Document Type : Research Paper
Authors
1 Ph.D. student, Department of Exercise Physiology, Faculty of Sport Sciences, Shahid Chamran University of Ahvaz, Ahvaz, Iran
2 Assistant Professor, Department of Exercise Physiology, Faculty of Sport Sciences, Shahid Chamran University of Ahvaz, Ahvaz, Iran
3 Associate Professor, Department of Exercise Physiology, Faculty of Sport Sciences, Shahid Chamran University of Ahvaz, Ahvaz, Iran
Abstract
The aim of this study was to evaluate the effect of eight weeks of aerobic exercise on leptin to adiponectin (L/A) ratio and glycemic control indices in type 2 diabetic patients. Among men with type 2 diabetes, 24 person [mean age (48.7 ± 0.71 years) and BMI (30.7 ± 3.3 kg / m2)] randomly divided into two groups of aerobic exercise (n = 12) and control group (n = 12). The aerobic exercise program was performed as eight weeks of running, five sessions per week, for one hour with an intensity of 50 to 75% of the HRR. Leptin, adiponectin, L/A ratio, HbA1c, plasma glucose, insulin, HOMA-IR and insulin sensitivity were measured in pretest and posttest. Analysis of covariance and Pearson correlation tests were used to analyze the data. The results of the intergroup test showed that plasma leptin levels and L/A ratio decreased and adiponectin levels increased significantly compared to the control group (P <0.05). Moreover, insulin, glucose, HbA1c and HOMA-IR levels in the aerobic exercise group decreased compared to the control group and the level of insulin sensitivity increased significantly compared to the control group (P <0.05). Despite these results, the correlation test indicated no significant relationship between L/A ratio with glycemic control indices (P> 0.05). The improvement in L/A appears to be due to the effect of aerobic exercise on changes in BMI and fat percentage; however, the improvement mechanism of glycemic control indices probably has other pathways than adipokines that need to be studied
Keywords
- Lai H, Lin N, Xing Z, Weng H, Zhang H. Association between the level of circulating adiponectin and prediabetes: a meta-analysis. J Diabetes Investig. 2015;6(4):416-29.
- Kaveeshwar SA, Cornwall J. The current state of diabetes mellitus in India. Australas Med J. 2014; 7:45–8.
- Speight J, Browne JL, Holmes-Truscott E, Hendrieckx C, Pouwer F. Diabetes MILES-Australia (management and impact for long-term empowerment and success): methods and sample characteristics of a national survey of the psychological aspects of living with type 1 or type 2 diabetes in Australian adults. BMC Public Health. 2012; 12(1):1-3.
- Coelho M, Oliveira T, Fernandes R. Biochemistry of adipose tissue: An endocrine organ. Arch Med Sci. 2013; 9:191–200.
- Niafar M, Nader ND. Adiponectin as serum biomarker of insulin resistance in patients with polycystic ovarian syndrome. Gynecol Endocrinol. 2015; 31:473–6.
- The role of adiponectin in cardiometabolic diseases: effects of nutritional
interventions. J Nutr. 2016; 146:422S-6S.
- Mendoza-Nunez VM, Garcia-Sanchez A, Sanchez-Rodriguez M, Galvan-Duarte RE, and Fonseca-Yerena ME. Overweight, waist circumference,age, gender, and insulin resistance as risk factors for hyperleptinemia. Obes Res. 2002; 10:253–9.
- Kang DR, Yadav D, Koh SB, Kim JY, Ahn SV. Impact of serum leptin to adiponectin ratio on regression of metabolic syndrome in high-risk individuals: the ARIRANG study. Yonsei Med J. 2017; 58(2):339-346.
- Aslfalah H, Jamilian M, Khosrowbeygi A. Elevation of the adiponectin/leptin ratio in women with gestational diabetes mellitus after supplementation with alpha-lipoic acid. Gynecol Endocrinol. 2019. 4; 35(3):271-5.
- Frühbeck G, Catalán V, Rodríguez A, Ramírez B, Becerril S, Salvador J, et al. Adiponectin-leptin ratio is a functional biomarker of adipose tissue inflammation. Nutrients. 2019; 11(2):454-66.
- Frühbeck G, Catalán V, Rodríguez A, Gómez-Ambrosi J. Adiponectin-leptin ratio: a promising index to estimate adipose tissue dysfunction. Relation with obesity-associated cardiometabolic risk. Adipocyte. 2018 2; 7(1):57-62.
- Verheggen RJ, Maessen MF, Green DJ, Hermus AR, Hopman MT, Thijssen DH. A systematic review and meta-analysis on the effects of exercise training versus hypocaloric diet: distinct effects on body weight and visceral adipose tissue. Obes Rev. 2016; 17(8):664-90.
- Yu N, Ruan Y, Gao X, Sun J. Systematic review and meta-analysis of randomized, controlled trials on the effect of exercise on serum leptin and adiponectin in overweight and obese individuals. Horm Metab Res. 2017; 49(03):164-73.
- Sakurai T, Ogasawara J, Kizaki T, Sato S, Ishibashi Y, Takahashi M, et al. The effects of exercise training on obesity-induced dysregulated expression of adipokines in white adipose tissue. Int J Endocrinol. 2013;2013:8017-43.
- Umpierre D, Ribeiro PA, Kramer CK, Leitao CB, Zucatti AT, Azevedo MJ, et al. Physical activity advice only or structured exercise training and association with HbA1c levels in type 2 diabetes: a systematic review and meta-analysis. JAMA. 2011; 305(17):1790-9.
