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Ennequin G, Buchard B, Pereira B, Bonjean L, Courteix D, Lesourd B, Chapier R, Obert P, Vinet A, Walther G, Zak M, Bagheri R, Ugbolue CU, Abergel A, Dutheil F, Thivel D. Noninvasive biomarkers of non-alcoholic fatty liver disease in patients with metabolic syndrome: insights from the RESOLVE Study. Minerva Gastroenterol (Torino) 2023; 69:494-503. [PMID: 35144365 DOI: 10.23736/s2724-5985.22.03139-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The aim of the present study was to evaluate: 1) the presence of liver steatosis using Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI) and Liver Fat Score (LFS) in patients suffering from metabolic syndrome (MS); and 2) the association of FLI, HSI and LFS with the cardiometabolic risks. METHODS A total of 91 patients with MS (39 men, 52 women) and 44-age matched healthy subjects (control; 23 men and 21 women) were enrolled in the study. A continuous cardiometabolic score (MetsScore) and the noninvasive tests of hepatic steatosis were calculated for comparison and association analysis. RESULTS Liver steatosis was detected in 86%, 84% and 80% of people diagnosed with MS using FLI, HSI and LFS respectively and MetsScore increases with FLI severity (P<0.05). Also, FLI and LFS were positively associated with MetsScore (P<0.01 and P<0.05 respectively) but not HSI. Multivariate linear regression models revealed that FLI has a stronger association with MetsScore compared with HSI and LFS (P<0.001). CONCLUSIONS FLI is associated with the severity of MS and represent a good indicator to assess the relation between liver steatosis and a cardiometabolic disorders in clinical routine.
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Affiliation(s)
- Gaël Ennequin
- CRNH, AME2P, Clermont Auvergne University, Clermont-Ferrand, France -
| | - Benjamin Buchard
- Department of Digestive and Hepatobiliary Medicine, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Bruno Pereira
- Unit of Biostatistics, DRCI, CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Line Bonjean
- CRNH, AME2P, Clermont Auvergne University, Clermont-Ferrand, France
| | - Daniel Courteix
- CRNH, AME2P, Clermont Auvergne University, Clermont-Ferrand, France
| | - Bruno Lesourd
- CRNH, AME2P, Clermont Auvergne University, Clermont-Ferrand, France
| | - Robert Chapier
- CRNH, AME2P, Clermont Auvergne University, Clermont-Ferrand, France
| | - Philippe Obert
- Laboratoire de Pharm-Écologie Cardiovasculaire (LAPEC) EA4278, Avignon University, Avignon, France
| | - Agnes Vinet
- Laboratoire de Pharm-Écologie Cardiovasculaire (LAPEC) EA4278, Avignon University, Avignon, France
| | - Guillaume Walther
- Laboratoire de Pharm-Écologie Cardiovasculaire (LAPEC) EA4278, Avignon University, Avignon, France
| | - Marek Zak
- Collegium Medicum, The Institute of Health Sciences, The Jan Kochanowski University, Kielce, Poland
| | - Reza Bagheri
- Department of Exercise Physiology, University of Isfahan, Isfahan, Iran
| | - Chris U Ugbolue
- School of Health and Life Sciences, Institute for Clinical Exercise and Health Science, University of the West of Scotland, Glasgow, UK
| | - Armand Abergel
- Department of Digestive and Hepatobiliary Medicine, CHU Clermont-Ferrand, Clermont-Ferrand, France
- UMR CNRS 6284, Clermont Auvergne University, Clermont-Ferrand, France
| | - Frédéric Dutheil
- CNRS, LaPSCo, Unit of Preventive and Occupational Medicine, Department of Physiological and Psychosocial Stress, Witty Fit, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, University of Clermont Auvergne, Clermont-Ferrand, France
| | - David Thivel
- CRNH, AME2P, Clermont Auvergne University, Clermont-Ferrand, France
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Tremblay A, Clinchamps M, Pereira B, Courteix D, Lesourd B, Chapier R, Obert P, Vinet A, Walther G, Chaplais E, Bagheri R, Baker JS, Thivel D, Drapeau V, Dutheil F. Dietary Fibres and the Management of Obesity and Metabolic Syndrome: The RESOLVE Study. Nutrients 2020; 12:nu12102911. [PMID: 32977595 PMCID: PMC7650763 DOI: 10.3390/nu12102911] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 09/16/2020] [Accepted: 09/17/2020] [Indexed: 01/12/2023] Open
Abstract
Objectives: This study was performed to evaluate the long-term maintenance of nutritional changes promoted during an intensive initial intervention to induce body weight loss. The ability of these changes to predict long-term health outcomes was also examined. Methods: Nutritional variables, body composition, and metabolic markers collected in the RESOLVE project were analyzed before and after a 3-week intensive diet–exercise intervention (Phase 1), and during a subsequent supervision under free living conditions, of 12 months (Phase 2). Results: As expected, the macronutrient composition of the diet was modified to promote a negative energy balance during Phase 1. The decrease in carbohydrates imposed during this phase was maintained during Phase 2 whereas the increase in protein intake returned to baseline values at the end of the program. Dietary fiber intake was almost doubled during Phase 1 and remained significantly greater than baseline values throughout Phase 2. Moreover, fiber intake was the only nutritional variable that systematically and significantly predicted variations of health outcomes in the study. Conclusion: The adequacy of dietary fiber intake should be a matter of primary consideration in diet-based weight reduction programs.
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Affiliation(s)
- Angelo Tremblay
- Institute of Nutrition and Functional Foods (INAF), Université Laval, Quebec City, QC G1V 0A6, Canada;
- Department of Kinesiology, Université Laval, Quebec City, QC G1V 0A6, Canada
- Correspondence: ; Tel.: +418-656-7294; Fax: +418-656-3044
| | - Maëlys Clinchamps
- Preventive and Occupational Medicine, University Hospital of Clermont-Ferrand, 63000 Clermont-Ferrand, France; (M.C.); (F.D.)
| | - Bruno Pereira
- Biostatistics, University Hospital of Clermont-Ferrand, 63000 Clermont-Ferrand, France;
| | - Daniel Courteix
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Université Clermont Auvergne, 63000 Clermont-Ferrand, France; (D.C.); (B.L.); (D.T.)
| | - Bruno Lesourd
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Université Clermont Auvergne, 63000 Clermont-Ferrand, France; (D.C.); (B.L.); (D.T.)
| | | | - Philippe Obert
- Laboratory of Cardiovascular Pharm-ecology (LaPEC EA4278), Université d’Avignon, 84000 Avignon, France; (P.O.); (A.V.); (G.W.)
| | - Agnes Vinet
- Laboratory of Cardiovascular Pharm-ecology (LaPEC EA4278), Université d’Avignon, 84000 Avignon, France; (P.O.); (A.V.); (G.W.)
| | - Guillaume Walther
- Laboratory of Cardiovascular Pharm-ecology (LaPEC EA4278), Université d’Avignon, 84000 Avignon, France; (P.O.); (A.V.); (G.W.)
| | - Elodie Chaplais
- Laboratory “Development, Adaption and Disability” (DevAH-EA 3450), Université de Lorraine, 54000 Nancy, France;
| | - Reza Bagheri
- Department of Exercise Physiology, University of Isfahan, Isfahan 81746-73441, Iran;
| | - Julien S. Baker
- Centre for Health and Exercise Science Research, Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong 999077, Hong Kong;
| | - David Thivel
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Université Clermont Auvergne, 63000 Clermont-Ferrand, France; (D.C.); (B.L.); (D.T.)
