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Li TT, Wang HY, Zhang H, Zhang PP, Zhang MC, Feng HY, Duan XY, Liu WB, Wang XW, Sun ZG. Effect of breathing exercises on oxidative stress biomarkers in humans: A systematic review and meta-analysis. Front Med (Lausanne) 2023; 10:1121036. [PMID: 37122322 PMCID: PMC10132211 DOI: 10.3389/fmed.2023.1121036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 03/20/2023] [Indexed: 04/09/2023] Open
Abstract
BackgroundBreathing exercises improve oxidative stress in healthy young adults and patients with diabetes, hypertension, and chronic obstructive pulmonary disease. Furthermore, the mechanism of respiratory intervention is controversial. Therefore, in this meta-analysis, we aimed to systematically evaluate the effects of breathing exercises on oxidative stress biomarkers in humans and provide evidence for the clinical application of breathing exercises.MethodsThe Embase, PubMed, Cochrane Library, Web of Science, CNKI, and WANFANG databases were searched for studies about the effects of breathing exercises on human oxidative stress levels, with no restraints regarding time, race, or language. The experimental group included various breathing exercises, and the outcome index included malondialdehyde, superoxide dismutase, and glutathione, nitric oxide, vitamin C, or total antioxidant capacity levels from a randomized controlled trial. Data were extracted by more than two authors and reviewed by one author.ResultsTen studies were included from five countries. Data from patients with no disease, chronic obstructive pulmonary disease, hypertension, or diabetes were included. Participants who performed breathing exercises had greater changes in the included biomarkers than those who did not, suggesting that these biomarkers can be used to evaluate oxidative stress after respiratory interventions.ConclusionBreathing exercises increased SOD and GSH activities and decreased MDA content.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022337119, identifier CRD42022337119.
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Affiliation(s)
- Ting-ting Li
- School of Rehabilitation Medicine, Weifang Medical University, Weifang, China
| | - Hong-ying Wang
- School of Rehabilitation Medicine, Weifang Medical University, Weifang, China
| | - Hui Zhang
- School of Rehabilitation Medicine, Weifang Medical University, Weifang, China
| | - Ping-ping Zhang
- School of Rehabilitation Medicine, Weifang Medical University, Weifang, China
| | - Ming-chen Zhang
- School of Rehabilitation Medicine, Weifang Medical University, Weifang, China
| | - Hai-yang Feng
- School of Rehabilitation Medicine, Weifang Medical University, Weifang, China
| | - Xiao-yong Duan
- Weifang People’s Hospital and Brain Hospital, Weifang, China
| | - Wen-bo Liu
- School of First Clinical Medical, Weifang Medical University, Weifang, China
- Weifang People’s Hospital, Weifang, China
| | - Xiao-wen Wang
- School of Rehabilitation Medicine, Weifang Medical University, Weifang, China
- Affiliated Hospital of Weifang Medical University, Weifang, China
- Xiao-wen Wang,
| | - Zhong-guang Sun
- School of Rehabilitation Medicine, Weifang Medical University, Weifang, China
- *Correspondence: Zhong-guang Sun,
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The Role of Exercise on Cardiometabolic Profile and Body Composition in Youth with Type 1 Diabetes. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121840. [PMID: 36553284 PMCID: PMC9776837 DOI: 10.3390/children9121840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/19/2022] [Accepted: 11/22/2022] [Indexed: 11/29/2022]
Abstract
Exercise has a direct positive effect on glycemic control by promoting insulin secretion from β-pancreatic islet-cells and by increasing skeletal muscle glucose uptake. The reduction in daily insulin needs and the optimization of glycemic control improves the patient's quality of life, self-esteem, mental wellness, as well as diabetes-related mobility and mortality. The aim of this study was to investigate the effect of physical activity in children and adolescents with type-1 diabetes (T1D) on diabetic control, cardiovascular, and biochemical profiles; hs-CRP; IL6; leptin; and adiponectin levels of the population under study. This is a prospective cross-sectional study that involved 80 participants (36 boys and 44 girls) with T1D, who were aged 6-21 years and who attended the Diabetes and Metabolism Clinic of the 2nd Pediatric Department, University of Athens, "P & A Kyriakou" Children's Hospital of Athens. Twenty (25%) children were above the 75th percentile regarding total levels of physical activity, while 40 (50%) and 20 (25%) were between the 25th and 75th percentile, as well as below the 25th percentile, respectively. In the group with an intermediate level of exercise, physical activity was negatively associated with the participant's family situation (traditional, single parent, grandparent, with others, or by himself/herself) (p = 0.013), ferritin (p = 0.031), lipoprotein(a) [Lp(a)] (p = 0.016), and squared leptin levels (p = 0.040). Whereas in the groups with extreme vs. no exercise there was a negative association with the number of daily glucose measurements (p = 0.047). However, in the group with non-vigorous exercise, physical activity was positively associated with high density lipoprotein-c (HDL-c) levels (p = 0.048). The findings of this study are indicative of the beneficial role of exercise on children and adolescents with T1D, which is achieved by primarily improving their cardiometabolic profile through the amelioration of lipid profile [HDL-c, Lp(a)] and leptin levels, as well as by reducing chronic systemic inflammatory response (ferritin) and ultimately decreasing the overall diabetes morbidity.
