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Moghaddaszadeh A, Roudier E, Edgell H, Vinet A, Belcastro AN. A 5-Week Guided Active Play Program Modulates Skin Microvascular Reactivity in Healthy Children. Pediatr Exerc Sci 2025; 37:128-137. [PMID: 38684217 DOI: 10.1123/pes.2023-0138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 01/28/2024] [Accepted: 02/12/2024] [Indexed: 05/02/2024]
Abstract
PURPOSE Children's poor levels of physical activity (PA) participation and early-onset vascular aging are identified as global health challenges. Children's guided activity play (GAP)-based PA programs have emerged as effective strategies to improve cardiovascular risk factors and health-related fitness. This study proposes to investigate whether GAP improves children's cutaneous microvascular reactivity and health-related fitness. METHODS Children's (n = 18; 9.8 [1.5] y) PA during a 5-week (4 d/wk; 1 h/d) GAP program was assessed (accelerometry) with preassessments and postassessments for anthropometric, musculoskeletal fitness, blood pressure, estimated aerobic power, and cutaneous microvascular reactivity. RESULTS PA averaged 556 (132) kcal·week-1 at 34.7% (7.5%) time at moderate to vigorous intensity. Resting heart rate (-9.5%) and diastolic blood pressure (-7.8%) were reduced without changes in health-related fitness indices. Cutaneous microvascular reactivity to sodium nitroprusside iontophoresis increased the average perfusion (+36.8%), average cutaneous vascular conductance (+30%), the area under the curve (+28.8%), and a faster rise phase (+40%) of perfusion (quadratic modeling; P ≤ .05). Chi-square and crosstabulation analysis revealed significant association between children's PA levels and sodium nitroprusside average perfusion levels, where children with PA levels ≥205.1 kcal.55 minute-1 were overrepresented in the medium/high levels of sodium nitroprusside perfusion. CONCLUSION A 5-week GAP modified the microvascular reactivity in children without changes in body mass, musculoskeletal fitness, or estimated aerobic power.
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Affiliation(s)
- Asal Moghaddaszadeh
- Pediatric Exercise Physiology Laboratory, Faculty of Health, York University, Toronto, ON,Canada
| | - Emilie Roudier
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, ON,Canada
- Muscle Health Research Center, York University, Toronto, ON,Canada
| | - Heather Edgell
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, ON,Canada
- Muscle Health Research Center, York University, Toronto, ON,Canada
| | - Agnes Vinet
- Laboratoire de Physiologie Expérimentale Cardiovasculaire, Faculté des Sciences, Avignon Université, Avignon,France
| | - Angelo N Belcastro
- Pediatric Exercise Physiology Laboratory, Faculty of Health, York University, Toronto, ON,Canada
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, ON,Canada
- Muscle Health Research Center, York University, Toronto, ON,Canada
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Talbot JS, Perkins DR, Dawkins TG, Lord RN, Oliver JL, Lloyd RS, McManus AM, Stembridge M, Pugh CJA. Flow-mediated dilation is modified by exercise training status during childhood and adolescence: preliminary evidence of the youth athlete's artery. Am J Physiol Heart Circ Physiol 2024; 327:H331-H339. [PMID: 38847760 DOI: 10.1152/ajpheart.00287.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 06/04/2024] [Accepted: 06/04/2024] [Indexed: 07/17/2024]
Abstract
Chronic exercise training is associated with an "athlete's artery" phenotype in young adults and an attenuated age-related decline in endothelium-dependent arterial function. Adolescence is associated with an influx of sex-specific hormones that may exert divergent effects on endothelial function, but whether training adaptations interact with biological maturation to produce a "youth athlete's artery" has not been explored. We investigated the influence of exercise-training status on endothelium-dependent arterial function during childhood and adolescence. Brachial artery flow-mediated dilation (FMD) was assessed in n = 102 exercise-trained (males, n = 25; females, n = 29) and untrained (males, n = 23; females, n = 25) youths, characterized as pre (males, n = 25; females, n = 26)- or post (males, n = 23; females, n = 28)-predicted age at peak height velocity (PHV). Baseline brachial artery diameter was larger in post- compared with pre-PHV youths (P ≤ 0.001), males compared with females (P ≤ 0.001), and trained compared with untrained youths (3.26 ± 0.51 vs. 3.11 ± 0.42 mm; P = 0.041). Brachial FMD was similar in pre- and post-PHV youths (P = 0.298), and males and females (P = 0.946). However, exercise-trained youths demonstrated higher FMD when compared with untrained counterparts (5.3 ± 3.3 vs. 3.0 ± 2.6%; P ≤ 0.001). Furthermore, brachial artery diameter (r2 = 0.142; P = 0.007 vs. r2 = 0.004; P = 0.652) and FMD (r2 = 0.138; P = 0.008 vs. r2 = 0.003; P = 0.706) were positively associated with cardiorespiratory fitness in post-, but not pre-PHV youths, respectively. Collectively, our data indicate that exercise training is associated with brachial artery remodeling and enhanced endothelial function during youth. However, arterial remodeling and endothelium-dependent function are only associated with elevated cardiorespiratory fitness during later stages of adolescence.NEW & NOTEWORTHY We report preliminary evidence of the "youth athlete's artery," characterized by training-related arterial remodeling and elevated endothelium-dependent arterial function in children and adolescents. However, training-related adaptations in brachial artery diameter and flow-mediated dilation (FMD) were associated with cardiorespiratory fitness in adolescents, but not in children. Our findings indicate that endothelium-dependent arterial function is modifiable with chronic exercise training during childhood, but the association between FMD and elevated cardiorespiratory fitness is only apparent during later stages of adolescence.
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Affiliation(s)
- Jack S Talbot
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
- Centre for Health, Activity and Wellbeing Research, Cardiff Metropolitan University, Cardiff, United Kingdom
- Cardiometabolic Health and Exercise Physiology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Dean R Perkins
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Tony G Dawkins
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Rachel N Lord
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
- Centre for Health, Activity and Wellbeing Research, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Jon L Oliver
- Youth Physical Development Centre, Cardiff Metropolitan University, Cardiff, United Kingdom
- Sports Performance Research Institute New Zealand, AUT University, Auckland, New Zealand
| | - Rhodri S Lloyd
- Youth Physical Development Centre, Cardiff Metropolitan University, Cardiff, United Kingdom
- Sports Performance Research Institute New Zealand, AUT University, Auckland, New Zealand
- Centre for Sport Science and Human Performance, Waikato Institute of Technology, Waikato, New Zealand
| | - Ali M McManus
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Mike Stembridge
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
- Youth Physical Development Centre, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Christopher J A Pugh
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
- Centre for Health, Activity and Wellbeing Research, Cardiff Metropolitan University, Cardiff, United Kingdom
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Annicchiarico A, Barile B, Buccoliero C, Nicchia GP, Brunetti G. Alternative therapeutic strategies in diabetes management. World J Diabetes 2024; 15:1142-1161. [PMID: 38983831 PMCID: PMC11229975 DOI: 10.4239/wjd.v15.i6.1142] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 02/17/2024] [Accepted: 04/12/2024] [Indexed: 06/11/2024] Open
Abstract
Diabetes is a heterogeneous metabolic disease characterized by elevated blood glucose levels resulting from the destruction or malfunction of pancreatic β cells, insulin resistance in peripheral tissues, or both, and results in a non-sufficient production of insulin. To adjust blood glucose levels, diabetic patients need exogenous insulin administration together with medical nutrition therapy and physical activity. With the aim of improving insulin availability in diabetic patients as well as ameliorating diabetes comorbidities, different strategies have been investigated. The first approaches included enhancing endogenous β cell activity or transplanting new islets. The protocol for this kind of intervention has recently been optimized, leading to standardized procedures. It is indicated for diabetic patients with severe hypoglycemia, complicated by impaired hypoglycemia awareness or exacerbated glycemic lability. Transplantation has been associated with improvement in all comorbidities associated with diabetes, quality of life, and survival. However, different trials are ongoing to further improve the beneficial effects of transplantation. Furthermore, to overcome some limitations associated with the availability of islets/pancreas, alternative therapeutic strategies are under evaluation, such as the use of mesenchymal stem cells (MSCs) or induced pluripotent stem cells for transplantation. The cotransplantation of MSCs with islets has been successful, thus providing protection against proinflammatory cytokines and hypoxia through different mechanisms, including exosome release. The use of induced pluripotent stem cells is recent and requires further investigation. The advantages of MSC implantation have also included the improvement of diabetes-related comorbidities, such as wound healing. Despite the number of advantages of the direct injection of MSCs, new strategies involving biomaterials and scaffolds have been developed to improve the efficacy of mesenchymal cell delivery with promising results. In conclusion, this paper offered an overview of new alternative strategies for diabetes management while highlighting some limitations that will need to be overcome by future approaches.
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Affiliation(s)
- Alessia Annicchiarico
- Department of Biosciences, Biotechnologies and Environment, University of Bari Aldo Moro, Bari 70125, Italy
| | - Barbara Barile
- Department of Biosciences, Biotechnologies and Environment, University of Bari Aldo Moro, Bari 70125, Italy
| | - Cinzia Buccoliero
- Department of Biosciences, Biotechnologies and Environment, University of Bari Aldo Moro, Bari 70125, Italy
| | - Grazia Paola Nicchia
- Department of Biosciences, Biotechnologies and Environment, University of Bari Aldo Moro, Bari 70125, Italy
| | - Giacomina Brunetti
- Department of Biosciences, Biotechnologies and Environment, University of Bari Aldo Moro, Bari 70125, Italy
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Seo MW, Lee S, Jung HC. Impact of supra-maximal interval training vs. high-intensity interval training on cardiac auto-regulation response in physically active adults. Eur J Appl Physiol 2024; 124:1771-1780. [PMID: 38244043 DOI: 10.1007/s00421-023-05402-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 12/12/2023] [Indexed: 01/22/2024]
Abstract
PURPOSE This study aimed to examine the impact of supra-maximal interval training (SMIT) and high-intensity interval training (HIIT) on cardiac auto-regulation response. METHODS Physically active young adults volunteered to participate in the study with a randomized cross-over counterbalanced design (N = 12). HIIT sessions consisted of 20 bouts of 10 s of exercise followed by 50 s of recovery, totaling 20 min at two different intensities; "all-out (SMIT)" vs. "115-130% Wmax (HIIT)". The cardiac auto-regulation included heart rate variability (HRV) and vascular function. HRV and vascular function were measured at baseline and five different time points after acute exercise. RESULTS The SMIT was higher in workload (31%), peak heart rate (28%), and rate of perceived exertion (40%) compared with HIIT (all p < 0.001). The R-R interval, NN50, and pNN50 measured until 60 min after acute exercise was higher in the HIIT compared with SMIT (all p < 0.05). The SMIT elicited a greater shift in ln LF/HF ratio immediately after acute exercise (3802%, p < 0.01) and induced a decrease in bilateral ba-PWV at the time point 5 min after acute exercise, persisting until 65 min after (p < 0.05). Yet, HIIT showed no change over time in the frequency domain of HRV and blood vascular tone after cessation of acute exercise. CONCLUSION Our findings confirmed that SMIT is a more potent modulator of the autonomic nervous system compared with HIIT. Further study is needed to monitor through complete recovery to baseline, to understand acute cardiac auto-regulation response after cessation of various exercise intensities identical interval training protocol.
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Affiliation(s)
- Myong-Won Seo
- Department of Sports and Leisure Studies, College of Physical Education, Keimyung University, Daegu, Republic of Korea
| | - Sukho Lee
- Department of Counseling, Health and Kinesiology, College of Education and Human Development, Texas A&M University at San Antonio, San Antonio, TX, USA
| | - Hyun Chul Jung
- Sports Science Research Center, College of Physical Education, Kyung Hee University, Yongin, Gyeonggi-do, Republic of Korea.
- Department of Sports Coaching, College of Physical Education, Kyung Hee University, Yongin, Gyeonggi-do, Republic of Korea.
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Akhtar S. Diabetes-induced peripheral neuropathy: Is prescribing physical exercise the answer? BIOMOLECULES & BIOMEDICINE 2024; 24:436-439. [PMID: 38215034 PMCID: PMC11088892 DOI: 10.17305/bb.2023.10188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 01/11/2024] [Indexed: 01/14/2024]
Abstract
Diabetes mellitus, a chronic metabolic disorder characterized by hyperglycemia, has become a global health concern with an increasing prevalence worldwide. The International Diabetes Federation (IDF) estimates that over 537 million adults currently have diabetes, and they project that this figure will likely exceed 780 million by 2045. In addition, a further 541 million adults are thought to exhibit impaired glucose tolerance/prediabetes. Among its many complications, diabetic peripheral neuropathy (DPN) affects up to 50% of sufferers, with some studies showing that its prevalence, even in prediabetes, may be as high as 77%. Read more in the PDF.
