Enhanced muscle insulin receptor autophosphorylation with short-term aerobic exercise training

Short-term exercise training improves flow-mediated dilation and circulating angiogenic cell number in older sedentary adults

Cardiovascular disease risk increases with age due, in part, to impaired endothelial function and decreased circulating angiogenic cell (CAC) number and function. We sought to determine if 10 days of aerobic exercise training improves endothelial function, CAC number, and intracellular redox balance in older sedentary adults. Eleven healthy subjects (4 men, 7 women), 61 ± 2 years of age participated in 60 min of aerobic exercise at 70% maximal oxygen consumption for 10 consecutive days while maintaining body weight. Before and after training, endothelial function was measured as flow-mediated dilation of the brachial artery and fasting blood was drawn to enumerate 3 CAC subtypes. Intracellular reactive oxygen species (ROS) and nitric oxide (NO) in CD34+ CACs were measured using fluorescent probes and reinforced via real-time quantitative polymerase chain reaction. Flow-mediated dilation improved significantly following training (10% ± 1.3% before vs. 16% ± 1.4% after training; P < 0.05). Likewise, CD34+/KDR+ number increased 104% and KDR+ number increased 151% (P < 0.05 for both), although CD34+ number was not significantly altered (P > 0.05). Intracellular NO and ROS levels in CD34+ CACs were not different after training (P > 0.05 for both). Messenger RNA expression of SOD1, endothelial nitric oxide synthase, and NADPH oxidase 2 and neutrophil cytosolic factor 1 in CD34+ CACs was not significantly altered with training (P > 0.05). In conclusion, 10 consecutive days of aerobic exercise increased flow-mediated dilation and CAC number in older, previously sedentary adults, but did not affect intracellular redox balance in CD34+ CACs. Overall, these data indicate that even short-term aerobic exercise training can have a significant impact on cardiovascular disease risk factors.

Psychological wellbeing and biochemical modulation in response to weight loss in obese type 2 diabetes patients

BACKGROUND

Obesity in type 2 diabetes patients is a serious health issue by itself; it is also associated with other health problems including psychiatric illnesses. The psychological effects of dieting and weight loss have been a matter of controversy in the field of obesity management.

OBJECTIVE

The aim of this study was to compare the impact of weight loss because of aerobic exercise training and dietary measures on psychological wellbeing and biochemical modulation in obese type 2 diabetes patients.

MATERIAL AND METHODS

One hundred obese type 2 diabetes patients of both sexes participated in this study, and were included into two equal groups. The first group (A) received aerobic exercise training, three sessions per week for three months combined with dietary measures. The second group (B) received no training intervention for three months.

RESULTS

There was a significant decrease in body mass index (BMI), leptin, total cholesterol (TC), low density lipoprotein cholesterol (LDL-c), triglycerides(TG), homeostasis model assessment-insulin resistance- index (HOMA-IR) , beck depression inventory (BDI ) & profile of mood states(POMS) and increase in high density lipoprotein cholesterol (HDL-c) & Rosenberg self-esteem scale (RSES) of group (A) after treatments, but the changes of group (B) were not significant. Moreover, there were significant differences between mean levels of the investigated parameters of group (B) and group (A) at the end of the study.

CONCLUSION

Physical training and dietary measures can be used as methods of choice for psychological wellbeing and biochemical modulation in obese type 2 diabetes patients.

Effects of different periods of hypoxic training on glucose metabolism and insulin sensitivity

This study examined the effects of different periods of hypoxic training on glucose metabolism. Sedentary subjects underwent hypoxic training (FiO2 = 15.0%) for either 2 weeks (2-week group; n = 11) or 4 weeks (4-week group; n = 10). The 2-week group conducted training sessions on 6 days week(-1) for 2 weeks, whereas the 4-week group conducted training sessions on 3 days week(-1) for 4 weeks. Body fat mass or abdominal fat area did not change after training period in either group. VO2max increased in both groups after training period (42 ± 2 versus 43 ± 2 ml min(-1) kg(-1) in 2-week group, 41 ± 1 versus 42 ± 2 ml min(-1) kg(-1) in 4-week group). Both groups showed a reduction in mean blood pressure after training period (92 ± 3 versus 90 ± 3 mmHg in 2-week group, 91 ± 2 versus 87 ± 2 mmHg in 4-week group, P ≤ 0.05). No change was observed in blood glucose response after glucose ingestion after training period. However, area under the curve for serum insulin concentrations after glucose ingestion significantly decreased in only 4-week group (6910 ± 763 versus 5812 ± 872 μIU ml(-1) 120 min, P ≤ 0.05). In conclusion, hypoxic training reduced blood pressure with independent on training duration. However, a longer period of hypoxic training led to greater improvements in insulin sensitivity compared with equivalent training over a shorter period, suggesting that hypoxic training programmes for more than 4 weeks might be more beneficial for improving insulin sensitivity.

Metabolic syndrome and insulin resistance: underlying causes and modification by exercise training

Metabolic syndrome (MS) is a collection of cardiometabolic risk factors that includes obesity, insulin resistance, hypertension, and dyslipidemia. Although there has been significant debate regarding the criteria and concept of the syndrome, this clustering of risk factors is unequivocally linked to an increased risk of developing type 2 diabetes and cardiovascular disease. Regardless of the true definition, based on current population estimates, nearly 100 million have MS. It is often characterized by insulin resistance, which some have suggested is a major underpinning link between physical inactivity and MS. The purpose of this review is to: (i) provide an overview of the history, causes and clinical aspects of MS, (ii) review the molecular mechanisms of insulin action and the causes of insulin resistance, and (iii) discuss the epidemiological and intervention data on the effects of exercise on MS and insulin sensitivity.

