Exercise individualized by TRIMPi method reduces arterial stiffness in early onset type 2 diabetic patients

A randomized controlled trial with aerobic interval training

Alfonso Bellia, Ferdinando Iellamo, Elisa De Carli, Aikaterini Andreadi, Elvira Padua, Mauro Lombardo, Giuseppe Annino, Francesca Campoli, Sara Tartaglione, Stefano D'Ottavio, David Della-Morte, Davide Lauro

Research output: Contribution to journalArticle

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Abstract

Background Arterial stiffness (AS) and baroreflex sensitivity (BRS) are subclinical markers of vascular diseases in type 2 diabetes (T2D). We evaluated the effects of aerobic interval training (AIT), with loads prescribed according to individual heart rate and lactate profiling obtained during a baseline treadmill test (TRIMPi method), on AS and BRS in patients with early-onset T2D without cardiovascular complications. Population study and methods Twenty-two sedentary overweight T2D patients (aged 57 ± 7 years) were randomized to 12-weeks open-label of supervised AIT by TRIMPi (n = 8) or unsupervised physical activity as per usual care (SOC) (n = 11). Following parameters were evaluated (pre- and post-): anthropometrics; six-minute walking test (6MWT); fasting glucose, insulin, HbA1c; Pulse Wave Velocity (PWV) and Augmentation Index (AIxHR75) using radial approach (SphigmoCor System); BRS using Finapress method. Results Both interventions significantly improved distance walked during 6MWT (AIT 52 ± 21 m; SOC 39 ± 24 m, p < 0.001 for both). PWV significantly improved with AIT (p < 0.001) whereas did not vary with SOC (p = 0.47). Similar trend was observed for AIxHR75. Resulting percent changes from baseline were significantly better for AIT vs SOC, in both PWV (− 15.8 ± 2.1 vs + 1.50 ± 3.4%, p < 0.001) and AIxHR75 (− 28.9 ± 3.2% vs + 12.7 ± 2.4%, p < 0.001). BRS similarly improved in both groups (p < 0.001 for both), as well as body weight, HbA1c and blood pressure. Conclusion In sedentary T2D patients, 12-weeks AIT individualized by TRIMPi method improved AS to a greater extent than usual recommendation on physical activity, whilst exerting comparable effects on exercise capacity, glycemic control and body weight. Further researches are needed to ascertain durability of these effects.

Original languageEnglish
Pages (from-to)314-319
Number of pages6
JournalInternational Journal of Cardiology
Volume248
DOIs
Publication statusPublished - Dec 1 2017

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Vascular Stiffness
Baroreflex
Type 2 Diabetes Mellitus
Pulse Wave Analysis
Randomized Controlled Trials
Exercise
Body Weight
Exercise Test
Vascular Diseases
Walking
Lactic Acid
Fasting
Heart Rate
Insulin
Blood Pressure
Glucose
Research
Population

Keywords

  • Aerobic interval training
  • Arterial stiffness
  • Baroreflex sensitivity
  • Structured physical activity
  • Type 2 diabetes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Exercise individualized by TRIMPi method reduces arterial stiffness in early onset type 2 diabetic patients : A randomized controlled trial with aerobic interval training. / Bellia, Alfonso; Iellamo, Ferdinando; De Carli, Elisa; Andreadi, Aikaterini; Padua, Elvira; Lombardo, Mauro; Annino, Giuseppe; Campoli, Francesca; Tartaglione, Sara; D'Ottavio, Stefano; Della-Morte, David; Lauro, Davide.

In: International Journal of Cardiology, Vol. 248, 01.12.2017, p. 314-319.

Research output: Contribution to journalArticle

Bellia, Alfonso ; Iellamo, Ferdinando ; De Carli, Elisa ; Andreadi, Aikaterini ; Padua, Elvira ; Lombardo, Mauro ; Annino, Giuseppe ; Campoli, Francesca ; Tartaglione, Sara ; D'Ottavio, Stefano ; Della-Morte, David ; Lauro, Davide. / Exercise individualized by TRIMPi method reduces arterial stiffness in early onset type 2 diabetic patients : A randomized controlled trial with aerobic interval training. In: International Journal of Cardiology. 2017 ; Vol. 248. pp. 314-319.
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abstract = "Background Arterial stiffness (AS) and baroreflex sensitivity (BRS) are subclinical markers of vascular diseases in type 2 diabetes (T2D). We evaluated the effects of aerobic interval training (AIT), with loads prescribed according to individual heart rate and lactate profiling obtained during a baseline treadmill test (TRIMPi method), on AS and BRS in patients with early-onset T2D without cardiovascular complications. Population study and methods Twenty-two sedentary overweight T2D patients (aged 57 ± 7 years) were randomized to 12-weeks open-label of supervised AIT by TRIMPi (n = 8) or unsupervised physical activity as per usual care (SOC) (n = 11). Following parameters were evaluated (pre- and post-): anthropometrics; six-minute walking test (6MWT); fasting glucose, insulin, HbA1c; Pulse Wave Velocity (PWV) and Augmentation Index (AIxHR75) using radial approach (SphigmoCor System); BRS using Finapress method. Results Both interventions significantly improved distance walked during 6MWT (AIT 52 ± 21 m; SOC 39 ± 24 m, p < 0.001 for both). PWV significantly improved with AIT (p < 0.001) whereas did not vary with SOC (p = 0.47). Similar trend was observed for AIxHR75. Resulting percent changes from baseline were significantly better for AIT vs SOC, in both PWV (− 15.8 ± 2.1 vs + 1.50 ± 3.4{\%}, p < 0.001) and AIxHR75 (− 28.9 ± 3.2{\%} vs + 12.7 ± 2.4{\%}, p < 0.001). BRS similarly improved in both groups (p < 0.001 for both), as well as body weight, HbA1c and blood pressure. Conclusion In sedentary T2D patients, 12-weeks AIT individualized by TRIMPi method improved AS to a greater extent than usual recommendation on physical activity, whilst exerting comparable effects on exercise capacity, glycemic control and body weight. Further researches are needed to ascertain durability of these effects.",
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T2 - A randomized controlled trial with aerobic interval training