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Affiliation(s)
- Saghir Akhtar
- Division of Human Function and Therapeutics, College of Medicine, QU Health, Qatar University, Doha, Qatar
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Qiu B, Zhou Y, Tao X, Hou X, Du L, Lv Y, Yu L. The effect of exercise on flow-mediated dilation in people with type 2 diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials. Front Endocrinol (Lausanne) 2024; 15:1347399. [PMID: 38596227 PMCID: PMC11002232 DOI: 10.3389/fendo.2024.1347399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 03/11/2024] [Indexed: 04/11/2024] Open
Abstract
INTRODUCTION An increasing number of studies have investigated the effect of exercise on flow-mediated dilation (FMD) in people with type 2 diabetes mellitus (T2DM), while the findings were controversial. The primary aim of this systematic review and meta-analysis was to investigate the effect of exercise on FMD in T2DM patients, and the secondary aim was to investigate the optimal type, frequency, session duration, and weekly time of exercise for T2DM patients. METHODS Searches were conducted in PubMed, Cochrane Library, Scopus, Web of Science, Embase and EBSCO databases. The Cochrane risk of bias tool (RoB2) in randomized trial and Physiotherapy Evidence Database (PEDro) scale were used to assess the methodological quality of the included studies. RESULTS From the 3636 search records initially retrieved, 13 studies met the inclusion criteria. Our meta-analysis revealed that exercise had a significant effect on improving FMD in T2DM patients [WMD, 2.18 (95% CI, 1.78-2.58), p < 0.00001, I2 = 38%], with high-intensity interval training (HIIT) being the most effective intervention type [HIIT, 2.62 (1.42-3.82); p < 0.0001; aerobic exercise, 2.20 (1.29-3.11), p < 0.00001; resistance exercise, 1.91 (0.01-3.82), p = 0.05; multicomponent training, 1.49 (0.15-2.83), p = 0.03]. In addition, a higher frequency [> 3 times, 3.06 (1.94-4.19), p < 0.00001; ≤ 3 times, 2.02 (1.59-2.45), p < 0.00001], a shorter session duration [< 60 min, 3.39 (2.07-4.71), p < 0.00001; ≥ 60 min, 1.86 (1.32-2.40), p < 0.00001], and a shorter weekly time [≤ 180 min, 2.40 (1.63-3.17), p < 0.00001; > 180 min, 2.11 (0.82-3.40), p = 0.001] were associated with larger improvements in FMD. CONCLUSION This meta-analysis provides clinicians with evidence to recommended that T2DM patients participate in exercise, especially HIIT, more than 3 times per week for less than 60 min, with a target of 180 min per week being reached by increasing the frequency of exercise. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/prospero, identifier CRD42023466575.
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Affiliation(s)
- Bopeng Qiu
- Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing, China
| | - Yilun Zhou
- Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing, China
| | - Xifeng Tao
- Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing, China
- School of Physical Education, Xihua University, Chengdu, China
| | - Xiao Hou
- School of Sport Sciences, Beijing Sport University, Beijing, China
| | - Liwen Du
- Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing, China
| | - Yuanyuan Lv
- China Institute of Sport and Health Science, Beijing Sport University, Beijing, China
| | - Laikang Yu
- Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing, China
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Li QQ, Qin KR, Zhang W, Guan XM, Cheng M, Wang YX. Advancements in the Regulation of Different-Intensity Exercise Interventions on Arterial Endothelial Function. Rev Cardiovasc Med 2023; 24:306. [PMID: 39076455 PMCID: PMC11262454 DOI: 10.31083/j.rcm2411306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/09/2023] [Accepted: 09/12/2023] [Indexed: 07/31/2024] Open
Abstract
Normal-functioning endothelium is crucial to maintaining vascular homeostasis and inhibiting the development and progression of cardiovascular diseases such as atherosclerosis. Exercise training has been proven effective in regulating arterial endothelial function, and the effect of this regulation is closely related to exercise intensity and the status of arterial endothelial function. With this review, we investigated the effects of the exercise of different intensity on the function of arterial endothelium and the underlying molecular biological mechanisms. Existing studies indicate that low-intensity exercise improves arterial endothelial function in individuals who manifest endothelial dysfunction relative to those with normal endothelial function. Most moderate-intensity exercise promotes endothelial function in individuals with both normal and impaired arterial endothelial function. Continuous high-intensity exercise can lead to impaired endothelial function, and high-intensity interval exercise can enhance both normal and impaired endothelial function. In addition, it was demonstrated that the production of vasomotor factors, oxidative stress, and inflammatory response is involved in the regulation of arterial endothelial function under different-intensity exercise interventions. We posit that this synthesis will then provide a theoretical basis for choosing the appropriate exercise intensity and optimize the prescription of clinical exercise for persons with normal and impaired endothelium.
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Affiliation(s)
- Qian-Qian Li
- School of Rehabilitation Medicine, Weifang Medical University, 261053 Weifang, Shandong, China
- School of Health and Life Sciences, University of Health and Rehabilitation Sciences, 266071 Qingdao, Shandong, China
| | - Kai-Rong Qin
- School of Biomedical Engineering, Faculty of Medicine, Dalian University of Technology, 116024 Dalian, Liaoning, China
| | - Wen Zhang
- School of Rehabilitation Medicine, Weifang Medical University, 261053 Weifang, Shandong, China
- Department of Neurology, Nanjing Drum Tower Hospital Group Suqian Hospital, 223800 Suqian, Jiangsu, China
| | - Xiu-Mei Guan
- School of Basic Medicine Sciences, Weifang Medical University, 261053 Weifang, Shandong, China
| | - Min Cheng
- School of Basic Medicine Sciences, Weifang Medical University, 261053 Weifang, Shandong, China
| | - Yan-Xia Wang
- School of Rehabilitation Medicine, Weifang Medical University, 261053 Weifang, Shandong, China
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Chen S, Zhou K, Shang H, Du M, Wu L, Chen Y. Effects of concurrent aerobic and resistance training on vascular health in type 2 diabetes: a systematic review and meta-analysis. Front Endocrinol (Lausanne) 2023; 14:1216962. [PMID: 37780628 PMCID: PMC10534066 DOI: 10.3389/fendo.2023.1216962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 08/29/2023] [Indexed: 10/03/2023] Open
Abstract
Objective To determine the impacts of concurrent aerobic and resistance training on vascular structure (IMT) and function (PWV, FMD, NMD) in type 2 diabetes (T2D). Methods The electronic databases PubMed, Web of Science Core Collection, Cochrane Library, Embase, Scopus, CINAHL, and SPORTDiscus were systematically searched for articles on "type 2 diabetes" and "concurrent training" published from inception to August 2, 2022. We included randomized controlled trials that examined the effects of concurrent training versus passive controls on IMT, PWV, FMD and NMD in T2D. Results Ten studies were eligible, including a total of 361 participants. For IMT, concurrent training showed a slight decrease by 0.05 mm (95% CI -0.11 to 0.01, p > 0.05). concurrent training induced an overall significant improvement in FMD by 1.47% (95% CI 0.15 to 2.79, p < 0.05) and PWV by 0.66 m/s (95% CI -0.89 to -0.43, p < 0.01) in type 2 diabetics. However, concurrent training seemed to exaggerate the impaired NMD (WMD = -2.30%, 95% CI -4.02 to -0.58, p < 0.05). Conclusions Concurrent training is an effective method to improve endothelial function and artery stiffness in T2D. However, within 24 weeks concurrent training exacerbates vascular smooth muscle dysfunction. More research is needed to explore whether longer and/or higher-intensity concurrent training interventions could enhance the vascular structure and smooth muscle function in this population. Systematic review registration www.crd.york.ac.uk/PROSPERO/, identifier CRD42022350604.
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Affiliation(s)
- Shengju Chen
- School of Physical Education, Liaoning Normal University, Dalian, China
| | - Kaixiang Zhou
- Sports Health College, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Huayu Shang
- School of Sports Medicine and Health, Chengdu Sport University, Chengdu, China
| | - Mingyang Du
- College of Physical Education, Chongqing University, Chongqing, China
| | - Linfeng Wu
- College of Physical Education, Chongqing University, Chongqing, China
| | - Yu Chen
- College of Physical Education, Chongqing University, Chongqing, China
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Kranen SH, Oliveira RS, Bond B, Williams CA, Barker AR. The effect of 4 weeks of high-intensity interval training and 2 weeks of detraining on cardiovascular disease risk factors in male adolescents. Exp Physiol 2023; 108:595-606. [PMID: 36855259 PMCID: PMC10103894 DOI: 10.1113/ep090340] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 01/31/2023] [Indexed: 03/02/2023]
Abstract
NEW FINDINGS What is the central question of this study? What is the effect of 4 weeks of high-intensity interval training (HIIT) and 2 weeks of detraining on vascular function and traditional cardiovascular disease (CVD) risk factors in male adolescents? What is the main finding and its importance? Four weeks of HIIT improved macrovascular function in adolescents. However, this training period did not measurably change microvascular function, body composition or blood biomarkers. Following 2 weeks of detraining, the improvement in flow-mediated dilatation (FMD) was lost. This highlights the importance of the continuation of regular exercise for the primary prevention of CVD. ABSTRACT High-intensity interval training (HIIT) represents an effective method to improve cardiometabolic health in adolescents. This study aimed to investigate the effect of 4 weeks of HIIT followed by 2 weeks of detraining on vascular function and traditional cardiovascular disease (CVD) risk factors in adolescent boys. Nineteen male adolescents (13.3 ± 0.5 years) were randomly allocated to either a training (TRAIN, n = 10) or control (CON, n = 9) group. Participants in TRAIN completed 4 weeks of HIIT running with three sessions per week. Macro- (flow-mediated dilatation, FMD) and microvascular (peak reactive hyperaemia, PRH) function, body composition (fat mass, fat free mass, body fat percentage) and blood biomarkers (glucose, insulin, total cholesterol, high- and low-density lipoprotein, triacylglycerol) were assessed pre-, 48 h post- and 2 weeks post-training for TRAIN and at equivalent time points for CON. Following training, FMD was significantly greater in TRAIN compared to CON (9.88 ± 2.40% and 8.64 ± 2.70%, respectively; P = 0.036) but this difference was lost 2 weeks after training cessation (8.22 ± 2.47% and 8.61 ± 1.99%, respectively; P = 0.062). No differences were detected between groups for PRH (P = 0.821), body composition (all P > 0.14) or blood biomarkers (all P > 0.18). In conclusion, 4 weeks of HIIT improved macrovascular function; however, this training period did not measurably change microvascular function, body composition or blood biomarkers. The reversal of the FMD improvement 2 weeks post-training highlights the importance of the continuation of regular exercise for the primary prevention of CVD.
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Affiliation(s)
- Sascha H. Kranen
- Children's Health and Exercise Research Centre, Public Health and Sports SciencesUniversity of Exeter Medical School, Faculty of Health and Life Sciences, University of ExeterExeterUK
| | - Ricardo S. Oliveira
- Children's Health and Exercise Research Centre, Public Health and Sports SciencesUniversity of Exeter Medical School, Faculty of Health and Life Sciences, University of ExeterExeterUK
- Department of Physical EducationFederal University of Rio Grande do NorteNatalBrazil
| | - Bert Bond
- Children's Health and Exercise Research Centre, Public Health and Sports SciencesUniversity of Exeter Medical School, Faculty of Health and Life Sciences, University of ExeterExeterUK
| | - Craig A. Williams
- Children's Health and Exercise Research Centre, Public Health and Sports SciencesUniversity of Exeter Medical School, Faculty of Health and Life Sciences, University of ExeterExeterUK
| | - Alan R. Barker
- Children's Health and Exercise Research Centre, Public Health and Sports SciencesUniversity of Exeter Medical School, Faculty of Health and Life Sciences, University of ExeterExeterUK
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Hayden J, O'Donnell G, deLaunois I, O'Gorman C. Endothelial Peripheral Arterial Tonometry (Endo-PAT 2000) use in paediatric patients: a systematic review. BMJ Open 2023; 13:e062098. [PMID: 36657756 PMCID: PMC9853225 DOI: 10.1136/bmjopen-2022-062098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVES Endo Peripheral Artery Tonometry (EndoPAT-2000) is a non-invasive technology for measuring endothelial dysfunction (ED). The reactive hyperaemia index (RHI) is resulted and is low when ED is present. We aim to synthesise the literature on paediatric ED that used Endo-PAT analysis. DESIGN A comprehensive systematic review was conducted from January 2015 to March 2021. The databases included Cochrane, MEDLINE EBSCO, EMBASE (Ovid), PUBMED and CINAHL EBSCO. Exclusion criteria were: (1) If a study used a different device, for example, (2) If the study had no results. Inclusion criteria were: (1) Published in the English, (2) more than 50% of study subjects were in the paediatric age range, (3) data relevant to paediatric age range children could be extrapolated from all data, where not all study subjects were children. RESULTS Following the removal of duplicates, 156 articles were initially identified. Following exclusion, 50 articles were included for review. We have subdivided these papers into different systems for ease of reference and have reported our findings in six tables: patients with type 1/2 diabetes, obesity, cardiovascular, respiratory, psychiatric conditions and miscellaneous diseases. For each, the study design, population, control group (if available), RHI results and conclusions were reported. CONCLUSIONS A number of papers using Endo-PAT for children with various chronic diseases have evidence of ED. However, in many cases, there has only been a single cohort study using Endo-PAT. Further studies are required to validate these findings and to help characterise the cardiovascular risk profile of children with chronic disease. Further studies are also required that will characterise more completely the cardiovascular risk profile of these children.Consensus on other vascular risk markers that could be included in future studies is ideal and if accomplished, this would facilitate meta-analyses of studies of relatively rare conditions.