Role of exercise duration on metabolic adaptations in working muscle to short-term moderate-to-heavy aerobic-based cycle training

This study aimed at investigating the relative roles of the duration versus intensity of exercise on the metabolic adaptations in vastus lateralis to short-term (10 day) aerobic-based cycle training. Healthy males with a peak aerobic power (VO2 peak) of 46.0 ± 2.0 ml kg(-1) min(-1) were assigned to either a 30-min (n = 7) or a 60-min (n = 8) duration performed at two different intensities (with order randomly assigned), namely moderate (M) and heavy (H), corresponding to 70 and 86 % VO2 peak, respectively. No change (P > 0.05) in VO2 peak was observed regardless of the training program. Based on the metabolic responses to prolonged exercise (60 % VO2 peak), both M and H and 30 and 60 min protocols displayed less of a decrease (P < 0.05) in phosphocreatine (PCr) and glycogen (Glyc) and less of an increase (P < 0.05) in free adenosine diphosphate (ADPf), free adenosine monophosphate (AMPf), inosine monophosphate (IMP) and lactate (La). Training for 60 min compared with 30 min resulted in a greater protection (P < 0.05) of ADPf, AMPf, PCr and Glyc during exercise, effects that were not displayed between M and H. The reduction in both VO2 and RER (P < 0.05) observed during submaximal exercise did not depend on training program specifics. These findings indicate that in conjunction with our earlier study (Green et al., Eur J Appl Physiol, 2012b), a threshold exists for duration rather than intensity of aerobic exercise to induce a greater training impact in reducing metabolic strain.

The effects of exercise on C-reactive protein, insulin, leptin and some cardiometabolic risk factors in Egyptian children with or without metabolic syndrome

BACKGROUND

The prevalence and magnitude of obesity in the children and the adolescents have increased dramatically in the developing countries over the last 20-30 years. The prevalence of metabolic syndrome (MS) in children is increasing.

AIM

This study aimed to investigate the changes of C-reactive protein (CRP), leptin, insulin, and blood lipids before and after the exercise therapy in normal and obese children (with or without metabolic syndrome).

METHODS

The study covered 49 normal children (control), 32 obese children without metabolic syndrome and 12 obese children with metabolic syndrome. We examined the influence of exercise (3 times/week) for 12 weeks on the levels of serum CRP, leptin, insulin, homeostatic model assessment insulin resistance (HOMA-IR), triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) in all groups.

RESULTS

There were significant correlations between HOMA-IR and the individual components of the metabolic syndrome. After 12 weeks of exercise, both of the obese children groups, with and without metabolic syndrome, showed reduced body weight, body mass index (BMI), and CRP level, and increased HDL-C level. The percentage of metabolic syndrome decreased from 12.9% before the exercise training to 7.5% after training. Also, there was a significant reduction in BMI (from 47.3 to 32.6%), in systolic blood pressure (from 18.3 to 15.1%) and in HDL-C level (from 18.3 to 9.7%).

CONCLUSION

Overweight children have multiple risk factors associated with the metabolic syndrome. 12-week exercise may have a positive effect on reducing risk factors for the metabolic syndrome.

Effects of training and nitric oxide on diabetic nephropathy progression in type I diabetic rats

The aim of the paper is to assess nitric oxide (NO) production during aerobic training and its role on the progression of diabetic nephropathy in rats. Induction of diabetes mellitus (DM) was achieved in adult male Wistar rats with streptozotocin. Half of the animals underwent training on a treadmill and the others (sedentary) stayed on a turned-off treadmill for the same period according to the following groups: sedentary control (CTL + SE); training control (CTL + EX); sedentary diabetic (DM + SE); and training diabetic (DM + EX) (n = 9 for all groups). The training on treadmill was carried out at a work rate of 16 m/min, 60 min/d, 5 d/week for eight weeks. Before and after the exercises, rats were placed in individual metabolic cages with standard chow and water ad libitum, for 24-h urine collection, followed by three hours' fasting blood sample withdrawal from the retro-orbital plexus, under anesthesia. Diabetic animals showed reduction of body weight, creatinine and urea depurations and NO excretion, increased blood glucose concentrations, albuminuria and thiobarbituric acid reactive substance (TBARS) excretion, when compared with the respective controls. All these alterations induced by DM were attenuated in the DM + EX versus DM + SE group. Analysis of insulin concentrations at the end of the protocol showed no significant change between the DM + SE and DM + EX groups. In conclusion, our data show that a routine physical exercise resulted in a better control of glycemia with an increased NO bioavailability and oxidative stress control, associated with an amelioration of renal function. We suggest aerobic training and the control of oxidative and nitrosative stress as useful non-pharmacological tools to delay the progression of diabetic nephropathy.

Insulin resistance in non-obese subjects is associated with activation of the JNK pathway and impaired insulin signaling in skeletal muscle

Background

The pathogenesis of insulin resistance in the absence of obesity is unknown. In obesity, multiple stress kinases have been identified that impair the insulin signaling pathway via serine phosphorylation of key second messenger proteins. These stress kinases are activated through various mechanisms related to lipid oversupply locally in insulin target tissues and in various adipose depots.

Methodology/Principal Findings

To explore whether specific stress kinases that have been implicated in the insulin resistance of obesity are potentially contributing to insulin resistance in non-obese individuals, twenty healthy, non-obese, normoglycemic subjects identified as insulin sensitive or resistant were studied. Vastus lateralis muscle biopsies obtained during euglycemic, hyperinsulinemic clamp were evaluated for insulin signaling and for activation of stress kinase pathways. Total and regional adipose stores and intramyocellular lipids (IMCL) were assessed by DXA, MRI and ¹H-MRS. In muscle of resistant subjects, phosphorylation of JNK was increased (1.36±0.23 vs. 0.78±0.10 OD units, P<0.05), while there was no evidence for activation of p38 MAPK or IKKβ. IRS-1 serine phosphorylation was increased (1.30±0.09 vs. 0.22±0.03 OD units, P<0.005) while insulin-stimulated tyrosine phosphorylation decreased (10.97±0.95 vs. 0.89±0.50 OD units, P<0.005). IMCL levels were twice as high in insulin resistant subjects (3.26±0.48 vs. 1.58±0.35% H₂O peak, P<0.05), who also displayed increased total fat and abdominal fat when compared to insulin sensitive controls.

