The Differential Effects Of Amount, Intensity, And Mode Of Exercise Training On A Novel Lipoprotein Multimarker Of Insulin Resistance

Abstract

PURPOSE: To examine the effects of amount, intensity, and mode of exercise training on Lipoprotein Insulin Resistance Index (LP-IR; a relatively new spectroscopic multimarker of insulin resistance) across 10 exercise interventions from the STRRIDE studies. METHODS: A total of 531 men and women with dyslipidemia [STRRIDE I (n=222) and STRRIDE AT/RT (n=142)] or prediabetes [STRRIDE-PD (n=167)] were randomized to either control group or one of 10 exercise interventions, which ranged from doses of 8-22 kcal/kg/week (KKW); intensities of 50-75% V̇O2peak; and durations of 6-9 months. Two groups included resistance training and one group included dietary intervention (weight loss goal of 7%). Fasting blood samples were obtained at both baseline and 16-24 hr after the final exercise bout. NMR spectroscopy was performed at LabCorp to determine LP-IR score, which is comprised of six lipoprotein subclass and size parameters. LP-IR score ranges from 0 (most insulin sensitive) to 100 (most insulin resistant). Paired t-tests determined post- minus pre-intervention change score significance within groups (p<0.05). Study-specific ANCOVA determined differences between groups. RESULTS: The inactive control group did not significantly change LP-IR. After training, seven of the 10 exercise groups significantly improved LP-IR, ranging from -4.0 ± 7.6 to -12.5 ± 14.2. The figure displays change scores across all groups. The Aerobic plus Resistance group resulted in significantly greater change than the Resistance only group in STRRIDE AT/RT. The Moderate plus Diet group had significantly greater LP-IR change than all other groups in STRRIDE-PD. CONCLUSION: On average, STRRIDE interventions improved LP-IR. Our results provide compelling evidence that adding resistance to aerobic training elicits a synergistic training effect on LP-IR. In individuals with prediabetes, incorporating dietary intervention with aerobic training results in the most robust LP-IR improvement.