Michou V, Nikodimopoulou M, Deligiannis A, Kouidi E. Metabolic and functional effects of exercise training in diabetic kidney transplant recipients. World J Transplant 2022; 12(7): 184-194 [PMID: 36051451 DOI: 10.5500/wjt.v12.i7.184]
Corresponding Author of This Article
Evangelia Kouidi, Doctor, PhD, Professor, Sports Medicine Laboratory, School of Physical Education & Sport Science, Aristotle University, Laboratory Building (3rd Floor), Thessaloniki 57001, Greece. kouidi@phed.auth.gr
Research Domain of This Article
Transplantation
Article-Type of This Article
Randomized Controlled Trial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Transplant. Jul 18, 2022; 12(7): 184-194 Published online Jul 18, 2022. doi: 10.5500/wjt.v12.i7.184
Metabolic and functional effects of exercise training in diabetic kidney transplant recipients
Vassiliki Michou, Maria Nikodimopoulou, Asterios Deligiannis, Evangelia Kouidi
Vassiliki Michou, Asterios Deligiannis, Evangelia Kouidi, Sports Medicine Laboratory, School of Physical Education & Sport Science, Aristotle University, Thessaloniki 57001, Greece
Maria Nikodimopoulou, Transplant Surgery Clinic of Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki 54642, Greece
Author contributions: Michou V designed this study and collected and analyzed the data; Michou V, Koudi E and Deligiannis A drafted the manuscript and gave final approval of the version to be published; Michou V and Koudi E took part in this study as cardiopulmonary exercise testing operators or assistants; Nikodimopoulou M recruited diabetic kidney transplant recipients to participate to the study.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of the Aristotle University of Thessaloniki (Protocol number:117461/2019).
Clinical trial registration statement: This study is registered at Laboratory of Sports Medicine, Aristotle University of Thessaloniki, TEFAA.
Informed consent statement: All study participant received all the necessary study information before the study enrollment and provided written informed consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Evangelia Kouidi, Doctor, PhD, Professor, Sports Medicine Laboratory, School of Physical Education & Sport Science, Aristotle University, Laboratory Building (3rd Floor), Thessaloniki 57001, Greece. kouidi@phed.auth.gr
Received: January 12, 2022 Peer-review started: January 12, 2022 First decision: March 16, 2022 Revised: April 20, 2022 Accepted: June 16, 2022 Article in press: June 16, 2022 Published online: July 18, 2022 Processing time: 183 Days and 7.1 Hours
Abstract
BACKGROUND
Physical activity levels are significantly lower in kidney transplant (KT) recipients compared to the general population. The effects of exercise training in KT recipients with diabetes mellitus remain unclear, and so little is known about the role of increased exercise on cardiovascular risk and metabolic profile of KT patients.
AIM
To investigate the effects of a 6-mo home-based exercise training program on functional capacity, glucose levels and lipid profile of diabetic KT patients.
METHODS
In total, 21 type II diabetic KT recipients were randomly assigned into two groups: Exercise (n = 11, aged 52.9 ± 10.1 years) and control (n = 10, aged 53.01 ± 9.5 years). All participants at baseline and the end of the study underwent biochemical tests for fasting plasma glucose levels, glycated hemoglobin and lipid profile and cardiopulmonary exercise testing for maximum oxygen uptake [(VO2)peak] estimation. The exercise group followed a 6-mo supervised home-based aerobic and progressive resistance exercise program of moderate intensity 3 times per week, while the control group continued to receive usual care.
RESULTS
At the end of the 6-mo study, the exercise group had significantly lower values in fasting plasma glucose by 13.4% (from 120.6 ± 28.9 mg/dL to 104.8 ± 21.9 mg/dL, P = 0.01), glycated hemoglobin by 1.5% (from 6.7% ± 0.4 to 6.6% ± 0.4, P = 0.01) and triglycerides by 8.5% (from 164.7 ± 14.8 mg/dL to 150.8 ± 11.6 mg/dL, P < 0.05) and higher values in high-density lipoprotein by 10.2% (from 51.4 ± 8.8 mg/dL to 57.2 ± 8.7 mg/dL, P < 0.05) and (VO2)peak by 4.7% (from 22.7 ± 3.3 to 23.8 ± 4.2, P = 0.02) than the control group. There were statistically significant differences between the two groups at the end of the study for fasting plasma glucose (decreased by 9.6%, P < 0.05), triglycerides (decreased by 4.5%, P = 0.04) and (VO2)peak (increased by 4.4%, P = 0.01). Finally, after training, there was a moderate, positive linear relationship between (VO2)peak and glycated hemoglobin in the exercise group (r = 0.408, P = 0.03).
CONCLUSION
The results demonstrated that a 6-mo home-based mixed type exercise training program can improve the functional capacity, levels of glucose and lipid profile of diabetic KT recipients.
Core Tip: Physical activity levels are significantly lower in kidney transplant (KT) recipients compared to the general population. The effects of exercise training in KT recipients with diabetes mellitus remain unclear, and so little is known about the role of increased exercise on cardiovascular risk and metabolic profile of KT patients. This randomized controlled trial aimed to investigate the effects of a 6-mo home-based exercise training program on functional capacity, glucose levels and lipid profile of diabetic KT patients. The results of the present study demonstrated that a long-term exercise training program is feasible and effective in diabetic KT recipients.