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Affiliation(s)
- Jenny Hayden
- Department of Paediatrics, University Hospital Limerick, Limerick, Ireland
| | - Gill O'Donnell
- Department of Paediatrics, University Hospital Limerick, Limerick, Ireland
| | | | - Clodagh O'Gorman
- Paediatrics, Graduate Entry Medical School, University of Limerick, Limerick, Ireland
- University Hospital Limerick, Dooradoyle, Limerick, Ireland
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11
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Liu H, Wu B, Shi X, Cao Y, Zhao X, Liang D, Qin Q, Liang X, Lu W, Wang D, Liu J. Aerobic exercise-induced circulating extracellular vesicle combined decellularized dermal matrix hydrogel facilitates diabetic wound healing by promoting angiogenesis. Front Bioeng Biotechnol 2022; 10:903779. [PMID: 36082169 PMCID: PMC9445842 DOI: 10.3389/fbioe.2022.903779] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 07/27/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Insufficient blood supply results in unsatisfactory wound healing, especially for challenging wound repair such as diabetic wound defects. Regular exercise training brings a lot of benefits to cardiovascular fitness and metabolic health including attenuation of T2DM progression. Circulating extracellular vesicles (EVs) are postulated to carry a variety of signals involved in tissue crosstalk by their modified cargoes, representing novel mechanisms for the effects of exercise. Prominently, both acute and chronic aerobic exercise training can promote the release of exercise-induced cytokines and enhance the angiogenic function of circulating angiogenic cell–derived EVs.Methods: We investigated the possible angiogenesis potential of aerobic exercise-induced circulating EVs (EXE-EVs) on diabetic wound healing. Circulating EVs were isolated from the plasma of rats subjected to 4 weeks of moderate aerobic exercise or sedentariness 24 h after the last training session. The therapeutic effect of circulating EVs was evaluated in vitro by proliferation, migration, and tube formation assays of human umbilical vein endothelial cells (HUVECs), as well as in vivo by quantification of angiogenesis and cutaneous wound healing in diabetic rats.Results: The number of circulating EVs did not change significantly in exercised rats 24 h post-exercise in comparison with the sedentary rats. Nevertheless, EXE-EVs showed remarkable pro-angiogenic effect by augmenting proliferation, migration, and tube formation of HUVECs. Furthermore, the findings of animal experiments revealed that the EXE-EVs delivered by decellularized dermal matrix hydrogel (DDMH) could significantly promote the repair of skin defects through stimulating the regeneration of vascularized skin.Discussion: The present study is the first attempt to demonstrate that aerobic exercise-induced circulating EVs could be utilized as a cell-free therapy to activate angiogenesis and promote diabetic wound healing. Our findings suggest that EXE-EVs may stand for a potential strategy for diabetic soft tissue wound repair.
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Affiliation(s)
- Haifeng Liu
- Guangzhou Medical University, Guangzhou, China
- Department of Sports Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, China
| | - Bing Wu
- Department of Sports Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, China
| | - Xin Shi
- Department of Limbs (Foot and Hand) Microsurgery, Affiliated Chenzhou Hospital, Hengyang Medical School, University of South China, Chenzhou, China
| | - Yanpeng Cao
- Department of Limbs (Foot and Hand) Microsurgery, Affiliated Chenzhou Hospital, Hengyang Medical School, University of South China, Chenzhou, China
| | - Xin Zhao
- Department of Limbs (Foot and Hand) Microsurgery, Affiliated Chenzhou Hospital, Hengyang Medical School, University of South China, Chenzhou, China
| | - Daqiang Liang
- Department of Sports Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, China
| | - Qihuang Qin
- Department of Sports Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, China
| | - Xinzhi Liang
- Department of Sports Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, China
| | - Wei Lu
- Department of Sports Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, China
| | - Daping Wang
- Guangzhou Medical University, Guangzhou, China
- Department of Sports Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, China
- *Correspondence: Daping Wang, ; Jun Liu,
| | - Jun Liu
- Department of Limbs (Foot and Hand) Microsurgery, Affiliated Chenzhou Hospital, Hengyang Medical School, University of South China, Chenzhou, China
- *Correspondence: Daping Wang, ; Jun Liu,
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12
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Kim TW, Park SS, Park HS. Physical exercise ameliorates memory impairment in offspring of old mice. J Exerc Rehabil 2022; 18:155-161. [PMID: 35846229 PMCID: PMC9271648 DOI: 10.12965/jer.2244262.131] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 05/28/2022] [Indexed: 11/29/2022] Open
Abstract
For humans, maternal old age means the age of 35 or older at the time of childbirth. Maternal metabolism not only affects the cognitive function of the offspring, but also affects their physical and neurological development. This study aims to elucidate the effects of exercise training on spatial learning memory, neurogenesis, and apoptosis in the off-spring of old mice. Using mice, the offspring of old mothers showed impaired spatial learning memory, decreased brain-derived neurotrophic factor and postsynaptic density protein 95 levels, suppressed neurogenesis, and increased hippocampal apoptotic cell death. In contrast, the offspring of the old mothers had improved spatial learning memory, increased brain-derived neurotrophic factor and postsynaptic density protein 95 levels, increased neurogenesis, and decreased hippocampal apoptotic cell death when they received exercise training. The present results indicate that there is apparent spatial learning memory impairment among the offspring of old mothers, but by contrast, exercise can ameliorate spatial learning memory impairment. Exercise can be an effective countermeasure against memory decline in the offspring of old mothers.
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Affiliation(s)
- Tae-Woon Kim
- Department of Human Health Care, Gyeongsang National University, Jinju, Korea
| | - Sang-Seo Park
- School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, NE, USA
- Department of Physiology, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Hye-Sang Park
- Department of Physiology, College of Medicine, Kyung Hee University, Seoul, Korea
- Corresponding author: Hye-Sang Park, Department of Physiology, College of Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea,
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13
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Caterini JE, Rendall K, Cifra B, Schneiderman JE, Ratjen F, Seed M, Rayner T, Weiss R, McCrindle BW, Noseworthy MD, Williams CA, Barker AR, Wells GD. Non-invasive MR imaging techniques for measuring femoral arterial flow in a pediatric and adolescent cohort. Physiol Rep 2022; 10:e15182. [PMID: 35614568 PMCID: PMC9133543 DOI: 10.14814/phy2.15182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 01/17/2022] [Accepted: 01/18/2022] [Indexed: 11/24/2022] Open
Abstract
Magnetic Resonance Imaging (MRI) is well‐suited for imaging peripheral blood flow due to its non‐invasive nature and excellent spatial resolution. Although MRI is routinely used in adults to assess physiological changes in chronic diseases, there are currently no MRI‐based data quantifying arterial flow in pediatric or adolescent populations during exercise. Therefore the current research sought to document femoral arterial blood flow at rest and following exercise in a pediatric‐adolescent population using phase contrast MRI, and to present test‐retest reliability data for this method. Ten healthy children and adolescents (4 male; mean age 14.8 ± 2.4 years) completed bloodwork and resting and exercise MRI. Baseline images consisted of PC‐MRI of the femoral artery at rest and following a 5 × 30 s of in‐magnet exercise. To evaluate test‐retest reliability, five participants returned for repeat testing. All participants successfully completed exercise testing in the MRI. Baseline flow demonstrated excellent reliability (ICC = 0.93, p = 0.006), and peak exercise and delta rest‐peak flow demonstrated good reliability (peak exercise ICC = 0.89, p = 0.002, delta rest‐peak ICC = 0.87, p = 0.003) between‐visits. All three flow measurements demonstrated excellent reliability when assessed with coefficients of variance (CV’s) (rest: CV = 6.2%; peak exercise: CV = 7.3%; delta rest‐peak: CV = 7.1%). The mean bias was small for femoral arterial flow. There was no significant mean bias between femoral artery flow visits 1 and 2 at peak exercise. There were no correlations between age or height and any of the flow measurements. There were no significant differences between male and female participants for any of the flow measurements. The current study determined that peripheral arterial blood flow in children and adolescents can be evaluated using non‐invasive phase contrast MRI. The MRI‐based techniques that were used in the current study for measuring arterial flow in pediatric and adolescent patients demonstrated acceptable test‐retest reliability both at rest and immediately post‐exercise.
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Affiliation(s)
- Jessica E Caterini
- Translational Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.,Graduate Department of Exercise Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Kate Rendall
- Translational Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Barbara Cifra
- Labatt Family Heart Centre, Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jane E Schneiderman
- Division of Respiratory Medicine, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.,Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Felix Ratjen
- Translational Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.,Division of Respiratory Medicine, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.,Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Mike Seed
- Labatt Family Heart Centre, Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Tammy Rayner
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Ruth Weiss
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Brian W McCrindle
- Labatt Family Heart Centre, Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Michael D Noseworthy
- Department of Electrical and Computer Engineering, McMaster University, Hamilton, Canada
| | - Craig A Williams
- Division of Respiratory Medicine, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.,Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, Exeter, UK
| | - Alan R Barker
- Division of Respiratory Medicine, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Gregory D Wells
- Translational Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
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14
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Kanaley JA, Colberg SR, Corcoran MH, Malin SK, Rodriguez NR, Crespo CJ, Kirwan JP, Zierath JR. Exercise/Physical Activity in Individuals with Type 2 Diabetes: A Consensus Statement from the American College of Sports Medicine. Med Sci Sports Exerc 2022; 54:353-368. [PMID: 35029593 PMCID: PMC8802999 DOI: 10.1249/mss.0000000000002800] [Citation(s) in RCA: 346] [Impact Index Per Article: 115.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
ABSTRACT This consensus statement is an update of the 2010 American College of Sports Medicine position stand on exercise and type 2 diabetes. Since then, a substantial amount of research on select topics in exercise in individuals of various ages with type 2 diabetes has been published while diabetes prevalence has continued to expand worldwide. This consensus statement provides a brief summary of the current evidence and extends and updates the prior recommendations. The document has been expanded to include physical activity, a broader, more comprehensive definition of human movement than planned exercise, and reducing sedentary time. Various types of physical activity enhance health and glycemic management in people with type 2 diabetes, including flexibility and balance exercise, and the importance of each recommended type or mode are discussed. In general, the 2018 Physical Activity Guidelines for Americans apply to all individuals with type 2 diabetes, with a few exceptions and modifications. People with type 2 diabetes should engage in physical activity regularly and be encouraged to reduce sedentary time and break up sitting time with frequent activity breaks. Any activities undertaken with acute and chronic health complications related to diabetes may require accommodations to ensure safe and effective participation. Other topics addressed are exercise timing to maximize its glucose-lowering effects and barriers to and inequities in physical activity adoption and maintenance.
