The effects of high intensity interval and moderate intensity aerobic continuous training on some of the glycemic control variables and fetuin-A in type 2 diabetic patients

Document Type : original article

Authors

Department of exercise physiology, faculty of sport sciences, Guilan university, Iran

Abstract

Background and Purpose: Regular exercise is one of the strongest modulators of type-2 diabetes and most of its effects on cells are caused by changes in cytokines. Fetuin A, as a hepatokine, with known effects on carbohydrate metabolism, is affected by exercise and possibly its intensity in healthy individuals. The aim of this study was to compare the two protocols of high intensity interval and moderate intensity continuous training on some glycemic control variables and plasma levels of fetuin A in patients with type-2 diabetes.
Material and Methods: 45 men with type-2 diabetes (age and BMI, respectively, 45.9 ± 4.2 years, and 30.5 ± 2.5 kg / m2) were randomly divided into three groups: control, high intensity interval training (HIIT) and moderate intensity continuous training (MICT). The HIIT protocol includes of four intervals of 4-minute activity with 85 to 95% reserve heart rate, separated by 3-minute active rest. The MICT group also did exercise for 47 minutes with 60 to 70% reserve heart rate.
Results: FBS and fetuin A was significantly decreased in both HIIT and MICT groups (P < 0.05) and there was no significant difference between two groups. Similarly, HOMA-IR and plasma insulin levels was decreased significantly in both HIIT and MICT groups (P < 0.05) and the reduction of these two factors in the HIIT group was greater than the MICT group (P < 0.05).
Conclusion: Based on the results, both HIIT and MICT can possibly lead to better control of glycemic control and also reduce plasma levels of fetuin A, which seems to be a favorable event due to its initial increase in patients with type 2 diabetes. However, this study did not find a difference between the two types of exercise in reducing fetuin A.

