatello L. The acute versus the chronic response to exercise. Med Sci Sports Exerc 2001; 33(6 Suppl): S438-45.
24. Boreham CA, Kennedy RA, Murphy MH, Tully M, Wallace WF, Young I. Training effects of short bouts of stair climbing on cardiorespiratory fitness, blood lipids, and homocysteine in sedentary young women. Br J Sports Med 2005; 39(9): 590-3.
25. Helge JW, Damsgaard R, Overgaard K, Andersen JL, Donsmark M, Dyrskog SE, et al. Low‐intensity training dissociates metabolic from aerobic fitness. Scand J Med Sci Sports 2008; 18(1): 86-94.
26. Angelopoulos TJ1, Sivo SA, Kyriazis GA, Caplan JD, Zoeller RF, Lowndes J, et al. Do age and baseline LDL cholesterol levels determine the effect of regular exercise on plasma lipoprotein cholesterol and apolipoprotein B levels? Eur J Appl Physiol 2007; 101(5): 621-8
27. Pescatello LS, Franklin BA, Fagard R, Farquhar WB, Kelley GA, Ray CA, et al. American College of Sports Medicine position stand. Exercise and hypertension. Med Sci Sports Exerc 2004; 36(3): 533-53.
28. Chrysohoou C, Pitsavos C, Panagiotakos DB, Kokkinos PF, Stefanadis C, Toutouzas P. The association between physical activity and the development of acute coronary syndromes in treated and untreated hypertensive subjects. J Clin Hypertens (Greenwich) 2003; 5(2):115-20.
29. Brum PC, Da Silva GJ, Moreira ED, Ida F, Negrão CE, Krieger EM. Exercise training increases baroreceptor gain sensitivity in normal and hypertensive rats. Hypertension 2000; 36(6): 1018-22.
30. Zinman B, Ruderman N, Campaigne BN, Devlin JT, Schneider SH; American Diabetes Association. Physical activity/exercise and diabetes mellitus. Diabetes Care 2003; 26 Suppl 1: S73-7.
31. Goldberg Y, Boaz M, Matas Z, Goldberg I, Shargorodsky M. Weight loss induced by nutritional and exercise intervention decreases arterial stiffness in obese subjects. Clin Nutr 2009; 28(1): 21-5.
32. Herder C, Peltonen M, Koenig W, Sütfels K, Lindström J, Martin S, et al. Anti-inflammatory effect of lifestyle changes in the Finnish Diabetes Prevention Study. Diabetologia 2009; 52(3): 433-42.
33. Nassis GP, Papantakou K, Skenderi K, Triandafillopoulou M, Kavouras SA, Yannakoulia M, et al. Aerobic exercise training improves insulin sensitivity without changes in body weight, body fat, adiponectin, and inflammatory markers in overweight and obese girls. Metabolism 2005; 54(11): 1472-9.
34. Kohut ML, McCann DA, Russell DW, Konopka DN, Cunnick JE, Franke WD. 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(3): 201-9.
35. Hewitt JA, Whyte GP, Moreton M, van Someren KA, Levine TS. The effects of a graduated aerobic exercise programme on cardiovascular disease risk factors in the NHS workplace: a randomised controlled trial.J Occup Med Toxicol 2008; 3: 7.
36. Campbell KL, Campbell PT, Ulrich CM, Wener M, Alfano CM, Foster-Schubert K, et al. No reduction in C-reactive protein following a 12-month randomized controlled trial of exercise in men and women. Cancer Epidemiol Biomarkers Prev 2008; 17(7): 1714-8.
37. Marcell TJ, McAuley KA, Traustadóttir T, Reaven PD. Exercise training is not associated with improved levels of C-reactive protein or adiponectin. Metabolism 2005; 54(4): 533-41.
38. Pedersen BK. The anti-inflammatory effect of exercise: its role in diabetes and cardiovascular disease control. Essays Biochem 2006; 42: 105-117.
39. Shephard RJ. Cytokine responses to physical activity, with particular reference to IL-6: sources, actions, and clinical implications. Crit Rev Immunol 2002; 22(3): 165-182.
40. Woods JA, Vieira VJ, Keylock KT. Exercise, inflammation, and innate immunity. Neurol Clin 2006; 24(3): 585-99.