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Affiliation(s)
- Jill A Kanaley
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO
| | - Sheri R Colberg
- Human Movement Sciences Department, Old Dominion University, Norfolk, VA
| | | | - Steven K Malin
- Department of Kinesiology and Health, Rutgers University, New Brunswick, NJ
| | - Nancy R Rodriguez
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT
| | - Carlos J Crespo
- Oregon Health and Science University-Portland State University School of Public Health, Portland, OR
| | - John P Kirwan
- Pennington Biomedical Research Center, Baton Rouge, LA
| | - Juleen R Zierath
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, SWEDEN
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15
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Argarini R, Carter HH, Smith KJ, Naylor LH, McLaughlin RA, Green DJ. Adaptation to Exercise Training in Conduit Arteries and Cutaneous Microvessels in Humans: An Optical Coherence Tomography Study. Med Sci Sports Exerc 2021; 53:1945-1957. [PMID: 33731650 DOI: 10.1249/mss.0000000000002654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Exercise training has antiatherogenic effects on conduit and resistance artery function and structure in humans and induces angiogenic changes in skeletal muscle. However, training-induced adaptation in cutaneous microvessels is poorly understood, partly because of technological limitations. Optical coherence tomography (OCT) is a novel high-resolution imaging technique capable of visualizing cutaneous microvasculature at a resolution of ~30 μm. We utilized OCT to visualize the effects of training on cutaneous microvessels, alongside assessment of conduit artery flow-mediated dilation (FMD). METHODS We assessed brachial FMD and cutaneous microcirculatory responses at rest and in response to local heating and reactive hyperemia: pretraining and posttraining in eight healthy men compared with age-matched untrained controls (n = 8). Participants in the training group underwent supervised cycling at 80% maximal heart rate three times a week for 8 wk. RESULTS We found a significant interaction (P = 0.04) whereby an increase in FMD was observed after training (post 9.83% ± 3.27% vs pre 6.97% ± 1.77%, P = 0.01), with this posttraining value higher compared with the control group (6.9% ± 2.87%, P = 0.027). FMD was not altered in the controls (P = 0.894). There was a significant interaction for OCT-derived speed (P = 0.038) whereby a significant decrease in the local disk heating response was observed after training (post 98.6 ± 3.9 μm·s-1 vs pre 102 ± 5 μm·s-1, P = 0.012), whereas no changes were observed for OCT-derived speed in the control group (P = 0.877). Other OCT responses (diameter, flow rate, and density) to local heating and reactive hyperemia were unaffected by training. CONCLUSIONS Our findings suggest that vascular adaptation to exercise training is not uniform across all levels of the arterial tree; although exercise training improves larger artery function, this was not accompanied by unequivocal evidence for cutaneous microvascular adaptation in young healthy subjects.
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Affiliation(s)
| | - Howard H Carter
- Cardiovascular Research Group, School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, AUSTRALIA
| | | | - Louise H Naylor
- Cardiovascular Research Group, School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, AUSTRALIA
| | | | - Daniel J Green
- Cardiovascular Research Group, School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, AUSTRALIA
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16
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Jenkins NDM, Rogers EM, Banks NF, Tomko PM, Sciarrillo CM, Emerson SR, Taylor A, Teague TK. Childhood psychosocial stress is linked with impaired vascular endothelial function, lower SIRT1, and oxidative stress in young adulthood. Am J Physiol Heart Circ Physiol 2021; 321:H532-H541. [PMID: 34328346 DOI: 10.1152/ajpheart.00123.2021] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Adverse childhood experiences (ACEs) are psychosocial stressors that occur during sensitive developmental windows and are associated with increased lifetime cardiovascular disease (CVD) risk in a dose-dependent manner. Vascular endothelial dysfunction is a pathophysiological mechanism that promotes hypertension and CVD and may be a mechanism by which ACEs contribute to lifetime CVD risk. We examined whether exposure to ACEs is associated with reduced vascular endothelial function (VEF) in otherwise healthy, young adult women (20.7 ± 3 yr) with (ACE+) versus without (ACE-) ACEs, explored whether differences in circulating sirtuin 1 (SIRT1) or systemic oxidative stress could explain ACEs-related differences in VEF, and examined the ability of a pilot, 8-wk exercise intervention to augment VEF and SIRT1 or reduce oxidized LDL cholesterol (oxLDL) in ACE+ young adult women. Forty-two otherwise healthy young adults completed this study. Prior to the intervention, VEF (P = 0.002) and SIRT1 (P = 0.004) were lower in the ACE+ than ACE- group, but oxLDL concentrations were not different (P = 0.77). There were also significant relationships (P ≤ 0.04) among flow-mediated dilation (FMD), SIRT1, and oxLDL in the ACE+, but not ACE- group. Adjusting for circulating SIRT1 and oxLDL reduced the differences in FMD observed between groups (P = 0.10), but only SIRT1 was a significant adjuster of the means (P < 0.05). Finally, the exercise intervention employed was unable to enhance VEF or SIRT1 in the ACE+ exercise group. Our data suggest that ACEs likely increase susceptibility to hypertension and CVD by causing endothelial dysfunction, perhaps through a SIRT1 pathway-related mechanism.NEW & NOTEWORTHY Our study provides novel evidence that young adult women with moderate-to-severe adverse childhood experience (ACE) exposure present impaired endothelial function and lower circulating sirtuin 1 (SIRT1) concentrations than age-matched controls. However, an 8-wk exercise intervention was unable to augment endothelial function or SIRT1 concentrations in a subset of those with ACEs. Our data suggest that ACEs-related impairments in endothelial function may be secondary to decreased NO bioavailability via SIRT1 and/or oxidative stress-related mechanisms.
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Affiliation(s)
- Nathaniel D M Jenkins
- Integrative Laboratory of Applied Physiology and Lifestyle Medicine, University of Iowa, Iowa City, Iowa.,Abboud Cardiovascular Research Center, University of Iowa, Iowa City, Iowa
| | - Emily M Rogers
- Integrative Laboratory of Applied Physiology and Lifestyle Medicine, University of Iowa, Iowa City, Iowa
| | - Nile F Banks
- Integrative Laboratory of Applied Physiology and Lifestyle Medicine, University of Iowa, Iowa City, Iowa
| | - Patrick M Tomko
- School of Health Sciences, Kent State University, Kent, Ohio
| | - Christina M Sciarrillo
- Laboratory of Applied Nutrition and Exercise Science, Oklahoma State University, Tulsa, Oklahoma
| | - Sam R Emerson
- Laboratory of Applied Nutrition and Exercise Science, Oklahoma State University, Tulsa, Oklahoma
| | - Ashlee Taylor
- Integrative Immunology Center, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma
| | - T Kent Teague
- Integrative Immunology Center, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma.,Department of Surgery, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma.,Department of Psychiatry, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma.,Department of Biochemistry and Microbiology, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
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17
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La Valle A, Crocco M, Chiarenza DS, Maghnie M, d'Annunzio G. Endothelial impairment evaluation by peripheral arterial tonometry in pediatric endocrinopathies: A narrative review. World J Diabetes 2021; 12:810-826. [PMID: 34168730 PMCID: PMC8192248 DOI: 10.4239/wjd.v12.i6.810] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/30/2021] [Accepted: 05/15/2021] [Indexed: 02/06/2023] Open
Abstract
Endothelial dysfunction (ED) is characterized by an imbalance between vasodilator and vasoconstriction agents. Several pathological conditions clinically diagnosed in childhood and adolescence are characterized by ED and increased risk for early development of microangiopathic and macroangiopathic impairment, in particular type 1 diabetes mellitus (T1DM), T2DM, obesity, metabolic syndromeand pituitary dysfunction associated to various endocrinopathies. More recently insulin resistance following chemotherapy or radiotherapy for tumors, bone marrow transplantation for hematological malignancies (i.e., cancer survivors), or immunosuppressive treatment for solid organ transplantation has been observed. Assessment of ED by means of non-invasive techniques is the gold standard for early ED detection before clinical manifestation. It is aimed to recognize patients at risk and to avoid the development and progression of more serious illnesses. Reactive hyperemia-peripheral artery tonometry is a noninvasive technique to assess peripheral endothelial function by measuring modifications in digital pulse volume during reactive hyperemia, and represents a non-invasive, reproducible and operator-independent tool able to detect precocious ED. This narrative review aimed to provide an overview of the most important papers regarding ED detection by EndoPat 2000 in children and adolescents with different endocrine diseases. A comprehensive search of English language articles was performed in the MEDLINE database without using other search filters except the publication interval between 2005 and 2020.
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Affiliation(s)
- Alberto La Valle
- Pediatric Clinic and Endocrinology, IRCCS Istituto Giannina Gaslini, Genoa16147, Italy
- Pediatric Clinic and Endocrinology, IRCCS Giannina Gaslini Institute, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health University of Genoa, Genoa16147, Italy
| | - Marco Crocco
- Pediatric Clinic and Endocrinology, IRCCS Istituto Giannina Gaslini, Genoa16147, Italy
- Pediatric Clinic and Endocrinology, IRCCS Giannina Gaslini Institute, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health University of Genoa, Genoa16147, Italy
| | - Decimo Silvio Chiarenza
- Pediatric Clinic and Endocrinology, IRCCS Istituto Giannina Gaslini, Genoa16147, Italy
- Pediatric Clinic and Endocrinology, IRCCS Giannina Gaslini Institute, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health University of Genoa, Genoa16147, Italy
| | - Mohamad Maghnie
- Pediatric Clinic and Endocrinology, IRCCS Istituto Giannina Gaslini, Genoa16147, Italy
- Pediatric Clinic and Endocrinology, IRCCS Giannina Gaslini Institute, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health University of Genoa, Genoa16147, Italy
| | - Giuseppe d'Annunzio
- Pediatric Clinic and Endocrinology, IRCCS Istituto Giannina Gaslini, Genoa16147, Italy
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18
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Herrera-Zelada N, Zuñiga-Cuevas U, Ramirez-Reyes A, Lavandero S, Riquelme JA. Targeting the Endothelium to Achieve Cardioprotection. Front Pharmacol 2021; 12:636134. [PMID: 33603675 PMCID: PMC7884828 DOI: 10.3389/fphar.2021.636134] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 01/04/2021] [Indexed: 12/11/2022] Open
Abstract
Despite considerable improvements in the treatment of myocardial infarction, it is still a highly prevalent disease worldwide. Novel therapeutic strategies to limit infarct size are required to protect myocardial function and thus, avoid heart failure progression. Cardioprotection is a research topic with significant achievements in the context of basic science. However, translation of the beneficial effects of protective approaches from bench to bedside has proven difficult. Therefore, there is still an unmet need to study new avenues leading to protecting the myocardium against infarction. In line with this, the endothelium is an essential component of the cardiovascular system with multiple therapeutic targets with cardioprotective potential. Endothelial cells are the most abundant non-myocyte cell type in the heart and are key players in cardiovascular physiology and pathophysiology. These cells can regulate vascular tone, angiogenesis, hemostasis, and inflammation. Accordingly, endothelial dysfunction plays a fundamental role in cardiovascular diseases, which may ultimately lead to myocardial infarction. The endothelium is of paramount importance to protect the myocardium from ischemia/reperfusion injury via conditioning strategies or cardioprotective drugs. This review will provide updated information on the most promising therapeutic agents and protective approaches targeting endothelial cells in the context of myocardial infarction.
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Affiliation(s)
- Nicolas Herrera-Zelada
- Advanced Center for Chronic Disease (ACCDiS), Facultad de Ciencias Químicas y Farmacéuticas and Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Ursula Zuñiga-Cuevas
- Advanced Center for Chronic Disease (ACCDiS), Facultad de Ciencias Químicas y Farmacéuticas and Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Andres Ramirez-Reyes
- Advanced Center for Chronic Disease (ACCDiS), Facultad de Ciencias Químicas y Farmacéuticas and Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Sergio Lavandero
- Advanced Center for Chronic Disease (ACCDiS), Facultad de Ciencias Químicas y Farmacéuticas and Facultad de Medicina, Universidad de Chile, Santiago, Chile
- Department of Internal Medicine (Cardiology Division), University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Jaime A. Riquelme
- Advanced Center for Chronic Disease (ACCDiS), Facultad de Ciencias Químicas y Farmacéuticas and Facultad de Medicina, Universidad de Chile, Santiago, Chile
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19
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Faulkner MS, Michaliszyn SF. Exercise Adherence in Hispanic Adolescents with Obesity or Type 2 Diabetes. J Pediatr Nurs 2021; 56:7-12. [PMID: 33181374 PMCID: PMC7855355 DOI: 10.1016/j.pedn.2020.09.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/12/2020] [Accepted: 09/15/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE Hispanic adolescents experience high rates of obesity and type 2 diabetes. The purpose of this study was to examine adherence to a 16-week personalized exercise intervention and the perception of family support for exercise, benefits and barriers to exercise and overall health in Hispanic adolescents diagnosed with obesity or type 2 diabetes. DESIGN AND METHODS Using a secondary analysis of a larger feasibility trial, data from 21 Hispanic adolescents, 13 with T2D and 8 who were obese and 14 that completed the entire 16-week study (7 T2D; 7 obese) were analyzed. Adolescents wore an Actigraph™ accelerometer for tracking exercise throughout the 16-week intervention. RESULTS The adherence rate for the intervention was 59% for those with T2D and was 88% for those with obesity. Overall perceptions of health improved for those completing the 16-week intervention. Barriers to exercise were negatively associated with moderate-to-vigorous physical activity and were higher in those with T2D. CONCLUSIONS Adolescents with T2D were less adherent to their personalized exercise program than those who were obese. PRACTICE IMPLICATIONS Strategies that address cultural preferences and family engagement are needed to address barriers to exercise for Hispanic youth, particularly those already diagnosed with T2D that have high risks for early onset of disease complications.
