(26-10-06) Exercise-Induced Improvement in Vasodilatory Function

Accompanies Increased Insulin Sensitivity in Obesity and Type 2 Diabetes Mellitus.

De Filippis E, Cusi K, Ocampo G, Berria R, Buck S, Consoli A, Mandarino LJ.

Center for Metabolic Biology, Arizona State University, Tempe, Arizona, Department of Medicine, University of Texas Health Science Center, San Antonio, Texas, Department of Obstetrics and Gynecology, Case Western Reserve University, Cleveland, Ohio, Texas Diabetes Institute, San Antonio Texas, Department of Medicine and Aging Sciences, University of Chieti, Italy.

Objective: The present study was undertaken to determine whether improved vasodilatory function accompanies increased insulin sensitivity in overweight, insulin resistant subjects (OW) and type 2 diabetic patients (T2DM) who participated in an 8-week exercise training regimen. Design: Before and after training, subjects had euglycemic clamps to determine insulin sensitivity. Brachial artery catheterization was done on another occasion for measurement of vasodilatory function. A lean, healthy, untrained group was studied as non-exercised controls. Results: Training increased VO2peak (OW: 29 +/- 1 to 37 +/- 4 ml/Kg FFM/min; T2DM: 33 +/- 2 to 43 +/- 3 ml/Kg FFM/min P < 0.05), improved insulin-stimulated glucose disposal (OW: 6.5 +/- 0.5 to 7.2 +/- 0.4 mg/Kg FFM/min; T2DM: 3.8 +/- 0.3 to 4.2 +/- 0.3 mg/Kg FFM/min P < 0.05) in insulin resistance. OW and T2DM, before training, had decreased acetylcholine and sodium nitroprusside mediated vasodilation, and decreased reactive hyperemia, compared with lean controls. Training increased the vasodilatory response to acetylcholine (OW: ACh (30 microg/min) 12.2 +/- 3.4 to 19 +/- 4.2 ml/100 g/min; T2DM: ACh (30 microg/min) 10.1 +/- 1.5 to 14.2 +/- 2.1 ml/100 g/min;P < 0.05) in both groups without affecting nitroprusside response. Conclusion: Since vasodilatory dysfunction has been postulated to contribute to insulin resistance, the exercise-induced improvement in vasodilatory function may signify changes in the endothelium that could contribute to the improvement in insulin sensitivity observed after aerobic exercise training.

Source: J Clin Endocrinol Metab.

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