Improved Cardiopulmonary Functional Capacity Following a One-Year Lifestyle Intervention Regimen...
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135 Determinants of Inflammatory Markers in Premenopausal Women: A MONET Group Study SAHAR RAZMJOU * , JEAN PHILIPPE BASTARD, ERIC DOUCET, REMI RABASA-LHORET, SORAYA FELLAHI, MARTIN BROCHU, JEAN-MARC LAVOIE, DENIS PRUD’HOMME Ottawa, ON; Paris, France; Montreal, QC; Sherbrook, QC Purpose: The purpose of this study was to investigate the asso- ciations between adiposity and metabolic indices, cardiorespira- tory fitness (CRF), total daily physical activity energy expenditure (PAEE) and inflammatory markers (IM: C-reactive protein, oroso- mucoid, haptoglobin and apolipoprotein B) in premenopausal women. Methods: Statistical analyses were performed using baseline data of 102 premenopausal women (age, 49.91.9 years; BMI, 23.32.2 kg/m 2 ) who participated to a 5-year MONET (Montreal, Ottawa, New Emerging Team) study on the effect of menopause transition on cardiovascular risk factors. Results: Positive correlations (0.22r0.39; p<0.05) were observed between adiposity indices and triglycerides levels and IM. On the other hand, negative correlations (e0.20re0.30; p<0.05) were observed between CRF and IM. PAEE was nega- tively correlated only with haptoglobin (r¼e0.33; p<0.05). Par- ticipants with a VO 2peak 30 mL O 2 /kg/min had significant lower C-reactive protein, haptoglobin and apolipoprotein B levels (all p<0.05). Also, participants reporting PAEE 1000 kcal/day had a significantly lower haptoglobin (p<0.05). The multiple regression analysis to document the determinants of IM individual variation showed that: 1) visceral fat and LDL-Chol explained 18% of C- reactive proteins, 2) visceral fat explained 20% of orosomucoid, 3) PAEE, fasting glucose and % body fat explained 32% of hapto- globin and 4) LDL-Chol and % body fat explained 41% of apoli- poprotein B levels. Conclusion: Higher adiposity indices, especially high visceral fat and low CRF and PAEE are associated with higher inflammatory markers levels in premenopausal women. 136 Improved Cardiopulmonary Functional Capacity Following a One-Year Lifestyle Intervention Regimen Does Not Explain Improved Postprandial Myocardial Dietary Fatty Acid Metabolism in Patients with Impaired Glucose Tolerance MARGARET KUNACH * , CHRISTOPHE NOLL, SÉBASTIEN M. LABBÉ, THOMAS GRENIER-LAROUCHE, LUCIE BOUFFARD, SERGE PHOENIX, BRIGITTE GUÉRIN, JEAN-PATRICE BAILLARGEON, MARIE-FRANCE LANGLOIS, ÉRIC E. TURCOTTE, ANDRÉ C. CARPENTIER Sherbrooke, QC; Québec, QC Background: Patients with impaired glucose tolerance (IGT+) display an increase in myocardial dietary fatty acid (DFA) parti- tioning associated with a decreased left ventricular ejection frac- tion (LVEF) and stroke volume (LVSV), as well as an increased early DFA fractional uptake rate and cardiac oxidative metabolism index. A 1-year individually tailored lifestyle intervention corrected all these abnormalities. Objective: To determine the effect of physical activity and func- tional capacity on changes in metabolic and functional cardiac abnormalities in IGT+. Method: Positron emission tomography (PET) acquisitions after oral 18FTHA ingestion with a standard meal and 11C-acetate (i.v.) to determine DFA partitioning/uptake and cardiac function/oxidative metabolism, respectively. Pedometer and the 6-minute walk test (6MWT) to determine physical activity level (PAL) and functional capacity, respectively. Results: Following a 1-year lifestyle intervention regimen in 9 IGT+ subjects, during which an approximate 5% to 10% loss of initial body weight was achieved through changes in dietary habits and increased PAL, a reduction in myocardial DFA uptake and fractional extraction as well as an improvement in LVEF and LVSV were observed. PAL (6171 [95% CI 3400 to 8942] pre- to 9591 [7201 to 11980] steps per day post-intervention, p¼0.03) and the 6MWT (524 [440 to 609] to 567 [473 to 661] metres, p¼0.04) improved significantly. However, no relationship was found between increased PAL or ameliorated functional capacity and decreased myocardial DFA partitioning. Conclusion: This underscores the need to assess other potential contributing factors, such as changes in diet and weight loss per se, to explain improved cardiac function/metabolism. 