J Korean Diabetes.  2011 Mar;12(1):6-12. 10.4093/jkd.2011.12.1.6.

The Effects of Aerobic/Resistance Exercise on Body Fat Mass, Muscle Strength and Endothelial Function in Korean Type 2 Diabetes mellitus Patients

• Min KW

• KMID: 1851895
• DOI: http://doi.org/10.4093/jkd.2011.12.1.6

Abstract

Regular exercise has been shown to reduce cardiovascular risk factors. Korean type 2 diabetic patients showed a reduced aerobic exercising capacity (VO2max 5.2 +/- 1.3 MET, VT 3.5 +/- 0.9 MET) when compared to normal subjects matched to anthropometric conditions. A typical activity of moderate intensity is "brisk" walking at 5.6 km/h on a flat surface requiring 3.8 MET. Thus, the duration of aerobic exercise training is more important than intensity in Korean type 2 diabetic patients. During 12 weeks of exercise intervention, aerobic exercise improved cardiopulmonary function and endothelial function in Korean type 2 diabetic patients. However, muscle strength was not changed significantly by aerobic exercise. The maximal muscle strength of Korean type 2 diabetes mellitus patients was decreased compared to normal subjects with similar body weight. The maximal muscle strength was decreased with age, especially more in the lower extremities than the upper extremities. Generally, increased muscle mass was correlated with body mass index, however, muscle mass in obese type 2 diabetic women was not increased proportion with weight gain. Therefore, combined exercise is recommended to obese Korean type 2 diabetic women. Low intensity resistance training using resistance bands was effective in increasing muscle mass and muscle strength and reducing abdominal fat mass in diabetic women. However, endothelial function was not changed significantly by resistance exercise.

Keyword

Aerobic exercise; Resistance; Type 2 diabetes mellitus

MeSH Terms

Abdominal Fat
Adipose Tissue
Body Mass Index
Body Weight
Diabetes Mellitus, Type 2
Exercise
Female
Humans
Lower Extremity
Muscle Strength
Muscles
Resistance Training
Risk Factors
Upper Extremity
Walking
Weight Gain

Figure

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  Fig. 1. Correlation between muscle mass and BMI for (A) men and (B) women; BMI, body mass index (Adapted from Kwon et al. Korean Diabetes J 2009;33:511-7 [23]).

Reference

1. Kemi OJ, Haram PM, Loennechen JP, Osnes JB, Skomedal T, Wisl⊘ff U, Ellingsen O. Moderate vs. high exercise intensity: differential effects on aerobic fitness, cardiomyocyte contractility, and endothelial function. Cardiovasc Res. 2005; 67:161–72.

2. Nagano M, Sasaki H, Kumagai S. Cardiorespiratory fitness and visceral fat impact the relationship between psychological fitness and metabolic syndrome in Japanese males with type 2 diabetes mellitus. Metab Syndr Relat Disord. 2004; 2:172–9.

3. Arsenault BJ, Lachance D, Lemieux I, Almeras N, Tremblay A, Bouchard C, Perusse L, Despres JP. Visceral adipose tissue accumulation, cardiorespiratory fitness, and features of the metabolic syndrome. Arch Intern Med. 2007; 167:1518–25.

4. Chen CN, Chuang LM, Wu YT. Clinical measures of physical fitness predict insulin resistance in people at risk for diabetes. Phys Ther. 2008; 88:1355–64.

05. Bertoli A, Di Daniele N, Ceccobelli M, Ficara A, Girasoli C, De Lorenzo A. Lipid profile, BMI, body fat distribution, and aerobic fitness in men with metabolic syndrome. Acta Diabetol. 2003; 40(Suppl 1):S130–3.

6. Wessel TR, Arant CB, Olson MB, Johnson BD, Reis SE, Sharaf BL, Shaw LJ, Handberg E, Sopko G, Kelsey SF, Pepine CJ, Merz NB. Relationship of physical fitness vs body mass index with coronary artery disease and cardiovascular events in women. JAMA. 2004; 292:1179–87.

7. Sigal RJ, Kenny GP, Wasserman DH, Castaneda-Sceppa C, White RD. Physical activity/exercise and type 2 diabetes: a consensus statement from the American Diabetes Association. Diabetes Care. 2006; 29:1433–8.

8. Weber KT, Janicki JS. Cardiopulmonary exercise testing for evaluation of chronic cardiac failure. Am J Cardiol. 1985; 55:22A–31A.

9. KKawaji K, Fujita Y, Yajima Y, Shirataka M, Kubo H. Usefulness of anaerobic threshold in estimating intensity of exercise for diabetics. Diabetes Res Clin Pract. 1989; 6:303–9.

10. Schneider SH, Khachadurian AK, Amorosa LF, Clemow L, Ruderman NB. Ten-year experience with an exercise-based outpatient lifestyle modification program in the treatment of diabetes mellitus. Diabetes Care. 1992; 15:1800–10.

11. An KH, Han KA, Min KW. Evaluation of physical capacity and proper calculation method of exercise intensity based on measured maximal heart rate in Korean type 2 diabetics. J Korean Diabetes Assoc. 2005; 29:479–85.

