Mobilization of visceral adipose tissue related to the improvement in insulin sensitivity in response to physical training in NIDDM. Effects of branched-chain amino acid supplements.
OBJECTIVE
To evaluate the effects of an intense physical training program on abdominal fat distribution, glycemic control, and insulin sensitivity in patients with NIDDM and to determine whether branched-chain amino acid (BCAA) supplements influence these effects.


METHODS
Twenty-four patients (ages 45 +/- 2 [mean +/- SE] years, BMI 30.2 +/- 0.9 kg/m2, HbA1c 7.9 +/- 0.3%) were randomly assigned to four groups: training plus BCAA supplement (n = 6), training plus placebo (n = 6), sedentary plus BCAA supplement (n = 6), and sedentary plus placebo (n = 6). Physical training consisted of a supervised 45-min cycling exercise at 75% of their oxygen uptake peak (VO2 peak) two times per week and an intermittent exercise one time per week for 2 months.


RESULTS
Patients who exercised increased their VO2 peak by 41% and their insulin sensitivity by 46%. Physical training significantly decreased abdominal fat evaluated by magnetic resonance imaging (umbilicus), with a greater loss of visceral adipose tissue (VAT) (48%) in comparison with the loss of subcutaneous adipose tissue (18%), but did not significantly affect body weight. The change in visceral abdominal fat was associated with the improvement in insulin sensitivity (r = 0.84, P = 0.001). BCAA supplementation had no effect on abdominal fat and glucose metabolism.


CONCLUSIONS
Physical training resulted in an improvement in insulin sensitivity with concomitant loss of VAT and should be included in the treatment program for patients with NIDDM.
Mourier
A
A
Service de Diabétologie et de Radiologie, Hôpital Saint-Louis, Paris, France.
Gautier
J F
JF
De Kerviler
E
E
Bigard
A X
AX
Villette
J M
JM
Garnier
J P
JP
Duvallet
A
A
Guezennec
C Y
CY
Cathelineau
G
G
D000273:Adipose Tissue / Q000187:drug effects / Q000378:metabolism*; D000328:Adult; D000597:Amino Acids, Branched-Chain / Q000494:pharmacology*; D000704:Analysis of Variance; D001786:Blood Glucose / Q000032:analysis / Q000187:drug effects / Q000378:metabolism; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000378:metabolism* / Q000503:physiopathology; D004734:Energy Metabolism / Q000502:physiology; D015444:Exercise / Q000502:physiology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis / Q000187:drug effects / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000097:blood / Q000378:metabolism*; D007333:Insulin Resistance / Q000502:physiology; D008053:Lipid Mobilization / Q000187:drug effects / Q000502:physiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology; D014781:Viscera
D000597:Amino Acids, Branched-Chain; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin