Moderate intensity exercise improves heart rate variability in obese adults with type 2 diabetes

Goit, Rajesh Kumar; Pant, Bhawana; Shrewastwa, Mukesh Kumar

doi:10.1016/j.ihj.2017.10.003

Cited by 19 publications

(32 citation statements)

References 50 publications

(52 reference statements)

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“…Two studies did not provide precise details regarding the intensity of exercises [19,52] and one used "moderate vigorous" exercises without further details [58]. The control of the intensity during exercise was achieved by using a heart rate monitor in 13 studies [20,21,23,24,[53][54][55][57][58][59][60][61][62], the Borg scale in one study [25], and was not reported in 7 studies [19,22,52,56,[63][64][65]. Heterogeneity of intensity measurements precluded further analyses.…”

Section: Study Characteristics: Inclusion and Exclusion Criteriamentioning

confidence: 99%

“…After a supervised training, SDNN (effect size = 0.84; 95%CI 0.42 to 1.25) [22,24,54,[54][55][56][62][63][64], RMSSD (0.82, 0.43 to 1.21) [22,54,56,[62][63][64], pNN50 (0.85, 0.55 to 1.15) [20,22,[62][63][64] were significantly higher; LF (-0.61,-1.01 to -0.21) [23,54,56,[62][63][64][65] and LF/HF (-0.72,-1.07 to -0.37) [23,54,56,[62][63][64][65] were significantly lower, HF (0.82,0.26 to 1.37) [23,54,56,[62][63][64][65] was significantly higher. After a partially supervised training, there were no changes in any HRV parameters except an increase in LF (0.33, 0.01 to 0.65) [21,57,58].…”

Section: Meta-analysis Stratified By Type Of Supervisionmentioning

confidence: 99%

“…We also limited the influence of extreme results and heterogeneity by repeating analyses after the exclusion of studies with results not evenly distributed around the funnel plots. Finally, even though in some studies [23,24,53,55,60,[62][63][64][65] patients were asked not to change their dietary intake, an assessment of their dietary intake should have been conducted to verify that the exercise intervention did not modify their eating habits (that could be a confounding factor).…”

Section: Limitationsmentioning

confidence: 99%

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Effect of exercise training on heart rate variability in type 2 diabetes mellitus patients: A systematic review and meta-analysis

et al. 2021

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Background Cardiac autonomic neuropathy is a common complication of type 2 diabetes mellitus (T2DM), that can be measured through heart rate variability (HRV)–known to be decreased in T2DM. Physical exercise can improve HRV in healthy population, however results are under debate in T2DM. We conducted a systemic review and meta-analysis to assess the effects of physical exercise on HRV in T2DM patients. Method PubMed, Cochrane, Embase, and ScienceDirect databases were searched for all studies reporting HRV parameters in T2DM patients before and after exercise training, until September 20th 2020, without limitation to specific years. We conducted random-effects meta-analysis stratified by type of exercise for each of the HRV parameters: RR–intervals (or Normal to Normal intervals–NN), standard deviation of RR intervals (SDNN), percentage of adjacent NN intervals varying by more than 50 milliseconds (pNN50), root mean square of successive RR-intervals differences (RMSSD), total power, Low Frequency (LF), High Frequency (HF) and LF/HF ratio. Sensitivity analyses were computed on studies with the highest quality. Results We included 21 studies (9 were randomized) for a total of 523 T2DM patients: 472 had an exercise training and 151 were controls (no exercise). Intervention was endurance (14 studies), resistance (2 studies), endurance combined with resistance (4 studies), and high intensity interval training (HIIT) (4 studies). After exercise training, all HRV parameters improved i.e. an increase in SDNN (effect size = 0.59, 95%CI 0.26 to 0.93), RMSSD (0.62, 0.28 to 0.95), pNN50 (0.62, 0.23 to 1.00), HF (0.58, -0.16 to 0.99), and a decrease in LF (-0.37, -0.69 to -0.05) and LF/HF (-0.52, -0.79 to -0.24). There were no changes in controls. Stratification by type of exercise showed an improvement in most HRV parameters (SDNN, RMSSD, pNN50, LF, HF, LF/HF) after endurance training, whereas mostly LF/HF was improved after both resistance training and HIIT. Supervised training improved most HRV parameters. Duration and frequency of training did not influence the benefits on HRV. Conclusion Exercise training improved HRV parameters in T2DM patients which may reflect an improvement in the activity of the autonomic nervous system. The level of proof is the highest for endurance training. Supervised training seemed beneficial.

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Section: Study Characteristics: Inclusion and Exclusion Criteriamentioning

confidence: 99%

Section: Meta-analysis Stratified By Type Of Supervisionmentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

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Effect of exercise training on heart rate variability in type 2 diabetes mellitus patients: A systematic review and meta-analysis

et al. 2021

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“…For instance, exercise training strengthens the heart’s ability to use fatty acids to provide energy by increasing the activity of related enzymes, which prevents lipid excessive accumulation in heart 43 . Besides, exercise training improves heart function such as cardiac contractibility and reduces heart failure in obesity individuals 44–47 . Moreover, it has been reported that exercise increases cardiac SOD and FOXO activity and enhances the ability of myocardial cells to resist oxidative stress 12,48 .…”

Section: Discussionmentioning

confidence: 99%

CardiacNmnat/NAD⁺/SIR2 pathways activation mediates endurance exercise resistance to heart defects induced by a high-fat diet in agingDrosophila

