PMID- 19793768
OWN - NLM
STAT- MEDLINE
DCOM- 20110111
LR  - 20151119
IS  - 1522-9645 (Electronic)
IS  - 0195-668X (Linking)
VI  - 31
IP  - 1
DP  - 2010 Jan
TI  - Long- but not short-term multifactorial intervention with focus on exercise 
      training improves coronary endothelial dysfunction in diabetes mellitus type 2 
      and coronary artery disease.
PG  - 112-9
LID - 10.1093/eurheartj/ehp398 [doi]
AB  - AIMS: Patients with type 2 diabetes mellitus (T2DM) suffer from accelerated 
      coronary artery disease. We assessed the effects of a multifactorial intervention 
      with focus on exercise training on coronary endothelial function, vascular 
      structure, and inflammation in serum and skeletal muscle biopsies, including mRNA 
      expression of diabetes candidate genes. METHODS AND RESULTS: Twenty-three 
      patients were randomized to either 4 weeks in-hospital exercise training (6 x 15 
      min bicycle/day, 5 days/week) and a hypocaloric diet, followed by a 5 months 
      ambulatory program (30 min ergometer/day, 5 days/week, plus 1 h group 
      exercise/week), or a control group. At the beginning of the study, at 4 weeks, 
      and after 6 months changes in diameter of coronary arteries in response to 
      acetylcholine and mean peak flow velocity were invasively measured; intramural 
      plaques were assessed by intravascular ultrasound. Six months of intervention led 
      to significant improvement of coronary endothelial function, whereas intramural 
      plaque burden remained unchanged. After 4 weeks, endothelial function remained 
      unchanged, however, lowest values for fasting glucose, HbA1c, high-sensitive 
      C-reactive protein, total and LDL-cholesterol, and highest values for mRNA 
      expression in skeletal muscle of p22, gp91, haem oxygenase 1, peroxisome 
      proliferator activator receptor (PPAR) alpha and gamma were observed. There was a 
      continuous increase for AdipoR1, AdipoR2, Glut4, interleukin-6, endothelial 
      nitric oxide synthase, and PPARgamma-coactivator-1alpha mRNA expression in 
      skeletal muscle. CONCLUSION: This is the first study to demonstrate improvement 
      in coronary endothelial function by a multifactorial intervention which focused 
      on exercise training in patients with T2DM. This coincided with improved markers 
      of hyperglycaemia, insulin sensitivity, and inflammation both in serum and 
      skeletal muscle biopsies.
FAU - Sixt, Sebastian
AU  - Sixt S
AD  - Department of Cardiology, Heart Centre, University of Leipzig, Leipzig, Germany.
FAU - Beer, Sebastian
AU  - Beer S
FAU - Bluher, Matthias
AU  - Bluher M
FAU - Korff, Nicolai
AU  - Korff N
FAU - Peschel, Thomas
AU  - Peschel T
FAU - Sonnabend, Melanie
AU  - Sonnabend M
FAU - Teupser, Daniel
AU  - Teupser D
FAU - Thiery, Joachim
AU  - Thiery J
FAU - Adams, Volker
AU  - Adams V
FAU - Schuler, Gerhard
AU  - Schuler G
FAU - Niebauer, Josef
AU  - Niebauer J
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20090930
PL  - England
TA  - Eur Heart J
JT  - European heart journal
JID - 8006263
RN  - 0 (Biomarkers)
RN  - 0 (Blood Glucose)
RN  - 0 (RNA, Messenger)
SB  - IM
MH  - Biomarkers/blood
MH  - Blood Glucose/metabolism
MH  - Body Weight
MH  - Coronary Artery Disease/metabolism/physiopathology/*therapy
MH  - Diabetes Mellitus, Type 2/metabolism/physiopathology/*therapy
MH  - Diabetic Angiopathies/*therapy
MH  - Dyslipidemias/therapy
MH  - Endothelium, Vascular/*physiopathology
MH  - Exercise Therapy/*methods
MH  - Female
MH  - Humans
MH  - Lipid Metabolism
MH  - Male
MH  - Muscle, Skeletal/metabolism
MH  - RNA, Messenger/metabolism
MH  - Ultrasonography, Interventional
EDAT- 2009/10/02 06:00
MHDA- 2011/01/12 06:00
CRDT- 2009/10/02 06:00
PHST- 2009/10/02 06:00 [entrez]
PHST- 2009/10/02 06:00 [pubmed]
PHST- 2011/01/12 06:00 [medline]
AID - ehp398 [pii]
AID - 10.1093/eurheartj/ehp398 [doi]
PST - ppublish
SO  - Eur Heart J. 2010 Jan;31(1):112-9. doi: 10.1093/eurheartj/ehp398. Epub 2009 Sep 
      30.