Enhanced external counterpulsation (EECP) decreases advanced glycation end products and proinflammatory cytokines in patients with non-insulin-dependent type II diabetes mellitus for up to 6 months following treatment.
OBJECTIVE
Enhanced external counterpulsation (EECP) is a noninvasive, non-pharmacologic intervention proven to increase nitric oxide bioavailability in patients with coronary artery disease. The purpose of the present study was to evaluate the potential clinical benefits of EECP on advanced glycation end products (AGEs) and proinflammatory cytokine concentrations in patients with a clinical diagnosis of type II diabetes mellitus (T2DM).


METHODS
Thirty subjects (60.7 ± 1.9 years) with T2DM were randomly assigned (2:1 ratio) to receive either 35 1-h sessions of EECP (n = 20) or time-matched standard care (n = 10). AGEs, receptors for AGEs (RAGEs), soluble vascular cell adhesion molecules-1 (sVCAM-1), and 8-iso-prostaglandin 2α (8-iso-PGF2α) were evaluated before and at 48 h, 2 weeks, 3, and 6 months following EECP treatment or time-matched control.


RESULTS
EECP significantly decreased AGEs and RAGEs at all follow-up measurement time points. AGEs and RAGEs were decreased at 48 h (-75 and -16 %), 2 weeks (-87 and -28 %), 3 months (-89 and -29 %), and 6 months (-92 and -20 %) following EECP treatment, respectively. sVCAM-1 and 8-iso-PGF2α were significantly decreased at 48 h (-30 and -49 %) and 2 weeks (-22 and -27 %) following EECP, respectively. sVCAM-1 (-27 %) remained significantly reduced at 3 months following EECP. Nitrite/nitrate (NOx) was significantly increased at 48 h (+48.4 %) and 2 weeks (+51.9 %) following EECP treatment.


CONCLUSIONS
Our findings provide novel evidence that EECP decreases AGE/RAGE concentrations, inflammation, and oxidative stress in patients with T2DM that persist for up to 6 months following treatment.
Department of Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, Gainesville, FL, 32611, USA. psardina@hhp.ufl.edu.
Paloma D
PD
Sardina
Department of Cell Biology and Physiology, Edward Via College of Osteopathic Medicine, Auburn Campus, Auburn, AL, 36832, USA.|School of Kinesiology, Auburn University, Auburn, AL, 36849, USA.
Jeffrey S
JS
Martin
Department of Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, Gainesville, FL, 32611, USA.
Wojciech K
WK
Dzieza
Department of Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, Gainesville, FL, 32611, USA.
Randy W
RW
Braith
D000368:Aged; D015415:Biomarkers / Q000097:blood; D015908:Counterpulsation / Q000009:adverse effects*; D016207:Cytokines / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D005260:Female; D017127:Glycation End Products, Advanced / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000097:blood; D000067759:Receptor for Advanced Glycation End Products / Q000097:blood; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood
D015415:Biomarkers; D016207:Cytokines; D017127:Glycation End Products, Advanced; D000067759:Receptor for Advanced Glycation End Products; D019010:Vascular Cell Adhesion Molecule-1; D009569:Nitric Oxide
Advanced glycation end products; Enhanced external counterpulsation; Proinflammatory cytokines; Type II diabetes