Zheng

Lü

et al. 2021

Preprint

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Endurance exercise is an important way to resist and treat a high-fat-diet(HFD)-induced heart defects, but the underlying molecular mechanisms are poorly understood. Here, we used Drosophila to identify whether cardiac Nmnat/NAD+/SIR2 pathways activation could mediate endurance exercise resistance to heart defects. The results showed that endurance exercise activated the cardiac Nmnat/NAD+/SIR2/FOXO pathway and Nmnat/NAD+/SIR2/PGC-1α pathway, including up-regulating cardiac Nmnat, SIR2, FOXO, PGC-1α expression, SOD activity, and NAD+ level, and it prevented HFD-induced or cardiac Nmnat knock-down-induced cardiac lipid accumulation, MDA content and fibrillation increase, and fractional shortening decrease. Cardiac Nmnat overexpression activated heart Nmnat/NAD+/SIR2 pathways and resisted HFD-induced cardiac malfunction, but it could not protect against HFD-induced lifespan reduction and locomotor impairment. Exercise improved lifespan and mobility in cardiac Nmnat knock-down flies. Therefore, current results confirmed that cardiac Nmnat/NAD+/SIR2 pathways were important antagonists of HFD-induced heart defects. The cardiac Nmnat/NAD+/SIR2 pathways activation was the important underlying molecular mechanism of endurance exercise and cardiac Nmnat overexpression against heart defects in Drosophila.

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“…In the present study, an increase in SD1 was greater than in SD2. Some authors have interpreted this index as follows: a lower ratio implies both a decreased vagal tone and increased sympathetic in uence 43,44 .…”

Section: Discussionmentioning

confidence: 99%

Differences in Heart Rate Variability and Body Composition in Breast Cancer Survivors and Women Without Cancer

Escutia-Reyes

Garduño-García

López-Chávez

et al. 2021

Preprint

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Purpose: To explore cardiac autonomic changes assessed by linear and nonlinear indexes of heart rate variability (HRV) and body composition modifications in breast cancer survivors and cancer-free control women. Methods: Women who were breast cancer survivors (BCS, n=27) and cancer-free control participants with similar characteristics (Control, n=31) were enrolled in the Regional General Hospital No. 251 of the Mexican Institute of Social Security (Metepec, Mexico). We processed five minutes of R-R interval time series, and we calculated relevant linear and nonlinear parameters of HRV such as mean RR interval (RRave), the Root Mean Square of the Successive Differences (RMSSD), the Poincaré plot measures SD1, SD2, SD1/SD2, and the sample entropy (SampEn). Additionally, we indirectly assessed body composition measures such as body weight, fat mass, visceral fat rating (VFR), normalized VRF (nVFR), muscle mass, metabolic age, and total body water.Results: We found that diverse HRV indexes and only one body composition measure showed statistical differences (p<0.05) between the BCS and Control groups: RRave: 729 (648–802) vs. 795 (713–852) ms; RMSSD: 16.5 (8.9–27.0) vs. 19.7 (14.2–28.5) ms; SD1: 11.6 (6.3–19.0) vs. 13.9 (10.0–20.1) ms; SD1/SD2: 2.5 (2.1–3.3) vs. 2.2 (1.9–2.7), SampEn: 1.5 (1.3–1.8) vs. 1.7 (1.5–1.8), and nVFR 0.12 (0.11–0.13) vs.0.10 (0.08–0.12) points/kg, respectively. The nVFR was significantly correlated to several indexes of HRV.Conclusions: BCS exhibit a lower parasympathetic cardiac activity and changes in HRV patterns than controls, likely because of the concomitant increase of visceral fat.

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Moderate intensity exercise improves heart rate variability in obese adults with type 2 diabetes

Abstract: This study suggests that thrice-a-week moderate intensity aerobic exercise for six months improves cardiac rhythm regulation as measured by HRV in obese adults with type 2 diabetes.

Cited by 19 publications

References 50 publications

Effect of exercise training on heart rate variability in type 2 diabetes mellitus patients: A systematic review and meta-analysis

Effect of exercise training on heart rate variability in type 2 diabetes mellitus patients: A systematic review and meta-analysis

CardiacNmnat/NAD⁺/SIR2 pathways activation mediates endurance exercise resistance to heart defects induced by a high-fat diet in agingDrosophila

Differences in Heart Rate Variability and Body Composition in Breast Cancer Survivors and Women Without Cancer

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Moderate intensity exercise improves heart rate variability in obese adults with type 2 diabetes

Abstract: This study suggests that thrice-a-week moderate intensity aerobic exercise for six months improves cardiac rhythm regulation as measured by HRV in obese adults with type 2 diabetes.

Cited by 19 publications

References 50 publications

Effect of exercise training on heart rate variability in type 2 diabetes mellitus patients: A systematic review and meta-analysis

Effect of exercise training on heart rate variability in type 2 diabetes mellitus patients: A systematic review and meta-analysis

CardiacNmnat/NAD+/SIR2 pathways activation mediates endurance exercise resistance to heart defects induced by a high-fat diet in agingDrosophila

Differences in Heart Rate Variability and Body Composition in Breast Cancer Survivors and Women Without Cancer

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CardiacNmnat/NAD⁺/SIR2 pathways activation mediates endurance exercise resistance to heart defects induced by a high-fat diet in agingDrosophila