The response of TNF-α, IL-6 serum levels and lipid profiles to two aerobic training frequencies with the same volume in obese middle-aged women with type 2 diabetic

Document Type : original article


1 Department of Physical Education and Sport Sciences, Faculty of Educational Sciences and Psychology, Mohaghegh Ardabili University, Ardabil, Iran

2 Faculty of Physical Education and Sports Sciences, University of Tehran, Tehran, Iran


Purpose: The aim of this study was to comparison of the effect of two different frequencies of aerobic exercise with the same volume and detraining period on the levels of IL-6, TNF-α and lipid profiles in obese middle-aged women with type 2 diabetes.
Methods: Thirty-six obese women age?? with type 2 diabetes were randomly divided into three groups of 12 equal members (Group I = three sessions and group two = six sessions per week, with the same volume). Subjects in Groups I and II performed aerobic training for eight weeks with an intensity of 60 to 75% of the maximum heart rate and the same volume. Samples were taken Pre-test, 48 hours and two weeks after the last training session. Biochemical variables were measured by ELISA method. The repeated measure of Analysis of Variance (ANOVA) with Bonferroni’s post hoc test was used to evaluate intra-group changes and One-way ANOVA with post-test Tukey test were used to evaluate the inter-group outcomes at each stage.
Results: After eight weeks of interventions, the intergroup results showed that TNF-α, IL-6, TG and total cholesterol were only significantly reduced in Group I (P <0.05). Also, the between-group results showed a significant difference between groups one with control, and I with two in the above variables (P < 0.05). However, there was no significant difference between the group two with control in the post-test and detraining stages (P <0.05). And there was no significant difference between group two and control in post-test and detraining stages (P <0.05). Moreover, results in weight, body fat and BMI variables were only significantly reduced in Group I (P <0.05).
Conclusion: The effect of exercise training with a longer duration than the frequency in short-term training sessions was better in controlling the IL-6, TNF-α and lipid profiles in obese women with type 2 diabetes.


