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The inflammation, vascular repair and injury responses to exercise in fit males with and without Type 1 diabetes: an observational study

Lookup NU author(s): Professor Mark Walker, Dr Fahad Ahmed, Stephanie Wijaya, Professor James Shaw, Dr Jolanta Weaver


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Background: Type 1 diabetes is associated with raised inflammation, impaired endothelial progenitor cell mobilisation and increased markers of vascular injury. Both acute and chronic exercise is known to influence these markers in non-diabetic controls, but limited data exists in Type 1 diabetes. We assessed inflammation, vascular repair and injury at rest and after exercise in physically-fit males with and without Type 1 diabetes.Methods: Ten well-controlled type 1 diabetes (27 +/- 2 years; BMI 24 +/- 0.7 kg. m(2); HbA1c 53.3 +/- 2.4 mmol/mol) and nine non-diabetic control males (27 +/- 1 years; BMI 23 +/- 0.8 kg. m2) matched for age, BMI and fitness completed 45-min of running. Venous blood samples were collected 60-min before and 60-min after exercise, and again on the following morning. Blood samples were processed for TNF-alpha using ELISA, and circulating endothelial progenitor cells (cEPCs; CD45(dim)CD34(+) VEGFR(2+)) and endothelial cells (cECs; CD45(dim)CD133(-)CD34(+)CD144(+)) counts using flow-cytometry.Results: TNF-alpha concentrations were 4-fold higher at all-time points in Type 1 diabetes, when compared with control (P < 0.001). Resting cEPCs were similar between groups; after exercise there was a significant increase in controls (P = 0.016), but not in Type 1 diabetes (P = 0.202). CEPCs peaked the morning after exercise, with a greater change in controls vs. Type 1 diabetes (+ 139 % vs. 27 %; P = 0.01). CECs did not change with exercise and were similar between groups at all points (P > 0.05). Within the Type 1 diabetes group, the delta change in cEPCS from rest to the following morning was related to HbA1c (r = -0.65, P = 0.021) and TNF-alpha (r = -0.766, P = 0.005).Conclusions: Resting cEPCs and cECs in Type 1 diabetes patients with excellent HbA1c and high physical-fitness are comparable to healthy controls, despite eliciting 4-fold greater TNF-alpha. Furthermore, Type 1 diabetes patients appear to have a blunted post-exercise cEPCs response (vascular repair), whilst a biomarker of vascular injury (cECs) remained comparable to healthy controls.

Publication metadata

Author(s): West DJ, Campbell MD, Gonzalez JT, Walker M, Stevenson EJ, Ahmed FW, Wijaya S, Shaw JA, Weaver JU

Publication type: Article

Publication status: Published

Journal: Cardiovascular Diabetology

Year: 2015

Volume: 14

Online publication date: 05/06/2015

Acceptance date: 27/05/2015

ISSN (electronic): 1475-2840

Publisher: BioMed Central Ltd.


DOI: 10.1186/s12933-015-0235-y


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