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http://dx.doi.org/10.12925/jkocs.2019.36.4.1268

Effects of Combined Exercise on Irisin, Body Composition and Glucose Metabolism in Obese Elderly Women with Type 2 Diabetes Mellitus  

Ha, Soo-Min (Department of Physical Education, Pusan National University)
Kim, Jung-Sook (Department of Physical Education, Pusan National University)
Ha, Min-Seong (Laboratory of Exercise Biochemistry and Neuroendocrinology, Faculty of Health and Sports Sciences, University of Tsukuba)
Kim, Bo-Sung (Department of Physical Education, Pusan National University)
Kim, Do-Yeon (Department of Physical Education, Pusan National University)
Publication Information
Journal of the Korean Applied Science and Technology / v.36, no.4, 2019 , pp. 1268-1280 More about this Journal
Abstract
The purpose of this study was to investigate the effects of combined exercise on irisin, body composition and glucose metabolism in obese elderly women with type 2 diabetes mellitus. The subjects were thirty-six obese elderly women with type 2 diabetes volunteers, aged 65 to 85 years, composed of the combined exercise type 2 diabetes mellitus group (n=20) and non-exercise type 2 diabetes mellitus group (n=16). The 60 minute combined exercise program (outdoor walking exercise & elastic-band exercise) was performed 3 times per week for 12 weeks. Exercise intensity of outdoor walking exercise was performed as medium intensity (RPE 5~6) and elastic-band exercise was progressively increased every four weeks (1-4 weeks: OMNI-RES 3~4, 5-8 weeks: OMNI-RES 5~6, 9-12 weeks: OMNI-RES 7~8). The results of the study in the combined exercise type 2 diabetes mellitus group were as follows; Irisin and skeletal muscle mass had significantly increased (p<.001), percentage of body fat had significantly decreased (p<.001). Further, HbA1c (p=.020) and fasting glucose (p<.001) was significantly decreased, and HOMA-β was significantly increased (p<.001). Correlation results showed that change of irisin had a significant negative correlation between percentage of body fat mass (r=-.423, p=.010), HbA1c (r=-.351, p=.036) and fasting glucose (r=-.424, p=.010). Also, irisin changes showed a positive correlation with aerobic endurance (r=.355, p=.034) and HOMA-β (r=.411, p=.013). In conclusion, the practice of regular combined exercise was found to increase the level of irisin in elderly women with type 2 diabetes and have a positive effect on body composition changes. In addition, HbA1c, fasting glucose and insulin secretion was improved, which helped to regulate glucose metabolism. Walking exercise and elastic band exercise are recommended as effective exercise for the prevention and management of diabetes in obese elderly women with type 2 diabetes mellitus.
Keywords
type 2 diabetes; combined exercise; irisin; body composition; glucose metabolism;
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1 S. Cinti, "Between brown and white: novel aspects of adipocyte differentiation." Ann Med, Vol. 43 No. 2 pp. 104-115, (2011).   DOI
2 P. Bostrom, J. Wu, M. P. Jedrychowsky, A. Korde, L. Ye, J. C. Lo, K. A. Rasbach, E. A. Bostrom, J. H. Choi, J. Z. Long, S. Kajimura, M. C. Zingaretti, B. F. Vind, H. Tu, S. Cinti, K. Hojlund, S. P. Gygi, B. M. Spiegelman, "A PGC1-${\alpha}$-dependent myokine that drives brown-fat-like development of white fat and thermogenesis." Nature, Vol. 481 No. 7382 pp. 463-468, (2012).   DOI