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Affiliation(s)
- Melissa Spezia Faulkner
- Professor and Lewis Distinguished Chair in Nursing, Byrdine F. Lewis College of Nursing and Health Professions, Atlanta, United States of America.
| | - Sara Fleet Michaliszyn
- Associate Professor and Department Chair, Department of Kinesiology and Sport Science, OH, United States of America
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20
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Madsen NL, Haley JE, Moore RA, Khoury PR, Urbina EM. Increased Arterial Stiffness Is Associated With Reduced Diastolic Function in Youth With Obesity and Type 2 Diabetes. Front Pediatr 2021; 9:781496. [PMID: 34912763 PMCID: PMC8666894 DOI: 10.3389/fped.2021.781496] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 10/29/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Increased arterial stiffness is associated with diastolic dysfunction in adults. Data in youth are lacking, so we examined the impact of arterial stiffness on diastolic function in youth. Methods: We obtained diastolic function and augmentation index, pulse wave velocity, brachial artery distensibility, and carotid stiffness on 612 youth [10-24 years, 65% female, 38% normal weight, 36% obese, and 26% with type 2 diabetes mellitus (T2DM)]. Participants were classified as compliant (C) vs. stiff (S) arteries based on seven arterial stiffness parameters [Global Stiffness Index (GSI), S = GSI > 4). Mean differences in covariates were evaluated by Student's t-tests. A stepwise regression analysis was performed to determine if GSI was an independent predictor of diastolic function. Results: Lower diastolic function and more adverse cardiovascular disease (CVD) risk factors were present in the S group (n = 67) than the C group (n = 545) (p < 0.001). Covariates that were associated with diastolic dysfunction were higher GSI, male sex, higher body mass index (BMI), and systolic blood pressure (SBP) z-score (R 2 = 0.18 to 0.25; p ≤ 0.05). Conclusion: Adverse diastolic function is seen in youth with increased arterial stiffness independent of CVD risk factors. Interventions to improve arterial stiffness prior to clinical onset of diastolic dysfunction are needed to prevent development of heart failure.
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Affiliation(s)
- Nicolas L Madsen
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Jessica E Haley
- Department of Pediatrics, Rady Children's Hospital, San Diego, CA, United States
| | - Ryan A Moore
- The Heart Institute, Cincinnati Children's Hospital Medical Center and the University of Cincinnati, Cincinnati, OH, United States
| | - Philip R Khoury
- The Heart Institute, Cincinnati Children's Hospital Medical Center and the University of Cincinnati, Cincinnati, OH, United States
| | - Elaine M Urbina
- The Heart Institute, Cincinnati Children's Hospital Medical Center and the University of Cincinnati, Cincinnati, OH, United States
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21
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Argarini R, McLaughlin RA, Joseph SZ, Naylor LH, Carter HH, Haynes A, Marsh CE, Yeap BB, Jansen SJ, Green DJ. Visualizing and quantifying cutaneous microvascular reactivity in humans by use of optical coherence tomography: impaired dilator function in diabetes. Am J Physiol Endocrinol Metab 2020; 319:E923-E931. [PMID: 32954827 DOI: 10.1152/ajpendo.00233.2020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The pathophysiology and time course of impairment in cutaneous microcirculatory function and structure remain poorly understood in people with diabetes, partly due to the lack of investigational tools capable of directly imaging and quantifying the microvasculature in vivo. We applied a new optical coherence tomography (OCT) technique, at rest and during reactive hyperemia (RH), to assess the skin microvasculature in people with diabetes with foot ulcers (DFU, n = 13), those with diabetes without ulcers (DNU, n = 9), and matched healthy controls (CON, n = 13). OCT images were obtained from the dorsal part of the foot at rest and following 5 min of local ischemia induced by inflating a cuff around the thigh at suprasystolic level (220 mmHg). One-way ANOVA was used to compare the OCT-derived parameters (diameter, speed, flow rate, and density) at rest and in response to RH, with repeated-measures two-way ANOVA performed to analyze main and interaction effects between groups. Data are means ± SD. At rest, microvascular diameter in the DFU (84.89 ± 14.84 µm) group was higher than CON (71.25 ± 7.6 µm, P = 0.012) and DNU (71.33 ± 12.04 µm, P = 0.019) group. Speed in DFU (65.56 ± 4.80 µm/s, P = 0.002) and DNU (63.22 ± 4.35 µm/s, P = 0.050) were higher than CON (59.58 ± 3.02 µm/s). Microvascular density in DFU (22.23 ± 13.8%) was higher than in CON (9.83 ± 2.94%, P = 0.008), but not than in the DNU group (14.8 ± 10.98%, P = 0.119). All OCT-derived parameters were significantly increased in response to RH in the CON group (all P < 0.01) and DNU group (all P < 0.05). Significant increase in the DFU group was observed in speed (P = 0.031) and density (P = 0.018). The change in density was lowest in the DFU group (44 ± 34.1%) compared with CON (199.2 ± 117.5%, P = 0.005) and DNU (148.1 ± 98.4, P = 0.054). This study proves that noninvasive OCT microvascular imaging is feasible in people with diabetes, provides powerful new physiological insights, and can distinguish between healthy individuals and patients with diabetes with distinct disease severity.
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Affiliation(s)
- Raden Argarini
- Physiology Department, Faculty of Medicine, Airlangga University, Surabaya, Indonesia
- Cardiovascular Research Group, School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, Australia
| | - Robert A McLaughlin
- Faculty of Health and Medical Sciences, Australian Research Council Centre of Excellence for Nanoscale Biophotonics, Adelaide Medical School, University of Adelaide, Australia
- Institute for Photonics and Advanced Sensing, University of Adelaide, Adelaide, Australia
- Department of Electrical, Electronic and Computer Engineering, University of Western Australia, Perth, Australia
| | - Simon Z Joseph
- Faculty of Health and Medical Sciences, School of Surgery, The University of Western Australia, Perth, Australia
| | - Louise H Naylor
- Cardiovascular Research Group, School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, Australia
| | - Howard H Carter
- Cardiovascular Research Group, School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, Australia
| | - Andrew Haynes
- Cardiovascular Research Group, School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, Australia
| | - Channa E Marsh
- Cardiovascular Research Group, School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, Australia
| | - Bu B Yeap
- Medical School, The University of Western Australia, Perth, Australia
- Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, Australia
| | - Shirley J Jansen
- Faculty of Health and Medical Sciences, School of Surgery, The University of Western Australia, Perth, Australia
- Department of Vascular and Endovascular Surgery Sir Charles Gardner Hospital, Perth, Australia
- Heart and Vascular Research Institute, Harry Perkins Institute of Medical Research, Perth, Australia
- Medical School, Curtin University, Perth, Australia
| | - Daniel J Green
- Cardiovascular Research Group, School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, Australia
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22
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Argarini R, McLaughlin RA, Joseph SZ, Naylor LH, Carter HH, Yeap BB, Jansen SJ, Green DJ. Optical coherence tomography: a novel imaging approach to visualize and quantify cutaneous microvascular structure and function in patients with diabetes. BMJ Open Diabetes Res Care 2020; 8:8/1/e001479. [PMID: 32847842 PMCID: PMC7451490 DOI: 10.1136/bmjdrc-2020-001479] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 06/05/2020] [Accepted: 06/27/2020] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION The pathophysiology of microvascular disease is poorly understood, partly due to the lack of tools to directly image microvessels in vivo. RESEARCH DESIGN AND METHODS In this study, we deployed a novel optical coherence tomography (OCT) technique during local skin heating to assess microvascular structure and function in diabetics with (DFU group, n=13) and without (DNU group, n=10) foot ulceration, and healthy controls (CON group, n=13). OCT images were obtained from the dorsal foot, at baseline (33°C) and 30 min following skin heating. RESULTS At baseline, microvascular density was higher in DFU compared with CON (21.9%±11.5% vs 14.3%±5.6%, p=0.048). Local heating induced significant increases in diameter, speed, flow rate and density in all groups (all p<0.001), with smaller changes in diameter for the DFU group (94.3±13.4 µm), compared with CON group (115.5±11.7 µm, p<0.001) and DNU group (106.7±12.1 µm, p=0.014). Heating-induced flow rate was lower in the DFU group (584.3±217.0 pL/s) compared with the CON group (908.8±228.2 pL/s, p<0.001) and DNU group (768.8±198.4 pL/s, p=0.014), with changes in density also lower in the DFU group than CON group (44.7%±15.0% vs 56.5%±9.1%, p=0.005). CONCLUSIONS This proof of principle study indicates that it is feasible to directly visualize and quantify microvascular function in people with diabetes; and distinguish microvascular disease severity between patients.
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Affiliation(s)
- Raden Argarini
- Physiology, Airlangga University Faculty of Medicine, Surabaya, Jawa Timur, Indonesia
- Cardiovascular Research Group, School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Crawley, Western Australia, Australia
| | - Robert A McLaughlin
- Faculty of Health and Medical Sciences, Adelaide Medical School, Australian Research Council Centre of Excellence for Nanoscale Biophotonics, University of Adelaide, Adelaide, South Australia, Australia
- Institute for Photonics and Advanced Sensing, University of Adelaide, Adelaide, South Australia, Australia
| | - Simon Z Joseph
- Faculty of Health and Medical Sciences, School of Surgery, The University of Western Australia, Perth, Western Australia, Australia
| | - Louise H Naylor
- Cardiovascular Research Group, School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Crawley, Western Australia, Australia
| | - Howard H Carter
- Cardiovascular Research Group, School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Crawley, Western Australia, Australia
| | - Bu B Yeap
- School of Medicine and Pharmacology, The University of Western Australia, Perth, Western Australia, Australia
- Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Shirley J Jansen
- Faculty of Health and Medical Sciences, School of Surgery, The University of Western Australia, Perth, Western Australia, Australia
- Vascular and Endovascular Surgery, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Daniel J Green
- Cardiovascular Research Group, School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Crawley, Western Australia, Australia
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Sokolovska J, Ostrovska K, Pahirko L, Varblane G, Krilatiha K, Cirulnieks A, Folkmane I, Pirags V, Valeinis J, Klavina A, Selavo L. Impact of interval walking training managed through smart mobile devices on albuminuria and leptin/adiponectin ratio in patients with type 2 diabetes. Physiol Rep 2020; 8:e14506. [PMID: 32652863 PMCID: PMC7354089 DOI: 10.14814/phy2.14506] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 06/16/2020] [Accepted: 06/16/2020] [Indexed: 12/13/2022] Open
Abstract
Background Interval walking training has demonstrated more pronounced positive effects on physical fitness and metabolism in type 2 diabetes (T2D), compared to continuous walking. One of the pathogenic mechanisms of T2D is associated with derangements in leptin/adiponectin axis, which might predispose affected individuals to vascular inflammation and albuminuria. The aim of this study was to investigate the effects of interval walking training delivered through smart mobile devices upon albuminuria and leptin/adiponectin ratio in patients with T2D. Methods Patients with T2D aged 35–75 were randomized into control (n = 26) and interval training (IT, n = 14) groups. Patients in IT group had to perform three 60‐min interval walking sessions (3 min intervals of slow and fast walking with the intensity of 40% and 70% of the peak energy expenditure) per week delivered by smartphone application for four months. The adherence to training was monitored remotely. Outcome measures were albuminuria, leptin/adiponectin ratio, obesity indicators, and glycaemic control. Leptin and adiponectin concentration was measured in serum samples by Luminex technology. Results In the IT group compared to control group, we observed a statistically significant decrease in albuminuria (p = .002) and leptin/adiponectin ratio (p = .01), as well as a decrease in HbA1c close to statistical significance (p = .09). In IT group, changes in leptin/adiponectin ratio correlated significantly with changes in hip circumference (p = .024). Conclusion Interval walking training is beneficial for vascular health in T2D via impact on albuminuria and leptin/adiponectin ratio.
