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Light physical activity determined by a motion sensor decreases insulin resistance, improves lipid homeostasis and reduces visceral fat in high-risk subjects: PreDiabEx study RCT.

Herzig KH, Ahola R, Leppäluoto J, Jokelainen J, Jämsä T, Keinänen-Kiukaanniemi S - Int J Obes (Lond) (2013)

Bottom Line: In contrast, changes in fasting and 2-h insulin (-3.4 mU l(-1), P=0.035 and -26.6, P=0.003, respectively), homeostasis model assessment-estimated insulin resistance (-1.0, P=0.036), total cholesterol (-0.55 mmol l(-1), P=0.041), low-density lipoprotein (LDL) cholesterol (-0.36 mmol l(-1), P=0.008) and visceral fat area (-5.5 cm(2), P=0.030) were significantly greater in the intervention than in control subjects.The overall effects of PA were analyzed by quartiles of daily steps of all subjects.There were significant reductions in total and LDL cholesterol and visceral fat area between the highest (daily steps over 6520) and the lowest quartile (1780-2810 daily steps).

View Article: PubMed Central - PubMed

Affiliation: 1] Institute of Biomedicine, Department of Physiology and Biocenter of Oulu, Oulu University, Oulu, Finland [2] Medical Research Center Oulu and Oulu University Hospital, Oulu, Finland.

ABSTRACT

Objective: To examine physical activity (PA) thresholds affecting glucose, insulin and lipid concentrations and body fat composition in high-risk patients for type 2 diabetes (T2D).

Intervention: A total of 113 subjects of both genders having abnormal glucose levels in the oral glucose tolerance test were contacted. A total of 78 subjects with age 58.8±10.4 years and body mass index 31.7±5.3 kg m(-2) were randomly assigned to intervention and control groups. INTERVENTION consisted of a supervised walking (60 min three times weekly) for 3 months. All the subjects received standard care for PA and weight reduction and wore an accelerometer during the whole wakeful time.

Results: Over 80% of the daily steps clustered at an acceleration level of 0.3-0.7 g (2-3 km h(-1) of walking) and were 5870 in the intervention and 4434 in the control group (P<0.029). Between 0 and 3 months no significant changes were observed in fasting and 2-h glucose, body weight or maximal oxygen uptake. In contrast, changes in fasting and 2-h insulin (-3.4 mU l(-1), P=0.035 and -26.6, P=0.003, respectively), homeostasis model assessment-estimated insulin resistance (-1.0, P=0.036), total cholesterol (-0.55 mmol l(-1), P=0.041), low-density lipoprotein (LDL) cholesterol (-0.36 mmol l(-1), P=0.008) and visceral fat area (-5.5 cm(2), P=0.030) were significantly greater in the intervention than in control subjects. The overall effects of PA were analyzed by quartiles of daily steps of all subjects. There were significant reductions in total and LDL cholesterol and visceral fat area between the highest (daily steps over 6520) and the lowest quartile (1780-2810 daily steps). The changes associated with PA remained significant after adjustments of baseline, sex, age and body weight change.

Conclusion: Habitual and structured PAs with the acceleration levels of 0.3-0.7 g and daily steps over 6520, equivalent to walking at 2-3 km h(-1) for 90 min daily, standing for the relative PA intensity of 30-35% of the maximal oxygen uptake, are clinically beneficial for overweight/obese and physically inactive individuals with a high risk for T2D.

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Related in: MedlinePlus

Flow chart of the PreDiabEx study participants and dropouts from the study.
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fig1: Flow chart of the PreDiabEx study participants and dropouts from the study.

Mentions: For this randomized controlled trial (acronym: PreDiabEx) between November 2009 and January 2010 Caucasian subjects from the outpatient diabetic clinics in the Oulu Deaconess Hospital and the City of Oulu were evaluated with the FINDRISC questionnaire for T2D (http://www.idf.org/webdata/docs/FINDRISC_English.pdf20). Those subjects receiving scores >15 were selected for the study. A total of 113 subjects with a median FINDRISC score of 20 (range 15–26) were further evaluated by an oral glucose tolerance test. We used the WHO criteria for impaired fasting glucose (⩾5.6 and <7.0 and 2-h glucose <7.8 mmol l−1) or impaired glucose tolerance (fasting glucose <7.8 and 2-h glucose ⩾7.8 and <11.1 mmol l−1). Seventy-eight subjects fulfilled the criteria and were willing to participate in the 3-month study (Figure 1). They were randomized based on age and gender using a parallel block design to distinguish intervention and control groups with the allocation ratio of 1:1. We used computerized random number generation. The estimated sample size to detect a 1.2-mmol l−1 (s.d.=2.5) change between intervention and control groups in 2-h glucose and 40-mU l−1 (s.d.=80) change in 2-h insulin with a significance level of 5% and a power of 80% was 65 and 62, respectively. Exclusion criteria were any functional limitation or chronic disease that might have limited the training and testing of the cardiovascular and respiratory systems, any medication for diabetes or current vigorous PA for more than 75 min per week as revealed by a questionnaire or physician's examination. The study protocol was approved by the institutional ethics committee (Northern Ostrobothnia Hospital District). All subjects gave their informed written consent. The Municipal Board of the Northern Ostrobothnia Hospital District approved the trial under the registration number 113/2009. The trial was also registered under NCT01649219 (clinicaltrial.gov). The CONSORT checklist is available as Supplementary Information (Checklist S1).


