1Assistant professor of physical education, Islamic Azad University, Shirvan branch, Shirvan, Iran
2Assistant professor of physical education, Islamic Azad University, Mashhad branch, Mashhad, Iran
3Instructor of physical education, Islamic Azad University, Mashhad branch, Mashhad, Iran
4Instructor of pediatric nursing, Nursing and Midwifery School, Mashhad University of medical sciences, Mashhad, Iran
5Post graduate student of physical education, Ferdowsi University of Mashhad, Mashhad, Iran
Background: Diabetes Mellitus is a heterogeneous group of different metabolic disorders that are characterized by chronic increase of blood glucose, cardiovascular diseases, and proteins, lipids and carbohydrate metabolism disorder. Leptin, that is a marker of fat mass in the body, has an important role in the body total metabolism and glucose homeostasis. Aim: To investigate the effect of 12 weeks of aerobic exercise on leptin and glucose homeostasis in patients with type II diabetes. Method: In this quasi-experimental study, 40 men with type П diabetes referring to Mashhad Parsian Clinic were allocated into two groups: aerobic (20 participants) and control (20 participants). Aerobic group performed selected exercises in 12 weeks (three 40 min sessions per week with %60-%70 heart rate reserves). The levels of leptin, fasting glucose, insulin and insulin resistant factor were measured. Data were analyzed with SPSS version 11.5 using t student and Paired t test, and also Mann-Whitney, and Wilcoxon tests. The level of significance was considered to be 95% (p<0.05). Results: The mean age of experimental group was 40.4 in experimental vs 38.3 in control group. The mean duration of diabetes mellitus was 5.38 and 5.20 in experimental and control group, respectively. There were significant differences in leptin (P<0.001), Fasting Blood Sugar (P<0.01), insulin (P<0.015) and insulin resistant factor (P<0.035) between aerobic exercise training and control group. Conclusion: Regular aerobic exercise causes insulin resistant reduction and glucose metabolic elevation and also reduction of leptin level in serum so that could have an important role in reduction of cardiovascular diseases and improvement of glucose metabolism in patients with type II diabetes mellitus.
Azizi F, Salehi P, Etemadi A, Zahedi-Asl S. Prevalence of Metabolic Syndrome in an Urban Population: Tehran Lipid and Glucose Study. Diabetes Res Clin Pract 2003; 61:29–37.
World Health Organizations. Technical report series 894. Obesity, Preventing and Managing the Global Epidemic. Report of a WHO consultation. Geneva: World Health Organization; 2000.
Chinikar M, Maddah M, Hoda S. Coronary Artery Disease in Iranian Overweight Women. Int J Cardiol 2006; 113:391-4.
Susan S, Steven H, Michael H.D, Ralph B. D, Steven Sr. F, George K, et al. Relationship of Abdominal Visceral and Subcutaneous Adipose Tissue with Lipoprotein Particle Number and Size in Type Ii Diabetes. Diabetes 2008; 57:2022-7.
Misra A, Alappan N, Vikram N, Goel K, Gupta N, Mittal K, et al. Effect of Supervised Progressive Resistance Exercise Training Protocol on Insulin Sensitivity, Glycemia, Lipids, and Body Composition in Asian Indians with Type 2diabetes. Diabetes Care 2008; 31(7):1282.
Anonymous.American Diabetes Association: Clinical Practice Recommendations 1999. Diabetes Care 1999; 22 (Suppl 1):S1-114.
Cauza E, Hanusch-Enserer U, Strasser B, Ludvik B, Metz-Schimmerl S, Pacini G, et al. The Relative Benefits of Endurance and Strength Training on the Metabolic Factors and Muscle Function of People with Type Ii Diabetes Mellitus. Arch Phys Med Rehabil 2005; 86:1527–33.
Segal KA, Edano A, Abalos J, Albu J, Bland L, Tomas MB, et al. Effects of Exercise Training on Insulin Sensitivity and Glucose Metabolism in Lean, Obese And Diabetic Men. J Appl Physiol 1991; 71:2402-11.
Massi-Benedetti M, Herz M, Pfeiffer C. The Effect of Acute Exercise on Metabolic Control in Type Ii Diabetic Patients Treated with Glimepiride or Glibenclamide. Horm Metab Res1996; 28:451-5.
Bruce CR, Kriketos AD, Cooney GJ, Hawlley JA. Disassociation of Muscle Triglyceride Content and Insulin Sensitivity after Exercise Training in Patients with Type Ii Diabetes. Diabetologia 2004; 47(1): 23-30.
Esfahani M. Effect of Physical Training on Blood Glycemia, Plasma Insulin and Cardiovascular Risk Factors in NIDDMs . Olympic games 2007; 14(4 (serial 36)):17-24.
American collage of sport medicine. The Recommended Quantity and Quality of Exercise for Developing and Maintaining Fitness in Healthy. Med Sci Sport Exercise 1990; 22:265-74.
Hjeltnes N, Heijboer AC, Groot PC, Stal W, Birkeland K. Effect of Training Intensity on Physical Capacity, Lipid Profile and Insulin Sensitivity in Early Rehabilitation of Spinal Cord Injured Individuals. Spinal Cord 2003; 41:673-9.
Tjønna EA, Lee S, Rognmo Q, Stolen TO, Bye A, Haram PM, et al . Aerobic Interval Training Versus Continuous Moderate Exercise as a Treatment for the Metabolic Syndrome. Circulation 2008; 118:346-54.
Kanabrocki EL, Hermida RC, Wright M, Young RM, Bremner FW, Third JL, et al. Circadian Variation of Serum Leptin in Healthy and Diabetic Men. Chronobiol Int 2001; 18: 273–283.