- Physical Institut, Universitaire de France, 75000 Paris, France
| | - Vicky Drapeau
- Institute of Nutrition and Functional Foods (INAF), Université Laval, Quebec City, QC G1V 0A6, Canada;
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Université Clermont Auvergne, 63000 Clermont-Ferrand, France; (D.C.); (B.L.); (D.T.)
| | - Frédéric Dutheil
- Preventive and Occupational Medicine, University Hospital of Clermont-Ferrand, 63000 Clermont-Ferrand, France; (M.C.); (F.D.)
- Physiological and Psychosocial Stress, LaPSCo, CNRS, University Clermont Auvergne, 63000 Clermont-Ferrand, France
- Witty Fit, 75000 Paris, France
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Tremblay A, Dutheil F, Drapeau V, Metz L, Lesour B, Chapier R, Pereira B, Verney J, Baker JS, Vinet A, Walther G, Obert P, Courteix D, Thivel D. Long-term effects of high-intensity resistance and endurance exercise on plasma leptin and ghrelin in overweight individuals: the RESOLVE Study. Appl Physiol Nutr Metab 2019; 44:1172-1179. [PMID: 30875481 DOI: 10.1139/apnm-2019-0019] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The objective of this study was to evaluate the effects of high-intensity resistance and endurance exercise on body composition and plasma leptin and ghrelin concentrations in overweight individuals. One hundred participants were randomly assigned to 3 exercise interventions: high-resistance-low-aerobic exercise (Re), low-resistance-high-aerobic exercise (rE), low-resistance-low-aerobic exercise (re). Interventions began with 3 weeks of residential supervision (phase 1) after which participants had to manage the physical activity programs individually (phase 2). Body composition and plasma variables were measured at baseline and after phase 1 as well as after 3, 6, and 12 months. Significant decreases in body weight and fat were observed after phase 1 (p < 0.001) and continued at a lower rate for up to 3 months and then remained stable for the rest of the protocol. Once a body weight plateau was reached, body fat loss after the Re and rE conditions exceeded the fat loss observed in the re condition by 1.5-2 kg (p < 0.05). Leptin was significantly decreased after day 21 and month 3 (p < 0.001) and remained stable for the rest of the study. Ghrelin was significantly increased after day 21 and month 3 (p < 0.001) and returned to a level comparable to baseline between month 6 and 12 when body weight and fat had reached a plateau. In conclusion, this study reinforces the idea that an increase in exercise intensity may accentuate body fat loss before the occurrence of a body weight plateau. Resistance to further fat loss was accompanied by a decrease in plasma leptin and an increase in plasma ghrelin.
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Affiliation(s)
- Angelo Tremblay
- Institute of Nutrition and Functional Foods (INAF), Université Laval, Québec, QC G0A 4V0, Canada.,Department of Kinesiology, Université Laval, Québec, QC G0A 4V0, Canada
| | - Frédéric Dutheil
- CNRS, LaPSCo, Physiological and Psychosocial Stress, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Preventive and Occupational Medicine, WittyFit, Université Clermont Auvergne, 63000 Clermont-Ferrand, France.,Faculty of Health, School of Exercise Science, Australian Catholic University, Melbourne, VIC 3000, Australia
| | - Vicky Drapeau
- Institute of Nutrition and Functional Foods (INAF), Université Laval, Québec, QC G0A 4V0, Canada.,Department of Physical Education, Université Laval, Québec, QC G1V 0A6, Canada
| | - Lore Metz
- Clermont Auvergne University, EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), 63000 Clermont-Ferrand, France.,CRNH-Auvergne, 63000 Clermont-Ferrand, France
| | - Bruno Lesour
- CHU G. Montpied, F-63000 Clermont-Ferrand, France
| | | | - Bruno Pereira
- Clermont-Ferrand University hospital, Biostatistics unit (DRCI), 63000 Clermont-Ferrand, France
| | - Julien Verney
- Clermont Auvergne University, EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), 63000 Clermont-Ferrand, France.,CRNH-Auvergne, 63000 Clermont-Ferrand, France
| | - Julien S Baker
- Institute of Clinical Exercise and Health Sciences, School of Science and Sport, University of the West of Scotland, Hamilton, Lanarkshire G72 0BN, Scotland, UK
| | - Agnes Vinet
- Avignon University LAPEC EA4278, F-84000 Avignon, France
| | | | - Philippe Obert
- Institute of Nutrition and Functional Foods (INAF), Université Laval, Québec, QC G0A 4V0, Canada
| | - Daniel Courteix
- Clermont Auvergne University, EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), 63000 Clermont-Ferrand, France.,CRNH-Auvergne, 63000 Clermont-Ferrand, France
| | - David Thivel
- Clermont Auvergne University, EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), 63000 Clermont-Ferrand, France.,CRNH-Auvergne, 63000 Clermont-Ferrand, France
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Vinet A, Obert P, Courteix D, Chapier R, Lesourd B, Verney J, Dutheil F, Walther G. Different modalities of exercise improve macrovascular function but not microvascular function in metabolic syndrome: The RESOLVE randomized trial. Int J Cardiol 2018; 267:165-170. [DOI: 10.1016/j.ijcard.2018.05.073] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 05/07/2018] [Accepted: 05/21/2018] [Indexed: 12/25/2022]
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Obert P, Walther G, Dutheil F, Lesourd B, Chapier R, Courteix D, Vinet A. Regional myocardial function abnormalities are associated with macro- and microcirculation dysfunction in the metabolic syndrome: the RESOLVE study. Heart Vessels 2018; 33:688-694. [PMID: 29352759 DOI: 10.1007/s00380-017-1108-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 12/15/2017] [Indexed: 12/16/2022]
Abstract
Abnormalities in myocardial and vascular function have been reported in the metabolic syndrome (MetS), but whether these alterations are related remains poorly documented. Our aim was accordingly to investigate interrelationships between macro- and microcirculatory vasoreactivity and left ventricular (LV) myocardial function in MetS patients. Eighty-eight MetS individuals and 44 age- and gender-matched healthy controls were enrolled. LV global longitudinal strain (GLS) was measured using Vector Velocity Imaging. Endothelial-dependent and independent reactivity in macro- and microcirculatory territories was established using flow-mediated dilation and nitrate-mediated dilation of the brachial artery and cutaneous blood flow measured with laser Doppler flowmetry in response to iontophoresis of acetylcholine and sodium nitroprusside, respectively. Carotid intima-media thickness (cIMT) was measured according to the Mannheim consensus. Compared to controls, MetS patients presented with reduced GLS (p < 0.001) increased cIMT and impaired (p < 0.001) endothelial and smooth muscle function of the brachial artery and the forearm skin microcirculation. Highly significant relationships (p < 0.01) were noticed between GLS and vascular outcomes. In addition, cIMT (β = 0.21, p = 0.024) and microcirculatory endothelium-dependent reactivity (β = - 0.20, p = 0.035) were identified as independent predictors of GLS. In MetS, abnormalities in myocardial function and endothelial as well as smooth muscle function of small and large arteries co-exist and are closely associated. This study supports a role for microvascular dysfunction in the pathogenesis of LV myocardial dysfunction.