Conclusions

This is the first report demonstrating that insulin resistance in non-obese, normoglycemic subjects is associated with activation of the JNK pathway related to increased IMCL and higher total body and abdominal adipose stores. While JNK activation is consistent with a primary impact of muscle lipid accumulation on metabolic stress, further work is necessary to determine the relative contributions of the various mediators of impaired insulin signaling in this population.

Short-term endurance training does not alter the oxidative capacity of human subcutaneous adipose tissue

Endurance training results in adaptations that enhance regulation of energy storage and expenditure at rest and during exercise. While processes involved in skeletal muscle oxidative remodelling are well described, it is unknown whether oxidative capacity of human subcutaneous white adipose tissue (WAT) is modified by endurance training. Since human WAT retains rudimentary characteristics required for upregulation of oxidative function, we hypothesised that 10 days of intense endurance training would promote changes in WAT that favour an increase in oxidative capacity. Eleven untrained males (age 22 +/- 1 years, body mass 81 +/- 5 kg, peak oxygen uptake (VO(2peak)) 3.7 +/- 0.2 l/min) undertook a 10-day endurance training protocol. Subcutaneous adipose tissue biopsies were taken from the abdomen prior to and 1 day after completion of training and analysed for fatty acid oxidative capacity, citrate synthase activity, and mitochondrial content via electron microscopy and gene expression analyses. There was a reduction in whole-body rates of carbohydrate oxidation, and concomitant increases in fat oxidation rate measured during 20-min of submaximal cycling (70% of pre-training VO(2peak)) and an increase in basal GLUT4 protein in skeletal muscle. Despite these training-induced adaptations, there were no changes in WAT of ex-vivo fat oxidation rate, maximal citrate synthase activity, mitochondrial volume or in selected genes involved in adipose tissue oxidative capacity. We conclude that 10 days training in previously untrained subjects results in adaptations in skeletal muscle but does not increase the oxidative capacity of WAT.

Combined effects of endurance training and dietary unsaturated fatty acids on physical performance, fat oxidation and insulin sensitivity

Endurance training improves exercise performance and insulin sensitivity, and these effects may be in part mediated by an enhanced fat oxidation. Since n-3 and n-9 unsaturated fatty acids may also increase fat oxidation, we hypothesised that a diet enriched in these fatty acids may enhance the effects of endurance training on exercise performance, insulin sensitivity and fat oxidation. To assess this hypothesis, sixteen normal-weight sedentary male subjects were randomly assigned to an isoenergetic diet enriched with fish and olive oils (unsaturated fatty acid group (UFA): 52 % carbohydrates, 34 % fat (12 % SFA, 12 % MUFA, 5 % PUFA), 14 % protein), or a control diet (control group (CON): 62 % carbohydrates, 24 % fat (12 % SFA, 6 % MUFA, 2 % PUFA), 14 % protein) and underwent a 10 d gradual endurance training protocol. Exercise performance was evaluated by measuring VO2max and the time to exhaustion during a cycling exercise at 80 % VO2max; glucose homeostasis was assessed after ingestion of a test meal. Fat oxidation was assessed by indirect calorimetry at rest and during an exercise at 50 % VO2max. Training significantly increased time to exhaustion, but not VO2max, and lowered incremental insulin area under the curve after the test meal, indicating improved insulin sensitivity. Those effects were, however, of similar magnitude in UFA and CON. Fat oxidation tended to increase in UFA, but not in CON. This difference was, however, not significant. It is concluded that a diet enriched with fish- and olive oil does not substantially enhance the effects of a short-term endurance training protocol in healthy young subjects.

Clinical measures of physical fitness predict insulin resistance in people at risk for diabetes

BACKGROUND AND PURPOSE

Physical inactivity has been well documented as a risk factor for type 2 diabetes. Previous studies measured the level of physical activity either with questionnaires or with direct measurements of maximum oxygen uptake. However, questionnaires are patient-report measures, and methods for obtaining direct maximum oxygen uptake measurements often are not available clinically. The purpose of this study was to investigate whether clinical measurement of health-related physical fitness with a simple test battery can predict insulin resistance, a precursor of type 2 diabetes, in people at risk for diabetes.

SUBJECTS AND METHODS

A total of 151 volunteers with at least one diabetes risk factor (overweight, hypertension, dyslipidemia, family history, impaired glucose tolerance, gestational diabetes, or delivering a baby weighing more than 4.0 kg) were recruited. Insulin resistance (as determined with the homeostasis model assessment of insulin resistance [HOMA-IR]), physical fitness (including body composition, as determined with the body mass index and waist circumference), muscle strength (handgrip strength [force-generating capacity]), muscle endurance (sit-up test), flexibility (sit-and-reach test), and cardiorespiratory endurance (step test) were measured, and a physical activity questionnaire was administered. Backward regression analysis was used to build the prediction models for insulin resistance from components of physical fitness and physical activity.

RESULTS

Body mass index, muscle strength, and cardiorespiratory fitness predicted HOMA-IR in men (adjusted R(2)=.264). In women, age, waist circumference, and cardiorespiratory fitness were the predictors of HOMA-IR (adjusted R(2)=.438).

