Impact of combined training with different exercise intensities on inflammatory and lipid markers in type 2 diabetes: a secondary analysis from a 1-year randomized controlled trial

Abstract

Background Exercise is a well-accepted strategy to improve lipid and inflammatory profile in individuals with type 2 diabetes (T2DM). However, the exercise intensity having the most benefits on lipids and inflammatory markers in patients with T2DM remains unclear. We aimed to analyse the impact of a 1-year combined high-intensity interval training (HIIT) with resistance training (RT), and a moderate continuous training (MCT) with RT on inflammatory and lipid profile in individuals with T2DM. Methods Individuals with T2DM (n = 80, aged 59 years) performed a 1-year randomized controlled trial and were randomized into three groups (control, n = 27; HIIT with RT, n = 25; MCT with RT, n = 28). Exercise sessions were supervised with a frequency of 3 days per week. Inflammatory and lipid profiles were measured at baseline and at 1-year follow-up. Changes in inflammatory and lipid markers were assessed using generalized estimating equations. Results After adjusting for sex, age and baseline moderate-to-vigorous physical activity (MVPA), we observed a time-by-group interaction for Interleukin-6 (IL-6) in both the MCT with RT (β = − 0.70, p = 0.034) and HIIT with RT (β = − 0.62, p = 0.049) groups, whereas, only the HIIT with RT group improved total cholesterol (β = − 0.03, p = 0.045) and LDL-C (β = − 0.03, p = 0.034), when compared to control. No effect was observed for C-reactive protein (CRP), cortisol, tumour necrosis factor-α (TNF-α), soluble form of the haptoglobin-hemoglobin receptor CD163 (sCD163), triglycerides and HDL-C in both groups (p > 0.05). Conclusions Favorable adaptations on IL-6 were observed in both the HIIT and MCT combined with RT groups following a long-term 1-year exercise intervention in individuals with T2DM. However, only the HIIT with RT prevented further derangement of total cholesterol and LDL-C, when compared to the control group. Therefore, in order to encourage exercise participation and improve inflammatory profile, either exercise protocols may be prescribed, however, HIIT with RT may have further benefits on the lipid profile. Trial registration Clinicaltrials.gov ID: NCT03144505

Inflammatory, antioxidant and glycemic status to different mode of high-intensity training in type 2 diabetes mellitus

“…Although these results are in line with prior investigations, which found only the HIIT with RT group improved TC and LDL-C compared to the control group (32). In another study, improvements for TG, HDL, and SBP has been found following the HIIT intervention (8).…”

Effects of High-Intensity Interval Training on Inflammatory Biomarkers in Patients with Type 2 Diabetes. A Systematic Review

“…Magalhães et al, 2020 [50] No significant results found for the HIIT group. However, there was a significant reduction in the MCT (−3.6 ± 16.4 pg/mL) Group compared with the control (7.0 ± 17.3 pg/mL) (p = 0.047) for the IL-6.…”

“…Out of the seven clinical trials used, the one ranking the highest as per the methodological evaluation scale reached 21 points out of 26 [ 50 ]. The one with the lowest score got 11 points out of 26 [ 51 ].…”

The Effects of Aerobic-Resistance Training and Broccoli Supplementation on Plasma Dectin-1 and Insulin Resistance in Males with Type 2 Diabetes

“…Our study also shows that insulin and insulin resistance (HOMA-IR) levels decreased in the S, TP, and TS groups, compared to their baseline levels with the greatest improvement in the TS group. CARET is a more potent exercise modality in improving insulin and glucose uptake in individuals with T2D [36][37][38], likely because of the different mechanisms of CARET [17,36,38]. For example, the activation of larger groups of muscle mass compared to resistance training or aerobic training alone, leading to greater improvements in insulin resistance and glucose uptake [17,38].…”