- Najafipour F, Mobasseri M, Yavari A, Nadrian H, Aliasgarzadeh A, Abbasi NM, et al. Effect of regular exercise training on changes in HbA1c, BMI and VO2max among patients with type 2 diabetes mellitus: an 8-year trial. BMJ Open Diab Res Care. 2017;5(1):e000414
- Abd El-Kader SM, Al-Jiffri OH. Impact of weight reduction on insulin resistance, adhesive molecules and adipokines dysregulation among obese type 2 diabetic patients. Afr Health Sci. 2018; 18(4):873-83.
- Jackson AS & Pollock ML. Generalized equations for predicting body density of men. Br J Nufr. 19781; 40:497-504.
- Salameh A.Graded exercise stress testing: Treadmill protocols comparison of peak exercise times in cardiac patients. [PhD dissertation]. [Ohio]: University of Akron; 2009.
- Katz A, Nambi SS, Mather K, Baron AD, Follmann DA, Sullivan G, et al. Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans. J Clin Endocrinol Metab. 2000; 85:2402–2410.
- Zhang LY, Liu T, Teng YQ, Yao XY, Zhao TT, Lin LY, et al. Effect of a 12-week aerobic exercise training on serum fetuin-A and adipocytokine levels in type 2 diabetes. Exp. Clin. Endocrino. 2018; 126(08):487-92.
- American Diabetes Association. Standards of medical care in diabetes. Diabetes Care. 2011; 34(1):11-61.
- Sokolovska J, Ostrovska K, Pahirko L, Varblane G, Krilatiha K, Cirulnieks A, et al. Impact of interval walking training managed through smart mobile devices on albuminuria and leptin/adiponectin ratio in patients with type 2 diabetes. Physiol Rep. 2020; 8(13):e14506.
- Kao HH, Hsu HS, Wu TH, Chiang HF, Huang HY, Wang HJ, et al. Effects of a single bout of short-duration high-intensity and long-duration low-intensity exercise on insulin resistance and adiponectin/leptin ratio. Obes Res Clin Pract. 2021; 15(1):58-63.
- Becic T, Studenik C, Hoffmann G. Exercise increases adiponectin and reduces leptin levels in prediabetic and diabetic individuals: systematic review and meta-analysis of randomized controlled trials. J Med Sci. 2018; 6(4):97-115.
- Bolboli L, Mamashli M, Rajabi M. The effect of aerobic exercise on hormone levels of adiponectin and insulin resistance index in women with type 2 diabetes. Sport Physiology. 2018; 10(37):63-86. (In Persian).
- Kraemer RR, Kraemer GR, Acevedo EO, Hebert EP, Temple E, Bates M, et al. Effects of aerobic exercise on serum leptin levels in obese women. Eur J Appl Physiol. 1999; 80(2):154-8.
- Evans RA, Dolmage TE, Robles PG, Brooks D, Goldstein RS. The effects of exercise modality and intensity on energy expenditure and cardiorespiratory response in adults with obesity and treated obstructive sleep apnoea. Chron Respir Dis. 2017; 14(4):342-51.
- Willis LH, Slentz CA, Bateman LA, Shields AT, Piner LW, Bales CW, et al. Effects of aerobic and/or resistance training on body mass and fat mass in overweight or obese adults. J Appl physiol. 2012; 113(12):1831-7.
- Skvarca A, Tomazic M, Blagus R, Krhin B, Janez A. Adiponectin/leptin ratio and insulin resistance in pregnancy. Int J Med Res. 2013; 41(1):123-8.
- Aly YE, Abdou AS, Rashad MM, Nassef MM. Effect of exercise on serum vitamin D and tissue vitamin D receptors in experimentally induced type 2 Diabetes Mellitus. J Adv Res. 2016; 7(5):671-9.
- zand s, nikooie r, moflehi d. the effect of endurance training at moderate intensity on changes of serum concentration of mif and it’s relationship with plasma white blood cells, glucose, and insulin changes in type 2 diabetic women. Sport Physiology. 2017; 9(35):105-18. (In Persian).
- Yaribeygi H, Farrokhi FR, Butler AE, Sahebkar A. Insulin resistance: Review of the underlying molecular mechanisms. J Cell Physiol. 2019; 234(6):8152-61.
- Park DR, Park KH, Kim BJ, Yoon CS, Kim UH. Exercise ameliorates insulin resistance via Ca2+ signals distinct from those of insulin for GLUT4 translocation in skeletal muscles. Diabetes. 2015; 64(4):1224-34.
- Prior SJ, Goldberg AP, Ortmeyer HK, Chin ER, Chen D, Blumenthal JB, et al. Increased skeletal muscle capillarization independently enhances insulin sensitivity in older adults after exercise training and detraining. Diabetes. 2015; 64(10):3386-95.
- Medeiros ND, de Abreu FG, Colato AS, de Lemos LS, Ramis TR, Dorneles GP, et al. Effects of concurrent training on oxidative stress and insulin resistance in obese individuals. Oxid Med Cell Longev. 2015;2015:6971-81
- Bacchi E, Negri C, Targher G, Faccioli N, Lanza M, Zoppini G, et al. Both resistance training and aerobic training reduce hepatic fat content in type 2 diabetic subjects with nonalcoholic fatty liver disease (the RAED2 randomized trial). J Hepatol. 2013; 58(4):1287-95.
- Corpeleijn E, Feskens EJ, Jansen EH, Mensink M, Saris WH, Blaak EE. Lifestyle intervention and adipokine levels in subjects at high risk for type 2 diabetes: the study on lifestyle intervention and Impaired glucose tolerance Maastricht (SLIM). Diabetes Care. 2007; 30(12):3125-7.
- Jamurtas AZ, Theocharis V, Koukoulis G, Stakias N, Fatouros IG, Kouretas D, et al. The effects of acute exercise on serum adiponectin and resistin levels and their relation to insulin sensitivity in overweight males. Eur J Appl physiol. 2006; 97(1):122-6.
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