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Original investigation
Impact of Combined Training with Different Exercise Intensities on Inflammatory and Lipid Markers in Type 2 Diabetes: A Secondary Analysis from a 1-year Randomized Controlled Trial
João P. Magalhães
Universidade de Lisboa Faculdade de Motricidade Humana
Corresponding Author
ORCiD: https://orcid.org/0000-0003-1073-8650
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at Cardiovascular Diabetology.
Background: Exercise is a well-accepted strategy to improve lipid and inflammatory profile in individuals with type 2 diabetes (T2DM). However, the exercise intensity having the most benefits on lipids and inflammatory markers in patients with T2DM remains unclear. We aimed to analyse the impact of a 1-year combined high-intensity interval training (HIIT) with resistance training (RT), and a moderate continuous training (MCT) with RT on inflammatory and lipid profile in individuals with T2DM.
Methods: Individuals with T2DM (n=80, aged 59 years) performed a 1-year randomized controlled trial and were randomized into three groups (control, n= 27; HIIT with RT, n=25; MCT with RT, n=28). Exercise sessions were supervised with a frequency of 3 days per week. Inflammatory and lipid profiles were measured at baseline and at 1-year follow-up. Changes in inflammatory and lipid markers were assessed using generalized estimating equations.
Results: After adjusting for sex, age and baseline moderate-to-vigorous physical activity (MVPA), we observed a time-by-group interaction for Interleukin-6 (IL-6) in both the MCT with RT (β=-0.70, p=0.034) and HIIT with RT (β=-0.62, p=0.049) groups, whereas, only the HIIT with RT group improved total cholesterol (β=-0.03, p=0.045) and LDL-C (β=-0.03, p=0.034), when compared to control. No effect was observed for C-reactive protein (CRP), cortisol, tumour necrosis factor-α (TNF-α), soluble form of the haptoglobin-hemoglobin receptor CD163 (sCD163), triglycerides and HDL-C in both groups (p>0.05).
Conclusions: Favorable adaptations on IL-6 were observed in both the HIIT and MCT combined with RT groups following a long-term 1-year exercise intervention in individuals with T2DM. However, only the HIIT with RT prevented further derangement of total cholesterol and LDL-C, when compared to the control group. Therefore, in order to encourage exercise participation and improve inflammatory profile, either exercise protocols may be prescribed, however, HIIT with RT may have further benefits on the lipid profile.
Trial registration: clinicaltrials.gov ID:NCT03144505
Keywords
High-intensity interval training, moderate continuous training, exercise, resistance training
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CURRENT STATUS: Published
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Posted 22 Sep, 2020
Published
On 07 Oct, 2020
No community comments so far
Editorial decision: Accept
On 21 Sep, 2020
Editor assigned
On 19 Sep, 2020
Submission checks complete
On 18 Sep, 2020
Editor invited
On 18 Sep, 2020
No comments provided
Review #4 received
Received 26 Jul, 2020
Editorial decision: Major Revision
On 26 Jul, 2020
Review #3 received
Received 23 Jul, 2020
Review #1 received
Received 19 Jul, 2020
Review #2 received
Received 19 Jul, 2020
Reviewer #4 agreed
On 04 Jul, 2020
Reviewer #3 agreed
On 03 Jul, 2020
Reviewers invited
Invitations sent on 03 Jul, 2020
Reviewer #1 agreed
On 03 Jul, 2020
Reviewer #2 agreed
On 03 Jul, 2020
Editor assigned
On 02 Jul, 2020
Editor invited
On 01 Jul, 2020
Submission checks complete
On 28 Jun, 2020
First submitted
On 22 Jun, 2020
Metrics
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PDF Downloads: ...
HTML Views: ...
Subject Areas
Cardiac & Cardiovascular Systems
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This preprint is under consideration at Cardiovascular Diabetology. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Original investigation
Impact of Combined Training with Different Exercise Intensities on Inflammatory and Lipid Markers in Type 2 Diabetes: A Secondary Analysis from a 1-year Randomized Controlled Trial
João P. Magalhães
Universidade de Lisboa Faculdade de Motricidade Humana
Corresponding Author
ORCiD: https://orcid.org/0000-0003-1073-8650
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 2
Posted 22 Sep, 2020
Published
On 07 Oct, 2020
No community comments so far
Editorial decision: Accept
On 21 Sep, 2020
Editor assigned
On 19 Sep, 2020
Submission checks complete
On 18 Sep, 2020
Editor invited
On 18 Sep, 2020
No comments provided
Review #4 received
Received 26 Jul, 2020
Editorial decision: Major Revision
On 26 Jul, 2020
Review #3 received
Received 23 Jul, 2020
Review #1 received
Received 19 Jul, 2020
Review #2 received
Received 19 Jul, 2020
Reviewer #4 agreed
On 04 Jul, 2020
Reviewer #3 agreed
On 03 Jul, 2020
Reviewers invited
Invitations sent on 03 Jul, 2020
Reviewer #1 agreed
On 03 Jul, 2020
Reviewer #2 agreed
On 03 Jul, 2020
Editor assigned
On 02 Jul, 2020
Editor invited
On 01 Jul, 2020
Submission checks complete
On 28 Jun, 2020
First submitted
On 22 Jun, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Cardiac & Cardiovascular Systems
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at Cardiovascular Diabetology.
Background: Exercise is a well-accepted strategy to improve lipid and inflammatory profile in individuals with type 2 diabetes (T2DM). However, the exercise intensity having the most benefits on lipids and inflammatory markers in patients with T2DM remains unclear. We aimed to analyse the impact of a 1-year combined high-intensity interval training (HIIT) with resistance training (RT), and a moderate continuous training (MCT) with RT on inflammatory and lipid profile in individuals with T2DM.
Methods: Individuals with T2DM (n=80, aged 59 years) performed a 1-year randomized controlled trial and were randomized into three groups (control, n= 27; HIIT with RT, n=25; MCT with RT, n=28). Exercise sessions were supervised with a frequency of 3 days per week. Inflammatory and lipid profiles were measured at baseline and at 1-year follow-up. Changes in inflammatory and lipid markers were assessed using generalized estimating equations.
Results: After adjusting for sex, age and baseline moderate-to-vigorous physical activity (MVPA), we observed a time-by-group interaction for Interleukin-6 (IL-6) in both the MCT with RT (β=-0.70, p=0.034) and HIIT with RT (β=-0.62, p=0.049) groups, whereas, only the HIIT with RT group improved total cholesterol (β=-0.03, p=0.045) and LDL-C (β=-0.03, p=0.034), when compared to control. No effect was observed for C-reactive protein (CRP), cortisol, tumour necrosis factor-α (TNF-α), soluble form of the haptoglobin-hemoglobin receptor CD163 (sCD163), triglycerides and HDL-C in both groups (p>0.05).
Conclusions: Favorable adaptations on IL-6 were observed in both the HIIT and MCT combined with RT groups following a long-term 1-year exercise intervention in individuals with T2DM. However, only the HIIT with RT prevented further derangement of total cholesterol and LDL-C, when compared to the control group. Therefore, in order to encourage exercise participation and improve inflammatory profile, either exercise protocols may be prescribed, however, HIIT with RT may have further benefits on the lipid profile.
Trial registration: clinicaltrials.gov ID:NCT03144505
Figure 1
Figure 2