Hypoxia and Exercise in the Elderly

Hypoxia and Aerobic Exercise Interactions in Age-related Metabolic Muscle Dysfunction

Ageing is the primary risk factor for most chronic diseases including type 2 diabetes mellitus. Sarcopenia and muscular mitochondrial dysfunction with aging are crucial mechanisms leading to decreased exercise tolerance and worsened insulin sensitivity. Thus, metabolic disease and frailty, which limits physical mobility as well as quality of life, share common cellular mechanisms.

The investigators will test the hypothesis that a combination of normobaric hypoxia and exercise training elicits a synergistic effect on age-associated metabolic skeletal muscle dysfunction and the investigators will address the molecular mechanisms. In a randomized clinical study, the investigators will compare normoxic and hypoxic training conditions in elderly subjects. Outcome measures will focus on whole body insulin sensitivity and mitochondrial responses in skeletal muscle before and after the 8-week training intervention.

Study Overview

• Status: Completed
• Conditions: Elderly Persons
• Intervention / Treatment: Other: Hypoxic exercise; Other: Normoxic Exercise

• Study Type: Interventional
• Enrollment (Actual): 29
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Germany
  • Lower Saxony
    • Hannover, Lower Saxony, Germany, 30625
      • Hannover Medical School

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 55 years to 75 years (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• 55 to 75 years of age
• body mass index: 20 - 35 kg/m2
• weight stable during last 6 months before screening (weight change < 2% body weight)
• HOMA-index of insulin resistance ≥ 2 to 4 units

Exclusion Criteria:

• more than 1 hour of scheduled exercise training per week
• known diagnosis of type 2 diabetes or measured HbA1c > 6,5%
• known drug or alcohol abuse
• any contraindication to perform exercise training
• acute or chronic infections
• increased bleeding risk by history, INR > 1,3, use of anticoagulants

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Hypoxic Exercise; Supervised, progressive aerobic exercise for 8 weeks under hypoxic conditions	Other: Hypoxic exercise; Supervised, progressive aerobic exercise program for 8 weeks under hypoxic conditions
Sham Comparator: Normoxic exercise; Supervised, progressive aerobic exercise for 8 weeks under normoxic conditions	Other: Normoxic Exercise; Supervised, progressive aerobic exercise program for 8 weeks under normoxic conditions

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Insulin sensitivity	Insulin sensitivity is assessed via the hyperinsulinemic euglycemic glucose clamp and expressed as the glucose infusion rate (GIR) in ml	At baseline and after 8 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Maximum oxygen uptake	Maximum oxygen uptake is measured during an incremental exhaustive exercise test and is expressed in ml/min/kg	At baseline and after 8 weeks
Mitochondrial number	Mitochondrial number and selected gene expression assessed from muscle biopsies from the vastus lateralis.	At baseline and after 8 weeks
Fat and carbohydrate oxidation during exercise	Fat and carbohydrate oxidation during exercise is assessed during an incremental exercise test by measurements of gas exchange and expressed as g/min	At baseline and after 8 weeks
Body fat and body fat free mass	Measured via by air-displacement plethysmography (ADP) and expressed in kg	At baseline and after 8 weeks
Health related quality of life	Assessed using the short form 36 (SF-36) questionnaires	At baseline and after 8 weeks

Collaborators and Investigators

• Sponsor: Hannover Medical School
• Collaborators: German Diabetes Center
• Investigators: Principal Investigator: Sven Haufe, Dr., Hannover Medical School

Publications and helpful links

General Publications

• Hein M, Chobanyan-Jurgens K, Tegtbur U, Engeli S, Jordan J, Haufe S. Effect of normobaric hypoxic exercise on blood pressure in old individuals. Eur J Appl Physiol. 2021 Mar;121(3):817-825. doi: 10.1007/s00421-020-04572-6. Epub 2020 Dec 23.
• Chobanyan-Jurgens K, Scheibe RJ, Potthast AB, Hein M, Smith A, Freund R, Tegtbur U, Das AM, Engeli S, Jordan J, Haufe S. Influences of Hypoxia Exercise on Whole-Body Insulin Sensitivity and Oxidative Metabolism in Older Individuals. J Clin Endocrinol Metab. 2019 Nov 1;104(11):5238-5248. doi: 10.1210/jc.2019-00411.

Study record dates

Study Major Dates

• Study Start (Actual): June 1, 2015
• Primary Completion (Actual): September 1, 2017
• Study Completion (Actual): January 1, 2019

Study Registration Dates

• First Submitted: July 18, 2014
• First Submitted That Met QC Criteria: July 18, 2014
• First Posted (Estimated): July 22, 2014

Study Record Updates

• Last Update Posted (Actual): June 29, 2025
• Last Update Submitted That Met QC Criteria: June 26, 2025
• Last Verified: August 1, 2017

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Signs and Symptoms, Respiratory; Hypoxia
• Other Study ID Numbers: HA 7037/2-1