DISCUSSION AND CONCLUSION

Clinical measures of physical fitness can predict insulin resistance in people at risk for diabetes. The findings support the validity of clinical measures of physical fitness for predicting insulin resistance in people at risk for diabetes.

Effects of two-month physical-endurance and diet-restriction programmes on lipid profiles and insulin resistance in obese adolescent boys

AIM

The aim of this study was to assess the impact of a two-month programme of physical endurance and dietary restriction, alone and combined, on plasma lipids and insulin resistance in obese adolescents.

METHODS

A total of 24 obese adolescent boys participated in programmes of either dietary restriction (R), physical endurance at the point of maximum lipid oxidation (LIPOX(max)) (E) or diet combined with training (R+E). Anthropometric characteristics, metabolic measures and biochemical analyses were performed in all subjects before and after the interventions. An estimated insulin resistance was calculated using the homoeostasis model assessment (HOMA-IR) index.

RESULTS

At the end of the two-month programmes, adolescents in the R+E group showed greater reductions in body mass index (-3.9+/-0.7 kg/m(2)) and waist circumference (-12.3+/-4.8 cm) (P<0.001) than either the R or E group. A significant decrease (P<0.01) in HOMA-IR index (-2.13+/-0.11), plasma triglycerides, LDL and total cholesterol was also seen in the R+E group. Moreover, at the end of the programme, the ratio of HDL cholesterol to triglycerides was significantly increased from baseline in the R+E group (0.93+/-0.09 vs. 0.68+/-0.11; P<0.01).

CONCLUSION

Compared with either moderate physical endurance or dietary restriction, a combination of both resulted in a significant decrease in cardiovascular risk factors and HOMA-IR index in obese adolescent boys.

Impact of hormone replacement therapy on exercise training-induced improvements in insulin action in sedentary overweight adults

Exercise training (ET) and hormone replacement therapy (HRT) are both recognized influences on insulin action, but the influence of HRT on responses to ET has not been examined. To determine if HRT use provided additive benefits for the response of insulin action to ET, we evaluated the impact of HRT use on changes in insulin during the course of a randomized, controlled, aerobic ET intervention. Subjects at baseline were sedentary, dyslipidemic, and overweight. These individuals were randomized to 6 months of one of 3 aerobic ET interventions or continued physical inactivity. In 206 subjects, an insulin sensitivity index (S(I)) was obtained with a frequently sampled intravenous glucose tolerance test pre- and post-ET. Baseline and postintervention fitness, regional adiposity, general adiposity, skeletal muscle biochemistry and histology, and serum lipoproteins were measured as other putative mediators influencing insulin action. Two-way analyses of variance were used to determine if sex or HRT use influenced responses to exercise training. Linear modeling was used to determine if predictors for response in S(I) differed by sex or HRT use(.) Women who used HRT (HRT+) demonstrated significantly greater improvements in S(I) with ET than women not using HRT (HRT-). In those HRT+ women, plasma triglyceride change best correlated with change in S(I). For HRT- women, capillary density change and, for men, subcutaneous adiposity change best correlated with change in S(I). In summary, in an ET intervention, HRT use appears to be associated with more robust responses in insulin action. Furthermore, relationships between ET-induced changes in insulin action and potential mediators of change in insulin action are different for men, and for women on or off HRT. These findings have implications for the relative utility of ET for improving insulin action in middle-aged men and women, particularly in the setting of differences in HRT use.

Effect of supervised exercise intervention on metabolic risk factors and physical fitness in Chinese obese children in early puberty

The aim of this paper was to study the effect of long-term supervised exercise-induced weight maintenance on metabolic risk factors and physical fitness in obese children in early puberty. A total of 49 obese children aged 12-14 years were divided into control and exercise groups. The children in the exercise group accepted exercise intervention supervised by a professional sports teacher for 9 of the 12 months. All participants in both groups received health education once every 3 months. Anthropometry and fasting serum lipids, glucose, insulin and homeostatic model assessment for insulin resistance (HOMA-IR) were measured at months 0, 3, 9, 12 of the intervention. Physical fitness was determined before and after intervention. After the intervention (i) BMI was reduced by 0.6 (P < 0.05) in the exercise group, but increased by 0.5 (P < 0.05) in the control group, compared with the pre-intervention level at the end of 9-month intervention; (ii) Triglyceride levels in the exercise group significantly decreased by 23.1% by 3 months (P < 0.05), and by 30.2% after 9 months (P < 0.05), but increased by 50% (P < 0.05) in the control group; high density lipoprotein-cholesterol (HDL-C) decreased more by 35% (P < 0.05) in the controls than in the exercise group (P < 0.05); (iii) Fasting serum glucose, insulin level and HOMA-IR decreased, respectively, by 23.1%, 36.6% and 48.5% in the exercise group at 9 months (P < 0.05), whereas glucose levels increased by 10.9% (P < 0.05) in the control group; (iv) Exercise performance, such as upper- and lower-limb strength, flexibility and endurance, were enhanced by 17.9%, 12.3%, 22.3% and 20.4% (P < 0.01), respectively and (v) At 12 months, i.e. 3 months after terminating the supervised exercise, serum triglycerides, glucose, insulin and HOMA-IR level all returned to the pre-intervention level. Supervised decrement exercise can effectively slow the progress of obesity, improve insulin sensitivity and metabolic risk factors, but once the supervised exercise is stopped, the health benefits weaken or vanish. The key to helping these obese children is for them to cultivate good exercise habits which are sustained throughout their lives.

The effects of a graduated aerobic exercise programme on cardiovascular disease risk factors in the NHS workplace: a randomised controlled trial

Background

Sufficient levels of physical activity provide cardio-protective benefit. However within developed society sedentary work and inflexible working hours promotes physical inactivity. Consequently to ensure a healthy workforce there is a requirement for exercise strategies adaptable to occupational time constraint. This study examined the effect of a 12 week aerobic exercise training intervention programme implemented during working hours on the cardiovascular profile of a sedentary hospital workforce.

