Conrad P Earnest1, Neil M Johannsen, Damon L Swift, Fiona B Gillison, Catherine R Mikus, Alejandro Lucia, Kimberly Kramer, Carl J Lavie, Timothy S Church. 1. 1Department for Health, University of Bath, Bath, UNITED KINGDOM; 2School of Kinesiology, Louisiana State University, Baton Rouge, LA; 3Department of Kinesiology, East Carolina University, Greenville, NC; 4Division of Cardiology, Duke University Medical Center, Durham, NC; 5Universidad Europea and Instituto de Investigación Sanitaria Hospital 12 de Octubre (i+12), Madrid, SPAIN; 6Division of Preventive Medicine, Pennington Biomedical Research Center, Baton Rouge, LA; and 7Cardiac Rehabilitation and Prevention, Ochsner Clinical School, University of Queensland School of Medicine, John Ochsner Heart and Vascular Institute, New Orleans, LA.
Abstract
PURPOSE: Concomitant type 2 diabetes (T2D) and metabolic syndrome exacerbates mortality risk; yet, few studies have examined the effect of combining (AER + RES) aerobic (AER) and resistance (RES) training for individuals with T2D and metabolic syndrome. METHODS: We examined AER, RES, and AER + RES training (9 months) commensurate with physical activity guidelines in individuals with T2D (n = 262; 63% female, 44% black). Primary outcomes were change in, and prevalence of, metabolic syndrome score at follow-up (mean and 95% confidence interval [CI]). Secondary outcomes included maximal cardiorespiratory fitness (VO2peak) and estimated METs from time-to-exhaustion (TTE) and exercise efficiency calculated as the slope of the line between ventilatory threshold, respiratory compensation, and maximal fitness. General linear models and bootstrapped Spearman correlations were used to examine changes in metabolic syndrome associated with training primary and secondary outcome variables. RESULTS: We observed a significant decrease in metabolic syndrome scores (P for trend = 0.003) for AER (-0.59, 95% CI = -1.00 to -0.21) and AER + RES (-0.79, 95% CI = -1.40 to -0.35), both being significant (P ≤ 0.02) versus control (0.26, 95% CI = -0.58 to 0.40) and RES (-0.13, 95% CI = -1.00 to 0.24). This led to a reduction in metabolic syndrome prevalence for the AER (56% vs 43%) and AER + RES (55% vs 46%) groups between baseline and follow-up. The observed decrease in metabolic syndrome was mediated by significant improvements in exercise efficiency for the AER and AER + RES training groups (P < 0.05), which was more strongly related to TTE (25%-30%; r = -0.38, 95% CI = -0.55 to -0.19) than VO2peak (5%-6%; r = -0.24, 95% CI = -0.45 to -0.01). CONCLUSIONS:AER and AER + RES training significantly improved metabolic syndrome scores and prevalence in patients with T2D. These improvements appear to be associated with improved exercise efficiency and are more strongly related to improved TTE versus VO2peak.
RCT Entities:
PURPOSE: Concomitant type 2 diabetes (T2D) and metabolic syndrome exacerbates mortality risk; yet, few studies have examined the effect of combining (AER + RES) aerobic (AER) and resistance (RES) training for individuals with T2D and metabolic syndrome. METHODS: We examined AER, RES, and AER + RES training (9 months) commensurate with physical activity guidelines in individuals with T2D (n = 262; 63% female, 44% black). Primary outcomes were change in, and prevalence of, metabolic syndrome score at follow-up (mean and 95% confidence interval [CI]). Secondary outcomes included maximal cardiorespiratory fitness (VO2peak) and estimated METs from time-to-exhaustion (TTE) and exercise efficiency calculated as the slope of the line between ventilatory threshold, respiratory compensation, and maximal fitness. General linear models and bootstrapped Spearman correlations were used to examine changes in metabolic syndrome associated with training primary and secondary outcome variables. RESULTS: We observed a significant decrease in metabolic syndrome scores (P for trend = 0.003) for AER (-0.59, 95% CI = -1.00 to -0.21) and AER + RES (-0.79, 95% CI = -1.40 to -0.35), both being significant (P ≤ 0.02) versus control (0.26, 95% CI = -0.58 to 0.40) and RES (-0.13, 95% CI = -1.00 to 0.24). This led to a reduction in metabolic syndrome prevalence for the AER (56% vs 43%) and AER + RES (55% vs 46%) groups between baseline and follow-up. The observed decrease in metabolic syndrome was mediated by significant improvements in exercise efficiency for the AER and AER + RES training groups (P < 0.05), which was more strongly related to TTE (25%-30%; r = -0.38, 95% CI = -0.55 to -0.19) than VO2peak (5%-6%; r = -0.24, 95% CI = -0.45 to -0.01). CONCLUSIONS: AER and AER + RES training significantly improved metabolic syndrome scores and prevalence in patients with T2D. These improvements appear to be associated with improved exercise efficiency and are more strongly related to improved TTE versus VO2peak.