Keywords


  1. Irandoost T, ABDI A, ABBASI DA. Effect of aerobic training with cinnamon extract supplementation on Resistin and Glycemic Indexes in rats with insulin-resistant. journal of sport and exercise physiology. 2019;12(1):43-57.(In Persian).
  2. Roden MJWMW. Hepatic glucose production and insulin resistance. Wien Med Wochenschr. 2008;158(19):558-61.
  3. Stefan N, Häring H-UJNRE. The role of hepatokines in metabolism. Nat Rev Endocrinol. 2013;9(3):144-52.
  4. Denecke B, Gräber S, Schäfer C, Heiss A, Wöltje M, Jahnen-Dechent WJBJ. Tissue distribution and activity testing suggest a similar but not identical function of fetuin-B and fetuin-A. Biochem J. 2003;376(1):135-45.
  5. Mathews ST, Singh GP, Ranalletta M, Cintron VJ, Qiang X, Goustin AS, et al. Improved insulin sensitivity and resistance to weight gain in mice null for the Ahsg gene. Diabetes. 2002;51(8):2450-8.
  6. Ix JH, Wassel CL, Kanaya AM, Vittinghoff E, Johnson KC, Koster A, et al. Fetuin-A and incident diabetes mellitus in older persons. Jama. 2008;300(2):182-8.
  7. Jung TW, Youn B-S, Choi HY, Lee SY, Hong HC, Yang SJ, et al. Salsalate and adiponectin ameliorate hepatic steatosis by inhibition of the hepatokine fetuin-A. Biochemical pharmacology. 2013;86(7):960-9.
  8. Soleimani Z, PIRI M. Comparision the effect of high intensity interval training and continuous endurance training on expression of MYOD in soleus muscle of diabetic rats. journal of sport and exercise physiology. 2016;2:1213-21.(In Persian).
  9. Blumenthal JB, Gitterman A, Ryan AS, Prior SJJJodr. Effects of exercise training and weight loss on plasma Fetuin-a levels and insulin sensitivity in overweight older men. J Diabetes Res. 2017;2017.
  10. Malin SK, Mulya A, Fealy CE, Haus JM, Pagadala MR, Scelsi AR, et al. Fetuin-A is linked to improved glucose tolerance after short-term exercise training in nonalcoholic fatty liver disease. Journal of Applied Physiology. 2013;115(7):988-94.
  11. Yang SJ, Hong HC, Choi HY, Yoo HJ, Cho GJ, Hwang TG, et al. Effects of a three‐month combined exercise programme on fibroblast growth factor 21 and fetuin‐A levels and arterial stiffness in obese women. Clin Endocrinol (Oxf). 2011;75(4):464-9.
  12. Zhang L-Y, Liu T, Teng Y-Q, Yao X-Y, Zhao T-T, Lin L-Y, et al. Effect of a 12-week aerobic exercise training on serum fetuin-A and adipocytokine levels in type 2 diabetes. Experimental and Clinical Endocrinology & Diabetes. 2018;126(08):487-92.
  13. Ramírez-Vélez R, García-Hermoso A, Hackney AC, Izquierdo MJLih, disease. Effects of exercise training on Fetuin-a in obese, type 2 diabetes and cardiovascular disease in adults and elderly: a systematic review and Meta-analysis. Lipids Health Dis. 2019;18(1):1-11.
  14. Thompson WR. Now trending: worldwide survey of fitness trends for 2014. ACSM's Health & Fitness Journal. 2013;17(6):10-20.
  15. Gibala MJJSSE. Physiological adaptations to low-volume high-intensity interval training. Sports Science Exchange. 2015;28(139):1-6.
  16. Weston KS, Wisløff U, Coombes JS. High-intensity interval training in patients with lifestyle-induced cardiometabolic disease: a systematic review and meta-analysis. Br J Sports Med. 2014;48(16):1227-34.
  17. Care AADJD. Updates to the Standards of Medical Care in Diabetes—2018. 2018;41(9):2045-7.
  18. Kleindorfer DO, Towfighi A, Chaturvedi S, Cockroft KM, Gutierrez J, Lombardi-Hill D, et al. 2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline From the American Heart Association/American Stroke Association. 2021:STR. 0000000000000375.
  19. Ribeiro PA, Boidin M, Juneau M, Nigam A, Gayda M. High-intensity interval training in patients with coronary heart disease: prescription models and perspectives. Annals of physical and rehabilitation medicine. 2017;60(1):50-7.
  20. Wisløff U, Støylen A, Loennechen JP, Bruvold M, Rognmo Ø, Haram PM, et al. Superior cardiovascular effect of aerobic interval training versus moderate continuous training in heart failure patients. Circulation. 2007;115(24):3086-94.
  21. Gayda M, Ribeiro PA, Juneau M, Nigam A. Comparison of different forms of exercise training in patients with cardiac disease: where does high-intensity interval training fit?. Canadian Journal of Cardiology. 2016;32(4):485-94.
  22. Tanaka H, Monahan KD, Seals DR. Age-predicted maximal heart rate revisited. Journal of the American College of Cardiology. 2001;37(1):153-6.
  23. Matthews DR, Hosker J, Rudenski A, Naylor B, Treacher D, Turner RJD. Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28(7):412-9.
  24. Li Y, Li R, Li X, Liu L, Zhu J, Li DJM. Effects of different aerobic exercise training on glycemia in patients with type 2 diabetes: A protocol for systematic review and meta analysis. Medicine. 2021;100(18).
  25. Li J, Zhang W, Guo Q, Liu X, Zhang Q, Dong R, et al. Duration of exercise as a key determinant of improvement in insulin sensitivity in type 2 diabetes patients. Tohoku J Exp Med. 2012;227(4):289-96.
  26. Zhang L-Y, Liu T, Teng Y-Q, Yao X-Y, Zhao T-T, Lin L-Y, et al. Effect of a 12-week aerobic exercise training on serum fetuin-A and adipocytokine levels in type 2 diabetes. Exp Clin Endocrinol Diabetes. 2018;126(08):487-92.
  27. Keihanian A, Arazi H, Kargarfard MJPi. Effects of aerobic versus resistance training on serum fetuin-A, fetuin-B, and fibroblast growth factor-21 levels in male diabetic patients. Physiol Int. 2019;106(1):70-80.
  28. Mori K, Emoto M, Araki T, Yokoyama H, Lee E, Teramura M, et al. Effects of pioglitazone on serum fetuin-A levels in patients with type 2 diabetes mellitus. Metabolism. 2008;57(9):1248-52.
  29. Stefan N, Hennige AM, Staiger H, Machann J, Schick F, Kröber SM, et al. α2-Heremans-Schmid glycoprotein/fetuin-A is associated with insulin resistance and fat accumulation in the liver in humans. Diabetes Care. 2006;29(4):853-7.
  30. Mathews ST, Rakhade S, Zhou X, Parker GC, Coscina DV, Grunberger GJB, et al. Fetuin-null mice are protected against obesity and insulin resistance associated with aging. Biochem Biophys Res Commun. 2006;350(2):437-43.
  31. Heinrichsdorff J, Olefsky JMJNm. Fetuin-A: the missing link in lipid-induced inflammation. Nat Med. 2012;18(8):1182-3.
  32. Lee S, Norheim F, Gulseth HL, Langleite TM, Kolnes KJ, Tangen DS, et al. Interaction between plasma fetuin‐A and free fatty acids predicts changes in insulin sensitivity in response to long‐term exercise. Physiol Rep. 2017;5(5):e13183.
  33. Picard M, Tauveron I, Magdasy S, Benichou T, Bagheri R, Ugbolue UC, et al. Effect of exercise training on heart rate variability in type 2 diabetes mellitus patients: A systematic review and meta-analysis. PLoS One. 2021;16(5):e0251863.
  • Receive Date: 07 July 2021
  • Revise Date: 04 August 2021
  • Accept Date: 23 August 2021
  • First Publish Date: 22 June 2022
  • Publish Date: 22 June 2022