1. International Diabetes Federation. IDF Diabetes Atlas. 7th Edition. Online version of IDF Diabetes Atlas; Chapter 3. 2015, p. 42-45.
2. Irvine C, Taylor NF. Progressive resistance exercise improves glycaemic control in people with type 2 diabetes mellitus: a systematic review. Aust J Physiother. 2009; 55(4): 237-46.
3. Chudyk A, Petrella J. Effects of Exercise on Cardiovascular Risk Factors in Type 2 Diabetes. Diabetes Care. 2011; 34(12): 1228–1237.
4. Henrickcsen EJ. Exercise effects of muscle insulin signaling and action. Invited Review: Effects of acute exercise and exercise training on insulin resistance. J Appl Physiol. 2002; 93: 788-796.
5. Askari A, Askari B, Fallah Z, Kazemi Sh. Effect of eight weeks aerobic training on serum lipid and lipoprotein levels in women. Journal of Gorgan University of Medical Sciences. 2012; 14(1): 26-32. [In Persian].
6. Ouchi N, Parker JL, Lugus JJ, Walsh K. Adipokines in inflammation and metabolic disease. Nature Reviews Immunology. 2011; 11:85-97.
7. Luciana C, Jaime D, Carlos E, Menezes S, Fabiano T, Célio F, et al, editors. Physical Exercise on Inflammatory Markers in Type 2 Diabetes Patients: A Systematic Review of Randomized Controlled Trials. Oxidative Medicine and Cellular Longevity. 2017; 18: 1-10.
8. Plomgaard P, Nielsen A, Fischer C, Mortensen O, Broholm C, Penkowa M, et al, editors. Associations between insulin resistance and TNF-α in plasma, skeletal muscle and adipose tissue in humans with and without type 2 diabetes. Diabetologia. 2007; 50: 2562-2571.
9. Moller DE. Potential role of TNF-a in the pathogenesis of insulin resistance and type 2 diabetes. Trends in Endocrinology & Metabolism. 2000; 11: 212-217.
10. Shils M, Shike M. Modern nutrition in health and disease. 2nd ed. Philadelphia: PA: Lippincott Williams & Wilkins. 2006; P. 124-9.
11. Agha Alinejad H, Molanori Shamsi M. [Exercise induced release of cytokines from skeletal muscle: emphasis on IL-6]. Iran J Endocrinol Metab. 2010; 12(2); 181-90. [in Persian]
12. Bente KP. Anti-inflammatory effects of exercise: role in diabetes and cardiovascular disease. European J of Clinical Investigation. 2017; 47: 600-611.
13. Nicklas BJ, Hsu FC, Brinkley TJ, Church T, Goodpaster BH, Kritchevsky SB, et al, editors. Exercise Training and plasma C-reactive protein and interleukin-6 in elderly people. J Am Geriatr Soc. 2008; 56: 2045-2052.
14. Ryan AS, Nicklas BJ, Berman DM, Elahi D. Adiponectin levels do not change with moderate dietary induced weight loss and exercise in obese postmenopausal women. Int J Obes Relat Metab Disord. 2003; 27: 1066-71.
15. Touvra AM, Volaklis KA, Spassis AT, Zois CE, Douda HT, Kotsa K, et al, editors. Combined strength and aerobic training increases transforming growth factor-β1 in patients with type 2 diabetes. Hormones. 2011; 10: 125-30.
16. Fasshauer M, Klein J, Neumann S, Eszlinger M, Paschke R. Hormonal regulation of adiponectin gene expression in 3T3-L1 adipocytes. Biochemical and Biophysical Research Communications. 2002; 290:1084-9.
17. Kasapis C, Thompson PD. The effects of physical activity on serum C-reactive protein and inflammatory markers: a systematic review. Journal of the American College of Cardiology. 2005; 45:1563-9.
18. Straczkowski M, Kowalska I, Dzienis-Straczkowska S, Stepien A, Skibinska E, Szelachowska M, et al, editors. Changes in tumor necrosis factor-alpha system and insulin sensitiv-ity during an exercise training program in obese women with normal and impaired glucose tolerance. European Journal of Endocrinology. 2001; 145:273-80.
19. American Diabetes Association. standards of medical care in diabetes. diabetes care. 2011; 34(1); 11-61.
20. Afzali H, Majdzade R, Fotohi A. Methodology of Applied Research in Medical Sciences. First edition, Tehran Medical Sciences Press, Publishing & Printing Institute. 2005; p. 47-53. [In Persian].
21. Haghdoost A. Do you want to understand the concept of sample size and the power of statistical tests more accurately? Iranian Journal of Epidemiology. 2009; (5):57-63. [In Persian].
22. Fallahzadeh H. Bases and Methods of Biostatistics. Second edition, Sobhan Publishing House. 2014; p. 154-161. [In Persian].
23. Yousefi P. Tadibi V, Behpour N, Parnoo A, et al. The effect of aerobic exercise on blood glucose control and cardiovascular risk factors in people with type 2 diabetes. Journal of Mashhad University of Medical Sciences. 2014; (57): 976-984. [In Persian].
24. Tofighi A, Ghafari Gh. Effect of regular aerobic exercise and supplementation of omega-3 supplementation on sICAM-1 and serum lipoprotein levels in obese elderly women. Journal of Science and Research in Nutrition Sciences and Food Industry of Iran. 2013; (8): 35-44. [In Persian].
