The association of physical activity with novel adipokines in patients with type 2 diabetes

Background: Adipose-tissue derivatives, known as adipokines, have been involved in the inflammatory-mediated metabolic and cardiovascular disorders of type 2 diabetes mellitus (T2DM). This study examined the association between novel adipokines and self-reported physical activity, a potential anti-inflammatory mediator. Methods: We enrolled 247 men and women with T2DM, free from overt cardiovascular disease. Based on a physical activity questionnaire, patients were classified into groups: A) sedentary, who did not report any physical activity or reported light activities >2 h/week and B) active, referring to low or moderate-intensity physical activities > 2 h/week. Among them, 88 patients were randomly selected to perform a cardiorespiratory ergocycle testing. Clinical parameters, glycemic and lipid profiles, HOMA-IR, and serum levels of visfatin, apelin, vaspin, ghrelin and adiponectin were assessed. Results: With the exception of fat-mass, our groups did not differ in anthropometric parameters and pharmaceutical regimen. Active patients showed ameliorated glucose regulation, HOMA-IR, hsCRP and exercise capacity compared to sedentary counterparts (p<0.01). Active rather than sedentary patients showed lower visfatin (10.16 +/- 5.53 ng/ml vs 14.77 +/- 8.48 ng/ml, p = 0.013), higher apelin (1.39 +/- 0.65 ng/ml vs 1.04 +/- 0.35 ng/ml, p=0.018) and adiponectin (11.82 +/- 3.06 mu g/ml vs 7.81 +/- 2.11 mu g/ml, p=0.033) levels. There were non-significant differences in the rest of parameters between groups. After adjusting for age, sex and BMI, physical activity along with hsCRP and ghrelin remained independent determinants of visfatin levels (R-2 = 0.328, p=0.032), while physical activity was independently associated with apelin (R-2 = 0.221, p=0.022). Conclusions: Self-controlled physical activity of, even, moderate intensity ameliorates adipokines, such as visfatin, apelin and adiponectin, in patients with T2DM. Prospective interventional studies will confirm our results. The ClinicalTrials. gov identifier is: NCT00306176. (C) 2011 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.