Volume 26, Issue 2 (Avicenna Journal of Clinical Medicine-Summer 2019)                   Avicenna J Clin Med 2019, 26(2): 75-82 | Back to browse issues page

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Rahbar S, Naimi S S. Decreased Intima-Media Carotid Artery Thickness after 24 Sessions of Combined Aerobic and Resistance Exercise in Type 2 Diabetic Patients. Avicenna J Clin Med 2019; 26 (2) :75-82
URL: http://sjh.umsha.ac.ir/article-1-1913-en.html
Decreased Intima-Media Carotid Artery Thickness after 24 Sessions of Combined Aerobic and Resistance Exercise in Type 2 Diabetic Patients
Soulmaz Rahbar , Sedigheh Sadat Naimi 1
1- , naimi.se@sbmu.ac.ir
Abstract:   (3717 Views)
Background and Objective: Diabetes type 2 has been estimated as the seventh leading cause of death worldwide. Diabetic patients are 2-3 times more likely to be at the risk of atherosclerosis, compared to normal people. It has been reported that exercise prevents atherosclerosis in diabetic patients. Therefore, the aim of this study was to investigate the effect of exercise on vascular variables of patients with type 2 diabetes. 
Materials and Methods: This clinical trial was conducted on 40 patients out of 702 volunteers with diabetes who were randomly assigned into two groups of combined (aerobic and resistance) and control. The intervention protocol included 24 30-min sessions of aerobic exercise on the treadmill without any slope during 8 weeks (three sessions per week). The protocol intensity was set at 50-70% maximum heart rate and volunteers wore a weighted vest during exercise. On the other hand, the control group had no exercise for two months. All variables were measured before the intervention and after 24 sessions of the intervention protocol.
Results: According to the results, there were no differences between the groups regarding demographic characteristics and a history of type 2 diabetes before the intervention. After 24 sessions, there was a significant decrease in the intima-media thickness. Moreover, the ratio of the intima-media thickness to the lumen in three sections of Carotid Bulb, Internal Carotid, and Common Carotid was significantly reduced in the combined exercise group, compared to the control group (P<0.05); however, no significant difference was observed in the lumen diameter (P>0.05). All vascular parameters remained unchanged in the control group (P>0.05).
Conclusion: In total, 24 sessions of aerobic and resistance exercise had a positive effect on vascular parameters. According to the simulation of a backpack by a weighted vest, the method used in this study was considered as a cheap and useful technique for patients with type 2 diabetes.
Keywords: Diabetes Mellitus Type2, Exercise, Intima-Media Thickness
Full-Text [PDF 1124 kb]   (1333 Downloads)    
Type of Study: Original | Subject: Physical Therapy
References
1. Baba M, Talle M, Ibinaiye P, Abdul H, Buba F. Carotid intima-media thickness in patients with diabetes mellitus attending tertiary care hospital in Nigeria. Angiol. 2018;6(210):2. DOI: 10.4172/2329-9495.1000210
2. Momeni A, Taheri A, Mansuri M, Bazdar A, Sedehi M, Amiri M. Association of carotid intima-media thickness with exercise tolerance test in type 2 diabetic patients. Int J Cardiol Heart Vasc. 2018;21:74-7. PMID: 30364662 DOI: 10.1016/j.ijcha.2018.10.002
3. Barrett EJ, Liu Z. The endothelial cell: an “early responder” in the development of insulin resistance. Rev Endocr Metab Disord. 2013;14(1):21-7. PMID: 23306779 DOI: 10.1007/s11154-012-9232-6
