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      Physical activity-induced remodeling of vasculature in skeletal muscle: role in treatment of type 2 diabetes

      review-article
      Journal of Applied Physiology
      American Physiological Society
      angiogenesis, arteriogenesis, capillary, diabetes, muscle fibers

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          Abstract

          This manuscript summarizes and discusses adaptations of skeletal muscle vasculature induced by physical activity and applies this understanding to benefits of exercise in prevention and treatment of type 2 diabetes (T2D). Arteriolar trees of skeletal muscle are heterogeneous. Exercise training increases capillary exchange and blood flow capacities. The distribution of vascular adaptation to different types of exercise training are influenced by muscle fiber type composition and fiber recruitment patterns that produce different modes of exercise. Thus training-induced adaptations in vascular structure and vascular control in skeletal muscle are not homogeneously distributed throughout skeletal muscle or along the arteriolar tree within a muscle. Results summarized indicate that similar principles apply to vascular adaptation in skeletal muscle in T2D. It is concluded that exercise training-induced changes in vascular gene expression differ along the arteriolar tree and by skeletal muscle fiber type composition. Results suggest that it is unlikely that hemodynamic forces are the only exercise-induced signals mediating the regulation of vascular gene expression. In patients with T2D, exercise training is perhaps the most effective treatment of the many related symptoms. Training-induced changes in the vasculature and in insulin signaling in the muscle fibers and vasculature augment glucose and insulin delivery as well as glucose uptake. If these adaptations occur in a sufficient amount of muscle mass, exposure to hyperglycemia and hyperinsulinemia will decrease along with the risk of microvascular complications throughout the body. It is postulated that exercise sessions in programs of sufficient duration, that engage as much skeletal muscle mass as possible, and that recruit as many muscle fibers within each muscle as possible will produce the greatest benefit. The added benefit of combined resistance and aerobic training programs and of high-intensity exercise programs is not simply “more exercise is better”.

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          Author and article information

          Journal
          J Appl Physiol (1985)
          J. Appl. Physiol
          jap
          jap
          JAPPLPHYSIOL
          Journal of Applied Physiology
          American Physiological Society (Bethesda, MD )
          8750-7587
          1522-1601
          15 October 2015
          1 January 2016
          1 January 2017
          : 120
          : 1
          : 1-16
          Affiliations
          Department of Biomedical Sciences, Department of Medical Pharmacology & Physiology, and Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri
          Author notes
          Address for reprint requests and other correspondence: M. Harold Laughlin, Dept. of Biomedical Sciences, W102 Vet Med Bldg, Columbia, MO 65211 (e-mail: laughlinm@ 123456missouri.edu ).
          Article
          PMC4698444 PMC4698444 4698444 JAPPL-00789-2015
          10.1152/japplphysiol.00789.2015
          4698444
          26472876
          195adf2b-cda5-4a46-99ed-d96aa508c0a3
          Copyright © 2016 the American Physiological Society
          History
          : 16 September 2015
          : 8 October 2015
          Funding
          Funded by: National Institues of Health
          Award ID: HL36088
          Categories
          Review

          muscle fibers,diabetes,capillary,arteriogenesis,angiogenesis

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