Abstract

Objective To examine the effects of resistance training relative to aerobic training on abdominal adipose tissue and metabolic variables in adults with prediabetes. Methods 105 participants with prediabetes were randomized into the resistance training group (RT, n = 35), aerobic training group (AT, n = 35), and control group (CG, n = 35). The participants completed supervised 12-month exercise; the control group followed the primary lifestyle without exercise intervention. The primary outcomes were visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) measured by computed tomography (CT). Secondary outcomes were body composition, lipid profile, and metabolic variables. Results A total of 93 participants completed the study. There were nonsignificant differences between groups before intervention. After training, VAT decreased significantly in AT and RT compared with CG (P = 0.001 and P = 0.014, respectively). Although no significant difference in SAT was found across groups, SAT decreased significantly over time within each exercise group (all P = 0.001). Increase in muscle mass was greater in RT than that in AT and CG (P = 0.031 and P = 0.045, respectively). Compared with CG, fasting plasma glucose (FPG) decreased significantly in RT and AT (P = 0.003 and P = 0.014, respectively). There was a significant difference in the number of prediabetes who converted to diabetes among AT and RT, as compared with the control group (P = 0.031 and P = 0.011, respectively). No significant differences were observed in lipid, waist-to-hip ratio (WHR), body mass index (BMI), fasting insulin (FI), 2-hour postprandial glucose (2hPG), glycosylated hemoglobin (HbA1c), HOMA-IR, and HOMA-β across groups. Conclusion Both aerobic training and resistance training are effective in reducing abdominal adipose tissue and fasting plasma glucose in adults with prediabetes. Importantly, resistance training but not aerobic training is effective in augmenting muscle mass. Trial Registration The trial is registered with NCT02561377 (date of registration: 24/09/2015).

Highlights

  • Individuals with prediabetes have approximately a 30% chance of developing type 2 diabetes mellitus (T2DM) over a 10-year period [1,2,3]

  • To the best of our knowledge, this study is the first 3-arm randomized controlled trial involving participants with prediabetes to investigate the effects of 12-month RT and AT compared with CG on abdominal adipose tissue and metabolic variables

  • Our primary findings were that exercise groups both decreased visceral adipose tissue (VAT) compared to CG, with no statistical difference between exercise groups

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Summary

Introduction

Individuals with prediabetes have approximately a 30% chance of developing type 2 diabetes mellitus (T2DM) over a 10-year period [1,2,3]. Impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and the combination of IFG plus IGT characterized by different levels of insulin resistance are prediabetes states [4]. These represent intermediate states of abnormal glucose regulation between normal glucose homeostasis and diabetes mellitus. Individuals with IFG or IGT add to the risk of evolving type 2 diabetes mellitus. It is not inevitable but a reversible process. Exercise is a recognized strategy that is vital to prevention, care, and management of type 2 diabetes and prediabetes [6, 7]

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