Methods

Twenty healthy, sedentary full-time staff members of the North West London Hospital Trust cytology unit were randomly assigned to an exercise (n = 12; mean ± SD age 41 ± 8 years, body mass 69 ± 12 kg) or control (n = 8; mean ± SD age 42 ± 8 years, body mass 69 ± 12 kg) group. The exercise group was prescribed a progressive aerobic exercise-training programme to be performed 4 times a week for 8 weeks (initial intensity 65% peak oxygen consumption (VO_{2 peak})) and to be conducted without further advice for another 4 weeks. The control was instructed to maintain their current physical activity level. Oxygen economy at 2 minutes (2minVO₂), 4 minutes (4minVO₂), VO_{2 peak}, systolic blood pressure (SBP), diastolic blood pressure (DBP), BMI, C-reactive protein (CRP), fasting glucose (GLU) and total cholesterol (TC) were determined in both groups pre-intervention and at 4 week intervals. Both groups completed a weekly Leisure Time Questionnaire to quantify additional exercise load.

Results

The exercise group demonstrated an increase from baseline for VO_{2 peak} at week 4 (5.8 ± 6.3 %) and 8 (5.0 ± 8.7 %) (P < 0.05). 2minVO₂ was reduced from baseline at week 4 (-10.2 ± 10.3 %), 8 (-16.8 ± 10.6 %) and 12 (-15.1 ± 8.7 %), and 4minVO₂ at week 8 (-10.7 ± 7.9 %) and 12 (-6.8 ± 9.2) (P < 0.05). There was also a reduction from baseline in CRP at week 4 (-0.4 ± 0.6 mg·L^-1) and 8 (-0.9 ± 0.8 mg·L^-1) (P < 0.05). The control group showed no such improvements.

Conclusion

This is the first objectively monitored RCT to show that moderate exercise can be successfully incorporated into working hours, to significantly improve physical capacity and cardiovascular health.

Effects of acute exercise and training on insulin action and sensitivity: focus on molecular mechanisms in muscle

A single bout of exercise increases insulin sensitivity for several hours and the effect is mainly restricted to the muscles recruited during exercise. When exercise is repeated over time, adaptations to physical training occur that include more long-lasting increases in insulin sensitivity. The present review explores the molecular mechanisms involved in both the acute and chronic effects of exercise on insulin sensitivity in skeletal muscle.

Increased insulin-stimulated Akt pSer473 and cytosolic SHP2 protein abundance in human skeletal muscle following acute exercise and short-term training

The purpose of the present study was to determine in human skeletal muscle whether a single exercise bout and 7 days of consecutive endurance (cycling) training 1) increased insulin-stimulated Akt pSer(473) and 2) altered the abundance of the protein tyrosine phosphatases (PTPases), PTP1B and SHP2. In healthy, untrained men (n = 8; 24 +/- 1 yr), glucose infusion rate during a hyperinsulinemic euglycemic clamp, when compared with untrained values, was not improved 24 h following a single 60-min bout of endurance cycling but was significantly increased ( approximately 30%; P < 0.05) 24 h following completion of 7 days of exercise training. Insulin-stimulated Akt pSer(473) was approximately 50% higher (P < 0.05) 24 h following the acute bout of exercise, with this effect remaining after 7 days of training (P < 0.05). Insulin-stimulated insulin receptor and insulin receptor substrate-1 tyrosine phosphorylation were not altered 24 h after acute exercise and short-term training. Insulin did not acutely regulate the localization of the PTPases, PTP1B or SHP2, although cytosolic protein abundance of SHP2 was increased (P < 0.05; main effect) 24 h following acute exercise and short-term training. In conclusion, insulin-sensitive Akt pSer(473) and cytosolic SHP2 protein abundance are higher after acute exercise and short-term training, and this effect appears largely due to the residual effects of the last bout of prior exercise. The significance of exercise-induced alterations in cytosolic SHP2 and insulin-stimulated Akt pSer(473) on the improvement in insulin sensitivity requires further elucidation.

Short-term sprint interval versus traditional endurance training: similar initial adaptations in human skeletal muscle and exercise performance

Brief, intense exercise training may induce metabolic and performance adaptations comparable to traditional endurance training. However, no study has directly compared these diverse training strategies in a standardized manner. We therefore examined changes in exercise capacity and molecular and cellular adaptations in skeletal muscle after low volume sprint-interval training (SIT) and high volume endurance training (ET). Sixteen active men (21 +/- 1 years, ) were assigned to a SIT or ET group (n = 8 each) and performed six training sessions over 14 days. Each session consisted of either four to six repeats of 30 s 'all out' cycling at approximately 250% with 4 min recovery (SIT) or 90-120 min continuous cycling at approximately 65% (ET). Training time commitment over 2 weeks was approximately 2.5 h for SIT and approximately 10.5 h for ET, and total training volume was approximately 90% lower for SIT versus ET ( approximately 630 versus approximately 6500 kJ). Training decreased the time required to complete 50 and 750 kJ cycling time trials, with no difference between groups (main effects, P Collapse

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MESH Headings

• Adaptation, Physiological
• Adult
• Electron Transport Complex IV/metabolism
• Energy Metabolism
• Exercise/physiology
• Exercise Tolerance
• Glycogen/metabolism
• Humans
• Male
• Muscle, Skeletal/metabolism
• Muscle, Skeletal/physiology
• Physical Education and Training/methods
• Physical Endurance/physiology
• Time Factors

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Affiliation(s)

Martin J Gibala Department of Kinesiology IWC AB122, McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S 4K1, Canada.
Jonathan P Little
Martin van Essen
Geoffrey P Wilkin
Kirsten A Burgomaster
Adeel Safdar
Sandeep Raha
Mark A Tarnopolsky