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Affiliation(s)
- Philippe Obert
- LAPEC EA4278, Faculty of Sciences, University of Avignon, 301 rue Baruch de Spinoza, 84916, Avignon Cedex 9, France.
- School of Exercise Science, Australian Catholic University, Melbourne, Australia.
| | - Guillaume Walther
- LAPEC EA4278, Faculty of Sciences, University of Avignon, 301 rue Baruch de Spinoza, 84916, Avignon Cedex 9, France
| | - Frédéric Dutheil
- School of Exercise Science, Australian Catholic University, Melbourne, Australia
- Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological Conditions (AME2P), EA3533, Blaise Pascal University, Clermont-Ferrand, France
- University Hospital of Clermont-Ferrand CHU, Clermont-Ferrand, France
| | - Bruno Lesourd
- Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological Conditions (AME2P), EA3533, Blaise Pascal University, Clermont-Ferrand, France
- University Hospital of Clermont-Ferrand CHU, Clermont-Ferrand, France
| | | | - Daniel Courteix
- School of Exercise Science, Australian Catholic University, Melbourne, Australia
- Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological Conditions (AME2P), EA3533, Blaise Pascal University, Clermont-Ferrand, France
| | - Agnes Vinet
- LAPEC EA4278, Faculty of Sciences, University of Avignon, 301 rue Baruch de Spinoza, 84916, Avignon Cedex 9, France
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Lanhers C, Walther G, Chapier R, Lesourd B, Naughton G, Pereira B, Duclos M, Vinet A, Obert P, Courteix D, Dutheil F. Long-term cost reduction of routine medications following a residential programme combining physical activity and nutrition in the treatment of type 2 diabetes: a prospective cohort study. BMJ Open 2017; 7:e013763. [PMID: 28416496 PMCID: PMC5775459 DOI: 10.1136/bmjopen-2016-013763] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVES To demonstrate that lifestyle modifications will reduce the cost of routine medications in individuals with type 2 diabetes (T2D), through a mechanism involving glycaemic control. DESIGN A within-trial cost-medication analysis with a 1-year time horizon. SETTING Controlled environment within the spa resort of Chatel-Guyon, France. PARTICIPANTS Twenty-nine participants (aged 50-70 years) with T2D. INTERVENTIONS A 1-year follow-up intervention, beginning with a 3-week residential programme combining high exercise volume (15-20 hours/week), restrictive diet (-500 kcal/day) and education. Participants continued their routine medication, independently managed by their general practitioner. MAIN OUTCOME MEASURES Number of medications, number of pills, cost of medications and health-related outcomes. RESULTS Twenty-six participants completed the 1-year intervention. At 1 year, 14 patients out of 26 (54%) stopped/decreased their medications whereas only 5 (19%) increased or introduced new drugs (χ2=6.3, p=0.02). The number of pills per day decreased by 1.3±0.3 at 12 months (p<0.001). The annual cost of medications for T2D were lower at 1 year (€135.1±43.9) versus baseline (€212.6±35.8) (p=0.03). The regression coefficients on costs of routine medication were 0.507 (95% CI 0.056 to 0.959, p=0.027) for HbA1c and 0.156 (95% CI -0.010 to 0.322, p=0.06) for blood glucose levels. Diabetics patients with HbA1c >6.5% in the highest (last) quartile doubled their routine medication costs (66% vs 33%, p=0.037). CONCLUSIONS Individuals with T2D reduced routine medication costs following a long-term lifestyle intervention that started with a 3-week residential programme. Combining high exercise volume, restrictive diet and education effectively supported the health of T2D. The main factor explaining reduced medication costs was better glycaemic control, independent of weight changes. Despite limitations precluding generalisability, cost-effective results of reduced medication should contribute to the evidence base required to promote lifestyle interventions for individuals with T2D. TRIAL REGISTRATION NUMBER NCT00917917; Post-results.
