The association of physical activity with novel adipokines in patients with type 2 diabetes.

Adipose-tissue derivatives, known as adipokines, have been involved in the inflammatory-mediated metabolic and cardiovascular disorders of type 2 diabetes mellitus (T2DM). This study examined the association between novel adipokines and self-reported physical activity, a potential anti-inflammatory mediator. We enrolled 247 men and women with T2DM, free from overt cardiovascular disease. Based on a physical activity questionnaire, patients were classified into groups: A) sedentary, who did not report any physical activity or reported light activities<2 h/week and B) active, referring to low or moderate-intensity physical activities>2 h/week. Among them, 88 patients were randomly selected to perform a cardiorespiratory ergocycle testing. Clinical parameters, glycemic and lipid profiles, HOMA-IR, and serum levels of visfatin, apelin, vaspin, ghrelin and adiponectin were assessed. With the exception of fat-mass, our groups did not differ in anthropometric parameters and pharmaceutical regimen. Active patients showed ameliorated glucose regulation, HOMA-IR, hsCRP and exercise capacity compared to sedentary counterparts (p<0.01). Active rather than sedentary patients showed lower visfatin (10.16±5.53 ng/ml vs 14.77±8.48 ng/ml, p=0.013), higher apelin (1.39±0.65 ng/ml vs 1.04±0.35 ng/ml, p=0.018) and adiponectin (11.82±3.06 μg/ml vs 7.81±2.11 μg/ml, p=0.033) levels. There were non-significant differences in the rest of parameters between groups. After adjusting for age, sex and BMI, physical activity along with hsCRP and ghrelin remained independent determinants of visfatin levels (R(2)=0.328, p=0.032), while physical activity was independently associated with apelin (R(2)=0.221, p=0.022). Self-controlled physical activity of, even, moderate intensity ameliorates adipokines, such as visfatin, apelin and adiponectin, in patients with T2DM. Prospective interventional studies will confirm our results. The ClinicalTrials.gov identifier is: NCT00306176. Copyright © 2011 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.