Influences of Hypoxia Exercise on Whole-Body Insulin Sensitivity and Oxidative Metabolism in Older Individuals
Open accessAbstract
Context: Aging is a primary risk factor for most chronic diseases, including type 2 diabetes. Both exercise and hypoxia regulate pathways that ameliorate age-associated metabolic muscle dysfunction. Objective: We hypothesized that the combination of hypoxia and exercise would be more effective in improving glucose metabolism than normoxia exercise. Design and Participants: We randomized 29 older sedentary individuals (62 ± 6 years; 14 women, 15 men) to bicycle exercise under normobaric hypoxia (fraction of inspired oxygen = 15%) or normoxia (fraction of inspired oxygen = 21%). Intervention: Participants trained thrice weekly for 30 to 40 minutes over 8 weeks at a heart rate corresponding to 60% to 70% of peak oxygen update. Main Outcome Measures: Insulin sensitivity measured by hyperinsulinemic-euglycemic glucose clamp and muscle protein expression before and after hyperinsulinemic-euglycemic glucose clamp. Results: Heart rate and perceived exertion during training were similar between groups, with lower oxygen saturation when exercising under hypoxia (88.7 ± 1.5 vs 96.2 ± 1.2%, P < 0.01). Glucose infusion rate after 8 weeks increased in both the hypoxia (5.7 ± 1.1 to 6.7 ± 1.3 mg/min/kg; P < 0.01) and the normoxia group (6.2 ± 2.1 to 6.8 ± 2.1 mg/min/kg; P = 0.04), with a mean difference between groups of –0.44 mg/min/kg; 95% CI, –1.22 to 0.34; (P = 0.25). Markers of mitochondrial content and oxidative capacity in skeletal muscle were similar after training in both groups. Changes in Akt phosphorylation and glucose transporter 4 under fasting and insulin-stimulated conditions were not different between groups over time. Conclusions: Eight weeks of hypoxia endurance training led to similar changes in insulin sensitivity and markers of oxidative metabolism compared with normoxia training. Normobaric hypoxia exercise did not enhance metabolic effects in sedentary older women and men beyond exercise alone.
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There is emerging evidence that exercise increases mitochondrial biogenesis (PRT), oxidative metabolism (cycling-aerobic exercise), cellular senescence, and muscle oxidative capacity.
“However, there is emerging evidence that exercise increases mitochondrial biogenesis (PRT) [654], oxidative metabolism (cycling-aerobic exercise [655]), cellular senescence [72,73], and muscle oxidative capacity [656] (as measured by phosphocreatine recovery rate constant (kPCr) using 31 P Magnetic Resonance Spectroscopy).”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [655]
Exercise increases mitochondrial biogenesis (PRT), oxidative metabolism (cycling-aerobic exercise), cellular senescence, and muscle oxidative capacity.
“However, there is emerging evidence that exercise increases mitochondrial biogenesis (PRT) [654], oxidative metabolism (cycling-aerobic exercise [655]), cellular senescence [72,73], and muscle oxidative capacity [656] (as measured by phosphocreatine recovery rate constant (kPCr) using 31 P Magnetic Resonance Spectroscopy).”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [655]
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- Authors
- Chobanyan-Jürgens, K., Scheibe, R. J., Potthast, A. B., Hein, M., Smith, A., Freund, R., Tegtbur, U., Das, A. M., Engeli, S., Jordan, J., & Haufe, S.
- Affiliations
- University Hospital Heidelberg (DE)
- Medizinische Hochschule Hannover (DE)
- Deutsches Zentrum für Luft- und Raumfahrt e. V. (DLR) (DE)
- Corresponding author
- Haufe, Sven
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2019-04-03
- Volume
- 104
- Issue
- 11
- Pages
- 5238-5248
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2926292755
- Cited by
- 24
- References
- 44
- Citations by year
- 2026: 1 · 2025: 7 · 2024: 4 · 2023: 1 · 2022: 3 · 2021: 5 · 2020: 2 · 2019: 1
- FWCI
- 1.65
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- elib (German Aerospace Center) (acceptedVersion)
- Funders
- German Research Foundation (HA 7037/2-1)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › High Altitude and Hypoxia
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Rehabilitation › Exercise and Physiological Responses
- Keywords
- hypoxic exercise, normobaric hypoxia, insulin sensitivity, oxidative metabolism, skeletal muscle, older adults, endurance training, glucose metabolism, Akt phosphorylation, glucose transporter 4, mitochondrial content, type 2 diabetes risk, sedentary aging
- MeSH terms
- Aged, Hypoxia, Blood Glucose, Electron Transport, Female, Heart Rate, Humans, Insulin Resistance, Male, Middle Aged, Muscle Proteins, Prospective Studies, Glucose Clamp Technique, Exercise, Muscle, Skeletal
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