Effects of exercise intervention on vascular endothelium functions of patients with impaired glucose tolerance during prediabetes mellitus

Yiping Liu, Jianwei Li, Zhenghong Zhang, Yedong Tang, Zuosong Chen, Zhengchao Wang, Yiping Liu, Jianwei Li, Zhenghong Zhang, Yedong Tang, Zuosong Chen, Zhengchao Wang

Abstract

Endothelial dysfunction (ED) is an early pathophysiological change in patients with impaired glucose tolerance (IGT) during prediabetes mellitus. This study was designed to test the hypothesis that exercise intervention contributes to the reversal of vascular endothelium-dependent dysfunction in middle-aged patients with IGT. Following exercise intervention, significant changes in endothelin (ET)-1, C-type natriuretic peptide (CNP), ΔDia-P, oral glucose tolerance test (OGTT)2h, fasting insulin, homeostasis model of assessment-insulin resistance (HOMA-IR), body fat percentage, waist circumference and waist to hip ratio were measured. However, no marked changes in carotid artery intima-media thickness (IMT), fasting blood glucose and BMI were observed following exercise intervention. Validity analysis of index changes in the two exercise intervention groups further confirmed there was no change. Exercise intervention increased CNP levels, decreased ET-1 levels and increased ΔDia-P, indicating improved vascular endothelium function. Decreased HOMA-IR following exercise suggests enhanced insulin sensitivity. Exercise intervention also improved glucose metabolism via decreased OGTT2h and fasting insulin. In addition, decreased waist circumference, ratio of waist to hip and body fat percentage following exercise intervention improved changes of body composition, including BMI, body fat and waist circumference. These results indicate that exercise intervention may reverse vascular endothelium-dependent dysfunction in middle-aged patients with IGT. This study also provided direct clinical data supporting the use of exercise intervention to prevent diabetes mellitus (DM) during the early stage.

Keywords: diabetes mellitus; exercise intervention; impaired glucose tolerance.

References

    1. Mazzali G, Di Francesco V, Zoico E, et al. Interrelations between fat distribution, muscle lipid content, adipocytokines, and insulin resistance: effect of moderate weight loss in older women. Am J Clin Nutr. 2006;84:1193–1199.
    1. Pratley RE, Gilbert M. Clinical management of elderly patients with type 2 diabetes mellitus. Postgrad Med. 2012;124:133–143.
    1. Reaven GM. Insulin resistance: the link between obesity and cardiovascular disease. Med Clin North Am. 2011;95:875–892.
    1. Haque N, Salma U, Nurunnabi TR, Uddin MJ, Jahangir MF, Islam SM, Kamruzzaman M. Management of type 2 diabetes mellitus by lifestyle, diet and medicinal plants. Pak J Biol Sci. 2011;14:13–24.
    1. O’Gorman DJ, Krook A. Exercise and the treatment of diabetes and obesity. Med Clin North Am. 2011;95:953–969.
    1. Ryan AS. Exercise in aging: its important role in mortality, obesity and insulin resistance. Aging health. 2010;6:551–563.
    1. Martins AR, Nachbar RT, Gorjao R, et al. Mechanisms underlying skeletal muscle insulin resistance induced by fatty acids: importance of the mitochondrial function. Lipids Health Dis. 2012;11:30.
    1. Smutok MA, Reece C, Kokkinos PF, et al. Effects of exercise training modality on glucose tolerance in men with abnormal glucose regulation. Int J Sports Med. 1994;15:283–289.
    1. Pan XR, Li GW, Hu YH, et al. Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. The Da Qing IGT and Diabetes Study Diabetes Care. 1997;20:537–544.
    1. Tuomilehto J, Lindström J, Eriksson JG, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001;344:1343–1350.
    1. Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, Nathan DM. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346:393–403.
    1. Rewers M, Shetterly SM, Baxter J, Marshall JA, Hamman RF. Prevalence of coronary heart disease in subjects with normal and impaired glucose tolerance and non-insulin-dependent diabetes mellitus in a biethnic Colorado population. The San Luis Valley Diabetes Study. Am J Epidemiol. 1992;135:1321–1330.
    1. Schnell O, Standl E. Impaired glucose tolerance, diabetes, and cardiovascular disease. Endocr Pract. 2006;12(Suppl 1):S16–S19.
    1. Bonetti PO, Lerman LO, Lerman A. Endothelial dysfunction: a marker of atherosclerotic risk. Arterioscler Thromb Vasc Biol. 2003;23:168–175.
    1. Harriss DJ, Atkinson G. Update - ethical standards in sport and exercise science research. Int J Sports Med. 2011;32:819–821.
    1. Jiang CM, Zhang YM. The advancement and developing trend of physical fitness study in China. China Sport Sci. 2008;28:25–32. (In Chinese)
    1. The Writing Group of Guidelines of China Diabetes Prevention and Control. The diagnosis and classification of diabetes. In: Guidelines of China Diabetes Prevention and Control Writing Group, editor. Guidelines of China Diabetes Prevention and Control. 1st edition. Peking University Medical Press; Peking: 2004. pp. 10–12.
    1. Brendle DC, Joseph LJ, Corretti MC, Gardner AW, Katzel LI. Effects of exercise rehabilitation on endothelial reactivity in older patients with peripheral arterial disease. Am J Cardiol. 2001;87:324–329.
    1. Georgiou D, Belardinelli R. Exercise and coronary endothelial function. N Engl J Med. 2000;343:147–148.
    1. Eriksson J, Taimela S, Eriksson K, Parviainen S, Peltonen J, Kujala U. Resistance training in the treatment of non-insulin-dependent diabetes mellitus. Int J Sports Med. 1997;18:242–246.
    1. Melby C, Scholl C, Edwards G, Bullough R. Effect of acute resistance exercise on postexercise energy expenditure and resting metabolic rate. J Appl Physiol. 1993;75:1847–1853.
    1. Hamed S, Brenner B, Roguin A. Nitric oxide: a key factor behind the dysfunctionality of endothelial progenitor cells in diabetes mellitus type-2. Cardiovasc Res. 2011;91:9–15.
    1. Emori T, Hirata Y, Imai T, Eguchi S, Kanno K, Marumo F. Cellular mechanism of natriuretic peptides-induced inhibition of endothelin-1 biosynthesis in rat endothelial cells. Endocrinology. 1993;133:2474–2480.
    1. Evans JJ, Youssef AH, Yandle TG, Lewis LK, Nicholls MG. Effects of endothelin-1 on release of adrenomedullin and C-type natriuretic peptide from individual human vascular endothelial cells. J Endocrinol. 2002;175:225–232.

Source: PubMed

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