Document Type

Journal Article

Publication Date

4-2015

Journal

Journal of Endocrinology and Metabolism

Volume

Volume 5, Issue 1-2

Inclusive Pages

163-171

Abstract

Background: Pre-diabetes is associated with endothelial dysfunction and affects endothelium-associated stem cells. Lifestyle modification has been shown to prevent the progression from pre-diabetes to overt type 2 diabetes; however, the effect of such interventions on CD34+ progenitor cells in pre-diabetes participants has not been tested. The purpose of this study was to determine whether a home-based 6-week exercise intervention improved vascular function, circulating number, function, and gene expression of circulating CD34+progenitor cells in patients with pre-diabetes.

Methods: Patients (40 - 70 years, BMI of 25 - 39.9, n = 11) were enrolled in a 16-week randomized crossover study that consisted of 6 weeks each of an exercise (150 minutes/week) and non-exercise phase with a 4-week washout between phases. Adherence to the exercise regimen was monitored by accelerometry. All participants were encouraged to follow a low fat/low calorie diet throughout the 16 weeks. Endothelial function was assessed via brachial artery flow mediated dilatation (FMD) and CFU-Hill colony formation. CD34+ cell number, migratory function, gene expression, and serum inflammatory markers were evaluated.

Results: With the intervention, endothelial function improved (FMD, 5.7±0.6% to 11.2±0.9%, CFU-Hill, 3.3±0.2% to 8.2±0.6%, both P < 0.05). There was a significant reduction in cholesterol, triglyceride, insulin, leptin, interleukin-6 (IL-6), low density lipoprotein (LDL), apolipoprotein B (ApoB) and increase in apolipoprotein A1 (ApoA1) with the lifestyle intervention (all P < 0.05). An increase in circulating CD34+ cells (P < 0.005), decrease in CD34+ endothelin-1, IL-6, tumor necrosis factor (TNF)-α, p53, and p21 gene expression (all P < 0.05), and improved migration toward stromal cell derived factor (SDF)-1α occurred with the intervention.

Conclusion: The improvements in endothelial function and CD34+ circulating progenitor cells in patients with pre-diabetes indicate that pre-diabetes may be a clinical window of therapeutic opportunity for lifestyle interventions.

Comments

Reproduced with permission of Elmer Press, Inc. Journal of Endocrinology and Metabolism.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.

Peer Reviewed

1

Open Access

1

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