4. Wildman RP, Schott LL, Brockwell S, Kuller LH, Sutton-Tyrrell K. A dietary and exercise intervention slows menopause-associated progression of subclinical atherosclerosis as measured by intima-media thickness of the carotid arteries. J Am Coll Cardiol. 2004;44(3):579-85. PMID: 15358024 DOI: 10.1016/j.jacc.2004.03.078
5. Smith SC Jr, Greenland P, Grundy SM. AHA Conference Proceedings. Prevention conference V beyond secondary prevention: identifying the high-risk patient for primary prevention: executive summary. Circulation. 2000;101(1):111-6. PMID: 10618313 DOI: 10.1161/01.cir.101.1.111
6. Michos ED, Nasir K, Braunstein JB, Rumberger JA, Budoff MJ, Post WS, et al. Framingham risk equation underestimates subclinical atherosclerosis risk in asymptomatic women. Atherosclerosis. 2006;184(1):201-6. PMID: 15907856 DOI: 10.1016/j.atherosclerosis.2005.04.004
7. Thijssen DH, Cable NT, Green DJ. Noninvasive assessment of subclinical atherosclerosis in children and adolescents. Hypertension. 2010;55(3):e14. PMID: 20100991 DOI: 10.1161/HYPERTENSIONAHA.109.147744
8. Feinstein SB, Voci P, Pizzuto F. Noninvasive surrogate markers of atherosclerosis. Am J Cardiol. 2002;89(5):31C-43C. PMID: 11900717 DOI: 10.1016/s0002-9149(02)02226-9
9. Touboul PJ, Hennerici MG, Meairs S, Adams H, Amarenco P, Bornstein N, et al. Mannheim carotid intima-media thickness and plaque consensus (2004–2006–2011). An update on behalf of the advisory board of the 3rd, 4th and 5th watching the risk symposia, at the 13th, 15th and 20th European Stroke Conferences, Mannheim, Germany, 2004, Brussels, Belgium, 2006, and Hamburg, Germany, 2011. Cerebrovasc Dis. 2012;34(4):290-6. PMID: 23128470 DOI: 10.1159/000343145
10. Wenzel H, Unger E. Influence of a six-month strengthening programme on HbA1c, cholesterol and triglycerides in type II diabetics: a pilot study. South East Eur J Public Health. 2016;5(1):1-13. DOI 10.4119/UNIBI/SEEJPH-2016-96
11. Bowles DK, Laughlin MH. Mechanism of beneficial effects of physical activity on atherosclerosis and coronary heart disease. J Appl Physiol. 2011;111(1):308-10. PMID: 21617083 DOI: 10.1152/japplphysiol.00634.2011
12. Rahbar S, Naimi SS, RezaSoltani A, Rahimi A, Baghban AA, Noori A, et al. Changes in vascular structure in diabetic patients after 8 weeks aerobic physical exercise: a randomized controlled trial. Int J Diabet Dev Count. 2018;38(2):202-8. DOI: 10.1007/s13410-017-0579-9
13. Lenk K, Uhlemann M, Schuler G, Adams V. Role of endothelial progenitor cells in the beneficial effects of physical exercise on atherosclerosis and coronary artery disease. J Appl Physiol. 2011;111(1):321-8. PMID: 21350026 DOI: 10.1152/japplphysiol.01464.2010
14. Simões HG, Asano RY, Sales MM, Browne RA, Arsa G, Motta-Santos D, et al. Type 2 diabetes elicits lower nitric oxide, bradykinin concentration and kallikrein activity together with higher DesArg 9-BK and reduced post-exercise hypotension compared to non-diabetic condition. PloS One. 2013;8(11):e80348. PMID: 24265812 DOI: 10.1371/journal.pone.0080348
15. Rosales W, Cofre C, Alejandra C, Bertona C, Vizcaya A, Gonzalez J, et al. Validation of the Borg scale in participants with type 2 diabetes mellitus. Rev Med Chil. 2016;144(9):1159-63. PMID: 28060977 DOI: 10.4067/S0034-98872016000900009
16. Maiorana AJ, Naylor LH, Exterkate A, Swart A, Thijssen DH, Lam K, et al. The impact of exercise training on conduit artery wall thickness and remodeling in chronic heart failure patients. Hypertension. 2011;57(1):56-62. PMID: 21059991 DOI: 10.1161/HYPERTENSIONAHA.110.163022
17. Roghani T, Torkaman G, Movasseghe S, Hedayati M, Goosheh B, Bayat N. Effects of short-term aerobic exercise with and without external loading on bone metabolism and balance in postmenopausal women with osteoporosis. Rheumatol Int. 2013;33(2):291-8.