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Affiliation(s)
| | | | - Leonora Pahirko
- Faculty of Physics, Mathematics and Optometry, University of Latvia, Riga, Latvia
| | | | | | | | - Inese Folkmane
- Faculty of Medicine, University of Latvia, Riga, Latvia.,Centre of Nephrology, Pauls Stradins University Hospital, Riga, Latvia
| | - Valdis Pirags
- Faculty of Medicine, University of Latvia, Riga, Latvia.,Department of Internal Medicine, Pauls Stradins University Hospital, Riga, Latvia
| | - Janis Valeinis
- Faculty of Physics, Mathematics and Optometry, University of Latvia, Riga, Latvia
| | - Aija Klavina
- Latvian Academy of Sport Education, Riga, Latvia
| | - Leo Selavo
- Faculty of Computing, University of Latvia, Riga, Latvia
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24
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Smith KJ, Argarini R, Carter HH, Quirk BC, Haynes A, Naylor LH, McKirdy H, Kirk RW, McLaughlin RA, Green DJ. Novel Noninvasive Assessment of Microvascular Structure and Function in Humans. Med Sci Sports Exerc 2020; 51:1558-1565. [PMID: 30688767 DOI: 10.1249/mss.0000000000001898] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Optical coherence tomography (OCT) is a novel high-resolution imaging technique capable of visualizing in vivo structures at a resolution of ~10 μm. We have developed specialized OCT-based approaches that quantify diameter, speed, and flow rate in human cutaneous microvessels. In this study, we hypothesized that OCT-based microvascular assessments would possess comparable levels of reliability when compared with those derived using conventional laser Doppler flowmetry (LDF). METHODS Speckle decorrelation images (OCT) and red blood cell flux (LDF) measures were collected from adjacent forearm skin locations on 2 d (48 h apart), at baseline, and after a 30-min rapid local heating protocol (30°C-44°C) in eight healthy young individuals. OCT postprocessing quantified cutaneous microvascular diameter, speed, flow rate, and density (vessel recruitment) within a region of interest, and data were compared between days. RESULTS Forearm skin LDF (13 ± 4 to 182 ± 31 AU, P < 0.05) and OCT-derived diameter (41.8 ± 6.6 vs 64.5 ± 6.9 μm), speed (68.4 ± 9.5 vs 89.0 ± 7.3 μm·s), flow rate (145.0 ± 60.6 vs 485 ± 132 pL·s), and density (9.9% ± 4.9% vs 45.4% ± 5.9%) increased in response to local heating. The average OCT-derived microvascular flow response (pL·s) to heating (234% increase) was lower (P < 0.05) than the LDF-derived change (AU) (1360% increase). Pearson correlation was significant for between-day local heating responses in terms of OCT flow (r = 0.93, P < 0.01), but not LDF (P = 0.49). Bland-Altman analysis revealed that between-day baseline OCT-derived flow rates were less variable than LDF-derived flux. CONCLUSIONS Our findings indicate that OCT, which directly visualizes human microvessels, not only allows microvascular quantification of diameter, speed, flow rate, and vessel recruitment but also provides outputs that are highly reproducible. OCT is a promising novel approach that enables a comprehensive assessment of cutaneous microvascular structure and function in humans.
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Affiliation(s)
- Kurt J Smith
- Cardiovascular Research Group, School of Human Sciences (Exercise and Sport Science), Faculty of Science, The University of Western Australia, Perth, AUSTRALIA.,School of Kinesiology, Faculty of Health and Behavioural Science, Lakehead University, Thunderbay, Ontario, CANADA
| | - Raden Argarini
- Cardiovascular Research Group, School of Human Sciences (Exercise and Sport Science), Faculty of Science, The University of Western Australia, Perth, AUSTRALIA.,Department of Physiology, Faculty of Medicine, Airlangga University, Surabaya, INDONESIA
| | - Howard H Carter
- Cardiovascular Research Group, School of Human Sciences (Exercise and Sport Science), Faculty of Science, The University of Western Australia, Perth, AUSTRALIA
| | - Bryden C Quirk
- Australian Research Council Centre of Excellence for Nanoscale Biophotonics, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, AUSTRALIA.,Institute for Photonics and Advanced Sensing, University of Adelaide, Adelaide, AUSTRALIA
| | - Andrew Haynes
- Cardiovascular Research Group, School of Human Sciences (Exercise and Sport Science), Faculty of Science, The University of Western Australia, Perth, AUSTRALIA
| | - Louise H Naylor
- Cardiovascular Research Group, School of Human Sciences (Exercise and Sport Science), Faculty of Science, The University of Western Australia, Perth, AUSTRALIA
| | - Hamish McKirdy
- Cardiovascular Research Group, School of Human Sciences (Exercise and Sport Science), Faculty of Science, The University of Western Australia, Perth, AUSTRALIA
| | - Rodney W Kirk
- Australian Research Council Centre of Excellence for Nanoscale Biophotonics, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, AUSTRALIA.,Institute for Photonics and Advanced Sensing, University of Adelaide, Adelaide, AUSTRALIA
| | - Robert A McLaughlin
- Australian Research Council Centre of Excellence for Nanoscale Biophotonics, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, AUSTRALIA.,Institute for Photonics and Advanced Sensing, University of Adelaide, Adelaide, AUSTRALIA.,School of Electrical, Electronic and Computer Engineering, Faculty of Engineering and Mathematical Sciences, The University of Western Australia, Perth, AUSTRALIA
| | - Daniel J Green
- Cardiovascular Research Group, School of Human Sciences (Exercise and Sport Science), Faculty of Science, The University of Western Australia, Perth, AUSTRALIA
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25
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Scheer AS, Naylor LH, Gan SK, Charlesworth J, Benjanuvatra N, Green DJ, Maiorana AJ. The Effects of Water-based Exercise Training in People with Type 2 Diabetes. Med Sci Sports Exerc 2019; 52:417-424. [PMID: 31469709 DOI: 10.1249/mss.0000000000002133] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
PURPOSE To investigate the effects of 8 wk of upright water-based exercise training in people with type 2 diabetes. METHODS Thirteen participants with type 2 diabetes (54% male; 60.9 ± 9.6 yr, mean ± standard deviation) completed 8 wk of upright water-based exercise training at a moderate intensity (60%-80% of exercise test-derived maximum HR), for 1 h, three times a week (TG). Fourteen participants (64% male; 63.9 ± 9.8 yr) acted as a control group (CG) who maintained their usual activities. Preintervention and postintervention, participants performed cardiopulmonary exercise testing to determine V˙O2peak and one-repetition maximum testing to assess muscular strength. Blood profiles were assessed with standard assays. Body mass index and waist/hip ratio were employed as measures of anthropometry. Endothelium-dependent (brachial artery flow-mediated dilation) and independent (glyceryl trinitrate-mediated) function were assessed using vascular ultrasound. RESULTS Water-based training increased V˙O2peak (18.5 ± 4.3 mL·kg·min to 21.5 ± 5.4 mL·kg·min) (P = 0.002), overall muscle strength (123 ± 44 kg to 139 ± 43 kg) and leg strength (92 ± 28 kg to 104 ± 29 kg), compared with the CG (P = 0.001). The effect on pectoral strength (31 ± 17 kg to 35 ± 16 kg) was not significantly different to the CG (24 ± 12 kg to 26 ± 14 kg) (P = 0.08). No change was observed in anthropometry, blood profiles, or glyceryl trinitrate-mediated vascular function. Flow-mediated dilation was increased after training (6.1% ± 2.4% to 6.5% ± 3.0%), compared with controls who demonstrated a slight decrease (6.2% ± 1.6% to 5.4% ± 1.6%) (P = 0.002). CONCLUSIONS Water-based circuit training was well tolerated and appears to be an effective exercise modality for improving aerobic fitness, strength, and vascular function in people with type 2 diabetes.
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Affiliation(s)
- Anna S Scheer
- School of Physiotherapy and Exercise Science, Faculty of Health Science, Curtin University, Perth, Western Australia, AUSTRALIA
| | | | - Seng K Gan
- Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Crawley, Western Australia, AUSTRALIA
| | | | - Nat Benjanuvatra
- School of Human Sciences, Faculty of Science, University of Western Australia, Crawley, Western Australia, AUSTRALIA
| | - Daniel J Green
- School of Human Sciences, Faculty of Science, University of Western Australia, Crawley, Western Australia, AUSTRALIA
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Supplementary Nitric Oxide Donors and Exercise as Potential Means to Improve Vascular Health in People with Type 1 Diabetes: Yes to NO? Nutrients 2019; 11:nu11071571. [PMID: 31336832 PMCID: PMC6682901 DOI: 10.3390/nu11071571] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 06/26/2019] [Accepted: 07/10/2019] [Indexed: 12/16/2022] Open
Abstract
Type 1 diabetes (T1D) is associated with a greater occurrence of cardiovascular pathologies. Vascular dysfunction has been shown at the level of the endothelial layers and failure to maintain a continuous pool of circulating nitric oxide (NO) has been implicated in the progression of poor vascular health. Biochemically, NO can be produced via two distinct yet inter-related pathways that involve an upregulation in the enzymatic activity of nitric oxide synthase (NOS). These pathways can be split into an endogenous oxygen-dependent pathway i.e., the catabolism of the amino acid L-arginine to L-citrulline concurrently yielding NO in the process, and an exogenous oxygen-independent one i.e., the conversion of exogenous inorganic nitrate to nitrite and subsequently NO in a stepwise fashion. Although a body of research has explored the vascular responses to exercise and/or compounds known to stimulate NOS and subsequently NO production, there is little research applying these findings to individuals with T1D, for whom preventative strategies that alleviate or at least temper vascular pathologies are critical foci for long-term risk mitigation. This review addresses the proposed mechanisms responsible for vascular dysfunction, before exploring the potential mechanisms by which exercise, and two supplementary NO donors may provide vascular benefits in T1D.
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27
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Schmitz B, Niehues H, Lenders M, Thorwesten L, Klose A, Krüger M, Brand E, Brand SM. Effects of high-intensity interval training on microvascular glycocalyx and associated microRNAs. Am J Physiol Heart Circ Physiol 2019; 316:H1538-H1551. [DOI: 10.1152/ajpheart.00751.2018] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
High-intensity interval training (HIIT) has been proposed to exert vasculoprotective effects. This study aimed to evaluate whether HIIT affects the microvasculature, including the endothelial glycocalyx barrier, and to identify associated microRNAs (miRNAs). Fifty healthy participants (23.1 ± 3.0 yr) performed a 4-wk 4 × 30-s all-out running HIIT. Sidestream dark-field imaging was performed at baseline and follow-up to detect changes of the sublingual microvasculature including the endothelial glycocalyx. Exercise parameters were determined by continuous running field test and documentation of high-intensity runs. miRNAs potentially associated with glycocalyx thickness were selected by structured literature search and blood samples for miRNA, and lactate measurements were drawn at baseline and follow-up HIIT. At baseline, a correlation between maximal exercise performance capacity and glycocalyx thickness (determined by perfused boundary region) was detected ( P = 0.045, r = 0.303). Increased exercise performance at follow-up also correlated with glycocalyx thickness ( P = 0.031, r = 0.416), and increased high-intensity sprinting speed was associated with an increased number of perfused vessels ( P = 0.0129, r = 0.449). Literature search identified miR-143, -96-5p, and -24, which were upregulated by HIIT already at baseline and showed an association with peak blood lactate levels after sprints (all P < 0.05). Moreover, increased baseline miR-143 levels predicted increased glycocalyx thickness at follow-up (AUCmiR-143 = 0.92, 95% confidence interval, 0.81–1.0, P = 0.0008). Elevated resting miR-126 levels after the intervention were associated with cell-free versican mRNA levels. We conclude that HIIT induces changes in the endothelial glycocalyx of the microvasculature. Associated miRNAs such as miR-143 may represent a tool for monitoring early vasculoprotective adaptations to physical activity. NEW & NOTEWORTHY High-intensity interval training is known to improve health-related fitness in general and in lifestyle-induced chronic diseases. To visualize microvasculature structure and to detect exercise-induced changes, sublingual sidestream dark-field imaging microscopy was used, and circulating miRNAs were measured. This study shows that exercise-induced changes correlate with associated circulating miRNA, which might be useful for monitoring vasculoprotective effects. Furthermore, sidestream dark-field imaging may represent a sensitive tool for the early detection of exercise-induced systemic vascular changes.