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Beneficial Effects of Physical Activity in Diabetic Patients. J Funct Morphol Kinesiol 2020; 5:jfmk5030070. [PMID: 33467285 PMCID: PMC7739324 DOI: 10.3390/jfmk5030070] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/30/2020] [Accepted: 09/01/2020] [Indexed: 12/14/2022] Open
Abstract
One of the main goals of diabetic therapy is to achieve the best metabolic control to prevent the development and progression of potential complications. A multidisciplinary approach characterized by the combination of diet, physical activity (PA) and drug therapy with oral and injectable (non-insulin) pharmacological agents, is desirable to optimize metabolic control. The aim of this review is to explain the contribution of PA and its beneficial effects on patients affected by type 1 (T1D) and type 2 diabetes (T2D). We provide an overview of evidence on the effects of PA for the main two types of diabetes mellitus (DM) to identify the right level of PA to be recommended. We discuss the physiological and clinical role of PA in people with DM. It can be concluded that the objective of antidiabetic therapy should be the achievement and optimization of metabolic control through a multidisciplinary approach involving non-pharmacological therapy such as diet and PA, which has a crucial role.
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Calella P, Gallè F, Fornelli G, Liguori G, Valerio G. Type 1 diabetes and body composition in youth: A systematic review. Diabetes Metab Res Rev 2020; 36:e3211. [PMID: 31352688 DOI: 10.1002/dmrr.3211] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 07/04/2019] [Accepted: 07/23/2019] [Indexed: 02/06/2023]
Abstract
An increasing prevalence of overweight and obesity was reported in youth with type 1 diabetes, likely due to the intensive insulin treatment and/or an unhealthy lifestyle. Analyses of body composition may help describe the real increase in fat mass, which contributes to the diabetes-related cardio-metabolic risk. This systematic review evaluated the current literature on body composition assessments in youth with type 1 diabetes and the potential association with cardio-metabolic, functional, or behavioural risk factors. A systematic search of literature studies reporting assessments of body composition in youth with type 1 diabetes published until April 2018 was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Twenty-three articles with different study designs reported assessments of body composition. The following methods were used to assess body composition: computerized dual energy X-ray absorptiometry (n = 10), bioelectrical impedance analysis (n = 8), skinfold thickness measurement (n = 4), and air displacement plethysmography (n = 1). Higher fat mass values were found in youth with type 1 diabetes in seven of the 13 studies that included a healthy control group. Most studies investigating the association between body composition and cardio-metabolic risk factors showed that youth with higher fat mass levels had poor glycaemic control, dyslipidaemia, or higher blood pressure. Assessments of body composition may represent a useful clinical procedure to support decision-making in type 1 diabetes management. Further research is needed to standardize the assessment of body composition and develop a consensus guideline.
