Changes in insulin resistance and HbA1c are related to exercise-mediated changes in body composition in older adults with type 2 diabetes: Interim outcomes from the GREAT2DO trial

Yorgi Mavros, Shelley Kay, Kylie A. Anderberg, Michael K. Baker, Yi Wang, Renru Zhao, Jacinda Meiklejohn, Mike Climstein, Anthony J. O'Sullivan, Nathan de Vos, Bernhard T. Baune, Steven N. Blair, David Simar, Kieron Rooney, Nalin A. Singh, Maria A Fiatarone Singh

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Abstract

OBJECTIVE-To investigate changes in body composition after 12 months of high-intensity progressive resistance training (PRT) in relation to changes in insulin resistance (IR) or glucose homeostasis in older adults with type 2 diabetes. RESEARCH DESIGN AND METHOD S-One-hundred three participants were randomized to receive either PRT or sham exercise 3 days per week for 12 months. Homeostasis model assessment 2 of insulin resistance (HOMA2-IR) and glycosylated hemoglobin (HbA1c) were used as indices of IR and glucose homeostasis. Skeletal muscle mass (SkMM) and total fat mass were assessed using bioelectrical impedance. Visceral adipose tissue, mid-thigh cross-sectional area, and mid-thigh muscle attenuation were quantified using computed tomography. RESULTS-Within the PRT group, changes in HOMA2-IR were associated with changes in SkMM (r =20.38; P = 0.04) and fat mass (r=0.42; P = 0.02). Changes in visceral adipose tissue tended to be related to changes in HOMA2-IR (r = 0.35; P = 0.07). Changes in HbA1c were related to changes in mid-thigh muscle attenuation (r = 0.52; P = 0.001). None of these relationships were present in the sham group (P > 0.05). Using ANCOVA models, participants in the PRT group who had increased SkMM had decreased HOMA2-IR (P = 0 > 05) and HbA1c (P = 0.09) compared with those in the PRT group who lost SkMM. Increases in SkMM in the PRT group decreased HOMA2-IR (P = 0.07) and HbA1c (P < 0.05) compared with those who had increased SkMM in the sham group. CONCLUSIONS-Improvements in metabolic health in older adults with type 2 diabetes were mediated through improvements in body composition only if they were achieved through high-intensity PRT.

Original languageEnglish
Pages (from-to)2372-2379
Number of pages8
JournalDiabetes Care
Volume36
Issue number8
DOIs
Publication statusPublished - 2013

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Resistance Training
Body Composition
Type 2 Diabetes Mellitus
Insulin Resistance
Homeostasis
Skeletal Muscle
Thigh
Intra-Abdominal Fat
Fats
Glucose
Muscles
Glycosylated Hemoglobin A
Electric Impedance
Research Design
Tomography
Health