3 J. M. Moreno-Navarrete, F. Ortega, M. Serrano, E. Guerra, G. Pardo, F. Tinahones, W. Ricart, J. M. Fernandez-Real, "Irisin is expressed and produced by human muscle and adipose tissue in association with obesity and insulin resistance." The Journal of Clinical Endocrinology & Metabolism, Vol. 98 No. 4, pp. E769-E778, (2013).   DOI
4 F. Li, Y. Li, Y. Duan, C.-A. A. Hu, Y. Tang, Y. Yin, "Myokines and adipokines: Involvement in the crosstalk between skeletal muscle and adipose tissue." Cytokine Growth Factor Reviews, Vol. 33 pp. 73-82, (2017).   DOI
5 A. Shoukry, S. M. Shalaby, S. El-Arabi Bdeer, A. A. Mahmoud, M. M. Mousa, A. Khalifa, "Circulating serum irisin levels in obesity and type 2 diabetes mellitus." IUBMB Life, Vol. 68 No. 7 pp. 544-556, (2016).   DOI
6 M. I. Hernandez-Alvarez, H. Thabit, N. Burns, S. Shah, I. Brema, M. Hatunic, F. Finucane, M. Liesa, C. Chiellini, D. Naon, A. Zorzano, J. J. Nolan, "Subjects with early-onset type 2 diabetes show defective activation of the skeletal muscle PGC-1{alpha}/Mitofusin-2 regulatory pathway in response to physical activity." Diabetes Care, Vol. 33 No. 3 pp. 645-651, (2010).   DOI
7 R. J. Sigal, G. P. Kenny, N. G. Boule, G. A. Wells, D. Prud'homme, M. Fortier, R. D. Reid, H. Tulloch, D. Coyle, P. Phillips, A. Jennings, J. Jaffey, "Effects of aerobic training, resistance training, or both on glycemic control in type 2 diabetes: a randomized trial." Annals of Internal Medicine, Vol. 147 No. 6 pp. 357-369, (2007).   DOI
8 C. Xin, J. Liu, J. Zhang, D. Zhu, H. Wang, L. Xiong, Y. Lee, J. Ye, K. Lian, C. Xu, L. Zhang, Q. Wang, Y. Liu, L. Tao, 1"Irisin improves fatty acid oxidation and glucose utilization in type 2 diabetes by regulating the AMPK signaling pathway." International journal of obesity, Vol.40 No.3, pp. 443-451, (2016).   DOI
9 S. Liu, F. Du, X. Li, M. Wang, R. Duan, J. Zhang, Y. Wu, Q. Zhang, "Effects and underlying mechanisms of irisin on the proliferation and apoptosis of pancreatic ${\beta}$ cells." PLoS One, Vol.12 No.4 pp. e0175498-e0175498, (2017).   DOI
10 A. Natalicchio, N. Marrano, G. Biondi, R. Spagnuolo, R. Labarbuta, I. Porreca, A. Cignarelli, M. Bugliani, P. Marchetti, S. Perrini, L. Laviola, F. Giorgino, "The Myokine Irisin Is Released in Response to Saturated Fatty Acids and Promotes Pancreatic ${\beta}$-Cell Survival and Insulin Secretion." Diabetes, Vol.66 No.11, pp. 2849-2856, (2017)   DOI
11 M. Gizaw, P. Anandakumar, T. Debela, "A review on the role of irisin in insulin resistance and Type 2 diabetes mellitus." Journal of pharmacopuncture, Vol.20 No. 4 pp. 235-242, (2017).   DOI
12 J. C. Colado, F. M. Pedrosa, A. Juesas, P. Gargallo, J. J. Carrasco, J. Flandez, M. U. Chupel, A. M. Teixeira, F. Naclerio, "Concurrent validation of the OMNI-Resistance Exercise Scale of perceived exertion with elastic bands in the elderly." Experimental Gerontology, Vol. 103 pp. 11-16, (2018).   DOI
13 W. R. Martins, R. J. de Oliveira, R. S. Carvalho, V. de Oliveira Damasceno, V. Z. M. da Silva, M. S. Silva, "Elastic resistance training to increase muscle strength in elderly: a systematic review with meta-analysis." Archives of Gerontology and Geriatrics, Vol. 57 No. 1 pp. 8-15, (2013).   DOI
14 A. Jose, S. Dal Corso, "Inpatient rehabilitation improves functional capacity, peripheral muscle strength and quality of life in patients with community-acquired pneumonia: a randomised trial." Journal of Physiotherapy, Vol. 62 No. 2 pp. 96-102, (2016).   DOI
15 B. K. Pedersen, B. Saltin, "Exercise as medicine - evidence for prescribing exercise as therapy in 26 different chronic diseases." Scandinavian Journal of Medicine & Science in Sports, Vol. 25 Suppl 3 pp. 1-72, (2015).
