- April 24, 2010
- Long- but not short-term multifactorial intervention with focus on exercise training improves coronary endothelial dysfunction in diabetes mellitus type 2 and coronary artery disease. Eur Heart J 2010;31:112-9
- Sixt S, Beer S, Blüher M, Korff N, Peschel T, Sonnabend M, Teupser D, Thiery J, Adams V, Schuler G, Niebauer J.
Description of this Publication
This study was conducted to investigate the effects of a multifactorial intervention with focus on exercise training on coronary endothelial function, vascular structure, and inflammation in serum and skeletal muscle biopsies, including mRNA expression of diabetes candidate genes. Twenty-three patients with coronary artery disease and type 2 diabetes were randomized to an intervention program (n=11) or to a control group (n=12). The intervention included 4 weeks in-hospital exercise training (6 x 15 min bicycle/day, 5 days/week) and a hypocaloric diet, followed by a 5-month ambulatory program (30 min ergometer/day, 5 days/week, plus 1-h group exercise/week). After 6 months of intervention, the coronary endothelial function was improved in patients with type 2 diabetes, but no regression was observed for the intramural coronary lesions of less than 25%. A significant improvement was observed after only 4 weeks for fasting plasma glucose, high-sensitive C-reactive protein and HbA1c levels, but a return to their baseline levels was observed after 6 months which could be explained by the slight regain in weight. The expression of oxidative stress-related genes measured in skeletal muscle was increased after 4 weeks of exercise training and showed a decline in expression after 6 months; similar results were observed for PPAR- and . Moreover, mRNA expression of AdipoR1, AdipoR2, IL-6, eNOS, and PGC-1 increased after 4 weeks of intervention and were even higher after 6 months. These findings show the beneficial effects of exercise on endothelial function as well as on markers of hyperglycemia and inflammation in both serum and skeletal muscle of patients with type 2 diabetes.