Effects of Adding Exercise to a 16-Week Very Low-Calorie Diet in Obese, Insulin-Dependent Type 2 Diabetes Mellitus Patients (Articolo in rivista)

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  • Effects of Adding Exercise to a 16-Week Very Low-Calorie Diet in Obese, Insulin-Dependent Type 2 Diabetes Mellitus Patients (Articolo in rivista) (literal)
Anno
  • 2012-01-01T00:00:00+01:00 (literal)
Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#doi
  • 10.1210/jc.2011-3178 (literal)
Alternative label
  • Snel, M ; Gastaldelli, A ; Ouwens, DM ; Hesselink, MKC; Schaart, G ; Buzzigoli, E; Frolich, M ; Romijn, JA ; Pijl, H ; Meinders, AE ; Jazet, IM (2012)
    Effects of Adding Exercise to a 16-Week Very Low-Calorie Diet in Obese, Insulin-Dependent Type 2 Diabetes Mellitus Patients
    in The Journal of clinical endocrinology and metabolism; Endocrine Society, Chevy Chase (Stati Uniti d'America)
    (literal)
Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#autori
  • Snel, M ; Gastaldelli, A ; Ouwens, DM ; Hesselink, MKC; Schaart, G ; Buzzigoli, E; Frolich, M ; Romijn, JA ; Pijl, H ; Meinders, AE ; Jazet, IM (literal)
Pagina inizio
  • 2512 (literal)
Pagina fine
  • 2520 (literal)
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  • http://www.ncbi.nlm.nih.gov/pubmed/22569236 (literal)
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  • 97 (literal)
Rivista
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  • 9 (literal)
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  • 7 (literal)
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  • [ 1,8,9,10,11 ] Leiden Univ, Med Ctr, Dept Endocrinol & Metab Gen Internal Med, NL-2300 RC Leiden, Netherlands [ 3 ] Leiden Univ, Med Ctr, Dept Mol Cell Biol, NL-2300 RC Leiden, Netherlands [ 7 ] Leiden Univ, Med Ctr, Dept Clin Chem, NL-2300 RC Leiden, Netherlands [ 2,6 ] Univ Pisa, Sch Med, Inst Clin Physiol, Natl Res Ctr, I-56127 Pisa, Italy [4,5] Maastricht Univ, Med Ctr, Nutr & Toxicol Res Inst Maastricht, Dept Human Movement Sci, NL-6200 MD Maastricht, Netherlands (literal)
Titolo
  • Effects of Adding Exercise to a 16-Week Very Low-Calorie Diet in Obese, Insulin-Dependent Type 2 Diabetes Mellitus Patients (literal)
Abstract
  • Context: Reduction of 50% excess body weight, using a very low-calorie diet (VLCD; 450 kcal/d) improves insulin sensitivity in obese type 2 diabetes mellitus patients. Objective: The objective of the study was to evaluate whether adding exercise to the VLCD has additional benefits. Design: This was a randomized intervention study. Setting: The study was conducted at a clinical research center in an academic medical center. Subjects: Twenty-seven obese [body mass index 37.2 +/- 0.9 kg/m(2) (mean +/- SEM)] insulin-treated type 2 diabetes mellitus patients. Intervention: Patients followed a 16-wk VLCD. Thirteen of them simultaneously participated in an exercise program (E) consisting of 1-h, in-hospital training and four 30-min training sessions on a cycloergometer weekly. Outcome Measures: Insulin resistance was measured by a hyperinsulinemic euglycemic clamp. Insulin signaling, mitochondrial DNA (mtDNA) content, and intramyocellular lipid content was measured in skeletal muscle biopsies. Results: Baseline characteristics were identical in both groups. Substantial weight loss occurred (-23.7 +/- 1.7 kg VLCD-only vs. -27.2 +/- 1.9 kg VLCD+E, P = NS within groups). The exercise group lost more fat mass. Insulin-stimulated glucose disposal increased similarly in both study groups [15.0 +/- 0.9 to 39.2 +/- 4.7 mu mol/min(-1) . kg lean body mass (LBM-1) VLCD-only vs. 17.0 +/- 1.0 to 37.5 +/- 3.5 mu mol/min(-1) . kg LBM-1 in VLCD+E], as did phosphorylation of the phosphatidylinositol 3-kinase-protein kinase B/AKT insulin signaling pathway. In contrast, skeletal muscle mtDNA content increased only in the VLCD+E group (1211 +/- 185 to 2288 +/- 358, arbitrary units, P = 0.016 vs. 1397 +/- 240 to 1196 +/- 179, P = NS, VLCD-only group). Maximum aerobic capacity also only increased significantly in the VLCD+E group (+6.6 +/- 1.7 ml/min(-1) . kg LBM-1 vs. +0.7 +/- 1.5 ml/min(-1) . kg LBM-1 VLCD-only, P = 0.017). Conclusion: Addition of exercise to a 16-wk VLCD induces more fat loss. Exercise augments maximum aerobic capacity and skeletal muscle mtDNA content. These changes are, however, not reflected in a higher insulin-stimulated glucose disposal rate. (J Clin Endocrinol Metab 97: 2512-2520, 2012) (literal)
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