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Affiliation(s)
- Charlotte Lanhers
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and psychosocial stress, CHU Clermont-Ferrand, Preventive and Occupational Medicine, Sports Medicine, F-63000 Clermont-Ferrand, France
| | - Guillaume Walther
- Université d'Avignon, LaPEC EA4278, Laboratory of Cardiovascular Pharm-Ecology, F-84000 Avignon, France
| | - Robert Chapier
- Université Clermont Auvergne, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P), F-63000 Clermont-Ferrand, France
| | - Bruno Lesourd
- Université Clermont Auvergne, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P), F-63000 Clermont-Ferrand, France
| | - Geraldine Naughton
- Australian Catholic University, Faculty of Health, School of Exercise Science, Melbourne, Victoria 3065, Australia
| | - Bruno Pereira
- CHU Clermont-Ferrand, the Clinical Research and Innovation Direction, F-63000 Clermont-Ferrand, France
| | - Martine Duclos
- Université Clermont Auvergne, INRA, UNH, Unité de Nutrition Humaine, CRNH Auvergne, CHU Clermont-Ferrand, Sports Medicine, F-63000 Clermont-Ferrand, France
| | - Agnès Vinet
- Université d'Avignon, LaPEC EA4278, Laboratory of Cardiovascular Pharm-Ecology, F-84000 Avignon, France
| | - Philippe Obert
- Université d'Avignon, LaPEC EA4278, Laboratory of Cardiovascular Pharm-Ecology, F-84000 Avignon, France
- Australian Catholic University, Faculty of Health, School of Exercise Science, Melbourne, Victoria 3065, Australia
| | - Daniel Courteix
- Université Clermont Auvergne, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P), F-63000 Clermont-Ferrand, France
- Australian Catholic University, Faculty of Health, School of Exercise Science, Melbourne, Victoria 3065, Australia
| | - Frédéric Dutheil
- Australian Catholic University, Faculty of Health, School of Exercise Science, Melbourne, Victoria 3065, Australia
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and psychosocial stress, CHU Clermont-Ferrand, Preventive and Occupational Medicine, WittyFit, F-63000 Clermont-Ferrand, France
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Boudet G, Walther G, Courteix D, Obert P, Lesourd B, Pereira B, Chapier R, Vinet A, Chamoux A, Naughton G, Poirier P, Dutheil F. Paradoxical dissociation between heart rate and heart rate variability following different modalities of exercise in individuals with metabolic syndrome: The RESOLVE study. Eur J Prev Cardiol 2016; 24:281-296. [PMID: 27856807 DOI: 10.1177/2047487316679523] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Aims To analyse the effects of different modalities of exercise training on heart rate variability (HRV) in individuals with metabolic syndrome (MetS). Methods and results Eighty MetS participants (aged 50-70 years) were housed and managed in an inpatient medical centre for 21 days, including weekends. Physical activity and food intake/diet were intensively monitored. Participants were randomly assigned into three training groups, differing only by intensity of exercise: moderate-endurance-moderate-resistance ( re), high-resistance-moderate-endurance ( Re), and moderate-resistance-high-endurance ( rE). HRV was recorded before and after the intervention by 24-hour Holter electrocardiogram. Although mean 24-hour heart rate decreased more in Re than re (-11.6 ± 1.6 vs. -4.8 ± 2.1%; P = 0.010), low frequency/high frequency decreased more in re than Re (-20.4 ± 5.5% vs. + 20.4 ± 9.1%; P = 0.002) and rE (-20.4 ± 5.5% vs. -0.3 ± 11.1%; P = 0.003). Very low frequency increased more in Re than re (+121.2 ± 35.7 vs. 42.9 ± 11.3%; P = 0.004). For all HRV parameters, rE ranged between re and Re values. Low frequency/high frequency changes were linked with visceral fat loss only in re (coefficient 5.9, 95% CI 1.9-10.0; P = 0.004). By day 21, HRV parameters of MetS groups (heart rate -8.6 ± 1.0%, standard deviation of R-R intervals + 34.0 ± 6.6%, total power + 63.3 ± 11.1%; P < 0.001) became closer to values of 50 aged-matched healthy controls. Conclusions A 3-week residential programme with intensive volumes of physical activity (15-20 hours per week) enhanced HRV in individuals with MetS. Participants with moderate intensity of training had greater improvements in sympathovagal balance, whereas those with high intensity in resistance training had greater decreases in heart rate and greater increases in very low frequency. Modality-specific relationships were observed between enhanced HRV and visceral fat loss. Clinical Trial Registration URL: http://www.clinicaltrials.gov . Unique identifier: NCT00917917.
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Affiliation(s)
- Gil Boudet
- 1 University Clermont Auvergne, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P, EA3533), France.,2 University Hospital of Clermont Ferrand (CHU), Preventive and Occupational Medicine, France
| | | | - Daniel Courteix
- 1 University Clermont Auvergne, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P, EA3533), France
| | | | - Bruno Lesourd
- 1 University Clermont Auvergne, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P, EA3533), France
| | - Bruno Pereira
- 4 University Hospital of Clermont Ferrand (CHU), Clinical Research and Innovation Direction, France
| | - Robert Chapier
- 1 University Clermont Auvergne, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P, EA3533), France
| | - Agnès Vinet
- 3 University of Avignon, LaPEC EA4278, France
| | - Alain Chamoux
- 2 University Hospital of Clermont Ferrand (CHU), Preventive and Occupational Medicine, France
| | - Geraldine Naughton
- 5 Australian Catholic University, School of Exercise Science, Faculty of Health, Australia
| | - Paul Poirier
- 6 Centre de recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Canada.,7 Faculté de Pharmacie, Université Laval, Canada
| | - Frédéric Dutheil
- 1 University Clermont Auvergne, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P, EA3533), France.,2 University Hospital of Clermont Ferrand (CHU), Preventive and Occupational Medicine, France.,5 Australian Catholic University, School of Exercise Science, Faculty of Health, Australia.,8 CNRS, UMR 6024, Physiological and Psychosocial Stress, University Clermont Auvergne, France
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8
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Serrano-Ferrer J, Crendal E, Walther G, Vinet A, Dutheil F, Naughton G, Lesourd B, Chapier R, Courteix D, Obert P. Effects of lifestyle intervention on left ventricular regional myocardial function in metabolic syndrome patients from the RESOLVE randomized trial. Metabolism 2016; 65:1350-60. [PMID: 27506742 DOI: 10.1016/j.metabol.2016.05.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 04/07/2016] [Accepted: 05/11/2016] [Indexed: 12/18/2022]
Abstract
AIMS The purpose of our study was to determine the effect of lifestyle intervention on left ventricular (LV) regional myocardial function in patients with metabolic syndrome (MetS) and investigate the relationships of the changes in myocardial function to changes in epicardial adipose tissue (EAT), inflammatory profile and MetS components. METHODS Eighty-seven MetS patients were enrolled in a 6month lifestyle intervention program based on dietary management and increased physical activity, and compared with 44 aged and sex-matched healthy controls. MetS individuals were allocated to different groups randomized (computer-generated randomization) on exercise modalities (high-intensity dominant resistance or aerobic training, and moderate-intensity of both modes). EAT was measured by transthoracic echocardiography and LV longitudinal strains and strain rates were obtained using vector velocity imaging. Blood chemistry allowed assessments of adipocytokines (TNF-α: tumor necrosis factor α, PAI active: active plasminogen activator inhibitor-1 and adiponectin) and glucose tolerance markers. RESULTS Regardless of exercise training modalities, lifestyle intervention improved significantly LV strains and strain rates (p<0.001) as well as metabolic and inflammatory profiles. Stepwise multiple regression analyses revealed EAT (β=0.73, p<0.01), log adiponectin (β=-0.13, p<0.05) and log TNF-α (β=0.15, p<0.05) as independent predictors of LV longitudinal strain (R(2)=0.74, p<0.001) while myocardial function improvement consecutive to lifestyle intervention was explained by EAT changes only (R(2)=0.54, p<0.001). CONCLUSION The mechanisms through which regional myocardial function is impaired in MetS and improved consecutive to intervention involved EAT, possibly via paracrine effects of adipocytokines. EAT should be considered as a future therapeutic target of interest in the treatment of metabolic-related cardiac diseases.