137 Assessment of the MyWellness Key Accelerometer in People with Type 2 Diabetes SAMANTHA K. MCGINLEY * , MARNI J. ARMSTRONG, RONALD J. SIGAL Calgary, AB Objective: To examine the accuracy of the new MyWellness Key (MWK) accelerometer against objective and subjective physical activity (PA) in people with type 2 diabetes (T2D). People with T2D are typically older and overweight, and this accelerometer has only been validated in young, slim adults. Research Design: Validation study. Setting: Objective testing on a treadmill in the lab, and home- based free-living PA. Participants: Twenty-one adults with T2D, mean (SD) age of 65 (7.8) years. Intervention: Two partsd(1) lab visit: structured treadmill pro- tocol wearing MWKs on each hip (all subjects) and bra strap (women only) and (2) free-living testing: participants wore the MWK for all waking hours for 2 weeks, were asked to walk/jog at least 30 minutes 3 times/week and recorded exercise in PA log. Main Outcome Measures: Minutes at each intensity level (low, moderate, vigorous) recorded by the MWK, which are compared to minutes at each intensity recorded in the PA logs, minutes per- formed in the treadmill protocol and minutes recorded on other MWKs worn simultaneously. Results: Nineteen participants were included in the analysis. Two participants were excluded as they held on to the treadmill, yielding inaccurate results. Initial analysis determined the accuracy of the MWK discriminating between low intensity (1.1 to 2.9 METs) and moderate intensity (3.0 to 5.9 METs) exercise. Mean (SD) cut- point between low and moderate exercise for the waistband MWKs in treadmill protocol was 3.14 METs. Conclusions: The MWK discriminated low from moderate in- tensity exercise in middle-aged and older adults with T2D. 138 Long-Term Exercise Adherence After Completion of the Diabetes Aerobic and Resistance Exercise (DARE) Trial CHRISTOPHER S. TRAN * , YUAN KONG, AMBIKA GUPTA, PENNY PHILLIPS, HEATHER TULLOCH, NORMAN G. BOULÉ, MARNI J. ARMSTRONG, GLEN P. KENNY, RONALD J. SIGAL, JANINE MALCOLM Ottawa, ON; Edmonton, AB; Calgary, AB Background: Exercise in type 2 diabetes (T2DM) improves glyce- mic control and decreases morbidity and mortality. Few studies have assessed long-term exercise maintenance in T2DM. Abstracts / Can J Diabetes 37 (2013) S13eS84 S50
Transcript of Improved Cardiopulmonary Functional Capacity Following a One-Year Lifestyle Intervention Regimen...
Abstracts / Can J Diabetes 37 (2013) S13eS84S50
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Determinants of Inflammatory Markers in PremenopausalWomen: A MONET Group StudySAHAR RAZMJOU*, JEAN PHILIPPE BASTARD, ERIC DOUCET,REMI RABASA-LHORET, SORAYA FELLAHI, MARTIN BROCHU,JEAN-MARC LAVOIE, DENIS PRUD’HOMMEOttawa, ON; Paris, France; Montreal, QC; Sherbrook, QC
Purpose: The purpose of this study was to investigate the asso-ciations between adiposity and metabolic indices, cardiorespira-tory fitness (CRF), total daily physical activity energy expenditure(PAEE) and inflammatory markers (IM: C-reactive protein, oroso-mucoid, haptoglobin and apolipoprotein B) in premenopausalwomen.Methods: Statistical analyses were performed using baseline dataof 102 premenopausal women (age, 49.9�1.9 years; BMI, 23.3�2.2kg/m2) who participated to a 5-year MONET (Montreal, Ottawa,New Emerging Team) study on the effect of menopause transitionon cardiovascular risk factors.Results: Positive correlations (0.22�r�0.39; p<0.05) wereobserved between adiposity indices and triglycerides levels andIM. On the other hand, negative correlations (e0.20�r�e0.30;p<0.05) were observed between CRF and IM. PAEE was nega-tively correlated only with haptoglobin (r¼e0.33; p<0.05). Par-ticipants with a VO2peak �30 mL O2/kg/min had significant lowerC-reactive protein, haptoglobin and apolipoprotein B levels (allp<0.05). Also, participants reporting PAEE �1000 kcal/day had asignificantly lower haptoglobin (p<0.05). The multiple regressionanalysis to document the determinants of IM individual variationshowed that: 1) visceral fat and LDL-Chol explained 18% of C-reactive proteins, 2) visceral fat explained 20% of orosomucoid, 3)PAEE, fasting glucose and % body fat explained 32% of hapto-globin and 4) LDL-Chol and % body fat explained 41% of apoli-poprotein B levels.Conclusion: Higher adiposity indices, especially high visceral fatand low CRF and PAEE are associated with higher inflammatorymarkers levels in premenopausal women.
