Anti-inflammatory effect of exercise training in subjects with type 2 diabetes and the metabolic syndrome is dependent on exercise modalities and independent of weight loss

Balducci, S.; Zanuso, S.; Nicolucci, A.; Fernando, F.; Cavallo, S.; Cardelli, P.; Fallucca, S.; Alessi, E.; Letizia, C.; Jimenez, A.; Fallucca, F.; Pugliese, G.

doi:10.1016/j.numecd.2009.04.015

Cited by 566Adipokines, Inflammation, and Metabolic DiseasesExercise and Physiological ResponsesPhysical Activity and Health

Anti-inflammatory effect of exercise training in subjects with type 2 diabetes and the metabolic syndrome is dependent on exercise modalities and independent of weight loss

Balducci, S., Zanuso, S., Nicolucci, A., Fernando, F., Cavallo, S., Cardelli, P., Fallucca, S., Alessi, E. +4 more·2010·Nutrition, Metabolism and Cardiovascular Diseases

DOI 10.1016/j.numecd.2009.04.015

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Abstract

Background and aims We investigated the effect of different exercise modalities on high sensitivity-C reactive protein (hs-CRP) and other inflammatory markers in patients with type 2 diabetes and the metabolic syndrome.Methods and results Eighty-two patients were randomized into 4 groups: sedentary control (A); receiving counseling to perform low-intensity physical activity (B); performing prescribed and supervised high-intensity aerobic (C) or aerobic+resistance (D) exercise (with the same caloric expenditure) for 12 months. Evaluation of leisure-time physical activity and assessment of physical fitness, cardiovascular risk factors and inflammatory biomarkers was performed at baseline and every 3 months. Volume of physical activity increased and HbA(1c) decreased in Groups B-D. VO(2max), HOMA-IR index, HDL-cholesterol, waist circumference and albuminuria improved in Groups C and D, whereas strength and flexibility improved only in Group D. Levels of hs-CRP decreased in all three exercising groups, but the reduction was significant only in Groups C and D, and particularly in Group D. Changes in VO(2max) and the exercise modalities were strong predictors of hs-CRP reduction, independent of body weight. Leptin, resistin and interleukin-6 decreased, whereas adiponectin increased in Groups C and D. Interleukin-1β, tumor necrosis factor-α and interferon-γ decreased, whereas anti-inflammatory interleukin-4 and 10 increased only in Group D.Conclusion Physical exercise in type 2 diabetic patients with the metabolic syndrome is associated with a significant reduction of hs-CRP and other inflammatory and insulin resistance biomarkers, independent of weight loss. Long-term high-intensity (preferably mixed) training, in addition to daytime physical activity, is required to obtain a significant anti-inflammatory effect.

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Metabolic issues associated with low healthy behaviors are reversed with exposure to physical activity (e.g., exercise).
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Authors: Balducci, S., Zanuso, S., Nicolucci, A., Fernando, F., Cavallo, S., Cardelli, P., Fallucca, S., Alessi, E., Letizia, C., Jimenez, A., Fallucca, F., & Pugliese, G.
Affiliations: Azienda Ospedaliera Sant'Andrea (IT)
University of Padua (IT)
Mario Negri Sud Foundation (IT)
Policlinico Umberto I (IT)
Corresponding author: Balducci, S.
ORCID: Balducci, S.
Zanuso, S.
Nicolucci, A.
Cardelli, P.
Letizia, C.
Pugliese, G.
Venue: Nutrition, Metabolism and Cardiovascular Diseases
Publisher: Elsevier BV
Published: 2010-10
Volume: 20
Issue: 8
Pages: 608-617
ISSN: 0939-4753 (ISSN-L)
DOI: 10.1016/j.numecd.2009.04.015
OpenAlex: W1972980481
Cited by: 566
References: 33
Citations by year: 2026: 11 · 2025: 21 · 2024: 27 · 2023: 31 · 2022: 48 · 2021: 28 · 2020: 38 · 2019: 33 · 2018: 38 · 2017: 40 · 2016: 39 · 2015: 39 · 2014: 42 · 2013: 42 · 2012: 48
FWCI: 19.47
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Nutrition Metabolism and Cardiovascular Diseases (publishedVersion)
PubMed (publishedVersion)
ABACUS. Repositorio de Producción Científica (Universidad Europea) (submittedVersion)
Greenwich Academic Literature Archive (University of Greenwich) (submittedVersion)
IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
Funders: American Heart Association
Topics: Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
Health Sciences › Medicine › Rehabilitation › Exercise and Physiological Responses
Health Sciences › Medicine › Physiology › Physical Activity and Health
Keywords: type 2 diabetes, metabolic syndrome, exercise training, high-intensity aerobic exercise, resistance training, high-sensitivity C-reactive protein, inflammation, insulin resistance, HOMA-IR, adipokines, interleukin-6, leptin, resistin, adiponectin, VO2max, weight loss, physical activity
MeSH terms: Adult, Aged, C-Reactive Protein, Diabetes Mellitus, Type 2, Female, Humans, Inflammation, Cholesterol, HDL, Cholesterol, LDL, Male, Middle Aged, Tumor Necrosis Factor-alpha, Weight Loss, Exercise, Interleukin-6, Metabolic Syndrome

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Anti-inflammatory effect of exercise training in subjects with type 2 diabetes and the metabolic syndrome is dependent on exercise modalities and independent of weight loss

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