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Affiliation(s)
- Juan Serrano-Ferrer
- EA4278 LaPEC, Laboratory of Cardiovascular Pharm-Ecology, Avignon University, Avignon, France
| | - Edward Crendal
- Australian Catholic University, Faculty of Health, School of Exercise Science, East Melbourne, Victoria, Australia
| | - Guillaume Walther
- EA4278 LaPEC, Laboratory of Cardiovascular Pharm-Ecology, Avignon University, Avignon, France
| | - Agnes Vinet
- EA4278 LaPEC, Laboratory of Cardiovascular Pharm-Ecology, Avignon University, Avignon, France
| | - Frédéric Dutheil
- Australian Catholic University, Faculty of Health, School of Exercise Science, East Melbourne, Victoria, Australia; EA3533 AME2P, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological Conditions, Clermont Auvergne University, Clermont-Ferrand, France; Preventive and Occupational Medicine, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Geraldine Naughton
- Australian Catholic University, Faculty of Health, School of Exercise Science, East Melbourne, Victoria, Australia
| | - Bruno Lesourd
- EA3533 AME2P, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological Conditions, Clermont Auvergne University, Clermont-Ferrand, France
| | - Robert Chapier
- EA3533 AME2P, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological Conditions, Clermont Auvergne University, Clermont-Ferrand, France
| | - Daniel Courteix
- Australian Catholic University, Faculty of Health, School of Exercise Science, East Melbourne, Victoria, Australia; EA3533 AME2P, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological Conditions, Clermont Auvergne University, Clermont-Ferrand, France
| | - Philippe Obert
- EA4278 LaPEC, Laboratory of Cardiovascular Pharm-Ecology, Avignon University, Avignon, France; Australian Catholic University, Faculty of Health, School of Exercise Science, East Melbourne, Victoria, Australia.
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Courteix D, Valente-Dos-Santos J, Ferry B, Lac G, Lesourd B, Chapier R, Naughton G, Marceau G, Coelho-E-Silva MJ, Vinet A, Walther G, Obert P, Dutheil F. Correction: Multilevel Approach of a 1-Year Program of Dietary and Exercise Interventions on Bone Mineral Content and Density in Metabolic Syndrome - the RESOLVE Randomized Controlled Trial. PLoS One 2015; 10:e0140307. [PMID: 26440101 PMCID: PMC4595444 DOI: 10.1371/journal.pone.0140307] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Courteix D, Valente-dos-Santos J, Ferry B, Lac G, Lesourd B, Chapier R, Naughton G, Marceau G, João Coelho-e-Silva M, Vinet A, Walther G, Obert P, Dutheil F. Multilevel Approach of a 1-Year Program of Dietary and Exercise Interventions on Bone Mineral Content and Density in Metabolic Syndrome--the RESOLVE Randomized Controlled Trial. PLoS One 2015; 10:e0136491. [PMID: 26376093 PMCID: PMC4574281 DOI: 10.1371/journal.pone.0136491] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 08/01/2015] [Indexed: 01/04/2023] Open
Abstract
Background Weight loss is a public health concern in obesity-related diseases such as metabolic syndrome (MetS). However, restrictive diets might induce bone loss. The nature of exercise and whether exercise with weight loss programs can protect against potential bone mass deficits remains unclear. Moreover, compliance is essential in intervention programs. Thus, we aimed to investigate the effects that modality and exercise compliance have on bone mineral content (BMC) and density (BMD). Methods We investigated 90 individuals with MetS who were recruited for the 1-year RESOLVE trial. Community-dwelling seniors with MetS were randomly assigned into three different modalities of exercise (intensive resistance, intensive endurance, moderate mixed) combined with a restrictive diet. They were compared to 44 healthy controls who did not undergo the intervention. Results This intensive lifestyle intervention (15–20 hours of training/week + restrictive diet) resulted in weight loss, body composition changes and health improvements. Baseline BMC and BMD for total body, lumbar spine and femoral neck did not differ between MetS groups and between MetS and controls. Despite changes over time, BMC or BMD did not differ between the three modalities of exercise and when compared with the controls. However, independent of exercise modality, compliant participants increased their BMC and BMD compared with their less compliant peers. Decreases in total body lean mass and negative energy balance significantly and independently contributed to decreases in lumbar spine BMC. Conclusion After the one year intervention, differences relating to exercise modalities were not evident. However, compliance with an intensive exercise program resulted in a significantly higher bone mass during energy restriction than non-compliance. Exercise is therefore beneficial to bone in the context of a weight loss program. Trial Registration ClinicalTrials.gov NCT00917917
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Affiliation(s)
- Daniel Courteix
- Clermont Auvergne University, Blaise Pascal University, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P, EA3533), Clermont-Ferrand, France
- Australian Catholic University, Faculty of Health, School of Exercise Science, Melbourne, Victoria, Australia
- Research Centre in Human Nutrition (CRNH) Auvergne, Clermont-Ferrand, France
| | - João Valente-dos-Santos
- Lusófona University of Humanities and Technologies, Faculty of Physical Education and Sport, Lisbon, Portugal
- University of Coimbra, Faculty of Sport Sciences and Physical Education, Research Unit for Sport and Physical Activity (CIDAF), Coimbra, Portugal
| | - Béatrice Ferry
- Clermont Auvergne University, Blaise Pascal University, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P, EA3533), Clermont-Ferrand, France
- Research Centre in Human Nutrition (CRNH) Auvergne, Clermont-Ferrand, France
| | - Gérard Lac
- Clermont Auvergne University, Blaise Pascal University, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P, EA3533), Clermont-Ferrand, France
- Research Centre in Human Nutrition (CRNH) Auvergne, Clermont-Ferrand, France
| | - Bruno Lesourd
- Clermont Auvergne University, Blaise Pascal University, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P, EA3533), Clermont-Ferrand, France
- Research Centre in Human Nutrition (CRNH) Auvergne, Clermont-Ferrand, France
- Auvergne University, Faculty of Medicine, Geriatric, Clermont-Ferrand, France
| | - Robert Chapier
- Clermont Auvergne University, Blaise Pascal University, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P, EA3533), Clermont-Ferrand, France
- Research Centre in Human Nutrition (CRNH) Auvergne, Clermont-Ferrand, France
| | - Geraldine Naughton
- Australian Catholic University, Faculty of Health, School of Exercise Science, Melbourne, Victoria, Australia
| | - Geoffroy Marceau
- University Hospital of Clermont-Ferrand (CHU), Biochemistry, Clermont-Ferrand, France
| | - Manuel João Coelho-e-Silva
- University of Coimbra, Faculty of Sport Sciences and Physical Education, Research Unit for Sport and Physical Activity (CIDAF), Coimbra, Portugal
| | - Agnès Vinet
- Laboratory of Pharm-Ecology Cardiovascular (EA4278), University of Avignon, Avignon, France