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Affiliation(s)
- Patrizia Calella
- Department of Movement Sciences and Wellbeing, Parthenope University, Naples, Italy
| | - Francesca Gallè
- Department of Movement Sciences and Wellbeing, Parthenope University, Naples, Italy
| | - Gianfranco Fornelli
- School of Medicine and Surgery, Vita-Salute, San Raffaele University, Milan, Italy
| | - Giorgio Liguori
- Department of Movement Sciences and Wellbeing, Parthenope University, Naples, Italy
| | - Giuliana Valerio
- Department of Movement Sciences and Wellbeing, Parthenope University, Naples, Italy
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Farinha JB, Ramis TR, Vieira AF, Macedo RCO, Rodrigues-Krause J, Boeno FP, Schroeder HT, Müller CH, Boff W, Krause M, De Bittencourt PIH, Reischak-Oliveira A. Glycemic, inflammatory and oxidative stress responses to different high-intensity training protocols in type 1 diabetes: A randomized clinical trial. J Diabetes Complications 2018; 32:1124-1132. [PMID: 30270019 DOI: 10.1016/j.jdiacomp.2018.09.008] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Revised: 09/04/2018] [Accepted: 09/09/2018] [Indexed: 12/20/2022]
Abstract
AIMS To investigate the effects of high-intensity interval training (HIIT) and/or strength training (ST) on inflammatory, oxidative stress (OS) and glycemic parameters in type 1 diabetes (T1DM) patients. METHODS After a 4-week control period, volunteers were randomly assigned to 10-week HIIT, ST or ST + HIIT protocol, performed 3×/week. Blood biochemistry, anthropometric, strength and cardiopulmonary fitness variables were assessed. Outcomes were analyzed via generalized estimating equations (GEE), with Bonferroni post hoc analysis. RESULTS ST, HIIT and ST + HIIT improved glycemic (HbA1c and fasting glucose) and antioxidant parameters (total antioxidant capacity, catalase and superoxide dismutase activities), but not plasma inflammatory (C-reactive protein, TNF-α and IL-10) or OS markers (thiobarbituric acid-reactive substances, 8-hydroxy-2-deoxyguanosine and oxLDL) levels. Noteworthy, interventions reduced soluble receptors for advanced glycation end products levels. However, intracellular heat shock protein 70 content increased only after HIIT. While daily insulin dosage decreased only in the ST + HIIT group, all training models induced anthropometric and functional benefits. CONCLUSIONS Similar benefits afforded by ST, HIIT or ST + HIIT in T1DM people are associated with enhanced antioxidant systems and glucose-related parameter, even in a few weeks. From a practical clinical perspective, the performance of ST + HIIT may be advised for additional benefits regarding insulin dosage reduction.
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Affiliation(s)
- Juliano B Farinha
- School of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
| | - Thiago R Ramis
- School of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Alexandra F Vieira
- School of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Rodrigo C O Macedo
- School of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Josianne Rodrigues-Krause
- School of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Francesco P Boeno
- School of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Helena T Schroeder
- Department of Physiology, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Carlos Henrique Müller
- Department of Physiology, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Winston Boff
- Institute for Children with Diabetes, Porto Alegre, Brazil
| | - Maurício Krause
- Department of Physiology, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Paulo Ivo H De Bittencourt
- Department of Physiology, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Alvaro Reischak-Oliveira
- School of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Effect of short-term hazelnut consumption on DNA damage and oxidized LDL in children and adolescents with primary hyperlipidemia: a randomized controlled trial. J Nutr Biochem 2018; 57:206-211. [PMID: 29753234 DOI: 10.1016/j.jnutbio.2018.03.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 02/19/2018] [Accepted: 03/08/2018] [Indexed: 11/24/2022]
Abstract
Children with primary hyperlipidemia are prone to develop premature atherosclerosis, possibly associated with increased oxidative stress. Nutritional therapy is the primary strategy in the treatment of hyperlipidemia and associated conditions. Dietary interventions with bioactive-rich foods, such as nuts, may contribute to the modulation of both lipid profile and the oxidative/antioxidant status. Our study aimed to assess the impact of a dietary intervention with hazelnuts on selected oxidative stress markers in children and adolescents with primary hyperlipidemia. A single-blind, 8-week, randomized, controlled, three-arm, parallel-group study was performed. Children and adolescents diagnosed with primary hyperlipidemia (n=60) received dietary guidelines and were randomized into three groups: group 1 received hazelnuts with skin (HZN+S), and group 2 hazelnuts without skin (HZN-S), at equivalent doses (15-30 g/day, based on body weight); group 3 (controls) received only dietary recommendations (no nuts). At baseline and after 8 weeks, plasma oxidized low-density lipoprotein (ox-LDL) concentrations, oxidative levels of DNA damage in PBMCs and potential correlation with changes in serum lipids were examined. A reduction of endogenous DNA damage by 18.9%±51.3% (P=.002) and 23.1%±47.9% (P=.007) was observed after HZN+S and HZN-S, respectively. Oxidatively induced DNA strand breaks decreased by 16.0%±38.2% (P=.02) following HZN+S treatment. Ox-LDL levels did not change after HZN+S intervention but positively correlated with total cholesterol and LDL cholesterol. A short-term hazelnut intervention improves cell DNA protection and resistance against oxidative stress but not ox-LDL in hyperlipidemic pediatric patients. The trial was registered at ISRCTN.com, ID no. ISRCTN12261900.