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Improved Cardiopulmonary Functional Capacity Following aOne-Year Lifestyle Intervention Regimen Does Not ExplainImproved Postprandial Myocardial Dietary Fatty AcidMetabolism in Patients with Impaired Glucose ToleranceMARGARET KUNACH*, CHRISTOPHE NOLL, SÉBASTIEN M. LABBÉ,THOMAS GRENIER-LAROUCHE, LUCIE BOUFFARD, SERGE PHOENIX,BRIGITTE GUÉRIN, JEAN-PATRICE BAILLARGEON,MARIE-FRANCE LANGLOIS, ÉRIC E. TURCOTTE, ANDRÉ C. CARPENTIERSherbrooke, QC; Québec, QC
Background: Patients with impaired glucose tolerance (IGT+)display an increase in myocardial dietary fatty acid (DFA) parti-tioning associated with a decreased left ventricular ejection frac-tion (LVEF) and stroke volume (LVSV), as well as an increased earlyDFA fractional uptake rate and cardiac oxidative metabolism index.A 1-year individually tailored lifestyle intervention corrected allthese abnormalities.Objective: To determine the effect of physical activity and func-tional capacity on changes in metabolic and functional cardiacabnormalities in IGT+.Method: Positron emission tomography (PET) acquisitions afteroral 18FTHA ingestionwith a standardmeal and 11C-acetate (i.v.) todetermine DFA partitioning/uptake and cardiac function/oxidativemetabolism, respectively. Pedometer and the 6-minute walk test(6MWT) to determine physical activity level (PAL) and functionalcapacity, respectively.
Results: Following a 1-year lifestyle intervention regimen in 9 IGT+subjects, during which an approximate 5% to 10% loss of initial bodyweight was achieved through changes in dietary habits andincreased PAL, a reduction in myocardial DFA uptake and fractionalextraction as well as an improvement in LVEF and LVSV wereobserved. PAL (6171 [95% CI 3400 to 8942] pre- to 9591 [7201 to11980] steps per day post-intervention, p¼0.03) and the 6MWT(524 [440 to 609] to 567 [473 to 661] metres, p¼0.04) improvedsignificantly. However, no relationship was found betweenincreased PAL or ameliorated functional capacity and decreasedmyocardial DFA partitioning.Conclusion: This underscores the need to assess other potentialcontributing factors, such as changes in diet and weight loss per se,to explain improved cardiac function/metabolism.
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Assessment of the MyWellness Key Accelerometer in Peoplewith Type 2 DiabetesSAMANTHA K. MCGINLEY*, MARNI J. ARMSTRONG, RONALD J. SIGALCalgary, AB
Objective: To examine the accuracy of the new MyWellness Key(MWK) accelerometer against objective and subjective physicalactivity (PA) in people with type 2 diabetes (T2D). People with T2Dare typically older and overweight, and this accelerometer has onlybeen validated in young, slim adults.Research Design: Validation study.Setting: Objective testing on a treadmill in the lab, and home-based free-living PA.Participants: Twenty-one adults with T2D, mean (SD) age of 65(7.8) years.Intervention: Two partsd(1) lab visit: structured treadmill pro-tocol wearing MWKs on each hip (all subjects) and bra strap(women only) and (2) free-living testing: participants wore theMWK for all waking hours for 2 weeks, were asked to walk/jog atleast 30 minutes 3 times/week and recorded exercise in PA log.Main Outcome Measures: Minutes at each intensity level (low,moderate, vigorous) recorded by the MWK, which are compared tominutes at each intensity recorded in the PA logs, minutes per-formed in the treadmill protocol and minutes recorded on otherMWKs worn simultaneously.Results: Nineteen participants were included in the analysis. Twoparticipants were excluded as they held on to the treadmill,yielding inaccurate results. Initial analysis determined the accuracyof the MWK discriminating between low intensity (1.1 to 2.9 METs)and moderate intensity (3.0 to 5.9 METs) exercise. Mean (SD) cut-point between low andmoderate exercise for the waistbandMWKsin treadmill protocol was 3.14 METs.Conclusions: The MWK discriminated low from moderate in-tensity exercise in middle-aged and older adults with T2D.
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Long-Term Exercise Adherence After Completion of theDiabetes Aerobic and Resistance Exercise (DARE) TrialCHRISTOPHER S. TRAN*, YUAN KONG, AMBIKA GUPTA,PENNY PHILLIPS, HEATHER TULLOCH, NORMAN G. BOULÉ,MARNI J. ARMSTRONG, GLEN P. KENNY, RONALD J. SIGAL,JANINE MALCOLMOttawa, ON; Edmonton, AB; Calgary, AB
Background: Exercise in type 2 diabetes (T2DM) improves glyce-mic control and decreases morbidity and mortality. Few studieshave assessed long-term exercise maintenance in T2DM.
