title: Exercise training but not rosiglitazone improves endothelial function in prediabetic patients with coronary disease.
abstract: BACKGROUND
  Impaired glucose tolerance (IGT) is associated with endothelial dysfunction and upregulation of inflammatory markers, which is potentially reversible by adequate treatment. It was our aim to compare the impact of exercise training with that of rosiglitazone on endothelial function and inflammatory markers in patients with IGT and coronary artery disease (CAD).
  
  
  METHODS
  Patients with IGT and CAD were randomly assigned to either exercise training (n=13), rosiglitazone (8 mg; n=11), or a control group (n=10). During the first week, exercise training consisted of 6 x 15 min/d followed by three weeks of 30 min/d submaximal ergometer exercise. In addition, group exercise training of 1 h was performed twice per week.
  
  
  RESULTS
  After 4 weeks, triglycerides and uric acid were significantly lower in the exercise group whereas fasting glucose, HbA1c, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, C-reactive protein, fibrinogen, and body mass index did not differ between groups. In the exercise group, exercise capacity (123+/-33 vs. 144+/-31 W; P=0.006) and endothelium-dependent, flow-mediated vasodilatation (P<0.01) increased significantly, whereas in the rosiglitazone group and in the control group (P=n.s.) no changes were seen.
  
  
  CONCLUSIONS
  In patients with IGT and CAD, 4 weeks of exercise training exert significant and superior improvement of endothelium-dependent vasodilatation as compared with rosiglitazone therapy or usual care. This finding should be seen as an even further encouragement to recommend and, where available, prescribe exercise training to our patients.
authors.affiliation: Herzzentrum Bad Krozingen, Department of Angiology, Austria.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Sixt
authors.forename: Aljoscha
authors.initials: A
authors.lastname: Rastan
authors.forename: Steffen
authors.initials: S
authors.lastname: Desch
authors.forename: Melanie
authors.initials: M
authors.lastname: Sonnabend
authors.forename: Andrej
authors.initials: A
authors.lastname: Schmidt
authors.forename: Gerhard
authors.initials: G
authors.lastname: Schuler
authors.forename: Josef
authors.initials: J
authors.lastname: Niebauer
mesh_terms: D000368:Aged; D001783:Blood Flow Velocity; D003324:Coronary Artery Disease / Q000150:complications / Q000378:metabolism / Q000503:physiopathology* / Q000534:rehabilitation; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005081:Exercise Therapy; D017079:Exercise Tolerance; D005260:Female; D005542:Forearm; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000150:complications* / Q000188:drug therapy; D000077154:Rosiglitazone; D045162:Thiazolidinediones / Q000627:therapeutic use*; D014527:Uric Acid / Q000097:blood; D014664:Vasodilation
chemical_list: D007004:Hypoglycemic Agents; D008055:Lipids; D045162:Thiazolidinediones; D000077154:Rosiglitazone; D014527:Uric Acid