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Avloniti A, Chatzinikolaou A, Deli CK, Vlachopoulos D, Gracia-Marco L, Leontsini D, Draganidis D, Jamurtas AZ, Mastorakos G, Fatouros IG. Exercise-Induced Oxidative Stress Responses in the Pediatric Population. Antioxidants (Basel) 2017; 6:antiox6010006. [PMID: 28106721 PMCID: PMC5384170 DOI: 10.3390/antiox6010006] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 01/02/2017] [Accepted: 01/13/2017] [Indexed: 12/15/2022] Open
Abstract
Adults demonstrate an upregulation of their pro- and anti-oxidant mechanisms in response to acute exercise while systematic exercise training enhances their antioxidant capacity, thereby leading to a reduced generation of free radicals both at rest and in response to exercise stress. However, less information exists regarding oxidative stress responses and the underlying mechanisms in the pediatric population. Evidence suggests that exercise-induced redox perturbations may be valuable in order to monitor exercise-induced inflammatory responses and as such training overload in children and adolescents as well as monitor optimal growth and development. The purpose of this review was to provide an update on oxidative stress responses to acute and chronic exercise in youth. It has been documented that acute exercise induces age-specific transient alterations in both oxidant and antioxidant markers in children and adolescents. However, these responses seem to be affected by factors such as training phase, training load, fitness level, mode of exercise etc. In relation to chronic adaptation, the role of training on oxidative stress adaptation has not been adequately investigated. The two studies performed so far indicate that children and adolescents exhibit positive adaptations of their antioxidant system, as adults do. More studies are needed in order to shed light on oxidative stress and antioxidant responses, following acute exercise and training adaptations in youth. Available evidence suggests that small amounts of oxidative stress may be necessary for growth whereas the transition to adolescence from childhood may promote maturation of pro- and anti-oxidant mechanisms. Available evidence also suggests that obesity may negatively affect basal and exercise-related antioxidant responses in the peripubertal period during pre- and early-puberty.
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Affiliation(s)
- Alexandra Avloniti
- School of Physical Education and Sport Sciences, Democritus University of Thrace, Komotini 69100, Greece.
| | - Athanasios Chatzinikolaou
- School of Physical Education and Sport Sciences, Democritus University of Thrace, Komotini 69100, Greece.
| | - Chariklia K Deli
- School of Physical Education and Sport Sciences, University of Thessaly, Karies, Trikala 42100, Greece.
| | - Dimitris Vlachopoulos
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, Exeter EX1 2LU, UK.
| | - Luis Gracia-Marco
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, Exeter EX1 2LU, UK.
- Growth, Exercise, Nutrition and Development Research Group, University of Zaragoza, Zaragoza 50009, Spain.
| | - Diamanda Leontsini
- School of Physical Education and Sport Sciences, Democritus University of Thrace, Komotini 69100, Greece.
| | - Dimitrios Draganidis
- School of Physical Education and Sport Sciences, University of Thessaly, Karies, Trikala 42100, Greece.
| | - Athanasios Z Jamurtas
- School of Physical Education and Sport Sciences, University of Thessaly, Karies, Trikala 42100, Greece.
| | - George Mastorakos
- Faculty of Medicine, Endocrine Unit, "Aretaieion" Hospital, National and Kapodistrian University of Athens, Athens 11528, Greece.
| | - Ioannis G Fatouros
- School of Physical Education and Sport Sciences, University of Thessaly, Karies, Trikala 42100, Greece.
