Heat Shock Response is Blunted in Elderly Diabetic People But Recovered by Strength Training

Study Overview
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Brief Summary
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The aim of this study was to compare the heat shock response (HSR) between healthy middle-aged adults, healthy elderly adults and type 2 diabetic elderly people. In addition, considering the effects of strength exercise in promoting health, we aimed to test the effects of strength training over the HSR in diabetic elderly people. Thirty (19 females and 11 males) sedentary non-smoking participants volunteered for this study (11 healthy middle-age adults, 7 healthy old adults and 12 diabetic old subjects, previously diagnosed by their personal physicians). Firstly, venous blood samples were obtained from all participants to test the HSR. They were divided in three groups: healthy middle-age adults (45-59 y.o.), healthy elderly adults and elderly diabetic (> 60 y.o.). As we identify that diabetic people presented a poor HSR, we submit the diabetic group to a twelve-week resistance exercise training to verify if this intervention could improve the HS response. Diabetic subjects were randomly (1:1 block randomization) allocated in one of the two groups: Trained and Control (no training). Strength training was performed three times per week while the control group performed a placebo stretching/relaxing session once a week (for adherence purposes). Both interventions had twelve weeks of duration. To avoid any significant adaptation, all stretching exercises (for large muscle groups only) were performed at very low intensity without any significant discomfort. Supervised (by qualified sport and exercise scientists) exercise was performed in a gym on three non-consecutive days of the week. Each session lasted  60 min and consisted of a warm up, the resistance exercise training and a cool down. The training programme consisted of a combination of upper and lower body exercises using gym equipments, free weights and body weight as the primary resistance. The twelve weeks of strength training were divided into three mesocycles of four weeks each. Exercises included leg press, knee extensions and leg curls, biceps curls, triceps extensions, lat pull-downs, shoulder press, bench press and abdominal crunch. Before the start of the training period, subjects completed a familiarization session to practice the exercises they would further perform during the training sessions, where the exercise load was individually tested. The resistance training was performed using two to three sets per exercise at intensities between 12-15 repetition maximum-RM.

Official Title
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Heat-induced Extracellular HSP72 Release is Blunted in Elderly Diabetic People in Comparison With Healthy Middle-aged and Older Adults But is Partially Restored by Strength Training

Conditions
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Aging, Type 2 Diabetes Mellitus

Intervention / Treatment
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* Other: Strength training
* Other: No Training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: . Inclusion criteria for diabetic people were HbA1c ≤ 7,5% (within the last six months), controlled blood pressure and no use of insulin. Exclusion Criteria: Participants were excluded if they reported a history of myocardial infarction, cardiac illness, vascular disease, stroke, major systemic disease or any condition that would prevent them from engaging in an exercise study; or if they were already engaging in two or more planned and structured exercise sessions per week (in the last six months).

Ages Eligible for Study
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Minimum Age: 45 Years
Maximum Age: 85 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Basic Science
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: The aim of this study was to compare the heat shock response (HSR) between healthy middle-aged adults (45-59 years old), healthy elderly adults (> 60 y.o.) and type 2 diabetic elderly people (> 60 y.o.). In addition, considering the effects of strength exercise in promoting health, we aimed to test the effects of strength training over the HSR in diabetic elderly people.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Trained Group<br>Subjects performing strength training three times per week for twelve weeks. | Other: Strength training<br>* Strength training was performed three times per week for twelve weeks. Supervised (by qualified sport and exercise scientists) exercise was performed in a gym on three non-consecutive days of the week. Each session lasted  60 min and consisted of a warm up, the resistance exercise training and a cool down. The training programme consisted of a combination of upper and lower body exercises using gym equipments, free weights and body weight as the primary resistance. The twelve weeks of strength training were divided into three mesocycles of four weeks each. The resistance training was performed using two to three sets per exercise at intensities between 12-15 repetition maximum-RM.<br>|
| Placebo Comparator: No Training Group<br>Subjects performing placebo stretching/relaxing session once a week (for adherence purposes) for twelve weeks. | Other: No Training<br>* Control group performed a placebo stretching/relaxing session once a week (for adherence purposes) for twelve weeks. To avoid any significant adaptation, all stretching exercises (for large muscle groups only) were performed at very low intensity without any significant discomfort.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Heat Shock Response Change. | Capacity of cells to express and export heat shock protein 72kDa in response to heat (ng/mL). | Before and After twelve weeks of exercise training. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| hs-CRP Change. | Marker of Inflammation measured in mg/L. | Before and After twelve weeks of exercise training. | 
| Body composition Change. | Body mass index (in Kg/m2). | Before and After twelve weeks of exercise training. | 
| TNF-a Change. | Marker of Inflammation measured in pg/mL. | Before and After twelve weeks of exercise training. | 
| IL-10 Change. | Marker of Inflammation measured in pg/mL. | Before and After twelve weeks of exercise training. | 
| Visceral Adipose Tissue Change. | Amount of visceral adipose tissue measured in millimeters (mm). | Before and After twelve weeks of exercise training. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Diabetes, Heat Shock Response, Aging, Exercise