Diabetes Metab J.  2020 Feb;44(1):103-112. 10.4093/dmj.2018.0160.

Combined Aerobic and Resistance Exercise Training Reduces Circulating Apolipoprotein J Levels and Improves Insulin Resistance in Postmenopausal Diabetic Women

Affiliations
  • 1Division of Endocrinology and Metabolism, Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea. drsskim7@gmail.com
  • 2Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
  • 3Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. ykim2@bidmc.harvard.edu
  • 4Department of Physical Education, Kyungnam University College of Education, Changwon, Korea.
  • 5Department of Marine Sports, Pukyong National University, Busan, Korea.
  • 6Nutrition Service Team, Pusan National University Hospital, Busan, Korea.
  • 7Kim Yong Ki Internal Medicine Clinic, Busan, Korea.
  • 8Division of Nephrology, Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.

Abstract

BACKGROUND
Circulating apolipoprotein J (ApoJ) is closely associated with insulin resistance; however, the effect of exercise on circulating ApoJ levels and the association of ApoJ with metabolic indices remain unknown. Here, we investigated whether a combined exercise can alter the circulating ApoJ level, and whether these changes are associated with metabolic indices in patients with type 2 diabetes mellitus.
METHODS
Postmenopausal women with type 2 diabetes mellitus were randomly assigned into either an exercise (EXE, n=30) or control (CON, n=15) group. Participants in the EXE group were enrolled in a 12-week program consisting of a combination of aerobic and resistance exercises. At baseline, 4, 8, and 12 weeks, body composition and metabolic parameters including homeostatic model assessment of insulin resistance (HOMA-IR) and serum ApoJ levels were assessed.
RESULTS
In the EXE group, ApoJ levels decreased 26.3% and 19.4%, relative to baseline, at 8 and 12 weeks, respectively. Between-group differences were significant at 8 and 12 weeks (P<0.05 and P<0.001, respectively). In the EXE group, 12 weeks of exercise resulted in significant decreases in body weight, percent body fat, and HOMA-IR indices. Concurrently, weight-adjusted appendicular skeletal muscle mass (ASM/wt) was increased in the EXE group compared with the CON group. Importantly, changes in the ApoJ level were significantly correlated with changes in ASM/wt.
CONCLUSION
Exercise training resulted in a significant decrease in the circulating ApoJ level, with changes in ApoJ associated with an improvement in some insulin resistance indices. These data suggest that circulating ApoJ may be a useful metabolic marker for assessing the effects of exercise on insulin resistance.

Keyword

Apolipoprotein J; Exercise; Insulin resistance; Sarcopenia

MeSH Terms

Adipose Tissue
Apolipoproteins*
Body Composition
Body Weight
Clusterin*
Diabetes Mellitus, Type 2
Exercise
Female
Humans
Insulin Resistance*
Insulin*
Muscle, Skeletal
Sarcopenia
Apolipoproteins
Clusterin
Insulin

Figure

  • Fig. 1 Study design and patient disposition. (A) Schematic of the study design. (B) Details of patient disposition. CON, control group; EXE, exercise group.

  • Fig. 2 Effects of a combined exercise regimen on the circulating apolipoprotein J (ApoJ) level in postmenopausal women with type 2 diabetes mellitus. (A) Change in the serum ApoJ level over the course of the exercise program. Significant differences in the circulating ApoJ level between the exercise group (EXE) and control group (CON) are shown. (B) Percent changes in the serum ApoJ level, relative to baseline, at weeks 8 and 12. Values are mean±standard error. aP=0.019 at week 8, bP=0.007 at week 12, by repeated-measures analysis of variance, cP<0.05 vs. CON, dP<0.001 vs. CON.

  • Fig. 3 Correlations of changes in the circulating apolipoprotein J (ApoJ) level with changes in (A) total fat mass (TFM), (B) weight-adjusted appendicular skeletal muscle mass (ASM/wt), and (C) homeostatic model assessment of insulin resistance (HOMA-IR). Data represent Spearman's rank correlation coefficients and P values. Δ indicates the value at baseline minus that at 12 weeks.


Cited by  1 articles

Impact of Skeletal Muscle Mass on Metabolic Health
Gyuri Kim, Jae Hyeon Kim
Endocrinol Metab. 2020;35(1):1-6.    doi: 10.3803/EnM.2020.35.1.1.


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