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Abstract
Youth with type 1 diabetes are at risk for developing cardiovascular disease, and regular physical activity is strongly recommended as one strategy for prevention, as well as for good glycemic control. Despite recommendations, families in this pediatric population face unique barriers to physical activity, including fear of hypoglycemia. Moreover, families are not routinely counseled in the specific health and psychosocial benefits of following physical activity recommendations for youth with type 1 diabetes. To bridge this gap, the recent literature regarding physical activity in children with type 1 diabetes is reviewed with particular focus on young children. A discussion of the limitations of the current body of research, and recommendations for objectively measured physical activity are provided. Specific recommendations for clinical practice are given, including provider endorsements for regular physical activity for longer than 60 minutes, at least three times a week.
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Affiliation(s)
- Carrie Tully
- Center for Translational Research, Children's National Medical Center, 111 N. Michigan Avenue, NW, Washington, DC, 20010, USA.
| | - Laura Aronow
- Center for Translational Research, Children's National Medical Center, 111 N. Michigan Avenue, NW, Washington, DC, 20010, USA
| | - Eleanor Mackey
- Center for Translational Research, Children's National Medical Center, 111 N. Michigan Avenue, NW, Washington, DC, 20010, USA
- Department of Pediatrics, George Washington University School of Medicine, Washington, DC, USA
| | - Randi Streisand
- Center for Translational Research, Children's National Medical Center, 111 N. Michigan Avenue, NW, Washington, DC, 20010, USA
- Department of Pediatrics, George Washington University School of Medicine, Washington, DC, USA
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9
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Anaruma CP, Ferreira M, Sponton CHG, Delbin MA, Zanesco A. Heart rate variability and plasma biomarkers in patients with type 1 diabetes mellitus: Effect of a bout of aerobic exercise. Diabetes Res Clin Pract 2016; 111:19-27. [PMID: 26678666 DOI: 10.1016/j.diabres.2015.10.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 09/24/2015] [Accepted: 10/20/2015] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate: (1) the cardiovascular parameters and plasma biomarkers in people with type 1 diabetes mellitus (T1DM) at baseline; and (2) the heart rate variability (HRV) and blood glucose in response to a session of aerobic exercise (AE) and during recovery period. RESEARCH DESIGN AND METHODS Adults (18-35 years) were divided into two groups: control (CT, n=10) and T1DM (n=9). Anthropometric, cardiovascular, and biochemical parameters, and aerobic capacity (indirect peak oxygen uptake, VO2peak) were evaluated at baseline. Thirty minutes of AE (40-60% intensity) was performed on a treadmill. Blood glucose and HRV were determined at rest, during AE, and during the recovery period. RESULTS Anthropometric measurements, cardiovascular parameters, aerobic capacity, and biochemical parameters were similar between the groups at baseline. In the T1DM group, blood glucose, glycated hemoglobin, and thiobarbituric acid reactive substances concentrations were increased while nitrite/nitrate (NOx(-)) levels were reduced. During AE, the magnitude of the reduction of blood glucose was greater than that during the recovery period in the T1DM group. The RR intervals and SDNN were reduced at rest as well as in the recovery period in T1DM subjects, whereas the RMSSD and pNN50 were only reduced during the recovery period. No changes were observed in low frequency (LF), high frequency (HF), and LF/HF ratio. CONCLUSION Our study shows that T1DM patients on insulin therapy have poor blood glucose control with greater lipid peroxidation and lower NOx(-) levels, accompanied by an imbalance in autonomic function detected by the challenge of AE.
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Affiliation(s)
- Chadi P Anaruma
- Department of Physical Education, Institute of Biosciences, UNESP - Univ Estadual Paulista, Rio Claro, SP, Brazil
| | - Maycon Ferreira
- Department of Physical Education, Institute of Biosciences, UNESP - Univ Estadual Paulista, Rio Claro, SP, Brazil
| | - Carlos H G Sponton
- Department of Physical Education, Institute of Biosciences, UNESP - Univ Estadual Paulista, Rio Claro, SP, Brazil
| | - Maria A Delbin
- Department of Structural and Functional Biology, Institute of Biology, UNICAMP - University of Campinas, Campinas, SP, Brazil
| | - Angelina Zanesco
- Department of Physical Education, Institute of Biosciences, UNESP - Univ Estadual Paulista, Rio Claro, SP, Brazil.