Heilbronn LK, Rood J, Janderova L, Albu JB, Kelley DE, Ravussin E, et al. Relationship Between Serum Resistin Concentrations and Insulin Resistance in On-Obese, Obese, and Obese Diabetic Subjects. J Clin Endocrinol Metab 2004; 89: 1844–8.
Dyck DJ. Leptin Sensitivity in Skeletal Muscle is Modulated by Diet and Exercise. exercise & sport sciences reviews 2005; 33, 189-94.
Dengel DR, Pratley RE, Hagberg JM, Rogus EM, and Goldberg AP. Distinct Effects of Aerobic Exercise Training and Weight Loss on Glucose Homeostasis in Obese Sedentary Men. J Appl Physiol 1996; 81: 318–325.
Kraemer RR, Kraemer GR, Acevedo EO, Hebert EP, Temple E, Bates M, et al. Effects of Aerobic Exercise on Serum Leptin Levels in Obese Women. Eur j appl physiol 1999, 80:154–8.
Houmard JA, Cox JH, Maclean PS, Barakat HA. Effect of Short-Term Exercise Training on Leptin and Insulin Action. Metabolism 2000; 49: 858–61.
Kumru S, Ozmerdivenli R, Aydin S, Yasar A, Kilic N, Parmaksiz C, et al. Effects of Regular Physical Exercise on Serum Leptin and Androgen Concentrations in Young Women. J Men's Health and Gender 2005; 2(2):218–22.
Matthews D, Hosker J, Rudenski A, Naylor B, Treacher D, Turner R. Homeostasis Model Assessment: Insulin Resistance and -Cell Function from Fasting Plasma Glucose and Insulin Concentrations in Man. Diabetologia1985; 28(7):412-9.
Rowell LB, O'Leary DS, Kellogg DLJ. Integration of Cardiovascular Control Systems in Dynamic Exercise. Handbook of Physiology, section 12, Exercise: Regulation and Integration of Multiple Systems. New York: Oxford University Press; 1996.
Izawa T, Komabayashi T, Mochizuki T,Suda K, Tsuboi M. Enhanced Coupling of Adenylate Cyclase to Lipolysis in Permeabilized Adipocytes from Trained Rats. J Appl Physiol 1991; 71(1): 23-9.
Fontana L, Klein S, Holloszy J. Effects of Long-Term Calorie Restriction and Endurance Exercise on Glucose Tolerance, Insulin Action, and Adipokine Production. Age 2010; 32(1):97-108.
Gray S, Baker G, Wright A, Fitzsimons C, Mutrie N, Nimmo M. The Effect of a 12 Week Walking Intervention on Markers of Insulin Resistance and Systemic Inflammation. Preventive Med 2009; 48(1):39-44.
Carrel A, Mcvean J, Clark R, Peterson S, Eickhoff J, Allen D. School-Based Exercise Improves Fitness, Body Composition, Insulin Sensitivity, and Markers of Inflammation in Non-Obese Children. J Pediatr Endocrinol Metab 2009; 22(5):409-15.
Rubin D, Mcmurray R, Harrell J, Hackney A, Thorpe D, Haqq A. The Association between Insulin Resistance and Cytokines in Adolescents: the Role of Weight Status and Exercise. Metabolism 2008; 57(5):683-90.
Duncan GE, Perri MG, Theriaque DW, Hutson AD, Eckel RH, Stacpoole PW. Exercise Training, without Weight Loss, Increase Insulin Sensitivity and Post-Heparin Plasma Lipase Activity in Previously Sedentary Adults. Diabetes Care 2003; 26(3):557-62.
Cartee GO, Young DA, Sleeper MD, Zierath J, Wallberg-Henrikssn H, Holloszy JO. Prolonged Increase in Insulin-Stimulated Glucose Transport in Muscle after Exercise. Am J Physiol Endocrinal Metab 989; 256: E494-9.Kern MJ, Wells A, Stephens JM, Elton CW, Friedman JE, Topscott EB, et al. Insulin responsiveness in skeletal muscle is determined by glucose transporter (Glut4) protein level. Biochem J 1990; 270(2): 397-400.
Peeri M, Boghrabadi V, Amirkhani Z, Hejazi SM. The Effects of Aerobic Training on Leptin, Cortisol and Serum Testosterone Levels in Obese and Lean Men. Res on sport sci 2009; 22(2):99-116.
Olive JL and Miller GD. Differential Effects of Maximal- and Moderate-Intensity Runs on Plasma Leptin in Healthy Trained Subjects. Nutrition 2001; 17: 365–9.
Kraemer RR, Aboudehen KS, Carruth AK, Durand RT, Acevedo EO, Hebert EP, et al. Adiponectin Responses to Continuous and Progressively Intense Intermittent Exercise. Med Sci Sports Exerc 2003; 35: 1320–5.
Zaccaria M, Ermolao A, Roi GS, Englaro P, Tegon G, and Varnier M. Leptin Reduction after Endurance Races Differing in Duration and Energy Expenditure. Eur J Appl Physiol 2002; 87: 108–11.
Friedman JM and Halaas JL. Leptin and the Regulation of Body Weight In Mammals. Nature 1998; 395: 763–70.
Havel PJ. Role of Adipose Tissue in Body-Weight Regulation: Mechanisms Regulating Leptin Production and Energy Balance. Proc Nutr Soc 2000; 59: 359–71.
Mendoza-Nunez VM, Garcia-Sanchez A, Sanchez-Rodriguez M, Galvan-Duarte RE, and Fonseca-Yerena ME. Overweight, Waist Circumference, Age, Gender, and Insulin Resistance as Risk Factors for Hyper Leptinemia. Obes Res 2002; 10: 253–9.