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Affiliation(s)
- Boris Schmitz
- Institute of Sports Medicine, Molecular Genetics of Cardiovascular Disease, University Hospital Muenster, Muenster, Germany
| | - Hannah Niehues
- Institute of Sports Medicine, Molecular Genetics of Cardiovascular Disease, University Hospital Muenster, Muenster, Germany
| | - Malte Lenders
- Internal Medicine D, Department of Nephrology, Hypertension and Rheumatology, University Hospital Muenster, Muenster, Germany
| | - Lothar Thorwesten
- Institute of Sports Medicine, Molecular Genetics of Cardiovascular Disease, University Hospital Muenster, Muenster, Germany
| | - Andreas Klose
- Department of Physical Education and Sports History, University of Muenster, Muenster, Germany
| | - Michael Krüger
- Department of Physical Education and Sports History, University of Muenster, Muenster, Germany
| | - Eva Brand
- Internal Medicine D, Department of Nephrology, Hypertension and Rheumatology, University Hospital Muenster, Muenster, Germany
| | - Stefan-Martin Brand
- Institute of Sports Medicine, Molecular Genetics of Cardiovascular Disease, University Hospital Muenster, Muenster, Germany
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Dos Santos Araujo JE, Nunes Macedo F, Sales Barreto A, Viana Dos Santos MR, Antoniolli AR, Quintans-Junior LJ. Effects of Resistance and Combined training on Vascular Function in Type 2 Diabetes: A Systematic Review of Randomized Controlled Trials. Rev Diabet Stud 2019; 15:16-25. [PMID: 31132077 DOI: 10.1900/rds.2019.15.16] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is the main cause of mortality in type 2 diabetes (T2D). Exercise can reduce the risk factors associated with CVD in T2D patients. However, research evaluating its beneficial effects in these patients has used different measurement protocols and types of exercise, complicating comparison. AIM To assess the effects of resistance training (RT) and combined training (CT) on the vascular function of T2D patients. METHODS A database search (MEDLINE, Scopus, and Web of Science) was performed to identify relevant articles that were published up to August 2017. Only original studies evaluating the effects of RT or CT interventions on vascular function in T2D patients were included. The articles were reviewed independently by at least three reviewers. The Cochrane guidelines were used to assess the methodological quality of the studies. Fourteen studies were finally included. Two studies only used RT and twelve studies used CT as intervention strategy. RESULTS AND CONCLUSIONS The results show that resistance training is a useful means for primary treatment of vascular diseases and maintenance of vascular function in T2D patients. However, more studies are necessary to gain full knowledge of the beneficial effects and to identify tailored exercise plans to optimize these benefits. The information provided in this review may help to improve current treatment of vascular diseases in T2D patients and to design future studies.
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Affiliation(s)
- João E Dos Santos Araujo
- Laboratory of Cardiovascular Pharmacology, Department of Physiology, Federal University of Sergipe, Sergipe, Brazil
| | - Fabrício Nunes Macedo
- Laboratory of Cardiovascular Pharmacology, Department of Physiology, Federal University of Sergipe, Sergipe, Brazil
| | - André Sales Barreto
- Laboratory of Cardiovascular Pharmacology, Department of Physiology, Federal University of Sergipe, Sergipe, Brazil
| | - Márcio R Viana Dos Santos
- Laboratory of Cardiovascular Pharmacology, Department of Physiology, Federal University of Sergipe, Sergipe, Brazil
| | - Angelo R Antoniolli
- Laboratory of Neurosciences and Pharmacological Trials, Department of Physiology, Federal University of Sergipe, Sergipe, Brazi
| | - Lucindo J Quintans-Junior
- Laboratory of Neurosciences and Pharmacological Trials, Department of Physiology, Federal University of Sergipe, Sergipe, Brazil
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29
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Lopes GO, Farinatti P, Lopes KG, Medeiros-Lima DJ, Matsuura C, Oliveira RB, Bouskela E, Bottino DA, Muccillo F, Tibirica E, Borges JP. Increased vascular function and superoxide dismutase activity in physically active vs inactive adults living with HIV. Scand J Med Sci Sports 2018; 29:25-33. [PMID: 30267551 DOI: 10.1111/sms.13312] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 08/28/2018] [Accepted: 09/20/2018] [Indexed: 12/28/2022]
Abstract
This study compared macro- and microvascular endothelial function and redox status in active vs inactive HIV-infected patients (HIVP) under antiretroviral therapy. Using a cross-sectional design, macro- and microvascular reactivity, systemic microvascular density, and oxidative stress were compared between 19 HIVP (53.1 ± 6.1 year) enrolled in a multimodal training program (aerobic, strength and flexibility exercises) for at least 12 months (60-minutes sessions performed 3 times/wk with moderate intensity) vs 25 sedentary HIVP (51.2 ± 6.3 year). Forearm blood flow during reactive hyperemia (521.7 ± 241.9 vs 361.4% ± 125.0%; P = 0.04) and systemic microvascular density (120.8 ± 21.1 vs 105.6 ± 25.0 capillaries/mm2 ; P = 0.03) was greater in active than inactive patients. No significant difference between groups was detected for endothelium-dependent and independent skin microvascular vasodilation (P > 0.05). As for redox status, carbonyl groups (P = 0.22), lipid peroxidation (P = 0.86), catalase activity (P = 0.99), and nitric oxide levels (P = 0.72) were similar across groups. However, superoxide dismutase activity was greater in active vs inactive HIVP (0.118 ± 0.013 vs 0.111 ± 0.007 U/mL; P = 0.05). Immune function reflected by total T CD4 and T CD8 counts (cell/mm3 ) did not differ between active and inactive groups (P > 0.82). In conclusion, physically active HIVP exhibited similar immune function, but greater macrovascular reactivity, systemic microvascular density, and superoxide dismutase activity than inactive patients of similar age.
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Affiliation(s)
- Gabriella O Lopes
- Laboratory of Physical Activity and Health Promotion, Institute of Physical Education and Sports, University of Rio de Janeiro State, Rio de Janeiro, Brazil.,Graduate Program in Exercise and Sports Sciences, University of Rio de Janeiro State, Rio de Janeiro, Brazil
| | - Paulo Farinatti
- Laboratory of Physical Activity and Health Promotion, Institute of Physical Education and Sports, University of Rio de Janeiro State, Rio de Janeiro, Brazil.,Graduate Program in Exercise and Sports Sciences, University of Rio de Janeiro State, Rio de Janeiro, Brazil.,Graduate Program in Physical Activity Sciences, Salgado de Oliveira University, Niteroi, Brazil
| | - Karynne G Lopes
- Laboratory of Physical Activity and Health Promotion, Institute of Physical Education and Sports, University of Rio de Janeiro State, Rio de Janeiro, Brazil.,Clinical and Experimental Research Laboratory on Vascular Biology (BioVasc), Biomedical Center, University of Rio de Janeiro State, Rio de Janeiro, Brazil
| | - Daniel J Medeiros-Lima
- Department of Pharmacology and Psychobiology, University of Rio de Janeiro State, Rio de Janeiro, Brazil
| | - Cristiane Matsuura
- Department of Pharmacology and Psychobiology, University of Rio de Janeiro State, Rio de Janeiro, Brazil
| | - Ricardo B Oliveira
- Laboratory of Physical Activity and Health Promotion, Institute of Physical Education and Sports, University of Rio de Janeiro State, Rio de Janeiro, Brazil.,Graduate Program in Exercise and Sports Sciences, University of Rio de Janeiro State, Rio de Janeiro, Brazil
| | - Eliete Bouskela
- Clinical and Experimental Research Laboratory on Vascular Biology (BioVasc), Biomedical Center, University of Rio de Janeiro State, Rio de Janeiro, Brazil
| | - Daniel A Bottino
- Clinical and Experimental Research Laboratory on Vascular Biology (BioVasc), Biomedical Center, University of Rio de Janeiro State, Rio de Janeiro, Brazil
| | - Fabiana Muccillo
- National Institute of Cardiology, Ministry of Health, Rio de Janeiro, Brazil
| | - Eduardo Tibirica
- National Institute of Cardiology, Ministry of Health, Rio de Janeiro, Brazil
| | - Juliana P Borges
- Laboratory of Physical Activity and Health Promotion, Institute of Physical Education and Sports, University of Rio de Janeiro State, Rio de Janeiro, Brazil.,Graduate Program in Exercise and Sports Sciences, University of Rio de Janeiro State, Rio de Janeiro, Brazil
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Long TM, Rath SR, Wallman KE, Howie EK, Straker LM, Bullock A, Walwyn TS, Gottardo NG, Cole CH, Choong CS, Naylor LH. Exercise training improves vascular function and secondary health measures in survivors of pediatric oncology related cerebral insult. PLoS One 2018; 13:e0201449. [PMID: 30092052 PMCID: PMC6084859 DOI: 10.1371/journal.pone.0201449] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 07/16/2018] [Indexed: 11/18/2022] Open
Abstract
Adolescent and young adult (AYA) survivors of pediatric oncology related cerebral insult are vulnerable to numerous treatment-induced deficits that significantly enhance cardiovascular disease risk. Regular exercise improves endothelial function, fitness, body composition and musculoskeletal function which may reduce predisposition for cardiovascular disease. Here we assessed the feasibility and effectiveness of a 24-week exercise intervention on cardiovascular, physical and metabolic outcomes in this population. Thirteen survivors (6 male, 7 female; median age 19 y (range 16-23 y) were recruited to participate in a 48-week study consisting of a 24-week control period (regular care) followed by a 24-week exercise intervention. Outcome measures were collected at entry (week 0) and following regular care (24-week) and exercise (48-week). Assessed variables included endothelial function (flow mediated dilation, FMD), blood pressure, heart rate (HR), aerobic capacity, anthropometry, body composition, muscular strength (3 repetition maximum testing), muscular endurance (repetitions/min) and physical activity levels (accelerometry). Compared to baseline, delta diameter (p = 0.008) and FMD (p = 0.029) of the brachial artery increased following exercise. Bicep-curl strength also increased following exercise compared to baseline (p = 0.019), while submaximal (6 min mark) measures of ventilation (p = 0.012), rating of perceived exertion (p = 0.012), HR (p = 0.001), absolute (p = 0.000) and relative (p = 0.000) aerobic capacity decreased. Breaks in sedentary time increased (p = 0.043) following exercise compared to regular care. Although the sample was small and heterogeneous, this study demonstrates that exercise is achievable and has positive effects on vascular function, submaximal fitness, local strength and physical activity in a population of AYA survivors of pediatric oncology related cerebral insult.
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Affiliation(s)
- Treya M. Long
- School of Human Sciences, Exercise and Sport Science, The University of Western Australia, Perth, Western Australia, Australia
| | - Shoshana R. Rath
- Department of Endocrinology, Perth Children’s Hospital, Perth, Western Australia, Australia
- School of Medicine, Pediatrics, The University of Western Australia, Perth, Western Australia, Australia
| | - Karen E. Wallman
- School of Human Sciences, Exercise and Sport Science, The University of Western Australia, Perth, Western Australia, Australia
| | - Erin K. Howie
- School of Physiotherapy and Exercise Sciences, Curtin University, Perth, Western Australia, Australia
| | - Leon M. Straker
- School of Physiotherapy and Exercise Sciences, Curtin University, Perth, Western Australia, Australia
| | - Andrew Bullock
- Department of Cardiology, Perth Children’s Hospital, Perth, Western Australia, Australia
| | - Thomas S. Walwyn
- School of Medicine, Pediatrics, The University of Western Australia, Perth, Western Australia, Australia
- Department of Hematology and Oncology, Perth Children’s Hospital, Perth, Western Australia, Australia
| | - Nicholas G. Gottardo
- School of Medicine, Pediatrics, The University of Western Australia, Perth, Western Australia, Australia
- Department of Hematology and Oncology, Perth Children’s Hospital, Perth, Western Australia, Australia
- Telethon Kids Institute, Perth, Western Australia, Australia
| | - Catherine H. Cole
- School of Medicine, Pediatrics, The University of Western Australia, Perth, Western Australia, Australia
- Department of Hematology and Oncology, Perth Children’s Hospital, Perth, Western Australia, Australia
- Telethon Kids Institute, Perth, Western Australia, Australia
- Hematology, PathWest Laboratory Services, Perth, Western Australia, Australia
| | - Catherine S. Choong
- Department of Endocrinology, Perth Children’s Hospital, Perth, Western Australia, Australia
- School of Medicine, Pediatrics, The University of Western Australia, Perth, Western Australia, Australia
| | - Louise H. Naylor
- School of Human Sciences, Exercise and Sport Science, The University of Western Australia, Perth, Western Australia, Australia
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31
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Qiu S, Cai X, Yin H, Sun Z, Zügel M, Steinacker JM, Schumann U. Exercise training and endothelial function in patients with type 2 diabetes: a meta-analysis. Cardiovasc Diabetol 2018; 17:64. [PMID: 29720185 PMCID: PMC5930739 DOI: 10.1186/s12933-018-0711-2] [Citation(s) in RCA: 109] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 04/25/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND AND AIMS Exercise training is considered a cornerstone in the management of type 2 diabetes, which is associated with impaired endothelial function. However, the association of exercise training with endothelial function in type 2 diabetes patients has not been fully understood. This meta-analysis aimed to investigate their associations with focus on exercise types. METHODS Databases were searched up to January 2018 for studies evaluating the influences of exercise training with durations ≥ 8 weeks on endothelial function assessed by flow-mediated dilation (FMD) among type 2 diabetes patients or between type 2 diabetics and non-diabetics. Data were pooled using random-effects models to obtain the weighted mean differences (WMDs) and 95% confidence intervals (CIs). RESULTS Sixteen databases were included. Exercise training resulted in an overall improvement in FMD by 1.77% (95% CI 0.94-2.59%) in type 2 diabetes patients. Specifically, both aerobic and combined aerobic and resistance exercise increased FMD by 1.21% (95% CI 0.23-2.19%) and 2.49% (95% CI 1.17-3.81%), respectively; but resistance exercise only showed a trend. High-intensity interval aerobic exercise did not significantly improve FMD over moderate-intensity continuous exercise. Notably, the improvement in FMD among type 2 diabetes patients was smaller compared with non-diabetics in response to exercise training (WMD - 0.72%, 95% CI - 1.36 to - 0.08%) or specifically to aerobic exercise (WMD - 0.65%, 95% CI - 1.31 to 0.01%). CONCLUSIONS Exercise training, in particular aerobic and combined exercise, improves endothelial function in type 2 diabetes patients, but such an improvement appears to be weakened compared with non-diabetics. Trial registration PROSPERO CRD42018087376.
