The Effects of Aerobic/Resistance Exercise on Body Fat Mass, Muscle Strength and Endothelial Function in Korean Type 2 Diabetes mellitus Patients

Kyung Wan Min

doi:10.4093/jkd.2011.12.1.6

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Min: The Effects of Aerobic/Resistance Exercise on Body Fat Mass, Muscle Strength and Endothelial Function in Korean Type 2 Diabetes mellitus Patients

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J Korean Diabetes 2011;12(1):6-12.

Published online: 22 January 2011

DOI: https://doi.org/10.4093/jkd.2011.12.1.6

The Effects of Aerobic/Resistance Exercise on Body Fat Mass, Muscle Strength and Endothelial Function in Korean Type 2 Diabetes mellitus Patients

Kyung Wan Min

Department of Internal Medicine, Eulji University School of Medicine, Seoul, Korea

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Regular exercise has been shown to reduce cardiovascular risk factors. Korean type 2 diabetic patients showed a reduced aerobic exercising capacity (VO2max 5.2 ± 1.3 MET, VT 3.5 ± 0.9 MET) when compared to normal subjects matched to anthropometric conditions. A typical activity of moderate intensity is “brisk” walking at 5.6 km/h on a flat surface requiring 3.8 MET. Thus, the duration of aerobic exercise training is more important than intensity in Korean type 2 diabetic patients. During 12 weeks of exercise intervention, aerobic exercise improved cardiopulmonary function and endothelial function in Korean type 2 diabetic patients. However, muscle strength was not changed significantly by aerobic exercise. The maximal muscle strength of Korean type 2 diabetes mellitus patients was decreased compared to normal subjects with similar body weight. The maximal muscle strength was decreased with age, especially more in the lower extremities than the upper extremities. Generally, increased muscle mass was correlated with body mass index, however, muscle mass in obese type 2 diabetic women was not increased proportion with weight gain. Therefore, combined exercise is recommended to obese Korean type 2 diabetic women. Low intensity resistance training using resistance bands was effective in increasing muscle mass and muscle strength and reducing abdominal fat mass in diabetic women. However, endothelial function was not changed significantly by resistance exercise.

Keywords: Aerobic exercise, Resistance, Type 2 diabetes mellitus

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Fig. 1.

Correlation between muscle mass and BMI for (A) men and (B) women; BMI, body mass index (Adapted from Kwon et al. Korean Diabetes J 2009;33:511-7 [23]).

Table 1.

Physical capacity at ventilatory threshold and maximum exercise capacity (adapted from An et al. J Korean Diabetes Assoc 2005;29:479-85 [11])

	Male (N = 298)	Female (N = 283)	Total (N = 581)	Sig
Ventilatory Threshold
Load (watts)	d 668.0 ± 19.0	6643.6 ± 15.9	655.8 ± 21.5	< 0.001
METs	6663.6 ± 1.066	6663.4 ± 0.86	63.5 ± 0.9	0.012
Heart rate (beats/min)	113.2 ± 11.7	1114.1 ± 11.9	113.6 ± 11.8	NS
△Heart rate	627.4 ± 13.1	6626.5 ± 13.5	627.0 ± 13.3	NS
%HRmax	665.7 ± 7.36	6667.6 ± 7.36	66.6 ± 7.3	0.002
%HRR	634.6 ± 11.4	6634.8 ± 11.7	634.7 ± 11.5	NS
SBP (mm Hg)	142.0 ± 24.1	6140.2 ± 31.6	141.2 ± 28.1	NS
DBP (mm Hg)	684.5 ± 12.9	6686.1 ± 16.3	685.2 ± 14.6	NS
Max
Load (watts)	116.2 ± 26.4	6676.6 ± 21.0	696.8 ± 30.9	< 0.001
METs	665.4 ± 1.46	6665.0 ± 1.16	65.2 ± 1.3	0.002
Heart rate (beats/min)	139.2 ± 16.0	6135.4 ± 16.7	61375 ± 16.4	0.01
SBP (mm Hg)	175.7 ± 27.9	6167.5 ± 26.2	172.1 ± 27.5	0.001
DBP (mm Hg)	691.2 ± 15.6	6693.2 ± 13.3	692.2 ± 14.6	NS

MET, metabolic equivalent unit (1 MET = 3.5 mLkg^-1min^-1); △Heart rate, ventilatory threshold heart rate-resting heart rate; HR, heart rate; HRR, % heart rate reserve; SBP, systolic blood pressure; DBP, diastolic blood pressure.

Table 2.

Correlation between the duration of physical activity, regional fat and aerobic capacity (adapted from Kwon et al. Korean Diabetes J 2010;34:23-31 [14])

	TFA		VFA		SFA		VO2-AT
	r	P	r	P	r	P	r	P
Duration of physical activity, min/day
Light intensity	-0.184	0.358	-0.183	0.361	-0.096	0.635	0.134	0.507
Moderate intensity	-0.484	0.01a	0.305	0.122	-0.531	0.004a	0.343	0.080
High intensity	-0.115	0.568	-0.052	0.797	-0.144	0.474	0.414	0.032a

TFA, total fat area; VFA, visceral fat area; SFA, subcutaneous fat area; VO2-AT, oxygen consumption rate at the anaerobic threshold.

^a P-values ‹ 0.05.

Table 3.

One repetition maximum (1RM) according to age quartile (adapted from Kwon et al Korean Diabetes J 2009;33:412-20 [21])

Gender	Limb	Age (yr)	N	Weight (kg)	1 RM	P-value^a
Men	Upper	40~49	21	68.0 ± 9.56	335.2 ± 11.0	< 0.001
		50~59	32	69.5 ± 10.1	334.6 ± 12.0
		60~69	22	68.9 ± 11.1	329.8 ± 10.2
		70+	20	66.8 ± 9.16	323.5 ± 5.7c
	Lower	40~49	21	68.0 ± 9.56	146.5 ± 27.9	< 0.001
		50~59	32	69.5 ± 10.1	3127.0 ± 26.9b
		60~69	21	68.9 ± 11.1	113.0 ± 36.3
		70+	20	66.8 ± 9.16	333392.5 ± 18.4^b,c
Women	Upper	40~49	36	64.0 ± 10.6	20.2 ± 5.7	< 0.001
		50~59	57	64.0 ± 9.66	317.8 ± 5.2b
		60~69	56	62.8 ± 8.76	314.7 ± 4.0b
		70+	22	55.5 ± 8.76	13.3 ± 4.2
	Lower	40~49	36	64.0 ± 10.6	398.5 ± 29.3	< 0.001
		50~59	57	64.0 ± 9.66	389.8 ± 21.1
		60~69	56	62.8 ± 8.76	3377.8 ± 20.7b
		70+	21	55.5 ± 8.76	3364.1 ± 20.2b

Values are presented as mean ±SD.

^a Difference among age group from ANOVA.

^b Significantly lower than the antecedent age-group.

^c Significantly lower than 40s and 50s.

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