18. Shaw JM, Snow CM. Weighted vest exercise improves indices of fall risk in older women. J Gerontol A Biol Sci Med Sci. 1998;53(1):M53-8. PMID: 9467434 DOI: 10.1093/gerona/53a.1.m53
19. American Diabetes Association. Standards of medical care in diabetes-2016 abridged for primary care providers. Clin Diabetes. 2016;34(1):3-21.
20. Roghani T, Torkaman G, Movasseghe S, Hedayati M, Goosheh B, Bayat N. Effects of short-term aerobic exercise with and without external loading on bone metabolism and balance in postmenopausal women with osteoporosis. Rheumatol Int. 2013;33(2):291-8. PMID: 22441962 DOI: 10.1007/s00296-012-2388-2
21. Marcus RL, Smith S, Morrell G, Addison O, Dibble LE, Wahoff-Stice D, et al. Comparison of combined aerobic and high-force eccentric resistance exercise with aerobic exercise only for people with type 2 diabetes mellitus. Phys Ther. 2008;88(11):1345-54. PMID: 18801851 DOI: 10.2522/ptj.20080124
22. Patti AM, Nikolic D, Magan-Fernandez A, Giglio RV, Castellino G, Chianetta R, et al. Exenatide once-weekly improves metabolic parameters, endothelial dysfunction and carotid intima-media thickness in patients with type-2 diabetes: an 8-month prospective study. Diabetes Res Clin Pract. 2019;149:163-9. PMID: 30759365 DOI: 10.1016/j.diabres.2019.02.006
23. Hurst RT, Ng DW, Kendall C, Khandheria B. Clinical use of carotid intima-media thickness: review of the literature. J Am Soc Echocardiogr. 2007;20(7):907-14. PMID: 17617324 DOI: 10.1016/j.echo.2007.02.028
24. Byrkjeland R, Stensæth KH, Anderssen S, Njerve IU, Arnesen H, Seljeflot I, et al. Effects of exercise training on carotid intima-media thickness in patients with type 2 diabetes and coronary artery disease. Influence of carotid plaques. Cardiovasc Diabetol. 2016;15:13. PMID: 26801098 DOI: 10.1186/s12933-016-0336-2
25. Zanuso S, Jimenez A, Pugliese G, Corigliano G, Balducci S. Exercise for the management of type 2 diabetes: a review of the evidence. Acta Diabetol. 2010;47(1):15-22. PMID: 19495557 DOI: 10.1007/s00592-009-0126-3
26. Thijssen D, De Groot P, Smits P, Hopman M. Vascular adaptations to 8‐week cycling training in older men. Acta Physiol. 2007;190(3):221-8. PMID: 17394568 DOI: 10.1111/j.1748-1716.2007.01685.x
27. Olson TP, Dengel DR, Leon AS, Schmitz KH. Moderate resistance training and vascular health in overweight women. Med Sci Sports Exerc. 2006;38(9):1558-64. PMID: 16960515 DOI: 10.1249/01.mss.0000227540.58916.0e
28. Juonala M, Viikari JS, Kähönen M, Taittonen L, Laitinen T, Hutri-Kähönen N, et al. Life-time risk factors and progression of carotid atherosclerosis in young adults: the Cardiovascular Risk in Young Finns study. Eur Heart J. 2010;31(14):1745-51. PMID: 20501481 DOI: 10.1093/eurheartj/ehq141
29. Palatini P, Puato M, Rattazzi M, Pauletto P. Effect of regular physical activity on carotid intima-media thickness. Results from a 6-year prospective study in the early stage of hypertension. Blood Press. 2011;20(1):37-44. PMID: 20977389 DOI: 10.3109/08037051.2010.524080
