Impact of interval walking training managed through smart mobile devices on albuminuria and leptin/adiponectin ratio in patients with type 2 diabetes

Abstract

Background Interval walking training has demonstrated more pronounced positive effects on physical fitness and metabolism in type 2 diabetes (T2D), compared to continuous walking. One of the pathogenic mechanisms of T2D is associated with derangements in leptin/adiponectin axis, which might predispose affected individuals to vascular inflammation and albuminuria. The aim of this study was to investigate the effects of interval walking training delivered through smart mobile devices upon albuminuria and leptin/adiponectin ratio in patients with T2D. Methods Patients with T2D aged 35–75 were randomized into control ( n = 26) and interval training (IT, n = 14) groups. Patients in IT group had to perform three 60‐min interval walking sessions (3 min intervals of slow and fast walking with the intensity of 40% and 70% of the peak energy expenditure) per week delivered by smartphone application for four months. The adherence to training was monitored remotely. Outcome measures were albuminuria, leptin/adiponectin ratio, obesity indicators, and glycaemic control. Leptin and adiponectin concentration was measured in serum samples by Luminex technology. Results In the IT group compared to control group, we observed a statistically significant decrease in albuminuria ( p = .002) and leptin/adiponectin ratio ( p = .01), as well as a decrease in HbA1c close to statistical significance ( p = .09). In IT group, changes in leptin/adiponectin ratio correlated significantly with changes in hip circumference ( p = .024). Conclusion Interval walking training is beneficial for vascular health in T2D via impact on albuminuria and leptin/adiponectin ratio.

Effects of Exercise Training on Inflammatory and Cardiometabolic Risk Biomarkers in Patients With Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…Of those 46 studies, 25 met the inclusion criteria, and the other 21 studies were excluded: (A) 15 did not include control groups, (B) two included ages less than 18 years, (C) one used acute training; (D) three did not report complete data (lacked either pre-test or post-test data). In total, 25 RCTs (Ahmadi et al, 2012; Annibalini et al, 2017; Baigzadeh et al, 2020; Balducci et al, 2010; Boudou et al, 2003; Brooks et al, 2007; Corpeleijn et al, 2007; Doğan Dede et al, 2014; Gokulakrishnan et al, 2017; Ibáñez et al, 2010; Jorge et al, 2011; Kadoglou, Iliadis, Angelopoulou, et al, 2007; Kadoglou, Iliadis, Liapis, et al, 2007; Ku et al, 2010; Mendham et al, 2014; Moghadasi et al, 2011; Moghadasi et al, 2012; Okada et al, 2010; Parsian et al, 2012; Rokling-Andersen et al, 2007; Sixt et al, 2010; Sokolovska et al, 2020; Wu et al, 2011; Yang et al, 2020; Zhang et al, 2017) were included ( N = 1257 participants; 679 in the intervention groups, and 578 in the control groups). A flow diagram of the study search and selection, including reasons for exclusion, is shown in Figure 1.

Figure 1.PRISMA flow diagram of the literature search.

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“…Studies were carried out in Iran (5), USA (1), Japan (1), South Korea (1), Greece (2), Finland (1), Germany (1), China (2), Turkey (1), India (1), Latvia (1), Taiwan (1), France (1), Spain (1), Italy (2), Brazil (1), Australia (1), and Norway (1). Based on biological sex classification criteria, nine studies exclusively recruited male participants (Ahmadi et al, 2012; Annibalini et al, 2017; Baigzadeh et al, 2020; Boudou et al, 2003; Gokulakrishnan et al, 2017; Mendham et al, 2014; Moghadasi et al, 2011, 2012; Parsian et al, 2012), two studies exclusively recruited female participants (Ibáñez et al, 2010; Ku et al, 2010), and 14 studies recruited both males and females (Balducci et al, 2010; Brooks et al, 2007; Corpeleijn et al, 2007; Doğan Dede et al, 2014; Jorge et al, 2011; Kadoglou, Iliadis, Angelopoulou, et al, 2007; Kadoglou, Iliadis, Liapis, et al, 2007; Okada et al, 2010; Rokling-Andersen et al, 2007; Sixt et al, 2010; Sokolovska et al, 2020; Wu et al, 2011; Yang et al, 2020; Zhang et al, 2017). Based on age classification criteria, in 24 studies the mean age of participants varied from 40 to 67 years.…”

“…One study did not report the mean age of participants (Sixt et al, 2010). Two studies included adults with diabetes who were classified on average as normal weight according to BMI (Wu et al, 2011; Yang et al, 2020), nine as overweight (Annibalini et al, 2017; Baigzadeh et al, 2020; Boudou et al, 2003; Corpeleijn et al, 2007; Gokulakrishnan et al, 2017; Ku et al, 2010; Okada et al, 2010; Rokling-Andersen et al, 2007; Zhang et al, 2017), and 13 studies included obese participants (Ahmadi et al, 2012; Balducci et al, 2010; Brooks et al, 2007; Doğan Dede et al, 2014; Ibáñez et al, 2010; Jorge et al, 2011; Kadoglou, Iliadis, Angelopoulou, et al, 2007; Kadoglou, Iliadis, Liapis, et al, 2007; Mendham et al, 2014; Moghadasi et al, 2011; Moghadasi et al, 2012; Parsian et al, 2012; Sokolovska et al, 2020). One study did not report the mean BMI of participants (Sixt et al, 2010).…”

“…The number of training sessions per week ranged from 2 to 5 per week. Based on the training program classification criteria, 14 studies employed aerobic exercise training (Ahmadi et al, 2012; Corpeleijn et al, 2007; Doğan Dede et al, 2014; Gokulakrishnan et al, 2017; Kadoglou, Iliadis, Angelopoulou, et al, 2007; Kadoglou, Iliadis, Liapis, et al, 2007; Mendham et al, 2014; Moghadasi et al, 2011; Parsian et al, 2012; Rokling-Andersen et al, 2007; Sixt et al, 2010; Wu et al, 2011; Yang et al, 2020; Zhang et al, 2017), two studies included resistance training (Brooks et al, 2007; Ibáñez et al, 2010), two studies included combined training (aerobic plus resistance) (Annibalini et al, 2017; Okada et al, 2010), one study examined aerobic + combined (aerobic + resistance) (Baigzadeh et al, 2020), two studies included all three methods of training (aerobic, resistance, and combined) (Balducci et al, 2010; Jorge et al, 2011), one study included interval aerobic training (Boudou et al, 2003), one study used aerobic and resistance training (Ku et al, 2010), one study used interval walking training (Sokolovska et al, 2020), and one study used high-intensity intermittent training (Moghadasi et al, 2012). The relevant characteristics for each of the included studies are provided in Table 1.…”

“…Subgroup analysis by type of training also indicated no significant changes in HDL-C, LDL-C, TG, and TC following aerobic, resistance, interval, and combined (aerobic + resistance) training types. Sokolovska et al (2020) investigated the impact of interval training (three 60-min walking sessions per week, at 40% and 70% of peak energy expenditure, for a 4-month period) on lipid profile in 40 patients (aged 35–75 years) with T2DM. Results of this study showed that the levels of HDL-C, LDL-C and TG did not change.…”