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Collaborators Collapse

Effect of a diet and exercise intervention on oxidative stress, inflammation and monocyte adhesion in diabetic men

Diabetes increases the risk of coronary artery disease. We examined the effects of lifestyle modification on key contributing factors to atherogenesis, including oxidative stress, inflammation and cell adhesion. Diabetic men (N=13) were placed on a high-fiber, low-fat diet in a 3-week residential program where food was provided ad libitum and daily aerobic exercise was performed. In each subject, pre- and post-intervention fasting blood was drawn for circulating levels of serum lipids, glucose and insulin, oxidative stress marker 8-isoprostaglandin F2alpha (8-iso-PGF2alpha), the inflammatory protein C-reactive protein (CRP), and soluble intracellular adhesion molecule (sICAM)-1 and sE-selectin as indicators of endothelial activation. Using subject sera and human aortic endothelial cell (HAEC) culture systems, serum-induced monocyte adhesion, ICAM-1, vascular cell adhesion molecule-1 (VCAM-1) and cell surface abundance, and monocyte chemotactic protein-1 (MCP-1) production were determined. Nitric oxide (NO), superoxide, and hydrogen peroxide production were measured in vitro by fluorometric detection. After 3 weeks, significant reductions (p<0.05) in BMI, all serum lipids including total cholesterol (pre: 188.9+/-10.1 mg/dL versus post: 146.3+/-3.8 mg/dL) and low-density lipoprotein (103.1+/-10.2 mg/dL versus 76.4+/-4.3 mg/dL), fasting serum glucose (157.5+/-10.1 mg/dL versus 126.7+/-8.7 mg/dL), insulin (33.8+/-4.0 microU/ml versus 23.8+/-3.4 microU/ml), homeostasis model assessment for insulin resistance, 8-iso-PGF2alpha, CRP, sICAM-1, and sE-selectin were noted. In vitro, serum-stimulated monocyte adhesion, cellular ICAM-1 and VCAM-1 expression (p<0.05), and fluorometric detection of superoxide and hydrogen peroxide production decreased, while a concomitant increase in NO production was noted (all p<0.01). A combination of diet and exercise ameliorates oxidative stress, inflammation, and monocyte-endothelial interaction. Intensive lifestyle modification may improve novel CAD risk factors in men with diabetes.

Effect of a short-term diet and exercise intervention on metabolic syndrome in overweight children

Overweight and the metabolic syndrome are increasing radically in children. The present study was designed to examine the effects of lifestyle modification in 16 children who were placed on a high-fiber, low-fat diet in a 2-week residential program where food was provided ad libitum and daily aerobic exercise was performed. In each subject, pre- and postintervention fasting blood was drawn. Insulin (27.2 +/- 3.5 vs 18.3 +/- 1.7 microU/mL, P < .01), homeostasis model assessment for insulin resistance (5.79 +/- 0.81 vs 4.13 +/- 0.38, P < .05), and body weight (92.0 +/- 7.0 vs 88.0 +/- 6.8 kg, P < .01) were reduced significantly. Total cholesterol (165 +/- 7.8 vs 127 +/- 7.4 mg/dL, P < .01), low-density lipoprotein (94.1 +/- 8.2 vs 68.5 +/- 6.7 mg/dL, P < .01), triglycerides (146 +/- 16.2 vs 88.1 +/- 8.1 mg/dL, P < .01), and total cholesterol-high-density lipoprotein (4.16 +/- 0.30 vs 3.34 +/- 0.30, P < .01) and low-density lipoprotein-high-density lipoprotein ratios (2.41 +/- 0.3 vs 1.86 +/- 0.2, P < .01) were reduced, with no change in high-density lipoprotein observed (42.3 +/- 2.4 vs 40.8 +/- 3.0 mg/dL). Systolic blood pressure (130 +/- 3.1 vs 117 +/- 1.8 mm Hg, P < .001) and diastolic blood pressure (74.3 +/- 3.0 vs 67.2 +/- 2.3 mm Hg, P = .01) also decreased. Most notably, before the intervention, 7 of the 16 subjects were classified with metabolic syndrome. After the 2-week intervention, despite remaining overweight, reversal of metabolic syndrome was noted in all 7 subjects. All of these changes occurred despite only modest improvements in the percentage of body fat (37.5% +/- 1.1% vs 36.4% +/- 1.2%, P < .01) and body mass index (33.2 +/- 1.9 vs 31.8 +/- 1.9 kg/m(2), P < .01). These results indicate that a short-term rigorous diet and exercise regimen can reverse metabolic syndrome, even in youth without documented atherosclerosis.

Endurance training-induced changes in insulin sensitivity and gene expression

The beneficial effects of regular physical activity on insulin sensitivity (SI) and glucose tolerance are well documented, with considerable heterogeneity in responsiveness to exercise training (ET). To find novel candidate genes for ET-induced improvement in SI, we used microarray technology. Total RNA was isolated from vastus lateralis muscle before and after 20 wk of exercise from individuals participating in the HERITAGE Family Study. SI index was derived from a frequently sampled intravenous glucose tolerance test using MINMOD Millennium software. Sixteen subjects were selected: eight showing no changes in SI (low responders, LSIR) and eight displaying marked improvement in SI (high responders, HSIR) with ET. The SI increase was about four times greater in HSIR compared with LSIR (+3.6 +/- 0.5 vs. -1.2 +/- 0.5 microU.ml(-1).min(-1), mean +/- SE), whereas age, body mass index, percent body fat, and baseline SI were similar between the groups. Triplicate microarrays were performed, comparing pooled RNA with HSIR and LSIR individuals for differences in gene expression before and after ET using in situ-generated microarrays (18, 861 genes). Array data were validated by quantitative RT-PCR. Almost twice as many genes showed at least twofold differences between HSIR and LSIR after training compared with pretraining. We identified differentially expressed genes involved in energy metabolism and signaling, novel structural genes, and transcripts of unknown function. Genes of interest upregulated in HSIR include V-Ski oncogene, four-and-a-half LIM domain 1, and titin. Further study of these novel candidate genes should provide a better understanding of molecular mechanisms involved in the improvement in insulin sensitivity in response to regular exercise.

