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Effect of exercise training modality on c-reactive protein in type 2 diabetes
Swift DL, Johannsen NM, Earnest CP, Blair SN, Church TS
Medicine and Science in Sports and Exercise 2012 Jun;44(6):1028-1034
clinical trial
5/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

PURPOSE: Type 2 diabetes is associated with increased risk of cardiovascular disease and elevated c-reactive protein (CRP) levels. Aerobic exercise training has been shown to improve CRP; however, there are limited data evaluating the effect of other exercise training modalities (aerobic, resistance, or combination training) in individuals with type 2 diabetes. METHODS: Participants (n = 204) were randomized to an aerobic exercise (aerobic), resistance exercise (resistance), or a combination of both (combination) for 9 months. CRP was evaluated at baseline and at follow-up. RESULTS: Baseline CRP was correlated with fat mass, waist circumference, body mass index, and VO2peak (p < 0.05). CRP was not reduced after aerobic (0.16 mg/L, 95% confidence interval (CI) -1.0 to 1.3 mg/L), resistance (-0.03 mg/L, 95% CI -1.1 to 1.0 mg/L), or combination (-0.49 mg/L, 95% CI -1.5 to 0.6 mg/L) training compared to control (0.35 mg/L, 95% CI -1.0 to 1.7 mg/L). Changes in fasting glucose (r = 0.20, p = 0.009), glycated hemoglobin (HbA1c) (r = 0.21, p = 0.005), and fat mass (r = 0.19, p = 0.016) were associated with reductions in CRP but not with change in fitness or weight (p > 0.05). There were significant trends observed for CRP among tertiles of change in HbA1c (p = 0.009) and body fat (p = 0.040). CONCLUSIONS: Aerobic, resistance, or a combination of both did not reduce CRP levels in individuals with type 2 diabetes. However, exercise-related improvements in HbA1c, fasting glucose, and fat mass were associated with reductions in CRP.

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