Impact of Exercise on Cardiometabolic Component Risks in Spinal Cord–injured Humans

PURPOSESpinal cord injury (SCI) creates a complex pathology, characterised by low levels of habitual physical activity and an increased risk of cardiometabolic disease. This study aimed to assess the impact of a moderate-intensity upper-body exercise training intervention on, biomarkers of cardiomet...

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Published in:Medicine and science in sports and exercise 2017-12, Vol.49 (12), p.2469-2477
Main Authors: Nightingale, Tom E, Walhin, Jean-Philippe, Thompson, Dylan, Bilzon, James L.J
Format: Article
Language:English
Subjects:
Applied Sciences
Body Composition
Cardiorespiratory Fitness - physiology
Exercise - physiology
Female
Gene Expression
Humans
Insulin - blood
Insulin Resistance
Male
Middle Aged
Oxygen Consumption - physiology
Paraplegia - metabolism
Spinal Cord Injuries - metabolism
Subcutaneous Fat - metabolism
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Summary:PURPOSESpinal cord injury (SCI) creates a complex pathology, characterised by low levels of habitual physical activity and an increased risk of cardiometabolic disease. This study aimed to assess the impact of a moderate-intensity upper-body exercise training intervention on, biomarkers of cardiometabolic component risks, adipose tissue metabolism and cardiorespiratory fitness in persons with SCI. METHODSTwenty-one inactive men and women with chronic (>1 year) SCI (all paraplegic injuries), aged 47 ± 8 years (mean ± S.D), were randomly allocated to either a 6-week prescribed home-based exercise intervention (INT; n = 13) or control group (CON; n = 8). Participants assigned to the exercise group completed 4 x 45-min moderate-intensity (60-65% peak oxygen uptake [V[Combining Dot Above]O2 peak]) arm-crank exercise sessions per week. At baseline and follow-up, fasted and post-load blood samples (collected during oral glucose tolerance tests) were obtained to measure metabolic regulation and biomarkers of cardiovascular disease. Abdominal subcutaneous adipose tissue biopsies were also obtained and cardiorespiratory fitness assessed. RESULTSCompared to CON, INT significantly decreased (P = 0.04) serum fasting insulin (Δ, CON 3.1 ± 10.7 pmol·l; INT, -12.7 ± 18.7) and homeostasis model assessment of insulin resistance (HOMA2-IR Δ, CON 0.06 ± 0.20; INT, -0.23 ± 0.36). The exercise group also increased V[Combining Dot Above]O2 peak (Δ, 3.4 ml·kg·min, P ≤ 0.001). Adipose tissue metabolism, composite Insulin Sensitivity Index (C-ISIMatsuda) and other cardiovascular disease risk biomarkers were not different between groups. CONCLUSIONModerate-intensity upper-body exercise improved aspects of metabolic regulation and cardiorespiratory fitness. Changes in fasting insulin and HOMA2-IR, but not C-ISIMatsuda, suggest improved hepatic but not peripheral insulin sensitivity following 6 weeks of exercise training in persons with chronic paraplegia.Copyright © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
ISSN:0195-9131
1530-0315
DOI:10.1249/MSS.0000000000001390