Effects of exercise and diet on chronic disease

Currently, modern chronic diseases, including cardiovascular diseases, Type 2 diabetes, metabolic syndrome, and cancer, are the leading killers in Westernized society and are increasing rampantly in developing nations. In fact, obesity, diabetes, and hypertension are now even commonplace in children. Clearly, however, there is a solution to this epidemic of metabolic disease that is inundating today's societies worldwide: exercise and diet. Overwhelming evidence from a variety of sources, including epidemiological, prospective cohort, and intervention studies, links most chronic diseases seen in the world today to physical inactivity and inappropriate diet consumption. The purpose of this review is to 1) discuss the effects of exercise and diet in the prevention of chronic disease, 2) highlight the effects of lifestyle modification for both mitigating disease progression and reversing existing disease, and 3) suggest potential mechanisms for beneficial effects.

Acylation-stimulating protein: effect of acute exercise and endurance training

INTRODUCTION

Acylation-stimulating protein (ASP) is an adipocyte-derived protein that contributes to fatty acid clearance. Regular exercise training improves fatty acid handling.

OBJECTIVE

To examine the effect of acute exercise and short-term endurance training on ASP levels.

SUBJECTS

Eight untrained men (age: 23.5+/-3.4 y; maximal power output (Wmax): 3.7+/-0.6 W/kg body weight).

DESIGN

Subjects were trained for 2 weeks. Before and after training, blood was sampled during a 3-h exercise test, and insulin sensitivity was assessed by an insulin tolerance test.

RESULTS

Before training, ASP levels decreased during exercise (from 17.9+/-2.9 to 15.5+/-3.7 nmol/l at t=0 vs 180, P<0.05). Endurance training decreased fasting ASP levels significantly (17.9+/-2.9 vs 13.4+/-2.3 nmol/l pre- and post-training, P<0.001). Interestingly, after 2 weeks of endurance training, ASP levels tended to increase during exercise (from 13.4+/-2.3 to 17.2+/-4.5 nmol/l at t=0 vs 180, P=0.09). Baseline ASP levels correlated negatively with insulin sensitivity both before (r=-0.86, P<0.01) and after training (r=-0.82, P<0.05).

CONCLUSION

Short-term endurance training reduces baseline ASP levels. These data fit with the hypothesis that reduced ASP levels indicate improved ASP sensitivity.

Effective treatments for insulin resistance: trim the fat and douse the fire

Currently, only limited treatments are available for insulin resistance, a major cause of type 2 diabetes (T2D) and the metabolic syndrome. Combined innovative pharmaceutical and non-pharmaceutical strategies are needed. Obesity, a major cause of insulin resistance in T2D, can be treated relatively safely with modern bariatric surgery. Exercise training to increase VO(2max) is an important non-pharmaceutical approach to decrease insulin resistance. The thiazolidinediones are useful in treating insulin resistance, but newer agents with broader specificity might be more efficacious without deleterious side effects. Recently oxidative stress has been implicated in insulin resistance. One antioxidant that is safe and appears effective is alpha-lipoic acid. Thus, combinations of surgery, exercise training, insulin sensitizers and antioxidants will probably constitute future insulin resistance management.

[Role of zinc in insulin resistance]

This review reports the etiological aspects of insulin resistance as well as the participation of zinc in this process. Zinc participates in the metabolic pathways involving protein synthesis, and the metabolism of carbohydrate, lipid and nucleic acid. This element has been associated with the interaction between hormones and their receptors and to the improvement in the post-receptor stimulus. In vitro studies show that insulin may form a complex with zinc improving the solubility of this hormone in the pancreatic beta cells and also increasing the binding ability of insulin to its receptor. Regarding obesity and insulin resistance, alterations in zinc concentration and distribution in tissues, as well as improvement in sensitivity to insulin after supplementation with this element, have been detected. Thus, the metabolic role of zinc in the insulin resistance syndrome should be further investigated having in mind that this element may contribute to the control of the usual metabolic alterations present in obese patients.

Glycogen Synthase: Key Effect of Exercise on Insulin Action

Exercise improves insulin action in muscle, but the mechanisms are poorly characterized. Despite the notion that increased insulin signaling would accompany improved insulin sensitivity, this is not universally true. Increased activity or expression of other proteins seems to be more important. An increase in activity and expression of glycogen synthase and GLUT4 may be key to the effects of exercise.

Muscle insulin receptor concentrations in obese patients post bariatric surgery: relationship to hyperinsulinemia

OBJECTIVE

Obesity results in insulin resistance. Bariatric surgery for obese individuals induces weight loss, improves insulin sensitivity, and lowers insulin levels. We investigated the mechanisms of this improvement.

DESIGN

Insulin receptor (IR) content, IR signaling, and adiponectin levels were measured in nine morbidly obese subjects before and after bariatric surgery.

SUBJECTS

Seven female and two male, average age 44+/-2y, BMI >40 kg/m(2) and/or at least 100 lbs over ideal body weight, undergoing elective bariatric surgery.

MEASUREMENTS

Before surgery BMI, fasting plasma glucose, adiponectin, and insulin levels were measured. A fasting muscle biopsy was obtained from the vastus lateralis for IR concentration and autophosphorylation activity measurements. These procedures were repeated 1 y after surgery.

