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J Appl Physiol (December 22, 2005). doi:10.1152/japplphysiol.01336.2005
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Submitted on October 20, 2005
Accepted on December 16, 2005

Exercise-induced reversal of Insulin Resistance in Obese Elderly is associated with reduced Visceral Fat

Valerie B O'Leary1, Christine M Marchetti1, Raj K Krishnan1, Bradley P Stetzer2, Frank Gonzalez2, and John P Kirwan3*

1 Schwartz Center for Metabolism and Nutrition, Case Western Reserve University School of Medicine, Cleveland, OH 44109, USA, Cleveland, Ohio, USA; Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH 44109, USA, Cleveland, Ohio, USA
2 Department of Reproductive Biology, Case Western Reserve University School of Medicine, Cleveland, OH 44109, USA, Cleveland, Ohio, USA
3 Schwartz Center for Metabolism and Nutrition, Case Western Reserve University School of Medicine, Cleveland, OH 44109, USA, Cleveland, Ohio, USA; Department of Nutrition, Case Western Reserve University School of Medicine, Cleveland, OH 44109, USA, Cleveland, Ohio, USA

* To whom correspondence should be addressed. E-mail: jpk10{at}case.edu.

Exercise improves glucose metabolism and delays the onset and/or reverses insulin resistance in the elderly by an unknown mechanism. In the present study we examined the effects of exercise training on glucose metabolism, abdominal adiposity and adipocytokines in obese elderly. Sixteen obese men and women (Age=63 ± 1 years, BMI=33.2 ± 1.4 kg/m2) participated in a 12-week supervised exercise program (5 d/wk, 60 min/day, treadmill/cycle ergometry @ 85% of heart rate max). Visceral fat (VF), subcutaneous fat (SCF) and total abdominal fat (AF) were measured by computed tomography (CT). Fat mass (FM) and fat-free-mass (FFM) were assessed by hydrostatic weighing. An oral glucose tolerance test was used to determine changes in insulin resistance. Exercise training increased VO2max (21.3 ± 0.8 vs 24.3 ± 1.0 ml.kg.min-1, P<0.0001), decreased body weight (P<0.0001) and FM (P<0.001), while FFM was not altered (P>0.05). VF (176 ± 20 vs 136 ± 17 cm2, P<0.0001), SCF (351 ± 34 vs 305 ± 28 cm2, P<0.03) and AF (525 ± 40 vs 443 ± 34 cm2, P<0.003) were reduced through training. Circulating leptin was lower (P<0.003) after training, but total adiponectin and TNF-{alpha} remained unchanged. Insulin resistance was reversed by exercise (40.1 ± 7.7 vs 27.6 ± 5.6 units, P<0.01) and correlated with changes in VF (r=0.66, P<0.01) and VO2max (r=-0.48, P<0.05), but not adipocytokines. Visceral fat loss after aerobic exercise training improves glucose metabolism and is associated with the reversal of insulin resistance in older obese men and women.




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