Determinants of the changes in glycemic control with exercise training in type 2 diabetes: A randomized trial

Neil M Johannsen, Lauren M. Sparks, Zhengyu Zhang, Conrad Earnest, Steven R. Smith, Timothy S. Church, Eric Ravussin

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AIMS: To assess the determinants of exercise training-induced improvements in glucose control (HbA1C) including changes in serum total adiponectin and FFA concentrations, and skeletal muscle peroxisome proliferator-activated receptor-gamma coactivator-1alpha (PGC-1alpha) protein content.

METHODS: A sub-cohort (n = 35; 48% men; 74% Caucasian) from the HART-D study undertaking muscle biopsies before and after 9 months of aerobic (AT), resistance (RT), or combination training (ATRT).

RESULTS: Changes in HbA1C were associated with changes in adiponectin (r = -0.45, P = 0.007). Participants diagnosed with type 2 diabetes for a longer duration had the largest increase in PGC-1alpha (r = 0.44, P = 0.008). Statistical modeling examining changes in HbA1C suggested that male sex (P = 0.05), non-Caucasian ethnicity (P = 0.02), duration of type 2 diabetes (r = 0.40; P<0.002) and changes in FFA (r = 0.36; P<0.004), adiponectin (r = -0.26; P<0.03), and PGC-1alpha (r = -0.28; P = 0.02) explain approximately 65% of the variability in the changes in HbA1C.

CONCLUSIONS: Decreases in HbA1C after 9 months of exercise were associated with shorter duration of diabetes, lowering of serum FFA concentrations, increasing serum adiponectin concentrations and increasing skeletal muscle PGC-1alpha protein expression.

Original languageEnglish
Article numbere62973
JournalPLoS ONE
Issue number6
Publication statusPublished - 21 Jun 2013


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