RESULTS

At 1 y after surgery, the subjects had lost an average of 48.3+/-5.6 kg (P<0.001), insulin sensitivity had significantly increased as determined by the minimal model (SI 0.72+/-0.18 vs 3.86+/-1.43, P<0.05), and IR content had increased two-fold in muscle (2.1+/-0.4 vs 4.3+/-0.7 ng/mg protein, P<0.01). The increase in IR content was related to fasting insulin levels. In the subjects with the lowest IR function, there was also an increase in IR function. Plasma adiponectin increased by 40% following weight loss (7.4+/-1.6 pre vs 10.3+/-1.3 mg/ml post, P<0.05). There was no significant change in muscle content of the IR inhibitor, PC-1.

CONCLUSION

Increased IR content, most likely regulated by insulin levels, may be one contributor to the increased insulin sensitivity that occurs when morbidly obese patients undergo bariatric surgery.

Physical exercise enhances protein kinase C delta activity and insulin receptor tyrosine phosphorylation in diabetes-prone psammomys obesus

We recently reported that physical exercise prevents the progression of type 2 diabetes mellitus in Psammomys obesus, an animal model of nutritionally induced type 2 diabetes mellitus. In the present study we characterized the effect of physical exercise on protein kinase C delta (PKC delta) activity, as a mediator of the insulin-signaling cascade in vivo. Three groups of Psammomys obesus were exposed to a 4-week protocol: high-energy diet (HE/C), high-energy diet and exercise (HE/EX), or low-energy diet (LE/C). None of the animals in the HE/EX group became diabetic, whereas all the animals in the HE/C group became diabetic. After overnight fast, intraperitoneal (IP) insulin (1U) caused a greater reduction in blood glucose levels in the HE/EX and LE/C groups compared to the HE/C group. Tyrosine phosphorylation of insulin receptor (IR), insulin receptor substrate-1 (IRS-1), and phosphatidylinositol 3 kinase (PI3 kinase) was significantly higher in the HE/EX and LE/C groups compared with the HE/C group. Finally, IR-associated PKC delta was higher in the HE/EX and LE/C groups compared to the HE/C group. Coprecipitation of PKC delta with IR was higher in the HE/EX and LE/C groups compared to the HE/C group. Thus, we suggest that 4 weeks of physical exercise results in improved insulin-signaling response in Psammomys obesus accompanied by a direct connection between PKC delta and IR. We conclude that this mechanism may be involved in the preventive effect of exercise on type 2 diabetes mellitus in Psammomys obesus.

Behavioral, metabolic, and molecular correlates of lower insulin sensitivity in Mexican-Americans

We determined whether lower insulin sensitivity persists in young, nonobese, nondiabetic Mexican-American [MA; n = 13, 27.0 +/- 2.0 yr, body mass index (BMI) 23.0 +/- 0.7] compared with non-Hispanic white (NHW; n = 13, 24.8 +/- 1.5 yr, BMI 22.8 +/- 0.6) males and females after accounting for cardiorespiratory fitness (maximal O(2) uptake), abdominal fat distribution (computed tomography scans), dietary intake (4-day records), and skeletal muscle insulin-signaling protein abundance from muscle biopsies (Western blot analysis). MA were significantly less insulin sensitive compared with their NHW counterparts when estimated by homeostatic model assessment of insulin resistance (MA: 1.53 +/- 0.22 vs. NHW: 0.87 +/- 0.16, P < 0.05) and the revised quantitative insulin sensitivity check index (MA: 0.45 +/- 0.08 vs. NHW: 0.58 +/- 0.19, P = 0.05). However, skeletal muscle protein abundance of insulin receptor-beta (IRbeta), phosphatidylinositol 3-kinase p85 subunit, Akt1, Akt2, and GLUT4 were not significantly different. Differences in indexes of insulin sensitivity lost significance after percent dietary intake of palmitic acid, palmitoleic acid, and skeletal muscle protein abundance of IRbeta were accounted for. We conclude that differences in insulin sensitivity between nonobese, nondiabetic MA and NHW persist after effects of chronic and acute exercise and total and abdominal fat distribution are accounted for. These differences may be mediated, in part, by dietary fat intake.

Adiponectin is not altered with exercise training despite enhanced insulin action

Adiponectin is an adipocytokine that is hypothesized to be involved in the regulation of insulin action. The purpose of the present investigation was to determine whether plasma adiponectin is altered in conjunction with enhanced insulin action with exercise training. An insulin sensitivity index (S(I)) and fasting levels of glucose, insulin, and adiponectin were assessed before and after 6 mo of exercise training (4 days/wk for approximately 45 min at 65-80% peak O(2) consumption) with no loss of body mass (PRE, 91.9 +/- 3.8 kg vs. POST, 91.6 +/- 3.9 kg) or fat mass (PRE, 26.5 +/- 1.8 kg vs. POST, 26.7 +/- 2.2 kg). Insulin action significantly (P < 0.05) improved with exercise training (S(I) +98%); however, plasma adiponectin concentration did not change (PRE, 6.3 +/- 1.5 microg/ml vs. POST, 6.6 +/- 1.8 microg/ml). In contrast, in a separate group of subjects examined before and after weight loss, there was a substantial increase in adiponectin (+281%), which was accompanied by enhanced insulin action (S(I), +432%). These data suggest that adiponectin is not a contributory factor to the exercise-related improvements in insulin sensitivity.

Modulation of insulin signaling in human skeletal muscle in response to exercise

Exercise is widely recommended for the treatment of obesity, insulin resistance, and type II diabetes mellitus. Recent discoveries in the molecular and cellular regulation of insulin-mediated glucose metabolism in skeletal muscle have provided a deeper understanding of how exercise modulates insulin action.