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Quirk H, Blake H, Tennyson R, Randell TL, Glazebrook C. Physical activity interventions in children and young people with Type 1 diabetes mellitus: a systematic review with meta-analysis. Diabet Med 2014; 31:1163-73. [PMID: 24965376 PMCID: PMC4232875 DOI: 10.1111/dme.12531] [Citation(s) in RCA: 135] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 03/19/2014] [Accepted: 06/20/2014] [Indexed: 12/27/2022]
Abstract
AIMS To synthesize evidence from randomized and non-randomized studies of physical activity interventions in children and young people with Type 1 diabetes so as to explore clinically relevant health outcomes and inform the promotion of physical activity. METHOD We conducted a search of CINAHL Plus, the Cochrane Library, EMBASE, MEDLINE, PsycINFO, SCOPUS, SportDiscus and Web of Science between October and December 2012. Eligible articles included subjects aged ≤18 years with Type 1 diabetes and a physical activity intervention that was more than a one-off activity session. Physiological, psychological, behavioural or social outcomes were those of interest. RESULTS A total of 26 articles (10 randomized and 16 non-randomized studies), published in the period 1964-2012, were reviewed. Although there was heterogeneity in study design, methods and reporting, 23 articles reported at least one significant beneficial health outcome at follow-up. Meta-analyses of these studies showed potential benefits of physical activity on HbA1c (11 studies, 345 participants, standardized mean difference -0.52, 95% CI -0.97 to -0.07; P = 0.02), BMI (four studies, 195 participants, standardized mean difference -0.41, 95% CI -0.70 to -0.12; P = 0.006) and triglycerides (five studies, 206 participants, standardized mean difference -0.70, 95% CI -1.25 to -0.14; P = 0.01).The largest effect size was for total cholesterol (five studies, 206 participants, standardized mean difference -0.91, 95% CI -1.66 to -0.17; P = 0.02). CONCLUSIONS Physical activity is important for diabetes management and has the potential to delay cardiovascular disease, but there is a lack of studies that are underpinned by psychological behaviour change theory, promoting sustained physical activity and exploring psychological outcomes. There remains a lack of knowledge of how to promote physical activity in people with Type 1 diabetes.
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Affiliation(s)
- H Quirk
- School of Health Sciences, University of Nottingham
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11
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Giovannini C, Piaggi S, Federico G, Scarpato R. High levels of γ-H2AX foci and cell membrane oxidation in adolescents with type 1 diabetes. Mutat Res 2014; 770:128-35. [PMID: 25771879 DOI: 10.1016/j.mrfmmm.2014.08.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 06/12/2014] [Accepted: 08/20/2014] [Indexed: 12/24/2022]
Abstract
Oxidative stress caused by an excess of free radicals is implicated in the pathogenesis and development of type 1 diabetes mellitus (T1DM) and, in turn, it can lead to genome damage, especially in the form of DNA double-strand break (DSB). The DNA DSB is a potentially carcinogenic lesion for human cells. Thus, we aimed to evaluate whether the level of oxidative stress was increased in peripheral blood lymphocytes of a group of affected adolescents. In 35 T1DM adolescents and 19 healthy controls we assessed: (1) spontaneous and H2O2-induced oxidation of cell membrane using a fluorescence lipid probe; (2) spontaneous and LPS-induced expression of iNOS protein and indirect NO determination via cytofluorimetric analysis of O2(-); (3) immunofluorescent detection of the basal level of histone H2AX phosphorylation (γ-H2AX foci), a well-validated marker of DNA DSB. In T1DM, the frequencies of oxidized cells, both spontaneous and H2O2-induced (47.13±0.02) were significantly higher than in controls (35.90±0.03). Patients showed, in general, both a reduced iNOS expression and production of NO. Furthermore, the level of spontaneous nuclear damage, quantified as γ-H2AX foci, was markedly increased in T1DM adolescents (6.15±1.08% of γ-H2AX(+) cells; 8.72±2.14 γ-H2AXF/n; 9.26±2.37 γ-H2AXF/np), especially in females. In the present study, we confirmed the role that oxidative stress plays in the disease damaging lipids of cell membrane and, most importantly, causing genomic damage in circulating white blood cells of affected adolescents. This also indicates that oxidative stress can affect several tissues in the body. However, although the observed DNA damage is a clear indication that the proper DNA repair mechanisms are activated, the risk for young T1DM subjects of developing not only cardiovascular complications but also some type of cancer cannot be ruled out. In this view, females, probably due to hormonal imbalance typical of adolescence, might represent a more susceptible population.
