EFFECTS OF A 9 MONTHS EXERCISE TRAINING ON INFLAMMATORY AND LIPID MARKERS IN TYPE 2 DIABETIC PATIENTS

Aims: Desired effects of a rehabilitative training are: Decreases in inflammation and lipid risk factors, in HbA1c, and increases in cardiopulmonary capacity. Though the beneficial effects of intense training are well established, no epidemiologic relevance of such training regimens has been found. Apparently a moderate and stress free program is an important prerequisite for lasting acceptance and life style change. Therefore studies should point to low but still effective training intensity. Methods: 33 type 2 diabetes patients (63.8 ± 6.9 years) with insulin regimen had a 9 months rehabilitative exercise training two times/week. Plasma levels of inflammatory and lipid markers, specific diabetic and training parameters were measured at baseline, after three, six and nine months. Results: Rehabilitative training resulted in a significant increase in tumor necrosis factor-alpha (12.27 ± 7.93 vs. 15.12 ± 9.58 or 14.89 ± 9.25 pgxl-1 after 6 or 9 months). Interleukin-6 was reduced significantly after 3 months (4.3 ± 7.02 vs. 3.92 ± 6.68 pgxl-1 ) whereas C-reactive protein remained unchanged. Lipid parameters decreased markedly after 9 months (triglycerides 2.10 ± 1.2 vs. 1.82 ± 1.07 mmolxl-1 ; cholesterol 5.18 ± 1.12 vs. 4.92 ± 0.91 mmolxl-1 ; LDL 3.24 ± 0.85 vs. 2.88 ± 0.66 mmolxl-1 ). HDL and HbA1c remained almost unchanged. Weight decreased moderately but significantly (99.21 ± 17.62 vs. 97.73 ± 16.61 kg) also BMI (35.28 ± 5.3 vs. 34.78 ± 5.34). Endurance capacity was increased by 103%, ratepressure product at rest and blood pressure markedly decreased. Conclusions: 9 months of rehabilitative exercise training in type 2 diabetes patients had moderate but significant effects on lipid factors, no relevant effect on C-reactive protein and Interleukin-6 but resulted in a marked increase in tumor necrosis factor-alpha. A marked improvement in endurance capacity, cardiac stress and blood pressure was seen.