Anti-inflammatory effect of exercise training in subjects with type 2 diabetes and the metabolic syndrome is dependent on exercise modalities and independent of weight loss

• Published in: Nutrition, metabolism, and cardiovascular diseases Vol. 20; no. 8; pp. 608 - 617
• Main Authors: Balducci, S., Zanuso, S., Nicolucci, A., Fernando, F., Cavallo, S., Cardelli, P., Fallucca, S., Alessi, E., Letizia, C., Jimenez, A., Fallucca, F., Pugliese, G.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.10.2010
• Subjects: Adult; Aged; C-Reactive Protein - analysis; Cardiovascular; Cardiovascular disease; Cholesterol, HDL - blood; Cholesterol, LDL - blood; Diabetes Mellitus, Type 2 - immunology; Exercise; Female; Humans; Inflammation; Inflammation - prevention & control; Insulin resistance; Interleukin-6 - blood; Male; Metabolic Syndrome - immunology; Middle Aged; Physical fitness; Tumor Necrosis Factor-alpha - blood; Type 2 diabetes; Weight Loss; Type 2 diabetes; Cardiovascular disease; Insulin resistance; Physical fitness; Inflammation; Exercise
• ISSN: 0939-4753; 1590-3729; 1590-3729
• DOI: 10.1016/j.numecd.2009.04.015

We investigated the effect of different exercise modalities on high sensitivity-C reactive protein (hs-CRP) and other inflammatory markers in patients with type 2 diabetes and the metabolic syndrome. Eighty-two patients were randomized into 4 groups: sedentary control (A); receiving counseling to perform low-intensity physical activity (B); performing prescribed and supervised high-intensity aerobic (C) or aerobic + resistance (D) exercise (with the same caloric expenditure) for 12 months. Evaluation of leisure-time physical activity and assessment of physical fitness, cardiovascular risk factors and inflammatory biomarkers was performed at baseline and every 3 months. Volume of physical activity increased and HbA 1c decreased in Groups B–D. VO 2max, HOMA-IR index, HDL-cholesterol, waist circumference and albuminuria improved in Groups C and D, whereas strength and flexibility improved only in Group D. Levels of hs-CRP decreased in all three exercising groups, but the reduction was significant only in Groups C and D, and particularly in Group D. Changes in VO 2max and the exercise modalities were strong predictors of hs-CRP reduction, independent of body weight. Leptin, resistin and interleukin-6 decreased, whereas adiponectin increased in Groups C and D. Interleukin-1β, tumor necrosis factor-α and interferon-γ decreased, whereas anti-inflammatory interleukin-4 and 10 increased only in Group D. Physical exercise in type 2 diabetic patients with the metabolic syndrome is associated with a significant reduction of hs-CRP and other inflammatory and insulin resistance biomarkers, independent of weight loss. Long-term high-intensity (preferably mixed) training, in addition to daytime physical activity, is required to obtain a significant anti-inflammatory effect.