Light physical activity determined by a motion sensor decreases insulin resistance, improves lipid homeostasis and reduces visceral fat in high-risk subjects: PreDiabEx study RCT.

Herzig KH, Ahola R, Leppäluoto J, Jokelainen J, Jämsä T, Keinänen-Kiukaanniemi S - Int J Obes (Lond) (2013)

Flow chart of the PreDiabEx study participants and dropouts from the study.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4125749&req=5

fig1: Flow chart of the PreDiabEx study participants and dropouts from the study.
Mentions: For this randomized controlled trial (acronym: PreDiabEx) between November 2009 and January 2010 Caucasian subjects from the outpatient diabetic clinics in the Oulu Deaconess Hospital and the City of Oulu were evaluated with the FINDRISC questionnaire for T2D (http://www.idf.org/webdata/docs/FINDRISC_English.pdf20). Those subjects receiving scores >15 were selected for the study. A total of 113 subjects with a median FINDRISC score of 20 (range 15–26) were further evaluated by an oral glucose tolerance test. We used the WHO criteria for impaired fasting glucose (⩾5.6 and <7.0 and 2-h glucose <7.8 mmol l−1) or impaired glucose tolerance (fasting glucose <7.8 and 2-h glucose ⩾7.8 and <11.1 mmol l−1). Seventy-eight subjects fulfilled the criteria and were willing to participate in the 3-month study (Figure 1). They were randomized based on age and gender using a parallel block design to distinguish intervention and control groups with the allocation ratio of 1:1. We used computerized random number generation. The estimated sample size to detect a 1.2-mmol l−1 (s.d.=2.5) change between intervention and control groups in 2-h glucose and 40-mU l−1 (s.d.=80) change in 2-h insulin with a significance level of 5% and a power of 80% was 65 and 62, respectively. Exclusion criteria were any functional limitation or chronic disease that might have limited the training and testing of the cardiovascular and respiratory systems, any medication for diabetes or current vigorous PA for more than 75 min per week as revealed by a questionnaire or physician's examination. The study protocol was approved by the institutional ethics committee (Northern Ostrobothnia Hospital District). All subjects gave their informed written consent. The Municipal Board of the Northern Ostrobothnia Hospital District approved the trial under the registration number 113/2009. The trial was also registered under NCT01649219 (clinicaltrial.gov). The CONSORT checklist is available as Supplementary Information (Checklist S1).

Bottom Line: In contrast, changes in fasting and 2-h insulin (-3.4 mU l(-1), P=0.035 and -26.6, P=0.003, respectively), homeostasis model assessment-estimated insulin resistance (-1.0, P=0.036), total cholesterol (-0.55 mmol l(-1), P=0.041), low-density lipoprotein (LDL) cholesterol (-0.36 mmol l(-1), P=0.008) and visceral fat area (-5.5 cm(2), P=0.030) were significantly greater in the intervention than in control subjects.The overall effects of PA were analyzed by quartiles of daily steps of all subjects.There were significant reductions in total and LDL cholesterol and visceral fat area between the highest (daily steps over 6520) and the lowest quartile (1780-2810 daily steps).

View Article: PubMed Central - PubMed

Affiliation: 1] Institute of Biomedicine, Department of Physiology and Biocenter of Oulu, Oulu University, Oulu, Finland [2] Medical Research Center Oulu and Oulu University Hospital, Oulu, Finland.

ABSTRACT

Objective: To examine physical activity (PA) thresholds affecting glucose, insulin and lipid concentrations and body fat composition in high-risk patients for type 2 diabetes (T2D).

Intervention: A total of 113 subjects of both genders having abnormal glucose levels in the oral glucose tolerance test were contacted. A total of 78 subjects with age 58.8±10.4 years and body mass index 31.7±5.3 kg m(-2) were randomly assigned to intervention and control groups. INTERVENTION consisted of a supervised walking (60 min three times weekly) for 3 months. All the subjects received standard care for PA and weight reduction and wore an accelerometer during the whole wakeful time.

Results: Over 80% of the daily steps clustered at an acceleration level of 0.3-0.7 g (2-3 km h(-1) of walking) and were 5870 in the intervention and 4434 in the control group (P<0.029). Between 0 and 3 months no significant changes were observed in fasting and 2-h glucose, body weight or maximal oxygen uptake. In contrast, changes in fasting and 2-h insulin (-3.4 mU l(-1), P=0.035 and -26.6, P=0.003, respectively), homeostasis model assessment-estimated insulin resistance (-1.0, P=0.036), total cholesterol (-0.55 mmol l(-1), P=0.041), low-density lipoprotein (LDL) cholesterol (-0.36 mmol l(-1), P=0.008) and visceral fat area (-5.5 cm(2), P=0.030) were significantly greater in the intervention than in control subjects. The overall effects of PA were analyzed by quartiles of daily steps of all subjects. There were significant reductions in total and LDL cholesterol and visceral fat area between the highest (daily steps over 6520) and the lowest quartile (1780-2810 daily steps). The changes associated with PA remained significant after adjustments of baseline, sex, age and body weight change.

Conclusion: Habitual and structured PAs with the acceleration levels of 0.3-0.7 g and daily steps over 6520, equivalent to walking at 2-3 km h(-1) for 90 min daily, standing for the relative PA intensity of 30-35% of the maximal oxygen uptake, are clinically beneficial for overweight/obese and physically inactive individuals with a high risk for T2D.

Show MeSH
Related in: MedlinePlus