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Mavros, Yorgi ; Kay, Shelley ; Anderberg, Kylie A. ; Baker, Michael K. ; Wang, Yi ; Zhao, Renru ; Meiklejohn, Jacinda ; Climstein, Mike ; O'Sullivan, Anthony J. ; de Vos, Nathan ; Baune, Bernhard T. ; Blair, Steven N. ; Simar, David ; Rooney, Kieron ; Singh, Nalin A. ; Singh, Maria A Fiatarone. / Changes in insulin resistance and HbA1c are related to exercise-mediated changes in body composition in older adults with type 2 diabetes : Interim outcomes from the GREAT2DO trial. In: Diabetes Care. 2013 ; Vol. 36, No. 8. pp. 2372-2379.
@article{3d19d254e1b541d8ae48dd2279644eb7,
title = "Changes in insulin resistance and HbA1c are related to exercise-mediated changes in body composition in older adults with type 2 diabetes: Interim outcomes from the GREAT2DO trial",
abstract = "OBJECTIVE-To investigate changes in body composition after 12 months of high-intensity progressive resistance training (PRT) in relation to changes in insulin resistance (IR) or glucose homeostasis in older adults with type 2 diabetes. RESEARCH DESIGN AND METHOD S-One-hundred three participants were randomized to receive either PRT or sham exercise 3 days per week for 12 months. Homeostasis model assessment 2 of insulin resistance (HOMA2-IR) and glycosylated hemoglobin (HbA1c) were used as indices of IR and glucose homeostasis. Skeletal muscle mass (SkMM) and total fat mass were assessed using bioelectrical impedance. Visceral adipose tissue, mid-thigh cross-sectional area, and mid-thigh muscle attenuation were quantified using computed tomography. RESULTS-Within the PRT group, changes in HOMA2-IR were associated with changes in SkMM (r =20.38; P = 0.04) and fat mass (r=0.42; P = 0.02). Changes in visceral adipose tissue tended to be related to changes in HOMA2-IR (r = 0.35; P = 0.07). Changes in HbA1c were related to changes in mid-thigh muscle attenuation (r = 0.52; P = 0.001). None of these relationships were present in the sham group (P > 0.05). Using ANCOVA models, participants in the PRT group who had increased SkMM had decreased HOMA2-IR (P = 0 > 05) and HbA1c (P = 0.09) compared with those in the PRT group who lost SkMM. Increases in SkMM in the PRT group decreased HOMA2-IR (P = 0.07) and HbA1c (P < 0.05) compared with those who had increased SkMM in the sham group. CONCLUSIONS-Improvements in metabolic health in older adults with type 2 diabetes were mediated through improvements in body composition only if they were achieved through high-intensity PRT.",
author = "Yorgi Mavros and Shelley Kay and Anderberg, {Kylie A.} and Baker, {Michael K.} and Yi Wang and Renru Zhao and Jacinda Meiklejohn and Mike Climstein and O'Sullivan, {Anthony J.} and {de Vos}, Nathan and Baune, {Bernhard T.} and Blair, {Steven N.} and David Simar and Kieron Rooney and Singh, {Nalin A.} and Singh, {Maria A Fiatarone}",
year = "2013",
doi = "10.2337/dc12-2196",
language = "English",
volume = "36",
pages = "2372--2379",
journal = "Diabetes Reviews",
issn = "0149-5992",
publisher = "AMER DIABETES ASSOC",
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Mavros, Y, Kay, S, Anderberg, KA, Baker, MK, Wang, Y, Zhao, R, Meiklejohn, J, Climstein, M, O'Sullivan, AJ, de Vos, N, Baune, BT, Blair, SN, Simar, D, Rooney, K, Singh, NA & Singh, MAF 2013, 'Changes in insulin resistance and HbA1c are related to exercise-mediated changes in body composition in older adults with type 2 diabetes: Interim outcomes from the GREAT2DO trial' Diabetes Care, vol. 36, no. 8, pp. 2372-2379. https://doi.org/10.2337/dc12-2196

Changes in insulin resistance and HbA1c are related to exercise-mediated changes in body composition in older adults with type 2 diabetes : Interim outcomes from the GREAT2DO trial. / Mavros, Yorgi; Kay, Shelley; Anderberg, Kylie A.; Baker, Michael K.; Wang, Yi; Zhao, Renru; Meiklejohn, Jacinda; Climstein, Mike; O'Sullivan, Anthony J.; de Vos, Nathan; Baune, Bernhard T.; Blair, Steven N.; Simar, David; Rooney, Kieron; Singh, Nalin A.; Singh, Maria A Fiatarone.

In: Diabetes Care, Vol. 36, No. 8, 2013, p. 2372-2379.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Changes in insulin resistance and HbA1c are related to exercise-mediated changes in body composition in older adults with type 2 diabetes

T2 - Interim outcomes from the GREAT2DO trial

AU - Mavros, Yorgi

AU - Kay, Shelley

AU - Anderberg, Kylie A.

AU - Baker, Michael K.

AU - Wang, Yi

AU - Zhao, Renru

AU - Meiklejohn, Jacinda

AU - Climstein, Mike

AU - O'Sullivan, Anthony J.

