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The impact of exercise training compared to caloric restriction on hepatic and peripheral insulin resistance in obesity.

Publication ,  Journal Article
Coker, RH; Williams, RH; Yeo, SE; Kortebein, PM; Bodenner, DL; Kern, PA; Evans, WJ
Published in: J Clin Endocrinol Metab
November 2009

CONTEXT: It has been difficult to distinguish the independent effects of caloric restriction versus exercise training on insulin resistance. OBJECTIVE: Utilizing metabolic feeding and supervised exercise training, we examined the influence of caloric restriction vs. exercise training with and without weight loss on hepatic and peripheral insulin resistance. DESIGN, PARTICIPANTS, AND INTERVENTION: Thirty-four obese, older subjects were randomized to: caloric restriction with weight loss (CR), exercise training with weight loss (EWL), exercise training without weight loss (EX), or controls. Based on an equivalent caloric deficit in EWL and CR, we induced matched weight loss. Subjects in the EX group received caloric compensation. Combined with [6,6(2)H(2)]glucose, an octreotide, glucagon, multistage insulin infusion was performed to determine suppression of glucose production (SGP) and insulin-stimulated glucose disposal (ISGD). Computed tomography scans were performed to assess changes in fat distribution. RESULTS: Body weight decreased similarly in EWL and CR, and did not change in EX and controls. The reduction in visceral fat was significantly greater in EWL (-71 +/- 15 cm(2)) compared to CR and EX. The increase in SGP was also almost 3-fold greater (27 +/- 2%) in EWL. EWL and CR promoted similar improvements in ISGD [+2.5 +/- 0.4 and 2.4 +/- 0.9 mg x kg fat-free mass (FFM)(-1) x min(-1)], respectively. CONCLUSIONS: EWL promoted the most significant reduction in visceral fat and the greatest improvement in SGP. Equivalent increases in ISGD were noted in EWL and CR, whereas EX provided a modest improvement. Based on our results, EWL promoted the optimal intervention-based changes in body fat distribution and systemic insulin resistance.

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Published In

J Clin Endocrinol Metab

DOI

EISSN

1945-7197

Publication Date

November 2009

Volume

94

Issue

11

Start / End Page

4258 / 4266

Location

United States

Related Subject Headings

  • Weight Loss
  • Patient Selection
  • Overweight
  • Obesity
  • Middle Aged
  • Liver
  • Insulin Resistance
  • Insulin
  • Humans
  • Glucagon
 

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Coker, R. H., Williams, R. H., Yeo, S. E., Kortebein, P. M., Bodenner, D. L., Kern, P. A., & Evans, W. J. (2009). The impact of exercise training compared to caloric restriction on hepatic and peripheral insulin resistance in obesity. J Clin Endocrinol Metab, 94(11), 4258–4266. https://doi.org/10.1210/jc.2008-2033
Coker, Robert H., Rick H. Williams, Sophie E. Yeo, Patrick M. Kortebein, Don L. Bodenner, Philip A. Kern, and William J. Evans. “The impact of exercise training compared to caloric restriction on hepatic and peripheral insulin resistance in obesity.J Clin Endocrinol Metab 94, no. 11 (November 2009): 4258–66. https://doi.org/10.1210/jc.2008-2033.
Coker RH, Williams RH, Yeo SE, Kortebein PM, Bodenner DL, Kern PA, et al. The impact of exercise training compared to caloric restriction on hepatic and peripheral insulin resistance in obesity. J Clin Endocrinol Metab. 2009 Nov;94(11):4258–66.
Coker, Robert H., et al. “The impact of exercise training compared to caloric restriction on hepatic and peripheral insulin resistance in obesity.J Clin Endocrinol Metab, vol. 94, no. 11, Nov. 2009, pp. 4258–66. Pubmed, doi:10.1210/jc.2008-2033.
Coker RH, Williams RH, Yeo SE, Kortebein PM, Bodenner DL, Kern PA, Evans WJ. The impact of exercise training compared to caloric restriction on hepatic and peripheral insulin resistance in obesity. J Clin Endocrinol Metab. 2009 Nov;94(11):4258–4266.
Journal cover image

Published In

J Clin Endocrinol Metab

DOI

EISSN

1945-7197

Publication Date

November 2009

Volume

94

Issue

11

Start / End Page

4258 / 4266

Location

United States

Related Subject Headings

  • Weight Loss
  • Patient Selection
  • Overweight
  • Obesity
  • Middle Aged
  • Liver
  • Insulin Resistance
  • Insulin
  • Humans
  • Glucagon