Effects of aerobic exercise on adiponectin levels potentially mediated by vitamin D in type 2 diabetic patients

Abstract

Objective. The positive effects of exercise on adiponectin and vitamin D have independently been reported. Recent studies have suggested that vitamin D increases adiponectin synthesis through inhibition of the rennin-angiotensin system in adipose tissue. However, studies evaluating the effects of an aerobic exercise on adiponectin and vitamin D simultaneously investigating the potential mechanism of vitamin D-dependent adiponectin pathways in patients with type 2 diabetes mellitus (T2DM) are still limited. This study was undertaken to examine the effects of aerobic exercise on adiponectin and its association with vitamin D in patients with T2DM. Methods. Total twenty-two patients with T2DM were randomly divided into intervention and control group. The intervention group underwent a moderate intensity of a walking mode treadmill aerobic exercise for four weeks. The exercise protocol was adapted from modified Bruce test with a periodic speed and inclination increase. In both groups, body mass index (BMI), vitamin D, and adiponectin levels, were measured before and after four weeks of the lasting program. Results. The mean of the increased adiponectin and vitamin D levels after exercise was significantly higher in the intervened than the control group, but statistically significant difference was only found in the adiponectin effect (p=0.017). There was a significant association found between vitamin D and adiponectin in the intervention group after data adjustments to age and BMI (p=0.005). Conclusion. Moderate intensity of treadmill exercise with increased speed and inclination periodically increased adiponectin level in patients with T2DM. The increased adiponectin might potentially be mediated by increased vitamin D, but the level of their association impact was dependent on the age and BMI.

The effect of physical activity on vitamin D: A systematic review and meta-analysis of intervention studies in humans

“…We identified 946 articles through our database searches and three additional articles were identified through reference list searches. After removing duplicates, the titles and abstracts of 667 articles were screened; 123 full-text articles were assessed for eligibility, 32 were included in the review [ [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] ] and 24 in the meta-analysis [ [22] , [23] , [24] , [25] , [26] , 29 , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [40] , [41] , [42] , [43] , [45] , [46] , [47] , [48] , [49] , 51 ] ( Fig. 1 ).…”

“…In most studies the physical activity interventions were supervised but two home-based physical activity programs were unsupervised [ 26 , 40 ] and two studies had both supervised training sessions and unsupervised home-based sessions [ 39 , 44 ]. Six studies did not clearly state whether the physical activity sessions were supervised or not [ 36 , 38 , [46] , [47] , [48] , 52 ]. The frequency of the physical activity interventions ranged from once a week to once daily, with the length of each session ranging from 30 to 75 min.…”

“…The interventions in the control group were: no intervention (n = 16); vitamin D or vitamin D and calcium (n = 9; the intervention group received the same dose); placebo tablets of vitamin D (n = 2); non-exercise intervention (n = 3) such as health education classes, sham exercise training (breathing and stretching) combined with nutrition counselling, and cognitive training. In one study, the control group were encouraged to maintain a lifestyle based on standard medical care for diabetic patients that included a minimum of 150 min per week exercise [ 52 ]. One study maintained usual medical care in bariatric surgery patients in the control group [ 45 ].…”

“…Eight studies were not included in the meta-analysis due to the way the results were presented. Four of these, all of which were conducted indoors or indoors-presumed, reported that the change in 25(OH)D concentration from baseline to post-intervention differed minimally between the intervention and control groups [ 27 , 50 , 52 , 53 ]. Three studies found a greater change in the intervention group compared with the control group [ 30 , 39 , 44 ].…”

Molecular Crosstalk Between Vitamin D and Non-alcoholic Fatty Liver Disease

“…121 It is also reported that aerobic exercise can help to promote the vitamin D-mediated elevation of adiponectin level in T2DM. 122 Moreover, a single intramuscular injection of vitamin D (300,000 IU) can improve the adiponectin level in gestational diabetes mellitus. 123 Multiple studies have revealed that vitamin D is inversely correlated with the level of proinflammatory cytokines, such as TNFα, interleukin (IL) 1 beta (IL1β), IL6, IL8, IL17A and IL33 (Fig.…”