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Exercise may reverse increasing CV risk in patients with prediabetes
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PHILADELPHIA — New data indicate that regular aerobic exercise may restore the impaired vascular reactivity observed in prediabetic patients to the state in which it is in nondiabetic patients.
Sabyasachi Sen, MD, MRCP, FACP, of the Baystate Medical Center and professor of medicine at Tufts University School of Medicine in Massachusetts, and colleagues conducted a crossover trial to evaluate vascular reactivity in patients with prediabetes and whether a weight neutral aerobic exercise intervention affects this reactivity.
They enrolled exercise-naïve patients (mean age, 52 years; mean BMI, 30.3) into 2 groups of 10 and assigned them to 150 minutes of exercise per week for 6 weeks followed by a 4-week washout period before crossing over to a 6-week nonexercise period.
Results from the study indicate that patients demonstrated considerable improvement in flow mediated dilatation of the brachial artery from average 5.7% dilatation pre-exercise to average 11.2% dilatation post-exercise.
“Similar exercise intervention studies have been done in type 2 diabetes patients, and there, the percent change was only about 8%,” Sen said during a press conference. “[This 11% change] is impressive and indicates restoration of vascular reactivity to near normality. Prediabetes may represent a window period of therapeutic opportunity when aerobic exercise can significantly improve vascular reactivity.”
Results showed that patients did not experience significant weight loss, reductions in fat mass or decreases in blood pressure. However, substantial reductions were noted in leptin, interleukin-6, C-reactive protein, tumor necrosis factor-alpha (TNF-alpha), fasting triglycerides, LDL and apolipoprotein-B levels. Insulin sensitivity and apolipoprotein-A1 also improved, but fasting glucose levels, HbA1c and HDL levels did not change.
“These prediabetes patients have a reduction in vascular reactivity that is similar to a patient with diabetes at baseline,” Sen said. “An aerobic exercise intervention did improve their flow mediated dilatation; reduced inflammatory markers in spite of not inducing significant weight loss in this relatively short period of intervention; and can and does improve vascular reactivity. Non-medication interventions like exercise can improve the cardiovascular risks that these patients already face being prediabetic.”
Disclosure: Dr. Sen reports no relevant financial disclosures.