Aerobic and Strength Training in Concomitant Metabolic Syndrome and Type 2 Diabetes

Conrad P Earnest, Neil M Johannsen, Damon L Swift, Fiona B Gillison, Catherine R Mikus, Alejandro Lucia, Kimberly Kramer, Carl J Lavie, Timothy S Church

Research output: Contribution to journalArticle

21 Citations (Scopus)
80 Downloads (Pure)

Abstract

Concomitant type 2 diabetes (T2D) and metabolic syndrome exacerbates mortality risk; yet, few studies have examined the effect of combining (AER+RES) aerobic (AER) and resistance (RES) training for individuals with T2D and metabolic syndrome.

Methods: We examined AER, RES, and AER + RES training (9 months) commensurate with physical activity guidelines in individuals with T2D (n = 262; 63% female, 44% black). Primary outcomes were change in, and prevalence of, metabolic syndrome score at follow-up (mean and 95% confidence interval [CI]). Secondary outcomes included maximal cardiorespiratory fitness (V·O2peak) and estimated METs from time-to-exhaustion (TTE) and exercise efficiency calculated as the slope of the line between ventilatory threshold, respiratory compensation, and maximal fitness. General linear models and bootstrapped Spearman correlations were used to examine changes in metabolic syndrome associated with training primary and secondary outcome variables.

Results: We observed a significant decrease in metabolic syndrome scores (P for trend = 0.003) for AER (-0.59, 95% CI = -1.00 to -0.21) and AER + RES (-0.79, 95% CI = -1.40 to -0.35), both being significant (P <= 0.02) versus control (0.26, 95% CI = -0.58 to 0.40) and RES (-0.13, 95% CI = -1.00 to 0.24). This led to a reduction in metabolic syndrome prevalence for the AER (56% vs 43%) and AER + RES (55% vs 46%) groups between baseline and follow-up. The observed decrease in metabolic syndrome was mediated by significant improvements in exercise efficiency for the AER and AER + RES training groups (P < 0.05), which was more strongly related to TTE (25%–30%;r = -0.38, 95% CI = -0.55 to -0.19) than V·O2peak (5%–6%; r = -0.24, 95% CI = -0.45 to -0.01).

Conclusions: AER and AER + RES training significantly improved metabolic syndrome scores and prevalence in patients with T2D. These improvements appear to be associated with improved exercise efficiency and are more strongly related to improved TTE versus V·O2peak.

Original languageEnglish
Pages (from-to)1293-1301
Number of pages8
JournalMedicine and Science in Sports and Exercise
Volume46
Issue number7
DOIs
Publication statusPublished - Jul 2014

Fingerprint

Resistance Training
Type 2 Diabetes Mellitus
Confidence Intervals
Exercise
Linear Models
Guidelines
Mortality

Cite this

Aerobic and Strength Training in Concomitant Metabolic Syndrome and Type 2 Diabetes. / Earnest, Conrad P; Johannsen, Neil M; Swift, Damon L; Gillison, Fiona B; Mikus, Catherine R; Lucia, Alejandro; Kramer, Kimberly; Lavie, Carl J; Church, Timothy S.

In: Medicine and Science in Sports and Exercise, Vol. 46, No. 7, 07.2014, p. 1293-1301.