| | - Guillaume Walther
- Laboratory of Pharm-Ecology Cardiovascular (EA4278), University of Avignon, Avignon, France
| | - Philippe Obert
- Laboratory of Pharm-Ecology Cardiovascular (EA4278), University of Avignon, Avignon, France
| | - Frédéric Dutheil
- Clermont Auvergne University, Blaise Pascal University, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P, EA3533), Clermont-Ferrand, France
- Australian Catholic University, Faculty of Health, School of Exercise Science, Melbourne, Victoria, Australia
- Research Centre in Human Nutrition (CRNH) Auvergne, Clermont-Ferrand, France
- University Hospital of Clermont-Ferrand (CHU), Preventive and Occupational Medicine, Clermont-Ferrand, France
- * E-mail:
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Walther G, Obert P, Dutheil F, Chapier R, Lesourd B, Naughton G, Courteix D, Vinet A. Metabolic syndrome individuals with and without type 2 diabetes mellitus present generalized vascular dysfunction: cross-sectional study. Arterioscler Thromb Vasc Biol 2015; 35:1022-9. [PMID: 25657309 DOI: 10.1161/atvbaha.114.304591] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The first objective of this study was to demonstrate differences within endothelial-dependent and endothelial-independent vasoreactivity in macro- and microcirculation beds among patients with metabolic syndrome (MetS) with and without type 2 diabetes mellitus (T2D) compared with healthy counterparts. The second objective was to determine relationships among the function of macro- and microvascular systems and abdominal adiposity, as well as inflammatory markers in the 3 groups. APPROACH AND RESULTS Cross-sectional analyses of 53 patients with MetS without T2D and 25 with T2D, as well as aged 40 years and sex-matched healthy controls included microvascular (cutaneous blood flow measured with laser Doppler flowmetry in response to iontophoresis of acetylcholine and sodium nitroprusside), and macrovascular reactivity (flow-mediated dilation and nitrate-mediated dilation) along with anthropometric measures, plasma glucose, and insulin and inflammatory markers. Compared with controls, MetS participants showed depressed endothelial function of both micro- and macrocirculation beds. T2D in patients with MetS revealed an exacerbated vascular smooth muscle dysfunction in micro- and macrocirculation compared with MetS without T2D. Indices of micro- and macrocirculation were predominantly inversely related to abdominal fat and inflammatory markers. CONCLUSIONS MetS was associated with endothelial-dependent and endothelial-independent dysfunction, affecting both the macro- and the microvascular systems. Participants with diabetes mellitus demonstrated the most severe smooth muscle dysfunction. The presence of central abdominal fat and systemic inflammation seems implicated in the pathogenesis of vascular dysfunctions in MetS.
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Affiliation(s)
- Guillaume Walther
- From the Avignon University, LAPEC EA4278, Avignon, France (G.W., P.O., A.V.); Blaise Pascal University, Laboratory Metabolic Adaptations to Exercise in Physiological and Pathological Conditions (AME2P, EA3533), Clermont-Ferrand, France (F.D., B.L., D.C.); University Hospital of Clermont-Ferrand (CHU), Clermont-Ferrand, France (F.D., B.L.); Omental-Thermalia Center, Châtelguyon, France (R.C.); and School of Exercise Science, Australian Catholic University, Melbourne, Victoria, Australia (P.O., F.D., G.N., D.C.).
| | - Philippe Obert
- From the Avignon University, LAPEC EA4278, Avignon, France (G.W., P.O., A.V.); Blaise Pascal University, Laboratory Metabolic Adaptations to Exercise in Physiological and Pathological Conditions (AME2P, EA3533), Clermont-Ferrand, France (F.D., B.L., D.C.); University Hospital of Clermont-Ferrand (CHU), Clermont-Ferrand, France (F.D., B.L.); Omental-Thermalia Center, Châtelguyon, France (R.C.); and School of Exercise Science, Australian Catholic University, Melbourne, Victoria, Australia (P.O., F.D., G.N., D.C.)
| | - Frédéric Dutheil
- From the Avignon University, LAPEC EA4278, Avignon, France (G.W., P.O., A.V.); Blaise Pascal University, Laboratory Metabolic Adaptations to Exercise in Physiological and Pathological Conditions (AME2P, EA3533), Clermont-Ferrand, France (F.D., B.L., D.C.); University Hospital of Clermont-Ferrand (CHU), Clermont-Ferrand, France (F.D., B.L.); Omental-Thermalia Center, Châtelguyon, France (R.C.); and School of Exercise Science, Australian Catholic University, Melbourne, Victoria, Australia (P.O., F.D., G.N., D.C.)
| | - Robert Chapier
- From the Avignon University, LAPEC EA4278, Avignon, France (G.W., P.O., A.V.); Blaise Pascal University, Laboratory Metabolic Adaptations to Exercise in Physiological and Pathological Conditions (AME2P, EA3533), Clermont-Ferrand, France (F.D., B.L., D.C.); University Hospital of Clermont-Ferrand (CHU), Clermont-Ferrand, France (F.D., B.L.); Omental-Thermalia Center, Châtelguyon, France (R.C.); and School of Exercise Science, Australian Catholic University, Melbourne, Victoria, Australia (P.O., F.D., G.N., D.C.)
| | - Bruno Lesourd
- From the Avignon University, LAPEC EA4278, Avignon, France (G.W., P.O., A.V.); Blaise Pascal University, Laboratory Metabolic Adaptations to Exercise in Physiological and Pathological Conditions (AME2P, EA3533), Clermont-Ferrand, France (F.D., B.L., D.C.); University Hospital of Clermont-Ferrand (CHU), Clermont-Ferrand, France (F.D., B.L.); Omental-Thermalia Center, Châtelguyon, France (R.C.); and School of Exercise Science, Australian Catholic University, Melbourne, Victoria, Australia (P.O., F.D., G.N., D.C.)
| | - Geraldine Naughton
- From the Avignon University, LAPEC EA4278, Avignon, France (G.W., P.O., A.V.); Blaise Pascal University, Laboratory Metabolic Adaptations to Exercise in Physiological and Pathological Conditions (AME2P, EA3533), Clermont-Ferrand, France (F.D., B.L., D.C.); University Hospital of Clermont-Ferrand (CHU), Clermont-Ferrand, France (F.D., B.L.); Omental-Thermalia Center, Châtelguyon, France (R.C.); and School of Exercise Science, Australian Catholic University, Melbourne, Victoria, Australia (P.O., F.D., G.N., D.C.)
| | - Daniel Courteix
- From the Avignon University, LAPEC EA4278, Avignon, France (G.W., P.O., A.V.); Blaise Pascal University, Laboratory Metabolic Adaptations to Exercise in Physiological and Pathological Conditions (AME2P, EA3533), Clermont-Ferrand, France (F.D., B.L., D.C.); University Hospital of Clermont-Ferrand (CHU), Clermont-Ferrand, France (F.D., B.L.); Omental-Thermalia Center, Châtelguyon, France (R.C.); and School of Exercise Science, Australian Catholic University, Melbourne, Victoria, Australia (P.O., F.D., G.N., D.C.)
| | - Agnès Vinet
- From the Avignon University, LAPEC EA4278, Avignon, France (G.W., P.O., A.V.); Blaise Pascal University, Laboratory Metabolic Adaptations to Exercise in Physiological and Pathological Conditions (AME2P, EA3533), Clermont-Ferrand, France (F.D., B.L., D.C.); University Hospital of Clermont-Ferrand (CHU), Clermont-Ferrand, France (F.D., B.L.); Omental-Thermalia Center, Châtelguyon, France (R.C.); and School of Exercise Science, Australian Catholic University, Melbourne, Victoria, Australia (P.O., F.D., G.N., D.C.)
