Metabolic and functional effects of exercise training in diabetic kidney transplant recipients

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.