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Medicine & Science in Sports & Exercise:
doi: 10.1249/MSS.0000000000000242
Original Investigation: PDF Only

Aerobic and Strength Training in Concomitant Metabolic Syndrome and Type 2 Diabetes

Earnest, Conrad P.; Johannsen, Neil M.; Swift, Damon L.; Gillison, Fiona B.; Mikus, Catherine R.; Lucia, Alejandro; Kramer, Kimberly; Lavie, Carl J.; Church, Timothy S.

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Purpose: Concomitant type 2 diabetes (T2D) and metabolic syndrome exacerbates mortality risk; yet, few studies have examined the effect of combining (AER+RES) aerobic (AER) and resistance (RES) training for individuals with T2D and metabolic syndrome.

Methods: We examined AER, RES, and AER+RES training (9-months) commensurate with physical activity guidelines in individuals with T2D (N=262, 63% female, 44% black). Primary outcomes were change in, and prevalence of, metabolic syndrome score at follow-up (mean, 95%CI). Secondary outcomes included maximal cardiorespiratory fitness (VO2peak and estimated METs from time-to-exhaustion (TTE), and exercise efficiency calculated as the slope of the line between ventilatory threshold, respiratory compensation, and maximal fitness. General linear models and bootstrapped Spearman correlations were used to examine changes in metabolic syndrome associated with training primary and secondary outcome variables.

Results: We observed a significant decrease in metabolic syndrome scores (P-for-trend, 0.003) for AER (-0.59, 95%CI, -1.00, -0.21) and AER+RES (-0.79, 95%CI, -1.40, -0.35), both being significant (P <= 0.02) vs. Control (0.26, 95%CI, -0.58, 0.40) and RES (-0.13, 95%CI, -1.00, 0.24). This lead to a reduction in metabolic syndrome prevalence for the AER (56% vs. 43%) and AER+RES (55% vs. 46%) groups between baseline and follow-up. The observed decrease in metabolic syndrome was mediated by significant improvements in exercise efficiency for the AER and AER+RES training groups (P<0.05), which was more strongly related to TTE (25-30%; r= -0.38; 95% CI: -0.55, -0.19) than VO2peak (5-6%; r= -0.24; 95% CI: -0.45, -0.01).

Conclusion: Aerobic and AER+RES training significantly improves metabolic syndrome scores and prevalence in patients with T2D. These improvements appear to be associated with improved exercise efficiency and are more strongly related to improved TTE versus VO2peak.

(C) 2014 American College of Sports Medicine


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