Document Detail


The effect of strength and endurance training on insulin sensitivity and fat distribution in human immunodeficiency virus-infected patients with lipodystrophy.
MedLine Citation:
PMID:  18628529     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
CONTEXT: Fat redistribution, insulin resistance, and low-grade inflammation characterize HIV-infected patients with lipodystrophy. Currently, no effective therapies exist for the combined treatment of fat redistribution and insulin resistance. OBJECTIVE: Our objective was to evaluate the effects of strength and endurance training on insulin sensitivity and fat distribution in HIV-infected patients with lipodystrophy. SUBJECTS AND METHODS: Twenty sedentary HIV-infected men with lipodystrophy were randomly assigned to supervised strength or endurance training three times a week for 16 wk. The primary endpoints were improved peripheral insulin sensitivity (euglycemic-hyperinsulinemic clamp combined with isotope-tracer infusion) and body fat composition (dual-energy x-ray absorptiometry scan). Secondary endpoints included fasting lipids and inflammatory markers. RESULTS: Insulin-mediated glucose uptake increased with both endurance training (55.7 +/- 11 to 63.0 +/- 11 micromol glucose/kg lean mass.min, P = 0.02) and strength training (49.0 +/- 12 to 57.8 +/- 18 micromol glucose/kg lean mass.min, P = 0.005), irrespective of training modality (P = 0.24). Only strength training increased total lean mass 2.1 kg [95% confidence interval (CI), 0.8-3.3], decreased total fat 3.3 kg (95% CI, -4.6 to -2.0), trunk fat 2.5 kg (95% CI, -3.5 to -1.5), and limb fat 0.75 kg (95% CI, -1.1 to -0.4). Strength training significantly decreased total and limb fat mass to a larger extent than endurance training (P < 0.05). Endurance training reduced total cholesterol, low-density lipoprotein cholesterol, free fatty acids, high-sensitivity C-reactive protein, IL-6, IL-18, and TNF-alpha and increased high-density lipoprotein cholesterol, whereas strength training decreased triglycerides, free fatty acids, and IL-18 and increased high-density lipoprotein cholesterol (P < 0.05 for all measurements). CONCLUSION: This study demonstrates that both strength and endurance training improve peripheral insulin sensitivity, whereas only strength training reduces total body fat in HIV-infected patients with lipodystrophy.
Authors:
B Lindegaard; T Hansen; T Hvid; G van Hall; P Plomgaard; S Ditlevsen; J Gerstoft; B K Pedersen
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2008-07-15
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  93     ISSN:  0021-972X     ISO Abbreviation:  J. Clin. Endocrinol. Metab.     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-10-09     Completed Date:  2008-11-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3860-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Infectious Diseases, Copenhagen Muscle Research Centre, DK-2100 Copenhagen, Denmark. blm@rh.dk
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MeSH Terms
Descriptor/Qualifier:
Adult
Algorithms
Biological Markers / blood
Body Fat Distribution*
Energy Intake / physiology
Exercise Therapy / methods*
HIV-Associated Lipodystrophy Syndrome / blood,  physiopathology*,  therapy*
Humans
Inflammation Mediators / blood
Insulin Resistance / physiology*
Lipids / blood
Male
Middle Aged
Muscle Strength / physiology*
Physical Endurance / physiology*
Physical Fitness / physiology
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Inflammation Mediators; 0/Lipids

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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