Improved blood pressure and flow‐mediated dilatation via increased plasma adropin and nitrate/nitrite induced by high‐intensity interval training in patients with type 2 diabetes

Abstract

Adropin is a newly identified bioactive protein that is important in energy hemostasis and vascular endothelial function. Lower levels of adropin in patients with type 2 diabetes are related to coronary atherosclerosis, characterized by impaired flowmediated dilatation (FMD). The purpose of the present study was to investigate FMD and plasma levels of adropin and nitrite/nitrate (NOx) in patients with type 2 diabetes at baseline and follow-up after 12 weeks of high-intensity interval training (HIIT) or moderate-intensity continuous training (MICT). Sixty-six persons with type 2 diabetes were divided into HIIT, MICT, and control groups. The HIIT group intervention was 12 intervals (1.5 min) at 85-90% maximal heart rate (HR max ) separated by 2 min at 55-60% HR max in three sessions per week for 12 weeks. MICT training consisted of 42 min of cycling at 70% HR max . Before and after the intervention, FMD was recorded with high-resolution Doppler ultrasound. Plasma levels of adropin and NOx were measured by enzyme-linked immunosorbent assay. After training FMD was significantly higher in the MICT and HIIT groups compared to the control group (P < 0.05). Plasma levels of adropin and NOx were higher in both exercise groups, but the increase was greater in the HIIT group (P < 0.01). Peak oxygen consumption was increased after exercise training in both groups compared to the control group (P < 0.01). Percentage FMD showed a positive correlation with plasma levels of adropin and NOx (both P < 0.01), and a negative correlation with diastolic blood pressure (r = −0.530, P = 0.035) and systolic blood pressure (r = −0.606, P = 0.013) in the HIIT group. The results

Role of adropin in arterial stiffening associated with obesity and type 2 diabetes

“…Furthermore, adropin was no longer different than the control group despite a higher BMI (24). Likewise, middle-aged T2D subjects also demonstrated an increase in adropin following 12 weeks of moderate-intensity continuous exercise intervention consisting of cycling for 42 minutes at 70% HRmax (140). While continuous moderate-intensity exercise elicited an increase in adropin, high-intensity interval training, consisting of 12 1.5-minute intervals of 85-90% HRmax separated by 2 minutes of active recovery at 55-60% HRmax, induced a more robust increase in adropin concentrations in T2D subjects (140).…”

“…Likewise, middle-aged T2D subjects also demonstrated an increase in adropin following 12 weeks of moderate-intensity continuous exercise intervention consisting of cycling for 42 minutes at 70% HRmax (140). While continuous moderate-intensity exercise elicited an increase in adropin, high-intensity interval training, consisting of 12 1.5-minute intervals of 85-90% HRmax separated by 2 minutes of active recovery at 55-60% HRmax, induced a more robust increase in adropin concentrations in T2D subjects (140). In diet-induced non-alcoholic steatohepatitis mice, aerobic exercise training via treadmill run at 75% maximal volume of O2 (VO2max) 5 days per week for either 8-or12-weeks increased hepatic Enho expression and circulating adropin concentrations in concert with reduced body weight (145).…”

“…Meda et al (137) did report an increase in Enho mRNA expression in estrogen-treated ovariectomized mice. Despite the role of estrogen signaling in the regulation of hepatic Enho mRNA expression, males have higher circulating concentrations of adropin (21,29,138), however, this has not been universally reported (28,(139)(140)(141). Moreover, Choi et al (142) have reported that T2D females exhibit higher adropin concentrations than their male T2D counterparts.…”

The effect of exercise on flow-mediated dilation in people with type 2 diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials

“…The mean time from T2DM to intervention of participants ranged from 1.43 to 21.1 years. Most interventions specified aerobic exercise ( n = 7) ( 26 , 28 – 31 , 34 , 35 ), high-intensity interval training (HIIT, n = 5) ( 24 , 26 – 28 , 31 ), resistance exercise ( n = 3) ( 27 , 30 , 36 ), and multicomponent training ( n = 3) ( 25 , 32 , 33 ). For aerobic exercise, the total duration of intervention ranged from 8 to 12 weeks, with an average of 11.3 weeks, the frequency of intervention per week was 3 times, and minutes of intervention per session ranged from 30 to 62 minutes, with an average of 54 minutes.…”

Adropin Predicts Chronic Kidney Disease in Type 2 Diabetes Mellitus Patients with Chronic Heart Failure

“…Yet, elevated serum adropin levels after treatment with sitagliptin or SGLT2 inhibitors were strongly associated with improvements in fasting blood glucose, glycosylated haemoglobin (HbA1c), insulin sensitivity, and NP levels [ 26 , 27 ]. Along with it, aerobic exercise training was able to increase plasma levels of adropin in connection with blood pressure reduction by increasing nitric oxide production and bioavailability [ 28 ]. On the contrary, in patients with cardiac dysfunction, the serum levels of adropin increased significantly according to the New York Heart Association (NYHA) class of HF and demonstrated a tendency to decrease during treatment with hydralazine combined with sodium nitroprusside and SGLT2 inhibitors [ 27 , 29 , 30 , 31 ].…”