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Affiliation(s)
| | - Simona Piaggi
- Sezione di Patologia Sperimentale, Dipartimento di Ricerca Traslazionale e delle Nuove Tecnologie in Medicina e Chirurgia, Pisa University, Pisa, Italy
| | - Giovanni Federico
- Unità di Endocrinologia Pediatrica e Diabete, Dipartimento di Medicina Clinica e Sperimentale Pisa University, Pisa, Italy
| | - Roberto Scarpato
- Unità di Genetica, Dipartimento di Biologia, Pisa University, Pisa, Italy.
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12
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Shin KO, Moritani T, Woo J, Jang KS, Bae JY, Yoo J, Kang S. Exercise training improves cardiac autonomic nervous system activity in type 1 diabetic children. J Phys Ther Sci 2014; 26:111-5. [PMID: 24567687 PMCID: PMC3927020 DOI: 10.1589/jpts.26.111] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Accepted: 08/17/2013] [Indexed: 12/31/2022] Open
Abstract
[Purpose] We investigated the effect exercise training has on cardiac autonomic nervous
system (ANS) and cardiovascular risk profiles in children with type 1 diabetes mellitus
(DM). [Subjects] Fifteen type 1 DM children (all boys; 13.0±1.0 years of age) were
enrolled in the study. [Methods] The subjects received exercise training three times a
week in a 12-week program. Each child was asked to walk on a treadmill to achieve an
exercise intensity of VO2max 60%. ANS activity was measured by power spectral
analysis of the electrocardiogram (ECG). Blood samples were obtained for serum lipid
profiles. To evaluate Doppler-shifted Fourier pulsatility index (PI) analysis, a 5-MHz
continuous wave Doppler (VASCULAB D10) set was used to measure forward blood flow velocity
(FLOW) in the radial artery. [Results] Total and low-frequency (LF) power of heart rate
variability increased significantly after exercise intervention. Total cholesterol (TC)
levels were significant lower after exercise intervention. Total and high-frequency (HF)
power were significantly correlated with higher TC levels, but diastolic blood pressure
and HF was significantly correlated with lower TC levels. [Conclusion] Regular exercise
intervention should be prescribed for children with type 1 DM.
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Affiliation(s)
- Ki Ok Shin
- Laboratory of Exercise Biochemistry, Department of Physical Education, Dong-A University, Republic of Korea
| | - Toshio Moritani
- Laboratory of Applied Physiology, Graduate School of Human and Environmental Studies, Kyoto University, Japan
| | - Jinhee Woo
- Laboratory of Exercise Physiology, Department of Physical Education, Dong-A University, Republic of Korea
| | - Ki Soeng Jang
- Laboratory of Exercise Biochemistry, Department of Physical Education, Dong-A University, Republic of Korea
| | - Ju Yong Bae
- Laboratory of Exercise Biochemistry, Department of Physical Education, Dong-A University, Republic of Korea
| | - Jaeho Yoo
- Division of Endocrinology and Metabolism, Department of Pediatrics, Medical Center, Dong-A University, Republic of Korea
| | - Sunghwun Kang
- Laboratory of Exercise Physiology, Department of Physical Education, Dong-A University, Republic of Korea
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Malardé L, Gratas-Delamarche A, Le Douairon-Lahaye S, Zguira MS, Vincent S, Lemoine-Morel S, Groussard C. Endurance training and insulin therapy need to be associated to fully exert their respective beneficial effects on oxidant stress and glycemic regulation in diabetic rats. Free Radic Res 2014; 48:412-9. [DOI: 10.3109/10715762.2014.880428] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Woo J, Shin KO, Park SY, Jang KS, Kang S. Effects of exercise and diet change on cognition function and synaptic plasticity in high fat diet induced obese rats. Lipids Health Dis 2013; 12:144. [PMID: 24098984 PMCID: PMC3851938 DOI: 10.1186/1476-511x-12-144] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Accepted: 09/17/2013] [Indexed: 01/07/2023] Open
Abstract