AU - Bellia, Alfonso

AU - Iellamo, Ferdinando

AU - De Carli, Elisa

AU - Andreadi, Aikaterini

AU - Padua, Elvira

AU - Lombardo, Mauro

AU - Annino, Giuseppe

AU - Campoli, Francesca

AU - Tartaglione, Sara

AU - D'Ottavio, Stefano

AU - Della-Morte, David

AU - Lauro, Davide

PY - 2017/12/1

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N2 - Background Arterial stiffness (AS) and baroreflex sensitivity (BRS) are subclinical markers of vascular diseases in type 2 diabetes (T2D). We evaluated the effects of aerobic interval training (AIT), with loads prescribed according to individual heart rate and lactate profiling obtained during a baseline treadmill test (TRIMPi method), on AS and BRS in patients with early-onset T2D without cardiovascular complications. Population study and methods Twenty-two sedentary overweight T2D patients (aged 57 ± 7 years) were randomized to 12-weeks open-label of supervised AIT by TRIMPi (n = 8) or unsupervised physical activity as per usual care (SOC) (n = 11). Following parameters were evaluated (pre- and post-): anthropometrics; six-minute walking test (6MWT); fasting glucose, insulin, HbA1c; Pulse Wave Velocity (PWV) and Augmentation Index (AIxHR75) using radial approach (SphigmoCor System); BRS using Finapress method. Results Both interventions significantly improved distance walked during 6MWT (AIT 52 ± 21 m; SOC 39 ± 24 m, p < 0.001 for both). PWV significantly improved with AIT (p < 0.001) whereas did not vary with SOC (p = 0.47). Similar trend was observed for AIxHR75. Resulting percent changes from baseline were significantly better for AIT vs SOC, in both PWV (− 15.8 ± 2.1 vs + 1.50 ± 3.4%, p < 0.001) and AIxHR75 (− 28.9 ± 3.2% vs + 12.7 ± 2.4%, p < 0.001). BRS similarly improved in both groups (p < 0.001 for both), as well as body weight, HbA1c and blood pressure. Conclusion In sedentary T2D patients, 12-weeks AIT individualized by TRIMPi method improved AS to a greater extent than usual recommendation on physical activity, whilst exerting comparable effects on exercise capacity, glycemic control and body weight. Further researches are needed to ascertain durability of these effects.

AB - Background Arterial stiffness (AS) and baroreflex sensitivity (BRS) are subclinical markers of vascular diseases in type 2 diabetes (T2D). We evaluated the effects of aerobic interval training (AIT), with loads prescribed according to individual heart rate and lactate profiling obtained during a baseline treadmill test (TRIMPi method), on AS and BRS in patients with early-onset T2D without cardiovascular complications. Population study and methods Twenty-two sedentary overweight T2D patients (aged 57 ± 7 years) were randomized to 12-weeks open-label of supervised AIT by TRIMPi (n = 8) or unsupervised physical activity as per usual care (SOC) (n = 11). Following parameters were evaluated (pre- and post-): anthropometrics; six-minute walking test (6MWT); fasting glucose, insulin, HbA1c; Pulse Wave Velocity (PWV) and Augmentation Index (AIxHR75) using radial approach (SphigmoCor System); BRS using Finapress method. Results Both interventions significantly improved distance walked during 6MWT (AIT 52 ± 21 m; SOC 39 ± 24 m, p < 0.001 for both). PWV significantly improved with AIT (p < 0.001) whereas did not vary with SOC (p = 0.47). Similar trend was observed for AIxHR75. Resulting percent changes from baseline were significantly better for AIT vs SOC, in both PWV (− 15.8 ± 2.1 vs + 1.50 ± 3.4%, p < 0.001) and AIxHR75 (− 28.9 ± 3.2% vs + 12.7 ± 2.4%, p < 0.001). BRS similarly improved in both groups (p < 0.001 for both), as well as body weight, HbA1c and blood pressure. Conclusion In sedentary T2D patients, 12-weeks AIT individualized by TRIMPi method improved AS to a greater extent than usual recommendation on physical activity, whilst exerting comparable effects on exercise capacity, glycemic control and body weight. Further researches are needed to ascertain durability of these effects.

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