25. Ghaffarpour M, Houshiar A, Kianfar H. Household of Scales Guide, Conversion coefficients and Percent of Edible food. Tehran, Publication of Agricultural Sciences. 2000; 25: 24-29.
26. Praet S, Loon L. Optimizing the therapeutic benefits exercise in type 2 diabetes. J Appl Physiol. 2007; 103(2): 1113-1120.
27. Nezamdoost Z, Saghebjo M, Barzegar A. The effect of twelve weeks of aerobic training on serum vaspin levels, fasting glucose and insulin resistance in women with type 2 diabetes. Journal of Diabetes and Metabolism of Iran. 2014; (14): 99-104.
28. Swain D, Hrltz B. The fuel calculations (application of equations). Iran: Tehran. Publishers. 2001; 1: 41-112.
29. Meamarbashi A, Rajabi A. The effects of peppermint on exercise performance. Journal of the International Society of Sports Nutrition. 2013; 10: 15-21.
30. José M, Sandra M, Gustavo J, Carlos H, Everardo M, Guilherme D et al. Interleukin-6 increases the expression and activity of insulin-degrading enzyme Mirian A. Scientific Reports. 2017; 7: 1-12.
31. Mendham AE, Duffield R, Marino F, Coutts AJ. A 12-week sports-based exercise programme for inactive Indigenous Australian men improved clinical risk factors associated with type 2 diabetes mellitus. Journal of Science and Medicine in Sport. 2015; 18: 438-443.
32. Farinha JB, Steckling FM, Stefanello ST, Cardoso MS, Nunes LS, Barcelos RP, et al, editors. Response of oxidative stress and inflammatory biomarkers to a 12-week aerobic exercise training in women with metabolic syndrome. Sports medicine-open. 2015; 2: 1-10.
33. Kohut ML, McCann DA, Russell DW, Konopka DN, Cunnick JE, Franke WD, et al, editors. Aerobic exercise, but notflexibility/resistance exercise, reduces serum IL-18, CRP and IL-6 independent of beta-blockers, BMI andpsychosocial factors in older adults. Brain Behav Immun. 2006; 20: 201-9.
34. Monzillo LU, Hamdy O, Horton ES, Ledbury S, Mullooly C, Jarema C, et al, editors. Effect of lifestyle modification on adipokine levels in obese subjects with insulin resistance. Obesity research. 2003; 11: 1048-1054.
35. Mujumdar PP, Duerksen-Hughes PJ, Firek AF, Hessinger DA. Long-term, progressive, aerobic training increases adiponectin in middle-aged, overweight, untrained males and females. Scandinavian journal of clinical and laboratory investigation. 2011; 71: 101-107.
36. Ghorbani M. A Review of the Relationship Between Type 2 Diabetes and Obesity. Journal of Cellular-Molecular Biotechnology. 2015; (5): 9-14. [In Persian].
37. Aghamohammadi M, Habibi A, Rangbar R. Effect of Aerobic Exercise on Serum Irisin Levels and Insulin Resistance Index in Women with Type 2 Diabetic. Journal of Arak University of Medical Sciences. 2015; (18): 1-9. [In Persion].
38. Kim Y, Nam J, Dong W, Kim K, Sang H, Chul W. The effects of aerobic exercise training on serum osteocalcin, adipocytokines and insulin resistance on obese young males. Clin Endocrinol. 2015. 82; 686-694.
39. Cuff J, Meneilly S, Martin A, Lgnaszewski A, Tildesley D, Frohlich J. Effective exercise modality to reduce insulin resistance in women with type 2diabetes. Diabetes Care. 2003; 26(9): 2977-2982.
40. Maiorana A, Driscoll G, Goodman C, Taylor R, Green D. Combined aerobic and resistance exercise improves glycemic control and fitness in type 2 diabetes. Diabetes Research and Clinical Practice – Journal. 2002; 56: 115-123.
41. Balducci S, Zanuso S, Nicolucci A, Fernando F, Cavallo S, Cardelli P, et al. Anti-inflammatory effect of exercise training in subjects with type 2 diabetes and the metabolic syndrome is dependent on exercise modalities and independent of weight loss. Nutr Metab Cardiovasc Dis. 2010; 20(8): 608-17.
42. Zhang G, Zhang, Q, Zhao K, Wu X, Zhao J, Jiao M, et al. Relationship between blood glucose fluctuation and macro vascular endothelial dysfunction in type 2 diabetic patients with coronary heart disease”. European review for medical and pharmacological sciences. 2014; 18: 3593-3600.
43. Cavalcante EF, Ribeiro AS, do Nascimento MA, Silva AM, Tomeleri CM, Nabuco HCG. Effects of Different Resistance Training Frequencies on Fat in Overweight/Obese Older Women. Int J Sports Med. 2018; 39(7):527-534.
44. Heden T, Lox C, Rose P, Reid S, Kirk EP. One-set resistance training elevates energy expenditure for 72 h similar to three sets. Eur J Appl Physiol. 2011; 111: 477–484.
  • Receive Date: 04 January 2019
  • Revise Date: 05 March 2019
  • Accept Date: 11 May 2021
  • First Publish Date: 22 June 2021
  • Publish Date: 22 June 2021