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

Comparative Efficacy of 5 Exercise Types on Cardiometabolic Health in Overweight and Obese Adults: A Systematic Review and Network Meta-Analysis of 81 Randomized Controlled Trials

“…129 Such exercise-induced adaptations have been associated with reduced reactive oxygen species levels that potentially cause insulin resistance via a nuclear factor kappa B–dependent impairment of insulin-stimulated glucose uptake. 126 It should also be noted that an exercise-induced rise in lactate levels usually seen in response to CT, 130 HYB, 19 and INT 123 may activate some key molecular mechanisms responsible for regulating whole-body glucose homeostasis. Increased CRF seen in response to CT, HYB, and INT has been linked to increased GLUT4-mediated glucose transport, oxidative enzyme capacity, and mitochondrial biogenesis.…”

The dose-response effect of high-intensity interval neuromuscular training on health, performance and quality of life in overweight and obese adults

“…Such exercise-induced adaptations have been associated with reduced reactive oxygen species levels that potentially cause insulin resistance via a nuclear factor kappa B dependent impairment of insulin-stimulated glucose uptake (125). It should also be noted that an exercise-induced rise in lactate levels usually seen in response to CT (129), HYB (19), and INT (122) may activate some key molecular mechanisms responsible for regulating whole-body glucose homeostasis.…”