16 F. Faul, E. Erdfelder, A.-G. Lang, A. Buchner, "G* Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences." Behavior research methods, Vol. 39 No. 2 pp. 175-191, (2007).   DOI
17 R. Rikli, C. Jones, "Senior Fitness Test Manual-2nd Edition." Human Kinetics.
18 E. Ferriolli, F. P. A. S. Pessanha, J. C. L. S. Marchesi, "Diabetes and exercise in the elderly." Medicine and Sport Science, Vol. 60 pp. 122-129, (2014).   DOI
19 D. R. Matthews, J. P. Hosker, A. S. Rudenski, B. A. Naylor, D. F. Treacher, R. C. Turner, "Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man." Diabetologia, Vol. 28 No. 7 pp. 412-419, (1985).   DOI
20 J. H. Lee, "New Guidelines for Elderly Diabetic Patients." Journal of Korean Diabetes, Vol. 16 No. 2 pp. 89-100, (2015).   DOI
21 Y. Saisho, "${\beta}$-cell dysfunction: Its critical role in prevention and management of type 2 diabetes." World Journal of Diabetes, Vol. 6 No. 1 pp. 109-124, (2015).   DOI
22 N. Perakakis, G. A. Triantafyllou, J. M. Fernandez-Real, J. Y. Huh, K. H. Park, J. Seufert, C. S. Mantzoros, "Physiology and role of irisin in glucose homeostasis." Nature Reviews Endocrinology, Vol. 13 No. 6 pp. 324-337, (2017).   DOI
23 K. H. Park, L. Zaichenko, M. Brinkoetter, B. Thakkar, A. Sahin-Efe, K. E. Joung, M. A. Tsoukas, E. V. Geladari, J. Y. Huh, F. Dincer, C. R. Davis, J. A. Crowell, C. S. Mantzoros "Circulating irisin in relation to insulin resistance and the metabolic syndrome." Journal of Clinical Endocrinology & Metabolism, Vol. 98 No. 12 pp. 4899-4907, (2013).   DOI
24 Y. K. Choi, M. K. Kim, K. H. Bae, H. A. Seo, J. Y. Jeong, W. K. Lee, J. G. Kim, I. K. Lee, K. G. Park, "Serum irisin levels in new-onset type 2 diabetes." Diabetes research and clinical practice, Vol. 100, No, 1 pp. 96-101, (2013).   DOI
25 P. S. Leung, "The potential of irisin as a therapeutic for diabetes." Future Medical Chemistry, Vol. 9 No. 6 pp. 529-532, (2017).   DOI
26 D. Loffler, U. Muller, K. Scheuermann, D. Friebe, J. Gesing, J. Bielitz, S. Erbs, K. Landgraf, I. V. Wagner, W. Kiess, A. Korner, "Serum irisin levels are regulated by acute strenuous exercise." The Journal of clinical endocrinology and metabolism, Vol.100 No.4 pp. 1289-1299, (2015).   DOI
27 J. Y. Huh, G. Panagiotou, V. Mougios, M. Brinkoetter, M. T. Vamvini, B. E. Schneider, C. S. Mantzoros, "FNDC5 and irisin in humans: I. Predictors of circulating concentrations in serum and plasma and II. mRNA expression and circulating concentrations in response to weight loss and exercise." Metabolism: clinical and experimental, Vol.61 No.12 pp. 1725-1738, (2012).   DOI
28 M. F. Gregor, G. S. Hotamisligil, "Inflammatory mechanisms in obesity." Annual Review Immunology, Vol. 29 pp. 415-445, (2011).   DOI
29 S. E. Shoelson, J. Lee, A. B. Goldfine, "Inflammation and insulin resistance." Journal of Clinical Investigation, Vol. 116 No. 7 pp. 1793-1801, (2006).   DOI
30 K. Lois, S. Kumar, "Obesity and diabetes." Endocrinologia y nutricion : organo de la Sociedad Espanola de Endocrinologia y Nutricion Vol.56 Suppl 4 pp. 38-42, (2009).   DOI