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Vinet A, Obert P, Dutheil F, Diagne L, Chapier R, Lesourd B, Courteix D, Walther G. Impact of a lifestyle program on vascular insulin resistance in metabolic syndrome subjects: the RESOLVE study. J Clin Endocrinol Metab 2015; 100:442-50. [PMID: 25353072 DOI: 10.1210/jc.2014-2704] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
CONTEXT AND OBJECTIVE Impaired insulin-dependent vasodilation might contribute to microvascular dysfunction of metabolic syndrome (MetS). The aims of this study were to assess the insulin vasoreactivity in MetS, and to evaluate the effects of a lifestyle program. DESIGN, SETTING, PARTICIPANTS, AND OUTCOME MEASURES: Laser Doppler measurements were used to assess cutaneous blood flux (CBF) and flowmotion in response to iontophoresis of insulin and acetylcholine (ACh) in 38 MetS and 18 controls. Anthropometric, plasma insulin, glycemia, and inflammatory markers were measured. MetS subjects (n = 24) underwent a 6-month lifestyle intervention (M6) with a 3-week residential program (D21). RESULTS The absolute and relative peak insulin and ACh CBF were significantly higher in controls than in MetS subjects. Significant inverse correlations were found between peak insulin CBF and glycemia, insulin and glycated hemoglobin, active plasminogen activator inhibitor-1 (PAI-1), C-reactive protein (CRP), and IL-6. With respect to flowmotion, MetS subjects showed lower values in total spectrum CBF and in all its components (except respiratory one). At D21 and M6, peak insulin CBF increased and was no longer different from control values whereas peak ACh CBF did not change. From D21, all the different components and the total CBF spectrum became similar to the control values. The changes in peak insulin CBF and in endothelial component between M6 and baseline were inversely correlated with the change in CRP and PAI-1. CONCLUSIONS The local vasodilatory effects to insulin and its overall flowmotion are impaired in MetS subjects in relation to inflammation. The lifestyle intervention reversed this insulin-induced vascular dysfunction in parallel to decreased inflammation level.
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Affiliation(s)
- Agnes Vinet
- Avignon University (A.V., P.O., L.D., G.W.), LAPEC EA4278, F-84000 Avignon, France; School of Exercise Science (P.O., F.D., D.C.), Australian Catholic University, Melbourne, 3065 Australia; Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological Conditions (F.D., B.L., D.C.), EA3533, F-63000 Clermont-Ferrand, France; University Hospital of Clermont-Ferrand (F.D., B.L.), CHU G. Montpied, F-63000 Clermont-Ferrand, France; and Omental (R.C.)-Thermalia Center, F-63140 Châtelguyon, France
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Serrano-Ferrer J, Walther G, Crendal E, Vinet A, Dutheil F, Naughton G, Lesourd B, Chapier R, Courteix D, Obert P. Right ventricle free wall mechanics in metabolic syndrome without type-2 diabetes: effects of a 3-month lifestyle intervention program. Cardiovasc Diabetol 2014; 13:116. [PMID: 25407698 PMCID: PMC4149206 DOI: 10.1186/s12933-014-0116-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Accepted: 07/20/2014] [Indexed: 01/18/2023] Open
Abstract
Background Growing evidence demonstrates subtle left ventricular myocardial dysfunction in patients with metabolic syndrome (MetS), with central obesity, glucose intolerance and inflammation emerging as important contributors. Whether these results can be translated to the right ventricle (RV) is not yet fully elucidated. Furthermore, although lifestyle intervention favorably impacts MetS components and inflammatory biomarkers, its effect on RV myocardial function remains unknown today. Methods Thirty-nine MetS adults free of diabetes were enrolled in a three month lifestyle intervention program including diet and physical exercise, and compared with forty healthy controls. Blood biochemistry, echocardiography including tissue Doppler imaging (TDI), and vector velocity imaging of the RV free wall to assess global longitudinal strain (GLS) and strain rates (SR) were obtained at baseline and after the intervention. Results Compared with controls, MetS patients presented similar right atrial and RV morphology but reduced systolic (P = 0.04) and early diastolic (P = 0.02) velocities of the tricuspid annulus. They showed attenuated RV GLS (−21.4 ± 4.5vs-25.7 ± 4.9%, P < 0.001) as well as early diastolic (P = 0.003) and systolic (P < 0.001) SR. Multiple regression analyses revealed log PAI-1 active, (P < 0.001), log adiponectin, (P = 0.01), LV mass indexed (P = 0.004) and central fat (P = 0.03) as independent predictors of RV GLS (R2 = 0.46, P < 0.001). Biological markers of MetS and inflammation as well as RV GLS (−21.8 ± 3.8vs-24.3 ± 3.0%, P = 0.009) and systolic (P = 0.003) and early diastolic (P = 0.01) SR, but not TDI indexes, significantly improved after diet and exercise training, and vector velocity imaging data in MetS following the lifestyle intervention no longer differed from controls. Conclusions MetS is associated with subtle impairments in both RV free wall diastolic and systolic myocardial function which could be partly related to central-obesity induced changes in pro- and anti-inflammatory cytokines and left ventricular remodeling. The favorable impact of healthy dieting and physical activity on RV free wall mechanics indicates that cellular and sub-cellular alterations responsible for the RV myocardial abnormalities are probably not permanent and modifiable throughout adequate interventional strategies. Trial registration American National Institutes of Health database NCT00917917.
