Combined training increases thermogenic fat activity in patients with overweight and type 2 diabetes

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Padilha Bonfante, Ivan Luiz ; Monfort-Pires, Milena ; Duft, Renata Garbellini ; da Silva Mateus, Keryma Chaves ; de Lima Junior, Jose Carlos ; dos Santos Trombeta, Joice Cristina ; Rautenberg Finardi, Enrico Antonio ; Brunelli, Diego Trevisan ; Morari, Joseane ; Barbosa de Lima, Jessica Aparecida ; Bellotto, Maria Luisa ; Ferreira de Araujo, Thiago Matos ; Ramos, Celso Dario ; Traina Chacon-Mikahil, Mara Patricia ; Velloso, Licio Augusto ; Cavaglieri, Claudia Regina

• Document type: Journal article
• Source: International Journal of Obesity; v. 46, n. 6, p. 10-pg., 2022-02-16.

Abstract

BACKGROUND: Exercise is an important strategy in the management of diabetes. Experimental studies have shown that exercise acts, at least in part, by inducing the production of myokines that improve metabolic control and activate brown/beige adipose tissue depots. Combined training (CT) is recommended by the major diabetes guidelines due to its metabolic and cardiovascular benefits, however, its impact on brown/beige adipose tissue activities has never been tested in humans with overweight and type 2 diabetes (T2D). Here, we evaluated the effects of 16-week combined training (CT) program on brown adipose tissue activity; browning and autophagy markers, and serum pro-thermogenic/inflammatory inducers in patients with overweight and T2D. METHODS: Thirty-four patients with overweight and T2D were assigned to either a control group (CG) or a combined training group (CTG) in a randomized and controlled study. Functional/fitness parameters, anthropometry/body composition parameters, blood hormone/biochemical parameters, thermogenic/autophagic gene expression in subcutaneous adipose tissue were evaluated before and at the end of the intervention. In addition, cold-induced 18-Fluoroxyglucose Positron Emission Computed Tomography (18(F)-FDG PET/CT) was performed in the training group before and after the end of the intervention. RESULTS: CT increased cervical/supraclavicular brown adipose tissue (BAT) thermogenic activity (p = 0.03) as well as in perirenal adipose tissue (p = 0.02). In addition, CT increased the expression of genes related to thermogenic profile (TMEM26: + 95%, p = 0.04; and EPSTI1: + 26%, p = 0.03) and decreased autophagic genes (ULK1: -15%, p = 0.04; LC3: -5%, p = 0.02; and ATG4: -22%, p < 0.001) in subcutaneous adipose tissue. There were positive correlations between Delta% BAT activity with Delta% of post training energy expenditure cold exposure, HDL-c, IL4, adiponectin, irisin, meteorin-like, and TMEM26 and ZIC1 genes, besides negative correlations with LDL-c, total cholesterol and C-reactive protein. CONCLUSION: This is the first evidence of the beneficial actions of CT on adipose tissue thermogenic activity in humans, and it adds important support for the recommendation of CT as a strategy in the management of diabetes. (AU)

• FAPESP's process: 16/08751-3 - COMBINED TRAINING ANSWERS ON INFLAMMATION, METABOLIC FACTORS AND SERUM, MOLECULAR AND IMAGE MARKERS RELATED TO BROWN ADIPOSE TISSUE AND BROWNING OF WHITE ADIPOSE TISSUE IN OVERWEIGHT MIDDLE-AGE TYPE 2 DIABETIC
• Grantee: Claudia Regina Cavaglieri
• Support Opportunities: Regular Research Grants