31 J. P. Kirwan, J. Sacks, S. Nieuwoudt, "The essential role of exercise in the management of type 2 diabetes." Cleveland Clinical Journal of Medicine, Vol. 84 No. 7 Suppl 1 pp. S15-S21, (2017).   DOI
32 B. K. Pedersen, "Muscle as a secretory organ." Comprehensive Physiology, Vol. 3 No. 3 pp. 1337-1362, (2013).   DOI
33 L. Gamas, P. Matafome, R. Seica, "Irisin and myonectin regulation in the insulin resistant muscle: implications to adipose tissue: muscle crosstalk." Journal of Diabetes Research, Vol. 2015 pp. 359159, (2015).   DOI
34 I. Y. Martinez Munoz, E. D. S. Camarillo Romero, J. d. J. Garduno Garcia, "Irisin a Novel Metabolic Biomarker: Present Knowledge and Future Directions." International Journal of Endocrinol, Vol. 2018 pp. 7816806, (2018).   DOI
35 B. K. Pedersen, M. A. Febbraio, "Muscles, exercise and obesity: skeletal muscle as a secretory organ." Nature Reviews Endocrinology, Vol. 8 No. 8 pp. 457-465, (2012).   DOI
36 H. Toplak, D. R. Leitner, J. Harreiter, F. Hoppichler, T. C. Wascher, K. Schindler, B. Ludvik, ""Diabesity"-Obesity and type 2 diabetes (Update 2019)." Wiener klinische Wochenschrift, Vol.131 No.Suppl 1 pp. 71-76, (2019).   DOI
37 J. Y. Huh, F. Dincer, E. Mesfum, C. S. Mantzoros, "Irisin stimulates muscle growth-related genes and regulates adipocyte differentiation and metabolism in humans." International Journal of Obesity, Vol.38 No.12 pp. 1538-1544, (2014).   DOI
38 B. Egan, J. R. Zierath, "Exercise metabolism and the molecular regulation of skeletal muscle adaptation." Cell metabolism, Vol.17 No.2 pp. 162-184, (2013).   DOI
39 C. Planella-Farrugia, F. Comas, M. Sabater-Masdeu, M. Moreno, J. M. Moreno-Navarrete, O. Rovira, W. Ricart, J. M. Fernandez-Real, "Circulating Irisin and Myostatin as Markers of Muscle Strength and Physical Condition in Elderly Subjects." Frontiers in physiology, Vol.10 pp. 871, (2019).   DOI
40 M. G. Novelle, C. Contreras, A. Romero-Pico, M. Lopez, C. Dieguez, "Irisin, two years later." International journal of endocrinology, Vol.2013 pp. 746281-746281, (2013).   DOI
41 I. L. P. Bonfante, M. P. T. Chacon-Mikahil, D. T. Brunelli, A. F. Gaspari, R. G. Duft, W. A. Lopes, V. Bonganha, C. A. Libardi, C. R. Cavaglieri, "Combined training, FNDC5/irisin levels and metabolic markers in obese men: A randomised controlled trial." European journal of sport science, Vol.17 No.5 pp. 629-637, (2017).   DOI
42 H. J. Lee, J. O. Lee, N. Kim, J. K. Kim, H. I. Kim, Y. W. Lee, S. J. Kim, J. I. Choi, Y. Oh, J. H. Kim, S. Y. Hwang, S. H. Park, H. S. Kim, "Irisin, a Novel Myokine, Regulates Glucose Uptake in Skeletal Muscle Cells via AMPK." Molecular Endocrinology, Vol.29 No.6, pp. 873-881, (2015).   DOI
43 S. Soyal, F. Krempler, H. Oberkofler, W. Patsch, "PGC-1${\alpha}$: a potent transcriptional cofactor involved in the pathogenesis of type 2 diabetes." Diabetologia, Vol.49, No.7 pp. 1477-1488, (2006).   DOI