Research output: Contribution to journalArticle

Earnest, CP, Johannsen, NM, Swift, DL, Gillison, FB, Mikus, CR, Lucia, A, Kramer, K, Lavie, CJ & Church, TS 2014, 'Aerobic and Strength Training in Concomitant Metabolic Syndrome and Type 2 Diabetes', Medicine and Science in Sports and Exercise, vol. 46, no. 7, pp. 1293-1301. https://doi.org/10.1249/MSS.0000000000000242
Earnest, Conrad P ; Johannsen, Neil M ; Swift, Damon L ; Gillison, Fiona B ; Mikus, Catherine R ; Lucia, Alejandro ; Kramer, Kimberly ; Lavie, Carl J ; Church, Timothy S. / Aerobic and Strength Training in Concomitant Metabolic Syndrome and Type 2 Diabetes. In: Medicine and Science in Sports and Exercise. 2014 ; Vol. 46, No. 7. pp. 1293-1301.
@article{69fb46cff6924890a09482d8590aa964,
title = "Aerobic and Strength Training in Concomitant Metabolic Syndrome and Type 2 Diabetes",
abstract = "Concomitant type 2 diabetes (T2D) and metabolic syndrome exacerbates mortality risk; yet, few studies have examined the effect of combining (AER+RES) aerobic (AER) and resistance (RES) training for individuals with T2D and metabolic syndrome. Methods: We examined AER, RES, and AER + RES training (9 months) commensurate with physical activity guidelines in individuals with T2D (n = 262; 63{\%} female, 44{\%} black). Primary outcomes were change in, and prevalence of, metabolic syndrome score at follow-up (mean and 95{\%} confidence interval [CI]). Secondary outcomes included maximal cardiorespiratory fitness (V·O2peak) and estimated METs from time-to-exhaustion (TTE) and exercise efficiency calculated as the slope of the line between ventilatory threshold, respiratory compensation, and maximal fitness. General linear models and bootstrapped Spearman correlations were used to examine changes in metabolic syndrome associated with training primary and secondary outcome variables. Results: We observed a significant decrease in metabolic syndrome scores (P for trend = 0.003) for AER (-0.59, 95{\%} CI = -1.00 to -0.21) and AER + RES (-0.79, 95{\%} CI = -1.40 to -0.35), both being significant (P <= 0.02) versus control (0.26, 95{\%} CI = -0.58 to 0.40) and RES (-0.13, 95{\%} CI = -1.00 to 0.24). This led to a reduction in metabolic syndrome prevalence for the AER (56{\%} vs 43{\%}) and AER + RES (55{\%} vs 46{\%}) groups between baseline and follow-up. The observed decrease in metabolic syndrome was mediated by significant improvements in exercise efficiency for the AER and AER + RES training groups (P < 0.05), which was more strongly related to TTE (25{\%}–30{\%};r = -0.38, 95{\%} CI = -0.55 to -0.19) than V·O2peak (5{\%}–6{\%}; r = -0.24, 95{\%} CI = -0.45 to -0.01). Conclusions: AER and AER + RES training significantly improved metabolic syndrome scores and prevalence in patients with T2D. These improvements appear to be associated with improved exercise efficiency and are more strongly related to improved TTE versus V·O2peak.",
author = "Earnest, {Conrad P} and Johannsen, {Neil M} and Swift, {Damon L} and Gillison, {Fiona B} and Mikus, {Catherine R} and Alejandro Lucia and Kimberly Kramer and Lavie, {Carl J} and Church, {Timothy S}",
year = "2014",
month = "7",
doi = "10.1249/MSS.0000000000000242",
language = "English",
volume = "46",
pages = "1293--1301",
journal = "Medicine & Science in Sports & Exercise",
issn = "0195-9131",
publisher = "Lippincott Williams & Wilkins",
number = "7",

}

TY - JOUR

T1 - Aerobic and Strength Training in Concomitant Metabolic Syndrome and Type 2 Diabetes

