Insulin Responsiveness in Metabolic Syndrome after Eight Weeks of Cycle Training

STUART, CHARLES A.1; SOUTH, MARK A.2; LEE, MICHELLE L.3; MCCURRY, MELANIE P.1; HOWELL, MARY E. A.1; RAMSEY, MICHAEL W.2; STONE, MICHAEL H.2

Medicine & Science in Sports & Exercise: November 2013 - Volume 45 - Issue 11 - p 2021–2029
doi: 10.1249/MSS.0b013e31829a6ce8
Clinical Sciences

Introduction: Insulin resistance in obesity is decreased after successful diet and exercise. Aerobic exercise training alone was evaluated as an intervention in subjects with the metabolic syndrome.

Methods: Eighteen nondiabetic, sedentary subjects, 11 with the metabolic syndrome, participated in 8 wk of increasing intensity stationary cycle training.

Results: Cycle training without weight loss did not change insulin resistance in metabolic syndrome subjects or sedentary control subjects. Maximal oxygen consumption (V˙O2max), activated muscle AMP-dependent kinase, and muscle mitochondrial marker ATP synthase all increased. Strength, lean body mass, and fat mass did not change. The activated mammalian target of rapamycin was not different after training. Training induced a shift in muscle fiber composition in both groups but in opposite directions. The proportion of type 2× fibers decreased with a concomitant increase in type 2a mixed fibers in the control subjects, but in metabolic syndrome, type 2× fiber proportion increased and type 1 fibers decreased. Muscle fiber diameters increased in all three fiber types in metabolic syndrome subjects. Muscle insulin receptor expression increased in both groups, and GLUT4 expression increased in the metabolic syndrome subjects. The excess phosphorylation of insulin receptor substrate 1 (IRS-1) at Ser337 in metabolic syndrome muscle tended to increase further after training in spite of a decrease in total IRS-1.

Conclusions: In the absence of weight loss, the cycle training of metabolic syndrome subjects resulted in enhanced mitochondrial biogenesis and increased the expression of insulin receptors and GLUT4 in muscle but did not decrease the insulin resistance. The failure for the insulin signal to proceed past IRS-1 tyrosine phosphorylation may be related to excess serine phosphorylation at IRS-1 Ser337, and this is not ameliorated by 8 wk of endurance exercise training.

1Department of Internal Medicine, Quillen College of Medicine, East Tennessee State University, Johnson City, TN; 2Department of Exercise and Sport Science, Clemmer College of Education, East Tennessee State University, Johnson City, TN; and 3Department of Allied Health, College of Clinical and Rehabilitative Health, East Tennessee State University, Johnson City, TN

Address for correspondence: Charles A. Stuart, M.D., Quillen College of Medicine, East Tennessee State University, PO Box 70622, Johnson City, TN 37614-0622; E-mail: stuartc@etsu.edu.

Submitted for publication January 2013.

Accepted for publication May 2013.

© 2013 American College of Sports Medicine