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Diabetes. 2015 Nov;64(11):3737-50. doi: 10.2337/db15-0809. Epub 2015 Aug 20.

Exercise and Weight Loss Improve Muscle Mitochondrial Respiration, Lipid Partitioning, and Insulin Sensitivity After Gastric Bypass Surgery.

Author information

1
Translational Research Institute for Metabolism and Diabetes, Florida Hospital, Orlando, FL Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, PA Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, PA Sanford Burnham Prebys Medical Discovery Institute at Lake Nona, Orlando, FL.
2
Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, PA.
3
Translational Research Institute for Metabolism and Diabetes, Florida Hospital, Orlando, FL Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, PA Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA.
4
Department of Kinesiology, East Carolina University, Greenville, NC.
5
Translational Research Institute for Metabolism and Diabetes, Florida Hospital, Orlando, FL Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, PA.
6
Translational Research Institute for Metabolism and Diabetes, Florida Hospital, Orlando, FL.
7
Translational Research Institute for Metabolism and Diabetes, Florida Hospital, Orlando, FL Sanford Burnham Prebys Medical Discovery Institute at Lake Nona, Orlando, FL.
8
Translational Research Institute for Metabolism and Diabetes, Florida Hospital, Orlando, FL Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, PA Sanford Burnham Prebys Medical Discovery Institute at Lake Nona, Orlando, FL bret.goodpaster@flhosp.org.

Abstract

Both Roux-en-Y gastric bypass (RYGB) surgery and exercise can improve insulin sensitivity in individuals with severe obesity. However, the impact of RYGB with or without exercise on skeletal muscle mitochondria, intramyocellular lipids, and insulin sensitivity index (SI) is unknown. We conducted a randomized exercise trial in patients (n = 101) who underwent RYGB surgery and completed either a 6-month moderate exercise (EX) or a health education control (CON) intervention. SI was determined by intravenous glucose tolerance test. Mitochondrial respiration and intramyocellular triglyceride, sphingolipid, and diacylglycerol content were measured in vastus lateralis biopsy specimens. We found that EX provided additional improvements in SI and that only EX improved cardiorespiratory fitness, mitochondrial respiration and enzyme activities, and cardiolipin profile with no change in mitochondrial content. Muscle triglycerides were reduced in type I fibers in CON, and sphingolipids decreased in both groups, with EX showing a further reduction in a number of ceramide species. In conclusion, exercise superimposed on bariatric surgery-induced weight loss enhances mitochondrial respiration, induces cardiolipin remodeling, reduces specific sphingolipids, and provides additional improvements in insulin sensitivity.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT00692367.

PMID:
26293505
PMCID:
PMC4613980
DOI:
10.2337/db15-0809
[Indexed for MEDLINE]
Free PMC Article

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