Determinants of the Changes in Glycemic Control with Exercise Training in Type 2 Diabetes: A Randomized Trial

PLoS One. 2013 Jun 21;8(6):e62973. doi: 10.1371/journal.pone.0062973. Print 2013.

Abstract

Aims: To assess the determinants of exercise training-induced improvements in glucose control (HbA1C) including changes in serum total adiponectin and FFA concentrations, and skeletal muscle peroxisome proliferator-activated receptor-γ coactivator-1α (PGC-1α) protein content.

Methods: A sub-cohort (n = 35; 48% men; 74% Caucasian) from the HART-D study undertaking muscle biopsies before and after 9 months of aerobic (AT), resistance (RT), or combination training (ATRT).

Results: Changes in HbA1C were associated with changes in adiponectin (r = -0.45, P = 0.007). Participants diagnosed with type 2 diabetes for a longer duration had the largest increase in PGC-1α (r = 0.44, P = 0.008). Statistical modeling examining changes in HbA1C suggested that male sex (P = 0.05), non-Caucasian ethnicity (P = 0.02), duration of type 2 diabetes (r = 0.40; P<0.002) and changes in FFA (r = 0.36; P<0.004), adiponectin (r = -0.26; P<0.03), and PGC-1α (r = -0.28; P = 0.02) explain ∼65% of the variability in the changes in HbA1C.

Conclusions: Decreases in HbA1C after 9 months of exercise were associated with shorter duration of diabetes, lowering of serum FFA concentrations, increasing serum adiponectin concentrations and increasing skeletal muscle PGC-1α protein expression.

Trial registration: ClinicalTrials.gov NCT00458133.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adiponectin / blood*
  • Adult
  • Aged
  • Diabetes Mellitus, Type 2* / blood
  • Diabetes Mellitus, Type 2* / therapy
  • Exercise Therapy*
  • Female
  • Glycated Hemoglobin / metabolism*
  • Glycemic Index*
  • Humans
  • Male
  • Middle Aged
  • Peroxisome Proliferator-Activated Receptor Gamma Coactivator 1-alpha / blood*
  • Time Factors

Substances

  • ADIPOQ protein, human
  • Adiponectin
  • Glycated Hemoglobin A
  • PPARGC1A protein, human
  • Peroxisome Proliferator-Activated Receptor Gamma Coactivator 1-alpha
  • hemoglobin A1c protein, human

Associated data

  • ClinicalTrials.gov/NCT00458133