The Effect of a Six-Month Exercise Program on Very Low-Density Lipoprotein Apolipoprotein B Secretion in Type 2 Diabetes

• Published in: The journal of clinical endocrinology and metabolism Vol. 89; no. 2; pp. 688 - 694
• Main Authors: Alam, Saima, Stolinski, Michael, Pentecost, Claire, Boroujerdi, Massoud A., Jones, Richard H., Sonksen, Peter H., Umpleby, A. Margot
• Format: Journal Article
• Language: English
• Published: Bethesda, MD Endocrine Society 01-02-2004; Copyright by The Endocrine Society
• Subjects: Adult; Aged; Apolipoproteins B - blood; Apolipoproteins B - metabolism; Biological and medical sciences; Blood Glucose - analysis; Body Composition; Diabetes Mellitus - metabolism; Diabetes Mellitus - pathology; Diabetes Mellitus - physiopathology; Diabetes Mellitus - therapy; Diabetes Mellitus, Type 2 - metabolism; Diabetes Mellitus, Type 2 - pathology; Diabetes Mellitus, Type 2 - physiopathology; Diabetes Mellitus, Type 2 - therapy; Endocrinopathies; Exercise Therapy; Female; Fundamental and applied biological sciences. Psychology; Humans; Insulin Resistance; Kinetics; Lipids - blood; Lipoproteins, VLDL - blood; Lipoproteins, VLDL - metabolism; Male; Medical sciences; Middle Aged; Obesity; Physical Fitness; Quality of Life; Time Factors; Vertebrates: endocrinology; Apolipoprotein B; Type 2 diabetes; Physical exercise; Lipoprotein LDL; Program; Secretion; Endocrinology
• ISSN: 0021-972X; 1945-7197
• DOI: 10.1210/jc.2003-031036

The dyslipidemia and insulin resistance of type 2 diabetes can be improved by aerobic exercise. The effect of 6 months supervised exercise on very low-density lipoprotein (VLDL) apolipoprotein B metabolism was investigated in patients with type 2 diabetes. Moderately obese patients (n = 18) were randomized into supervised (n = 9) and unsupervised (n = 9) exercise groups. All patients were given a training session and a personal exercise program and asked to exercise four times per week at 70% maximal oxygen uptake for 6 months. Patients in the supervised group had a weekly session with an exercise trainer. VLDL apolipoprotein (apo)B metabolism was measured with an infusion of 1-13C leucine before and after 6 months of the exercise program.
Supervised exercise for 6 months resulted in a significant within-group decrease in percent hemoglobin A1c (P < 0.001), body fat (P < 0.004), nonesterified fatty acid (P < 0.04), and triglycerides (P < 0.05) and an increase in insulin sensitivity (P < 0.01). There was a decrease in VLDL apoB pool size (160.8 ± 42.6 to 84.9 ± 23.2 mg, P < 0.01) and VLDL apoB secretion rate (11.3 ± 2.6 to 5.5 ± 2.0 mg/kg·d, P < 0.05) with no change in fractional catabolic rate. In a between-group comparison, the decrease in VLDL apoB secretion rate in the supervised group did not achieve significance. This study demonstrates that in type 2 diabetes, a supervised exercise program reduces VLDL apoB pool size, which may be due to a decrease in VLDL apoB secretion rate.