Background Nutritional imbalance-induced obesity causes a variety of diseases and in particular is an important cause of cognitive function decline. This study was performed on Sprague Dawley (SD) rats with 13-weeks of high fat diet-induced obesity in connection to the effects of regular exercise and dietary control for 8 weeks on the synaptic plasticity and cognitive abilities of brain. Methods Four weeks-old SD rats were adopted classified into normal-normal diet-sedentary (NNS, n = 8), obesity-high fat diet-sedentary (OHS, n = 8), obesity-high fat diet-training (OHT, n = 8), obesity-normal diet-sedentary (ONS, n = 8) and obesity- normal diet-training (ONT, n = 8). The exercise program consisted of a treadmill exercise administered at a speed of 8 m/min for 1–4 weeks, and 14 m/min for 5–8 weeks. The Western blot method was used to measure the expression of NGF, BDNF, p38MAPK and p-p38MAPK proteins in hippocampus of the brain, and expressions of NGF, BDNF, TrkA, TrkB, CREB and synapsin1 mRNA were analyzed through qRT-PCR. Results The results suggest cognitive function-related protein levels and mRNA expression to be significantly decreased in the hippocampus of obese rats, and synaptic plasticity as well as cognitive function signaling sub-pathway factors were also significantly decreased. In addition, 8-weeks exercises and treatment by dietary change had induced significant increase of cognitive function-related protein levels and mRNA expression as well as synaptic plasticity and cognitive function signaling sub-pathway factors in obese rats. In particular, the combined treatment had presented even more positive effect. Conclusions Therefore, it was determined that the high fat diet-induced obesity decreases plasticity and cognitive function of the brain, but was identified as being improved by exercises and dietary changes. In particular, it is considered that regular exercise has positive effects on memory span and learning capacity unlike dietary control.
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Affiliation(s)
- Jinhee Woo
- Department of Physical Education, Laboratory of Exercise Physiology, College of Sports Science, Dong-A University, 840 Hadan2-dong, Saha-gu, Busan, Korea.
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Exercise training improve leptin sensitivity in peripheral tissue of obese rats. Biochem Biophys Res Commun 2013; 435:454-9. [DOI: 10.1016/j.bbrc.2013.05.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Accepted: 05/02/2013] [Indexed: 11/18/2022]
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Yoo JH. Nonpharmacological management and psychosocial support for children and adolescents with type 1 diabetes. KOREAN JOURNAL OF PEDIATRICS 2011; 54:45-50. [PMID: 21503196 PMCID: PMC3077500 DOI: 10.3345/kjp.2011.54.2.45] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/11/2011] [Accepted: 01/31/2011] [Indexed: 12/20/2022]
Abstract
Compared to that in the Caucasian population, type 1 diabetes mellitus (T1DM) incidence rates are very low in Koreans. Therefore, compared to the recent development of pharmacological therapy applicable to Korean children with T1DM, interest in nonpharmacological therapy and psychosocial support systems remains low, as is the development of Korean-style T1DM education programs for therapeutic application. Children who have been newly diagnosed with diabetes are placed in completely new environments for treatment. For appropriate control of diabetes, patients have to self-monitor blood glucose levels and inject insulin several times a day and must use extreme self-control when they eat foods to avoid increases in blood glucose levels. Blood glucose excursions resulting from impaired pancreatic β cell functions cause mental stress due to vague fears of chronic complications of diabetes. In addition, children with diabetes cannot be excluded from the substantial amount of studies required of Korean adolescents, and the absolute shortage of time for ideal control of diabetes adds to their mental stress. Many of these patients are psychologically isolated in school where they spend most of their time, and they are not appropriately considered or supported with respect to blood glucose control in many cases. In this respect, this author will introduce some of the newest views on nonpharmacological therapy and psychosocial support systems that account for important parts of T1DM management and seek measures to apply them in conformity with the social characteristics of Korea.
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Affiliation(s)
- Jae Ho Yoo
- Department of Pediatrics, Dong-A University College of Medicine, Busan, Korea
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