AU - de Vos, Nathan

AU - Baune, Bernhard T.

AU - Blair, Steven N.

AU - Simar, David

AU - Rooney, Kieron

AU - Singh, Nalin A.

AU - Singh, Maria A Fiatarone

PY - 2013

Y1 - 2013

N2 - OBJECTIVE-To investigate changes in body composition after 12 months of high-intensity progressive resistance training (PRT) in relation to changes in insulin resistance (IR) or glucose homeostasis in older adults with type 2 diabetes. RESEARCH DESIGN AND METHOD S-One-hundred three participants were randomized to receive either PRT or sham exercise 3 days per week for 12 months. Homeostasis model assessment 2 of insulin resistance (HOMA2-IR) and glycosylated hemoglobin (HbA1c) were used as indices of IR and glucose homeostasis. Skeletal muscle mass (SkMM) and total fat mass were assessed using bioelectrical impedance. Visceral adipose tissue, mid-thigh cross-sectional area, and mid-thigh muscle attenuation were quantified using computed tomography. RESULTS-Within the PRT group, changes in HOMA2-IR were associated with changes in SkMM (r =20.38; P = 0.04) and fat mass (r=0.42; P = 0.02). Changes in visceral adipose tissue tended to be related to changes in HOMA2-IR (r = 0.35; P = 0.07). Changes in HbA1c were related to changes in mid-thigh muscle attenuation (r = 0.52; P = 0.001). None of these relationships were present in the sham group (P > 0.05). Using ANCOVA models, participants in the PRT group who had increased SkMM had decreased HOMA2-IR (P = 0 > 05) and HbA1c (P = 0.09) compared with those in the PRT group who lost SkMM. Increases in SkMM in the PRT group decreased HOMA2-IR (P = 0.07) and HbA1c (P < 0.05) compared with those who had increased SkMM in the sham group. CONCLUSIONS-Improvements in metabolic health in older adults with type 2 diabetes were mediated through improvements in body composition only if they were achieved through high-intensity PRT.

AB - OBJECTIVE-To investigate changes in body composition after 12 months of high-intensity progressive resistance training (PRT) in relation to changes in insulin resistance (IR) or glucose homeostasis in older adults with type 2 diabetes. RESEARCH DESIGN AND METHOD S-One-hundred three participants were randomized to receive either PRT or sham exercise 3 days per week for 12 months. Homeostasis model assessment 2 of insulin resistance (HOMA2-IR) and glycosylated hemoglobin (HbA1c) were used as indices of IR and glucose homeostasis. Skeletal muscle mass (SkMM) and total fat mass were assessed using bioelectrical impedance. Visceral adipose tissue, mid-thigh cross-sectional area, and mid-thigh muscle attenuation were quantified using computed tomography. RESULTS-Within the PRT group, changes in HOMA2-IR were associated with changes in SkMM (r =20.38; P = 0.04) and fat mass (r=0.42; P = 0.02). Changes in visceral adipose tissue tended to be related to changes in HOMA2-IR (r = 0.35; P = 0.07). Changes in HbA1c were related to changes in mid-thigh muscle attenuation (r = 0.52; P = 0.001). None of these relationships were present in the sham group (P > 0.05). Using ANCOVA models, participants in the PRT group who had increased SkMM had decreased HOMA2-IR (P = 0 > 05) and HbA1c (P = 0.09) compared with those in the PRT group who lost SkMM. Increases in SkMM in the PRT group decreased HOMA2-IR (P = 0.07) and HbA1c (P < 0.05) compared with those who had increased SkMM in the sham group. CONCLUSIONS-Improvements in metabolic health in older adults with type 2 diabetes were mediated through improvements in body composition only if they were achieved through high-intensity PRT.

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U2 - 10.2337/dc12-2196

DO - 10.2337/dc12-2196

M3 - Article

VL - 36

SP - 2372

EP - 2379

JO - Diabetes Reviews

JF - Diabetes Reviews

SN - 0149-5992

IS - 8

ER -