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Resistance exercise but not aerobic exercise lowers remnant-like lipoprotein particle cholesterol in type 2 diabetes: A randomized controlled trial

  • Claire Gavin
    Affiliations
    Clinical Research Laboratory, Division of Endocrinology and Metabolism, Faculty of Medicine, University of Ottawa, Ottawa, Canada

    Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
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  • Ronald J. Sigal
    Affiliations
    Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada

    School of Human Kinetics, Faculty of Health Sciences University of Ottawa, Ottawa, Canada

    Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada

    Department of Medicine and Cardiac Sciences, Faculties of Medicine and Kinesiology, University of Calgary, Calgary, Alberta, Canada

    Department of Community Health Sciences, Faculties of Medicine and Kinesiology, University of Calgary, Calgary, Alberta, Canada
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  • Marion Cousins
    Affiliations
    Clinical Research Laboratory, Division of Endocrinology and Metabolism, Faculty of Medicine, University of Ottawa, Ottawa, Canada

    Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
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  • Michelle L. Menard
    Affiliations
    Clinical Research Laboratory, Division of Endocrinology and Metabolism, Faculty of Medicine, University of Ottawa, Ottawa, Canada

    Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
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  • Michelle Atkinson
    Affiliations
    Clinical Research Laboratory, Division of Endocrinology and Metabolism, Faculty of Medicine, University of Ottawa, Ottawa, Canada

    Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
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  • Farah Khandwala
    Affiliations
    Department of Community Health Sciences, Faculties of Medicine and Kinesiology, University of Calgary, Calgary, Alberta, Canada
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  • Glen P. Kenny
    Affiliations
    School of Human Kinetics, Faculty of Health Sciences University of Ottawa, Ottawa, Canada

    Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
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  • Spencer Proctor
    Affiliations
    Alberta Institute for Human Nutrition, University of Alberta, Edmonton, Alberta, Canada
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  • Teik Chye Ooi
    Correspondence
    Corresponding author at: The Ottawa Hospital Riverside Campus, 1967 Riverside Drive, Ottawa, ON K1H 7W9 Canada. Tel.: +1 613 738 8400x81937; fax: +1 613 738 8327.
    Affiliations
    Clinical Research Laboratory, Division of Endocrinology and Metabolism, Faculty of Medicine, University of Ottawa, Ottawa, Canada

    Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
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  • on behalf of the Diabetes Aerobic and Resistance Exercise (DARE) trial investigators

      Abstract

      The comparative effects of aerobic and resistance exercise on triglyceride-rich lipoproteins including remnant lipoproteins are controversial. This study examined exercise effect on remnant-like lipoprotein particle cholesterol (RLP-C) in type 2 diabetes. Participants were randomized to control (Control), aerobic (Aerobic), resistance (Resistance), or both (Combined) exercise groups. Baseline and 6-month fasting RLP-C and apolipoprotein B48 concentrations were measured. Data analysis was on an intention-to-treat basis.
      At 6 months, RLP-C was lower in all groups; ΔRLP-C mg/dl, (95% confidence interval), Control −3.91, (−6.21 to −1.6), p = 0.001; Aerobic −3.89, (−6.41 to −1.36), p = 0.003, Resistance −7.52, (−9.89 to −5.15), p = 0.0001, Combined −7.50, (−9.87 to −5.13), p = 0.0001. Total triglycerides were significantly lower in Resistance and Combined groups only; −17.7 mg/dl (−32.8 to −2.7), p = 0.02 and −27.5 (−42.5 to −11.5), p = 0.001, respectively. Inter-group comparisons showed no difference in RLP-C change between Aerobic and Control and a significant difference in RLP-C change only where groups incorporating resistance exercise were compared with those without. There was no significant difference in RLP-C change between Resistance and Combined. Inter-group comparisons of total triglycerides change were significant only between Combined and Control. Changes in apolipoprotein B48 were not significant in inter-group comparisons.
      In conclusion, our data indicate that resistance exercise training, not aerobic, lowers RLP-C in type 2 diabetes. This effect was not revealed by changes in total triglycerides and apolipoprotein B48. The discordance between changes in RLP-C and apolipoprotein B48 in response to resistance exercise may indicate (a) a decrease in VLDL remnant and not chylomicron remnant particle number and/or (b) a depletion of cholesterol in chylomicron and/or VLDL remnants.

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