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(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Exercise Increases Insulin Sensitivity and Skeletal Muscle AMPK Expression in Systemic Lupus Erythematosus: A Randomized Controlled Trial

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Benatti, Fabiana B. [1, 2] ; Miyake, Cintia N. H. [1] ; Dantas, Wagner S. [1] ; Zambelli, Vanessa O. [3] ; Shinjo, Samuel K. [1] ; Pereira, Rosa M. R. [1] ; Silva, Maria Elizabeth R. [4] ; Sa-Pinto, Ana Lucia [1] ; Borba, Eduardo [1] ; Bonfa, Eloisa [1] ; Gualano, Bruno [1]
Total Authors: 11
[1] Univ Sao Paulo, Fac Med FMUSP, Hosp Clin HCFMUSP, Div Rheumatol, Sao Paulo - Brazil
[2] Univ Estadual Campinas UNICAMP, Sch Appl Sci, Sao Paulo - Brazil
[3] Butantan Inst, Sao Paulo - Brazil
[4] Univ Sao Paulo, Fac Med FMUSP, Hosp Clin HCFMUSP, Div Endocrinol, Sao Paulo - Brazil
Total Affiliations: 4
Document type: Journal article
Source: FRONTIERS IN IMMUNOLOGY; v. 9, APR 27 2018.
Web of Science Citations: 3

Systemic lupus erythematosus (SLE) patients may show increased insulin resistance (IR) when compared with their healthy peers. Exercise training has been shown to improve insulin sensitivity in other insulin-resistant populations, but it has never been tested in SLE. Therefore, the aim of the present study was to assess the efficacy of a moderate-intensity exercise training program on insulin sensitivity and potential underlying mechanisms in SLE patients with mild/inactive disease. A 12-week, randomized controlled trial was conducted. Nineteen SLE patients were randomly assigned into two groups: trained (SLE-TR, n = 9) and non-trained (SLE-NT, n = 10). Before and after 12 weeks of the exercise training program, patients underwent a meal test (MT), from which surrogates of insulin sensitivity and beta-cell function were determined. Muscle biopsies were performed after the MT for the assessment of total and membrane GLUT4 and proteins related to insulin signaling {[} Akt and AMP-activated protein kinase (AMPK)]. SLE-TR showed, when compared with SLE-NT, significant decreases in fasting insulin {[}-39 vs. + 14%, p = 0.009, effect size (ES) = -1.0] and in the insulin response to MT (-23 vs. + 21%, p = 0.007, ES = -1.1), homeostasis model assessment IR (-30 vs. + 15%, p = 0.005, ES = -1.1), a tendency toward decreased proinsulin response to MT (-19 vs. + 6%, p = 0.07, ES = -0.9) and increased glucagon response to MT (+3 vs. -3%, p = 0.09, ES = 0.6), and significant increases in the Matsuda index (+66 vs. -31%, p = 0.004, ES = 0.9) and fasting glucagon (+4 vs. -8%, p = 0.03, ES = 0.7). No significant differences between SLT-TR and SLT-NT were observed in fasting glucose, glucose response to MT, and insulinogenic index (all p > 0.05). SLE-TR showed a significant increase in AMPK Thr 172 phosphorylation when compared to SLE-NT (+73 vs. -12%, p = 0.014, ES = 1.3), whereas no significant differences between groups were observed in Akt Ser 473 phosphorylation, total and membrane GLUT4 expression, and GLUT4 translocation (all p > 0.05). In conclusion, a 12-week moderate-intensity aerobic exercise training program improved insulin sensitivity in SLE patients with mild/inactive disease. This effect appears to be partially mediated by the increased insulin-stimulated skeletal muscle AMPK phosphorylation. (AU)

FAPESP's process: 17/02546-1 - Metabolic, physiologic and molecular effects of breaking sedentary time in rheumatoid arthritis patients: a randomized crossover study
Grantee:Fabiana Braga Benatti
Support type: Scholarships in Brazil - Post-Doctorate
FAPESP's process: 11/24093-2 - The effects of endurance exercise on the inflammatory profile and insulin sensitivity in women with systemic lupus erithematosus
Grantee:Eloisa Silva Dutra de Oliveira Bonfá
Support type: Regular Research Grants
FAPESP's process: 15/03756-4 - Assessment of relevance of blood levels of drugs in the monitoring rheumatic autoimmune diseases: safety, effectiveness and adherence to therapy
Grantee:Eloisa Silva Dutra de Oliveira Bonfá
Support type: Research Projects - Thematic Grants
FAPESP's process: 11/08302-0 - Effects of chronic aerobic training on the insulin sensitivity of patients with systemic lupus erythematosus
Grantee:Fabiana Braga Benatti
Support type: Scholarships in Brazil - Post-Doctorate