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Affiliation(s)
- Shanhu Qiu
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, People's Republic of China
| | - Xue Cai
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, People's Republic of China
| | - Han Yin
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, People's Republic of China
| | - Zilin Sun
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, People's Republic of China.
| | - Martina Zügel
- Division of Sports and Rehabilitation Medicine, Ulm University Medical Center, Ulm, Germany
| | | | - Uwe Schumann
- Division of Sports and Rehabilitation Medicine, Ulm University Medical Center, Ulm, Germany
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32
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Goncharov NV, Nadeev AD, Jenkins RO, Avdonin PV. Markers and Biomarkers of Endothelium: When Something Is Rotten in the State. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2017; 2017:9759735. [PMID: 29333215 PMCID: PMC5733214 DOI: 10.1155/2017/9759735] [Citation(s) in RCA: 132] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 09/05/2017] [Indexed: 12/14/2022]
Abstract
Endothelium is a community of endothelial cells (ECs), which line the blood and lymphatic vessels, thus forming an interface between the tissues and the blood or lympha. This strategic position of endothelium infers its indispensable functional role in controlling vasoregulation, haemostasis, and inflammation. The state of endothelium is simultaneously the cause and effect of many diseases, and this is coupled with modifications of endothelial phenotype represented by markers and with biochemical profile of blood represented by biomarkers. In this paper, we briefly review data on the functional role of endothelium, give definitions of endothelial markers and biomarkers, touch on the methodological approaches for revealing biomarkers, present an implicit role of endothelium in some toxicological mechanistic studies, and survey the role of reactive oxygen species (ROS) in modulation of endothelial status.
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Affiliation(s)
- Nikolay V. Goncharov
- Research Institute of Hygiene, Occupational Pathology and Human Ecology, Saint Petersburg, Russia
- Sechenov Institute of Evolutionary Physiology and Biochemistry RAS, Saint Petersburg, Russia
| | - Alexander D. Nadeev
- Sechenov Institute of Evolutionary Physiology and Biochemistry RAS, Saint Petersburg, Russia
- Institute of Cell Biophysics RAS, Pushchino, Russia
| | - Richard O. Jenkins
- School of Allied Health Sciences, De Montfort University, The Gateway, Leicester LE1 9BH, UK
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Abstract
PURPOSE OF REVIEW This review aims to discuss the burden of type 2 diabetes in youth and summarize the studies that have utilized noninvasive techniques to assess early vascular disease in youth with type 2 diabetes. RECENT FINDINGS Noninvasive imaging modalities provide researchers with tools to investigate the vasculature in adolescents with type 2 diabetes. The data published to date consistently show adolescents with type 2 diabetes have greater vascular thickness and stiffness and worse endothelial function compared to their obese and lean peers. As the prevalence of type 2 diabetes continues to increase adolescent youth, there is concern adolescents with type 2 diabetes are at risk to develop early onset cardiovascular disease and complications. Future studies need to address treatments that have the potential to improve or reverse vascular dysfunction and decrease the rate of cardiovascular disease and complications.
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Affiliation(s)
- Amy S Shah
- Division of Endocrinology, Cincinnati Children's Hospital Medical Center and the University of Cincinnati, 3333 Burnet Ave., ML 7012, Cincinnati, OH, 45229, USA.
| | - Elaine M Urbina
- The Heart Institute, Cincinnati Children's Hospital Medical Center and the University of Cincinnati, Cincinnati, OH, USA
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Green DJ, Hopman MTE, Padilla J, Laughlin MH, Thijssen DHJ. Vascular Adaptation to Exercise in Humans: Role of Hemodynamic Stimuli. Physiol Rev 2017; 97:495-528. [PMID: 28151424 DOI: 10.1152/physrev.00014.2016] [Citation(s) in RCA: 490] [Impact Index Per Article: 61.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
On the 400th anniversary of Harvey's Lumleian lectures, this review focuses on "hemodynamic" forces associated with the movement of blood through arteries in humans and the functional and structural adaptations that result from repeated episodic exposure to such stimuli. The late 20th century discovery that endothelial cells modify arterial tone via paracrine transduction provoked studies exploring the direct mechanical effects of blood flow and pressure on vascular function and adaptation in vivo. In this review, we address the impact of distinct hemodynamic signals that occur in response to exercise, the interrelationships between these signals, the nature of the adaptive responses that manifest under different physiological conditions, and the implications for human health. Exercise modifies blood flow, luminal shear stress, arterial pressure, and tangential wall stress, all of which can transduce changes in arterial function, diameter, and wall thickness. There are important clinical implications of the adaptation that occurs as a consequence of repeated hemodynamic stimulation associated with exercise training in humans, including impacts on atherosclerotic risk in conduit arteries, the control of blood pressure in resistance vessels, oxygen delivery and diffusion, and microvascular health. Exercise training studies have demonstrated that direct hemodynamic impacts on the health of the artery wall contribute to the well-established decrease in cardiovascular risk attributed to physical activity.
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Affiliation(s)
- Daniel J Green
- School of Sport Science, Exercise and Health, The University of Western Australia, Crawley, Western Australia; Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom; Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Physiology, Nijmegen, The Netherlands; Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri; Department of Child Health, University of Missouri, Columbia, Missouri; Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri; Department of Biomedical Sciences, University of Missouri, Columbia, Missouri; and Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, Missouri
| | - Maria T E Hopman
- School of Sport Science, Exercise and Health, The University of Western Australia, Crawley, Western Australia; Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom; Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Physiology, Nijmegen, The Netherlands; Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri; Department of Child Health, University of Missouri, Columbia, Missouri; Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri; Department of Biomedical Sciences, University of Missouri, Columbia, Missouri; and Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, Missouri
| | - Jaume Padilla
- School of Sport Science, Exercise and Health, The University of Western Australia, Crawley, Western Australia; Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom; Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Physiology, Nijmegen, The Netherlands; Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri; Department of Child Health, University of Missouri, Columbia, Missouri; Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri; Department of Biomedical Sciences, University of Missouri, Columbia, Missouri; and Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, Missouri
| | - M Harold Laughlin
- School of Sport Science, Exercise and Health, The University of Western Australia, Crawley, Western Australia; Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom; Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Physiology, Nijmegen, The Netherlands; Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri; Department of Child Health, University of Missouri, Columbia, Missouri; Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri; Department of Biomedical Sciences, University of Missouri, Columbia, Missouri; and Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, Missouri
| | - Dick H J Thijssen
- School of Sport Science, Exercise and Health, The University of Western Australia, Crawley, Western Australia; Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom; Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Physiology, Nijmegen, The Netherlands; Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri; Department of Child Health, University of Missouri, Columbia, Missouri; Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri; Department of Biomedical Sciences, University of Missouri, Columbia, Missouri; and Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, Missouri
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35
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Lenasi H, Klonizakis M. Assessing the evidence: Exploring the effects of exercise on diabetic microcirculation. Clin Hemorheol Microcirc 2017; 64:663-678. [PMID: 27767975 DOI: 10.3233/ch-168022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Diabetes mellitus (DM) is associated with cardiovascular complications. Impairment of glycemic control induces noxious glycations, an increase in oxydative stress and dearangement of various metabolic pathways. DM leads to dysfunction of micro- and macrovessels, connected to metabolic, endothelial and autonomic nervous system. Thus, assessing vascular reactivity might be one of the clinical tools to evaluate the impact of harmful effects of DM and potential benefit of treatment; skin and skeletal muscle microcirculation have usually been tested. Physical exercise improves vascular dysfunction through various mechanisms, and is regarded as an additional effective treatment strategy of DM as it positively impacts glycemic control, improves insulin sensitivity and glucose uptake in the target tissues, thus affecting glucose and lipid metabolism, and increases the endothelium dependent vasodilation. Yet, not all patients respond in the same way so titrating the exercise type individualy would be desirable. Resistance training has, apart from aerobic one, been shown to positively correlate to glycemic control, and improve vascular reactivity. It has been prescribed in various forms or in combination with aerobic training. This review would assess the impact of different modes of exercise, the mechanisms involved, and its potential positive and negative effects on treating patients with Type I and Type II DM, focusing on the recent literature.
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Affiliation(s)
- Helena Lenasi
- Institute of Physiology, Faculty of Medicine, University of Ljubljana, Slovenia
| | - Markos Klonizakis
- Centre for Sport and Exercise Science, Sheffield Hallam University, UK
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36
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Naylor LH, Davis EA, Kalic RJ, Paramalingam N, Abraham MB, Jones TW, Green DJ. Exercise training improves vascular function in adolescents with type 2 diabetes. Physiol Rep 2016; 4:4/4/e12713. [PMID: 26887327 PMCID: PMC4759041 DOI: 10.14814/phy2.12713] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The impact of exercise training on vascular health in adolescents with type 2 diabetes has not been previously studied. We hypothesized that exercise training would improve micro‐ and macrovascular health in adolescents with type 2 diabetes. Thirteen adolescents (13–21 years, 10F) with type 2 diabetes were recruited from Princess Margaret Hospital. Participants were randomized to receive either an exercise program along with standard clinical care (n = 8) or standard care alone (n = 5). Those in the intervention group received 12 weeks of gym‐based, personalized, and supervised exercise training. Those in the control group were instructed to maintain usual activity levels. Assessments were conducted at baseline and following week 12. The exercise group was also studied 12 weeks following the conclusion of their program. Assessments consisted of conduit artery endothelial function (flow‐mediated dilation, FMD) and microvascular function (cutaneous laser Doppler). Secondary outcomes included body composition (dual‐energy X‐ray absorptiometry, DXA), glycemic control (whole body insulin sensitivity, M) assessed using the euglycemic–hyperinsulinemic clamp protocol, cardiorespiratory fitness (V˙O2peak), and muscular strength (1RM). Exercise training increased FMD (P < 0.05), microvascular function (P < 0.05), total lean mass (P < 0.05), and muscle strength (P < 0.001). There were no changes in cardiorespiratory fitness, body weight, BMI, or M. In the control group, body weight (P < 0.01), BMI (P < 0.01), and total fat mass (P < 0.05) increased. At week 24, improvements in vascular function were reversed. This study indicates that exercise training can improve both conduit and microvascular endothelial function and health, independent of changes in insulin sensitivity in adolescents with type 2 diabetes.
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Affiliation(s)
- Louise H Naylor
- School of Sport Science, Exercise & Health, The University of Western Australia, Crawley, Australia
| | - Elizabeth A Davis
- School of Paediatric and Child Health, The University of Western Australia, Crawley, Australia Telethon Kids Institute, The University of Western Australia, Subiaco, Australia Department of Endocrinology and Diabetes, Princess Margaret Hospital, Subiaco, Australia
| | - Rachelle J Kalic
- Telethon Kids Institute, The University of Western Australia, Subiaco, Australia Department of Endocrinology and Diabetes, Princess Margaret Hospital, Subiaco, Australia
| | - Niru Paramalingam
- Telethon Kids Institute, The University of Western Australia, Subiaco, Australia Department of Endocrinology and Diabetes, Princess Margaret Hospital, Subiaco, Australia
| | - Mary B Abraham
- School of Paediatric and Child Health, The University of Western Australia, Crawley, Australia Department of Endocrinology and Diabetes, Princess Margaret Hospital, Subiaco, Australia
| | - Timothy W Jones
- School of Paediatric and Child Health, The University of Western Australia, Crawley, Australia Telethon Kids Institute, The University of Western Australia, Subiaco, Australia Department of Endocrinology and Diabetes, Princess Margaret Hospital, Subiaco, Australia
| | - Daniel J Green
- School of Sport Science, Exercise & Health, The University of Western Australia, Crawley, Australia Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
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