AU - Earnest, Conrad P

AU - Johannsen, Neil M

AU - Swift, Damon L

AU - Gillison, Fiona B

AU - Mikus, Catherine R

AU - Lucia, Alejandro

AU - Kramer, Kimberly

AU - Lavie, Carl J

AU - Church, Timothy S

PY - 2014/7

Y1 - 2014/7

N2 - Concomitant type 2 diabetes (T2D) and metabolic syndrome exacerbates mortality risk; yet, few studies have examined the effect of combining (AER+RES) aerobic (AER) and resistance (RES) training for individuals with T2D and metabolic syndrome. Methods: We examined AER, RES, and AER + RES training (9 months) commensurate with physical activity guidelines in individuals with T2D (n = 262; 63% female, 44% black). Primary outcomes were change in, and prevalence of, metabolic syndrome score at follow-up (mean and 95% confidence interval [CI]). Secondary outcomes included maximal cardiorespiratory fitness (V·O2peak) and estimated METs from time-to-exhaustion (TTE) and exercise efficiency calculated as the slope of the line between ventilatory threshold, respiratory compensation, and maximal fitness. General linear models and bootstrapped Spearman correlations were used to examine changes in metabolic syndrome associated with training primary and secondary outcome variables. Results: We observed a significant decrease in metabolic syndrome scores (P for trend = 0.003) for AER (-0.59, 95% CI = -1.00 to -0.21) and AER + RES (-0.79, 95% CI = -1.40 to -0.35), both being significant (P <= 0.02) versus control (0.26, 95% CI = -0.58 to 0.40) and RES (-0.13, 95% CI = -1.00 to 0.24). This led to a reduction in metabolic syndrome prevalence for the AER (56% vs 43%) and AER + RES (55% vs 46%) groups between baseline and follow-up. The observed decrease in metabolic syndrome was mediated by significant improvements in exercise efficiency for the AER and AER + RES training groups (P < 0.05), which was more strongly related to TTE (25%–30%;r = -0.38, 95% CI = -0.55 to -0.19) than V·O2peak (5%–6%; r = -0.24, 95% CI = -0.45 to -0.01). Conclusions: AER and AER + RES training significantly improved metabolic syndrome scores and prevalence in patients with T2D. These improvements appear to be associated with improved exercise efficiency and are more strongly related to improved TTE versus V·O2peak.

AB - Concomitant type 2 diabetes (T2D) and metabolic syndrome exacerbates mortality risk; yet, few studies have examined the effect of combining (AER+RES) aerobic (AER) and resistance (RES) training for individuals with T2D and metabolic syndrome. Methods: We examined AER, RES, and AER + RES training (9 months) commensurate with physical activity guidelines in individuals with T2D (n = 262; 63% female, 44% black). Primary outcomes were change in, and prevalence of, metabolic syndrome score at follow-up (mean and 95% confidence interval [CI]). Secondary outcomes included maximal cardiorespiratory fitness (V·O2peak) and estimated METs from time-to-exhaustion (TTE) and exercise efficiency calculated as the slope of the line between ventilatory threshold, respiratory compensation, and maximal fitness. General linear models and bootstrapped Spearman correlations were used to examine changes in metabolic syndrome associated with training primary and secondary outcome variables. Results: We observed a significant decrease in metabolic syndrome scores (P for trend = 0.003) for AER (-0.59, 95% CI = -1.00 to -0.21) and AER + RES (-0.79, 95% CI = -1.40 to -0.35), both being significant (P <= 0.02) versus control (0.26, 95% CI = -0.58 to 0.40) and RES (-0.13, 95% CI = -1.00 to 0.24). This led to a reduction in metabolic syndrome prevalence for the AER (56% vs 43%) and AER + RES (55% vs 46%) groups between baseline and follow-up. The observed decrease in metabolic syndrome was mediated by significant improvements in exercise efficiency for the AER and AER + RES training groups (P < 0.05), which was more strongly related to TTE (25%–30%;r = -0.38, 95% CI = -0.55 to -0.19) than V·O2peak (5%–6%; r = -0.24, 95% CI = -0.45 to -0.01). Conclusions: AER and AER + RES training significantly improved metabolic syndrome scores and prevalence in patients with T2D. These improvements appear to be associated with improved exercise efficiency and are more strongly related to improved TTE versus V·O2peak.

UR - http://dx.doi.org/10.1249/MSS.0000000000000242

U2 - 10.1249/MSS.0000000000000242

DO - 10.1249/MSS.0000000000000242

M3 - Article

VL - 46

SP - 1293

EP - 1301

JO - Medicine & Science in Sports & Exercise

JF - Medicine & Science in Sports & Exercise

SN - 0195-9131

IS - 7

ER -