Authors: Xing-Guo Sun; James E Hansen; Nuria Garatachea; Thomas W Storer; Karlman Wasserman Journal: Am J Respir Crit Care Med Date: 2002-12-01 Impact factor: 21.405
Authors: Charles E Matthews; Kong Y Chen; Patty S Freedson; Maciej S Buchowski; Bettina M Beech; Russell R Pate; Richard P Troiano Journal: Am J Epidemiol Date: 2008-02-25 Impact factor: 4.897
Authors: Lori A Bateman; Cris A Slentz; Leslie H Willis; A Tamlyn Shields; Lucy W Piner; Connie W Bales; Joseph A Houmard; William E Kraus Journal: Am J Cardiol Date: 2011-07-07 Impact factor: 2.778
Authors: Ronald J Sigal; Glen P Kenny; Normand G Boulé; George A Wells; Denis Prud'homme; Michelle Fortier; Robert D Reid; Heather Tulloch; Douglas Coyle; Penny Phillips; Alison Jennings; James Jaffey Journal: Ann Intern Med Date: 2007-09-18 Impact factor: 25.391
Authors: Lauren M Sparks; Neil M Johannsen; Timothy S Church; Conrad P Earnest; Esther Moonen-Kornips; Cedric Moro; Matthijs K C Hesselink; Steven R Smith; Patrick Schrauwen Journal: J Clin Endocrinol Metab Date: 2013-03-05 Impact factor: 5.958
Authors: Philip A Ades; Patrick D Savage; Annis M Marney; Jean Harvey; Kimberly A Evans Journal: J Cardiopulm Rehabil Prev Date: 2015 May-Jun Impact factor: 2.081
Authors: Jason D Allen; Mitch D Vanbruggen; Neil M Johannsen; Jennifer L Robbins; Daniel P Credeur; Carl F Pieper; Richard Sloane; Conrad P Earnest; Timothy S Church; Eric Ravussin; William E Kraus; Michael A Welsch Journal: Med Sci Sports Exerc Date: 2018-05 Impact factor: 5.411
Authors: Franciele R Figueira; Daniel Umpierre; Felipe V Cureau; Alessandra T N Zucatti; Mériane B Dalzochio; Cristiane B Leitão; Beatriz D Schaan Journal: Sports Med Date: 2014-11 Impact factor: 11.136
Authors: Isaac O Pérez-Martinez; Saul E Cifuentes-Mendiola; Diana L Solis-Suarez; Ana L García-Hernández Journal: Exp Brain Res Date: 2022-09-05 Impact factor: 2.064
Authors: Dong-Woo Kang; Rebekah L Wilson; Paola Gonzalo-Encabo; Mary K Norris; Marybeth Hans; Meghan Tahbaz; Jackie Dawson; Danny Nguyen; Amber J Normann; Alexandra G Yunker; Nathalie Sami; Hajime Uno; Jennifer A Ligibel; Steven D Mittelman; Christina M Dieli-Conwright Journal: Front Oncol Date: 2022-06-20 Impact factor: 5.738
Authors: Christina M Dieli-Conwright; Kerry S Courneya; Wendy Demark-Wahnefried; Nathalie Sami; Kyuwan Lee; Thomas A Buchanan; Darcy V Spicer; Debu Tripathy; Leslie Bernstein; Joanne E Mortimer Journal: J Clin Oncol Date: 2018-01-22 Impact factor: 44.544