The effect of strength and endurance training on insulin sensitivity and fat distribution in human immunodeficiency virus-infected patients with lipodystrophy.

Abstract

CONTEXT:

Fat redistribution, insulin resistance, and low-grade inflammation characterize HIV-infected patients with lipodystrophy. Currently, no effective therapies exist for the combined treatment of fat redistribution and insulin resistance.

OBJECTIVE:

Our objective was to evaluate the effects of strength and endurance training on insulin sensitivity and fat distribution in HIV-infected patients with lipodystrophy.

SUBJECTS AND METHODS:

Twenty sedentary HIV-infected men with lipodystrophy were randomly assigned to supervised strength or endurance training three times a week for 16 wk. The primary endpoints were improved peripheral insulin sensitivity (euglycemic-hyperinsulinemic clamp combined with isotope-tracer infusion) and body fat composition (dual-energy x-ray absorptiometry scan). Secondary endpoints included fasting lipids and inflammatory markers.

RESULTS:

Insulin-mediated glucose uptake increased with both endurance training (55.7 +/- 11 to 63.0 +/- 11 micromol glucose/kg lean mass.min, P = 0.02) and strength training (49.0 +/- 12 to 57.8 +/- 18 micromol glucose/kg lean mass.min, P = 0.005), irrespective of training modality (P = 0.24). Only strength training increased total lean mass 2.1 kg [95% confidence interval (CI), 0.8-3.3], decreased total fat 3.3 kg (95% CI, -4.6 to -2.0), trunk fat 2.5 kg (95% CI, -3.5 to -1.5), and limb fat 0.75 kg (95% CI, -1.1 to -0.4). Strength training significantly decreased total and limb fat mass to a larger extent than endurance training (P < 0.05). Endurance training reduced total cholesterol, low-density lipoprotein cholesterol, free fatty acids, high-sensitivity C-reactive protein, IL-6, IL-18, and TNF-alpha and increased high-density lipoprotein cholesterol, whereas strength training decreased triglycerides, free fatty acids, and IL-18 and increased high-density lipoprotein cholesterol (P < 0.05 for all measurements).

CONCLUSION:

This study demonstrates that both strength and endurance training improve peripheral insulin sensitivity, whereas only strength training reduces total body fat in HIV-infected patients with lipodystrophy.

• Authors: B Lindegaard, T Hansen, T Hvid, G van Hall, P Plomgaard, S Ditlevsen, J Gerstoft, B K Pedersen
• Journal: The Journal of clinical endocrinology and metabolism (J Clin Endocrinol Metab) Vol. 93 Issue 10 Pg. 3860-9 (Oct 2008) ISSN: 0021-972X [Print] United States
• PMID: 18628529 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers
• Inflammation Mediators
• Lipids

Topics

• Adult
• Algorithms
• Biomarkers (blood)
• Body Fat Distribution
• Energy Intake (physiology)
• Exercise Therapy (methods)
• HIV-Associated Lipodystrophy Syndrome (blood, physiopathology, therapy)
• Humans
• Inflammation Mediators (blood)
• Insulin Resistance (physiology)
• Lipids (blood)
• Male
• Middle Aged
• Muscle Strength (physiology)
• Physical Endurance (physiology)
• Physical Fitness (physiology)