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Exercise training attenuates insulin resistance and improves β-cell function in patients with systemic autoimmune myopathies: a pilot study

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Abstract

Introduction/objectives

To assess the effects of exercise training on insulin resistance and β-cell function in patients with systemic autoimmune myopathies (SAMs).

Method

This quasi-experimental, prospective study includes 9 patients with SAMs (six with dermatomyositis, two with antisynthetase syndrome, and one with polymyositis). Patients were submitted to a 12-week, twice a week, exercise training program comprising aerobic and resistance exercises. Baseline and after the intervention, we evaluated disease status, aerobic capacity, muscle strength, body composition, insulin resistance, and β-cell function parameters.

Results

The patients have a mean age of 46.7 years and stable disease. No clinical or laboratory parameter impairment was observed after the intervention. Compared with baseline, aerobic capacity, muscle strength, and function increased after 12 weeks (P < 0.05), while no changes were observed for body composition. Data from the oral glucose tolerance test showed that exercise did not change glucose area under the curve (AUC), whereas insulin and C-peptide AUC decreased significantly (P < 0.05). Furthermore, Matsuda index and HOMA2 percentage (both surrogates of insulin resistance) also improved (P < 0.05).

Conclusion

Exercise training improved aerobic capacity, muscle strength, and muscle function in patients with SAMs. In addition, exercise training led to an attenuation of insulin resistance and improvements in β-cell function parameters. These data indicate that exercise training can mitigate metabolic impairments, attenuating the cardiovascular risk in SAMs.

Key Points

• Exercise training improved aerobic capacity, muscle strength, and function without disease impairment

• Exercise training was capable of improve insulin resistance and β-cell function in patients with SAM

• These results suggest that exercise can mitigate metabolic impairments in patients with SAM, attenuating the cardiovascular risk

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Acknowledgments

The authors are thankful to Rafael Giovane Misse and Alexandre Moura dos Santos for exercise training assistance, Laboratorio de Avaliação e Condionamento em Reumatologia (LACRE) for the exercise room availability, and Lilian Takayama for densitometry analysis.

Financial support

Funding was provided by the Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) to D.S.O. (no. 2016/19771-5), to I.B.P.B. (no. 2016/20371-1), and to S.K.S. (no. 2017/13109-1) and Faculdade de Medicina da Universidade de Sao Paulo to S.K.S.

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Authors and Affiliations

  1. Division of Rheumatology, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil

    Diego Sales de Oliveira, Isabela Bruna Pires Borges, Jean Marcos de Souza, Bruno Gualano, Rosa Maria Rodrigues Pereira & Samuel Katsuyuki Shinjo

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  1. Diego Sales de Oliveira
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  2. Isabela Bruna Pires Borges
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  3. Jean Marcos de Souza
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  6. Samuel Katsuyuki Shinjo
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Correspondence to Diego Sales de Oliveira.

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de Oliveira, D.S., Borges, I.B.P., de Souza, J.M. et al. Exercise training attenuates insulin resistance and improves β-cell function in patients with systemic autoimmune myopathies: a pilot study. Clin Rheumatol 38, 3435–3442 (2019). https://doi.org/10.1007/s10067-019-04738-4

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  • DOI: https://doi.org/10.1007/s10067-019-04738-4

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