12. Pate RR, Pratt M, Blair SN, Haskell WL, Macera CA, Bouchard C, Buchner D, Ettinger W, Heath GW, King AC, et al. Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA. 1995; 273:402–7.

13. Kumahara H, Schutz Y, Ayabe M, Yoshioka M, Yoshitake Y, Shindo M, Ishii K, Tanaka H. The use of uniaxial accelerometry for the assessment of physical-activity-related energy expenditure: a validation study against whole-body indirect calorimetry. Br J Nutr. 2004; 91:235–43.

14. Kwon HR, Min KW, Ahn HJ, Seok HG, Koo BK, Kim HC, Han KA. Effects of aerobic exercise on abdominal fat, thigh muscle mass and muscle strength in type 2 diabetic subject. Korean Diabetes J. 2010; 34:23–31.

15. Sigal RJ, Kenny GP, Wasserman DH, Castaneda-Sceppa C. Physical activity/exercise and type 2 diabetes. Diabetes Care. 2004; 27:2518–39.

16. KShin HK, Lee SH, Tae KS. The correlation between 1RM and MVC for estimating strength. J Korea Sport Res. 2003; 14:409–14.

17. KAmerican College of Sports Medicine. ACSM's guidelines for exercise testing and prescription. 7th ed.Philadelphia: Lippincott Willams & Wilkins;2006.

18. KBassey EJ, Harries UJ. Normal values for handgrip strength in 920 men and women aged over 65 years, and longitudinal changes over 4 years in 620 survivors. Clin Sci (Lond). 1993; 84:331–7.

19. American College of Sports Medicine. ACSM's guidelines for exercise testing and prescription. 6th ed.Philadelphia: Lippincott Williams & Wilkins;2000.

20. Frontera WR, Hughes VA, Lutz KJ, Evans WJ. A cross-sectional study of muscle strength and mass in 45- to 78-yr-old men and women. J Appl Physiol. 1991; 71:644–50.

21. Kwon HR, Ku YH, Ahn HJ, Jeong JY, Ryu SR, Koo BK, Han KA, Min KW. Maximal muscle strength deteriorates with age in subjects with type 2 diabetes mellitus. Korean Diabetes J. 2009; 33:412–20.

22. Kwon YC, Park JH, Yun MS, Park SK. The effects of muscular resistance training on abdominal fat and insulin concentration in obese middle-aged women. J Sport Leis Stud. 2002; 17:127–36.

23. Kwon HR, Han KA, Ku YH, Ahn HJ, Koo BK, Min KW. Relationship of maximal muscle strength with body mass index and aerobics capacity in type 2 diabetic patients. Korean Diabetes J. 2009; 33:511–7.

24. Fleck SJ, Kraemer WJ. Designing resistance training programs. 2nd ed.Champaign: Human Kinetics;1997.

25. Baechle TR, Earle RW. Essentials of strength training and conditioning. 2nd ed.Champaign: Human Kinetics;2000.

26. Kwon HR, Han KA, Ku YH, Ahn HJ, Koo BK, Kim HC, Min KW. The effects of resistance training on muscle and body fat mass and muscle strength in type 2 diabetic women. Korean Diabetes J. 2010; 34:101–10.

27. Dean CM, Richards CL, Malouin F. Task-related circuit training improves performance of locomotor tasks in chronic stroke: a randomized, controlled pilot trial. Arch Phys Med Rehabil. 2000; 81:409–17.

28. An KH, Min KW, Han KA. The effects of aerobic training versus resistance training in non-obese type 2 diabetics. J Korean Diabetes Assoc. 2005; 29:486–94.

29. Perticone F, Ceravolo R, Pujia A, Ventura G, Iacopino S, Scozzafava A, Ferraro A, Chello M, Mastroroberto P, Verdecchia P, Schillaci G. Prognostic significance of endothelial dysfunction in hypertensive patients. Circulation. 2001; 104:191–6.

30. Caballero AE. Endothelial dysfunction in obesity and insulin resistance: a road to diabetes and heart disease. Obes Res. 2003; 11:1278–89.

31. Zoppini G, Targher G, Zamboni C, Venturi C, Cacciatori V, Moghetti P, Muggeo M. Effects of moderate-intensity exercise training on plasma biomarkers of inflammation and endothelial dysfunction in older patients with type 2 diabetes. Nutr Metab Cardiovasc Dis. 2006; 16:543–9.

32. Hamdy O, Ledbury S, Mullooly C, Jarema C, Porter S, Ovalle K, Moussa A, Caselli A, Caballero AE, Economides PA, Veves A, Horton ES. Lifestyle modification improves endothelial function in obese subjects with the insulin resistance syndrome. Diabetes Care. 2003; 26:2119–25.

33. Kwon HR, Min KW, Ahn HJ, Seok HG, Lee JH, Park GS, Han KA. Effect of aerobic exercise vs resistanc training on endothelial function in type 2 diabetic women subjects. Diabetes Metab J. Forthcoming. 2011.

34. Cohen ND, Dunstan DW, Robinson C, Vulikh E, Zimmet PZ, Shaw JE. Improved endothelial function following a 14-month resistance exercise training program in adults with type 2 diabetes. Diabetes Res Clin Pract. 2008; 79:405–11.