30. Tanaka H, Seals DR, Monahan KD, Clevenger CM, DeSouza CA, Dinenno FA. Regular aerobic exercise and the age-related increase in carotid artery intima-media thickness in healthy men. J Appl Physiol. 2002;92(4):1458-64. PMID: 11896010 DOI: 10.1152/japplphysiol.00824.2001
31. Moreau KL, Donato AJ, Seals DR, Dinenno FA, Blackett SD, Hoetzer GL, et al. Arterial intima-media thickness: site-specific associations with HRT and habitual exercise. Am J Physiol Heart Circ Physiol. 2002;283(4):H1409-17. PMID: 12234791 DOI: 10.1152/ajpheart.00035.2002
32. Okada K, Maeda N, Tatsukawa M, Shimizu C, Sawayama Y, Hayashi J. The influence of lifestyle modification on carotid artery intima-media thickness in a suburban Japanese population. Atherosclerosis. 2004;173(2):327-35. PMID: 15064110 DOI: 10.1016/j.atherosclerosis.2003.12.025
33. Rauramaa R, Halonen P, Väisänen SB, Lakka TA, Schmidt-Trucksass A, Berg A, et al. Effects of aerobic physical exercise on inflammation and atherosclerosis in men: the DNASCO Study: a six-year randomized, controlled trial. Ann Int Med. 2004;140(12):1007-14. PMID: 15197018 DOI: 10.7326/0003-4819-140-12-200406150-00010
34. Sato S, Makita S, Uchida R, Ishihara S, Majima M. Physical activity and progression of carotid intima-media thickness in patients with coronary heart disease. J Cardiol. 2008;51(3):157-62. PMID: 18522790 DOI: 10.1016/j.jjcc.2008.02.005
35. Kim SH, Lee SJ, Kang ES, Kang S, Hur KY, Lee HJ, et al. Effects of lifestyle modification on metabolic parameters and carotid intima-media thickness in patients with type 2 diabetes mellitus. Metabolism. 2006;55(8):1053-9. PMID: 16839841 DOI: 10.1016/j.metabol.2006.03.017
36. Magalhães JP, Melo X, Correia IR, Ribeiro RT, Raposo J, Dores H, et al. Effects of combined training with different intensities on vascular health in patients with type 2 diabetes: a 1-year randomized controlled trial. Cardiovasc Diabetol. 2019;18(1):34. PMID: 30885194 DOI: 10.1186/s12933-019-0840-2
37. Montero D, Walther G, Benamo E, Perez-Martin A, Vinet A. Effects of exercise training on arterial function in type 2 diabetes mellitus. Sports Med. 2013;43(11):1191-9. PMID: 23912806 DOI: 10.1007/s40279-013-0085-2
38. Thijssen DH, Cable NT, Green DJ. Impact of exercise training on arterial wall thickness in humans. Clin Sci. 2012;122(7):311-22. PMID: 22150253 DOI: 10.1042/CS20110469
39. Watarai T, Yamasaki Y, Ikeda M, Kubota M, Kodamam M, Tsujno T, et al. Insulin resistance contributes to carotid arterial wall thickness in patients with non-insulin-dependent-diabetes mellitus. Endocr J. 1999;46(5):629-38. PMID: 10670747 DOI: 10.1507/endocrj.46.629
40. Jae SY, Carnethon MR, Heffernan KS, Choi YH, Lee MK, Fernhall B. Association between cardiorespiratory fitness and prevalence of carotid atherosclerosis among men with hypertension. Am Heart J. 2007;153(6):1001-5. PMID: 17540202 DOI: 10.1016/j.ahj.2007.02.035
41. Meyer AA, Kundt G, Lenschow U, Schuff-Werner P, Kienast W. Improvement of early vascular changes and cardiovascular risk factors in obese children after a six-month exercise program. J Am Coll Cardiol. 2006;48(9):1865-70. PMID: 17084264 DOI: 10.1016/j.jacc.2006.07.035
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