The differential anti‐inflammatory effects of exercise modalities and their association with early carotid atherosclerosis progression in patients with Type 2 diabetes
Abstract
Objective: Adipokines, visfatin, apelin, vaspin and ghrelin have emerged as novel cardiovascular risk factors. We aimed to evaluate the effects of different exercise modalities on the aforementioned novel adipokines and carotid intima‐media thickness in patients with Type 2 diabetes mellitus. Methods: One hundred patients with Type 2 diabetes were equivalently (n = 25) randomized into four groups: (1) a control group with patients encouraged to perform self‐controlled exercise; (2) a supervised aerobic exercise group (exercise four times/week, 60 min/session, 60–75% of maximum heart rate); (3) a resistance training group (60–80% baseline maximum load achieved in one repetition); and (4) a combined aerobic exercise plus resistance training group, as in groups 2 and 3. All participants had HbA 1c levels ≥ 48 mmol/mol (≥ 6.5%), without overt diabetic vascular complications. Blood samples, clinical characteristics, peak oxygen uptake and carotid intima‐media thickness measurements were obtained at baseline and at the end of the study, after 6 months. Results: At baseline, there were non‐significant differences between groups. All active groups significantly ameliorated glycaemic profile, insulin sensitivity and triglycerides levels compared with the control group (P < 0.05). Aerobic training further improved lipids, systolic blood pressure and exercise capacity compared with the resistance training and the control groups (P < 0.05). Moreover, high‐sensitivity C‐reactive protein and visfatin decreased, while vaspin and apelin circulating levels increased within the aerobic exercise group and the aerobic exercise plus resistance training group, and compared with the other groups (P < 0.05). Within‐ and between‐group comparisons showed negligible alterations in ghrelin serum levels and body weight after all exercise modalities. Finally, aerobic training attenuated the carotid intima‐media thickness progression (0.017 ± 0.006 mm) compared with the control subjects (0.129 ± 0.042 mm, P < 0.001). That effect was independently associated with visfatin and amelioration of peak oxygen uptake. Conclusions: In subjects with Type 2 diabetes, all exercise training modalities improved metabolic profile. Importantly, aerobic training predominantly ameliorated adipokines concentrations and carotid intima‐media thickness progression.
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Physical activity stimulates myokines to release anti-inflammatory markers that reduce inflammatory signals from adipokines, visfatin, and apelin.
“PA stimulates muscle enzymes (myokines) to release additional anti-inflammatory markers that in turn reduce inflammatory signals from adipokines, visfatin, and apelin.”
From The Impact of Physical Activity in Patients With Type 2 Diabetes (2025) · cites this paper as [20]
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- Authors
- Kadoglou, N. P. E., Fotiadis, G., Kapelouzou, A., Kostakis, A., Liapis, C. D., & Vrabas, I. S.
- Affiliations
- Aristotle University of Thessaloniki (GR)
- Ippokrateio General Hospital of Thessaloniki (GR)
- Academy of Athens (GR)
- National and Kapodistrian University of Athens (GR)
- Corresponding author
- Kadoglou, N. P. E.
- Venue
- Diabetic Medicine
- Publisher
- Wiley
- Published
- 2013-01-21
- Volume
- 30
- Issue
- 2
- Pages
- e41-50
- ISSN
- 0742-3071 (ISSN-L)
- 1464-5491
- OpenAlex
- W2076475060
- Cited by
- 142
- References
- 30
- Citations by year
- 2026: 1 · 2025: 18 · 2024: 10 · 2023: 20 · 2022: 13 · 2021: 7 · 2020: 7 · 2019: 12 · 2018: 8 · 2017: 9 · 2016: 8 · 2015: 12 · 2014: 9 · 2013: 7
- FWCI
- 6.70
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetic Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Keywords
- type 2 diabetes, aerobic exercise, resistance training, concurrent training, adipokines, visfatin, apelin, vaspin, ghrelin, C-reactive protein, carotid intima-media thickness, peak oxygen uptake, insulin sensitivity, glycemic control, cardiovascular risk factors, anti-inflammatory activity
- MeSH terms
- Apelin, Analysis of Variance, Anti-Inflammatory Agents, Blood Glucose, Carotid Artery Diseases, Diabetes Mellitus, Type 2, Diabetic Angiopathies, Fasting, Female, Glycated Hemoglobin, Humans, Insulin Resistance, Male, Middle Aged, Risk Factors, Exercise, Serpins, Disease Progression, Intercellular Signaling Peptides and Proteins, Adipokines, Nicotinamide Phosphoribosyltransferase, Ghrelin, Resistance Training, Carotid Intima-Media Thickness
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