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Dutheil F, Walther G, Chapier R, Mnatzaganian G, Lesourd B, Naughton G, Verney J, Fogli A, Sapin V, Duclos M, Vinet A, Obert P, Courteix D, Lac G. Atherogenic subfractions of lipoproteins in the treatment of metabolic syndrome by physical activity and diet - the RESOLVE trial. Lipids Health Dis 2014; 13:112. [PMID: 25015177 PMCID: PMC4115215 DOI: 10.1186/1476-511x-13-112] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 07/07/2014] [Indexed: 11/11/2022] Open
Abstract
Background We aimed to comprehensively evaluate lipoprotein profile including lipid particle size following a lifestyle intervention in metabolic syndrome (MetS) volunteers and to assess the associations between lipoprotein subfractions and carotid-intima-media-thickness (CIMT) – a surrogate indicator of atherogenesis. Methods 100 participants (50–70 years) from the RESOLVE trial, underwent a one-year follow-up beginning with a three-week residential program combining high exercise volume (15-20 h/week), restrictive diet (-500 kcal/day), and education. For baseline references, 40 aged-matched healthy controls were recruited. Independent associations between subfractions of lipoproteins and CIMT were evaluated using a generalized estimating equations model accounting for variation in correlations between repeated measures. The lipoprotein subfractions profile was assessed using Lipoprint® electrophoresis allowing to separate: the very low-density lipoprotein (VLDL) fraction, then the intermediate-density lipoprotein (IDL) C, B and A, the low-density lipoprotein (LDL) with subfractions 1 and 2 as large LDL and subfractions 3 to 7 as small dense LDL (sdLDL), and the high density lipoprotein (HDL) subfractions categorized into large, intermediate, and small HDL. Apolipoproteins A1 and B were also measured. Results 78 participants completed the program. At baseline, apolipoproteins B/A1, VLDL, sdLDL and small HDL were higher in MetS than in healthy controls; IDL, LDL size, large and intermediate HDL were lower. Despite time-related regains during the follow-up, lipoprotein subfractions traditionally involved in cardiovascular risk, such as sdLDL, improved immediately after the residential program with values closest to those of healthy controls. CIMT improved throughout the lifestyle intervention. Using a generalized estimating equations model, none of the subfractions of lipoproteins nor apolipoproteins were linked to CIMT. Conclusions Lipoprotein subfractions traditionally involved in CVR, decreased after the 3-week residential program. During a 12 month follow-up, the time-related regains remained closer to the values of healthy controls than they were at baseline. CIMT improved throughout the lifestyle intervention. However, we failed to demonstrate a link between some lipoprotein subfractions and the atherogenicity directly measured from the wall thickness of arteries (CIMT). Further investigations are required to explore the atherogenicity of lipoprotein subfractions. Trial registration NCT00917917
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Affiliation(s)
| | | | | | | | | | - Geraldine Naughton
- School of Exercise Science, Australian Catholic University, East Melbourne, VIC, Australia.
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Crendal E, Walther G, Vinet A, Dutheil F, Naughton G, Lesourd B, Chapier R, Rupp T, Courteix D, Obert P. Myocardial deformation and twist mechanics in adults with metabolic syndrome: impact of cumulative metabolic burden. Obesity (Silver Spring) 2013; 21:E679-86. [PMID: 23804526 DOI: 10.1002/oby.20537] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Accepted: 05/25/2013] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The aim of the study is to characterize left ventricular (LV) myocardial mechanics in adults with metabolic syndrome (MetS), and elucidate the effects of multiple risk-factors on myocardial function using speckle tracking echocardiography (STE); a more sensitive method than conventional echocardiography for detecting subclinical myocardial dysfunction. DESIGN AND METHODS Cross-sectional analyses of 92 adults (50-70 years) with MetS, and 50 healthy controls included conventional echocardiography, blood biochemistry, and STE-derived myocardial longitudinal, circumferential, and twist mechanics. RESULTS Using conventional measures, MetS participants revealed LV hypertrophy and reduced diastolic function compared with controls, while systolic function was preserved. From STE, MetS participants showed attenuated longitudinal strain (-16.8% ± 2.8% vs. -20.6% ± 2.7%), and both diastolic (1.1 ± 0.2 vs. 1.4 ± 0.3 s s(-1) ) and systolic (-1.0 ± 0.1 vs. -1.2 ± 0.2 s s(-1) ) strain rate (SR). Circumferential strain, SR, and twist mechanics did not differ. Participants with the highest number of MetS factors or diabetes demonstrated the greatest reduction in longitudinal strain and SR. Abdominal obesity, TNF-α, HbA1c , and systolic dyssynchrony explained 48% of impairment in longitudinal strain. CONCLUSIONS Impaired longitudinal myocardial diastolic and systolic function, but preserved circumferential function and twist mechanics were found in MetS participants, indicative of altered subendocardial function. This dysfunction was best predicted by abdominal obesity, inflammation, glucose-intolerance, and systolic dyssynchrony.
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Affiliation(s)
- Edward Crendal
- Avignon University, LAPEC EA4278, Avignon, France; School of Exercise Science, Australian Catholic University, Melbourne, Australia
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Dutheil F, Lac G, Lesourd B, Chapier R, Walther G, Vinet A, Sapin V, Verney J, Ouchchane L, Duclos M, Obert P, Courteix D. Different modalities of exercise to reduce visceral fat mass and cardiovascular risk in metabolic syndrome: the RESOLVE* randomized trial. Int J Cardiol 2013; 168:3634-42. [DOI: 10.1016/j.ijcard.2013.05.012] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Revised: 04/15/2013] [Accepted: 05/04/2013] [Indexed: 10/26/2022]
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Dutheil F, Lesourd B, Courteix D, Chapier R, Doré E, Lac G. Blood lipids and adipokines concentrations during a 6-month nutritional and physical activity intervention for metabolic syndrome treatment. Lipids Health Dis 2010; 9:148. [PMID: 21194421 PMCID: PMC3022754 DOI: 10.1186/1476-511x-9-148] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2010] [Accepted: 12/31/2010] [Indexed: 11/25/2022] Open
Abstract
Background To report changes in body weight, total and central fat mass, metabolic, hormonal and inflammatory parameters in overweight people who participated in a six months weight loss intervention associating diet management and exercise. Subjects and Methods Fourteen subjects (10 M, 4 F, mean age 62.9 ± 6.9 years, BMI 30.4+/- 3.8 kg/m2) presenting the characteristics of the Metabolic Syndrome (MS) were included in the survey. They followed a three weeks (D0 to D20) cure in a medical establishment and a six months (D20 to M3 and M6) follow up at home. During the cure, they receive a balanced diet corresponding to 500 Kcal deficit vs their dayly energy expenditure (DEE) and they exercised 2 to 3 hours per day. At D0, D20, M3 and M6, body composition (lean mass, total and central fat mass) was analyzed with DEXA, blood pressure was taken and blood was collected to evaluate glycaemia, triglycerides, total, LDL and HDL cholesterol, insulin, leptin and adiponectin levels, CRP and pro-inflammatory interleukines IL1, IL.6 and TNFalpha. Results All parameters listed above except the cytokine were improved at D20, so that 4 subjects among 14 still presented the MS. After returning to home, these parameters remained stable. Conclusion The efficacy of therapeutic lifestyle modifications with education and exercise and diet was demonstrated, but the compliance to the new healthy lifestyle initiated during the cure was not optimal.
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