P-8-14 Improve insulin sensitivity in carbohydrate and lipid metabolism after long-term physical exercise training

Aims: Exercise training, a recommended nonpharmacological strategy for hypertensive patients, exerts beneficial effect on blood pressure modulation, but the underlying mechanisms remain elusive. Vascular insulin resistance is an early pathologic alteration in hypertensive vascular injury and plays a critical role in the development of hypertension. This study aimed to investigate whether long-term physical exercise starting at prehypertensive period prevents the development of hypertension via improving vascular insulin sensitivity. Methods: Young (4-week-old) prehypertensive spontaneously hypertensive rats (SHRs) and their normotensive Wistar-Kyoto controls (WKY) were subjected to a 10-week free-of-loading swim training session (60 min/day, 5 days/week). Insulin-induced mesenteric arteriolar vasorelaxation were determined. Results: SHRs showed higher systolic blood pressure (SBP) and decreased insulin sensitivity of the whole body and resistance vessels compared with those of WKY rats. SBP in the exercised SHRs was significantly lower than that in sedentary ones (180.2±5.1 vs. 205.7±3.7 mmHg, n=6, P<0.05). Vascular insulin sensitivity in mesenteric arteries was improved after exercise training as evidenced by increased vasodilation response to insulin (29.0%±2.5% vs. 18.4%±5.9% to 1 μmol/L insulin, n=6, P<0.05). In addition, exercise downregulated vascular GRK2 expression and activity, which further increased insulin-stimulated vascular Akt/eNOS activation in exercised SHRs. More importantly, suppression of GRK2 with siRNA mimicked the effect of exercise-enhanced vascular insulin sensitivity, while upregulation of GRK2 by Chariot-mediated delivery reversed the exercise-induced vascular insulin sensitization. Conclusions: Long-term regular physical exercise beginning at prehypertensive stage improves vascular insulin sensitivity via downregulating GRK2 and consequently delays the development of hypertension.

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5[beta]-reductase (AKR1D1) is a potent regulator of hepatic insulin sensitivity, carbohydrate and lipid metabolism in vitro and in vivo

Endocrine Abstracts ◽

10.1530/endoabs.59.oc3.6 ◽

2018 ◽

Author(s):

Nikolaos Nikolaou ◽

Laura Gathercole ◽

Lea Marchand ◽

Sara Althari ◽

Charlotte Green ◽

...

Keyword(s):

Lipid Metabolism ◽

Insulin Sensitivity ◽

Hepatic Insulin Sensitivity ◽

Carbohydrate And Lipid Metabolism

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Enhancing Patient Motivation through Intelligibility in Cardiac Tele-rehabilitation

Interacting with Computers ◽

10.1093/iwc/iwz008 ◽

2019 ◽

Vol 31 (2) ◽

pp. 122-137

Author(s):

Supraja Sankaran ◽

Kris Luyten ◽

Dominique Hansen ◽

Paul Dendale ◽

Karin Coninx

Keyword(s):

Medication Adherence ◽

Exercise Training ◽

Physical Exercise ◽

Health Outcomes ◽

Cardiac Rehabilitation ◽

Field Studies ◽

Activity Levels ◽

Patient Motivation ◽

Physical Exercise Training ◽

The Impact

Abstract Physical exercise training and medication compliance are primary components of cardiac rehabilitation. When rehabilitating independently at home, patients often fail to comply with their prescribed medication and find it challenging to interpret exercise targets or be aware of the expected efforts. Our work aims to assist cardiac patients in understanding their condition better, promoting medication adherence and motivating them to achieve their exercise targets in a tele-rehabilitation setting. We introduce a patient-centric intelligible visualization approach to present prescribed medication and exercise targets to patients. We assessed efficacy of intelligible visualizations on patients’ comprehension in two lab studies. We evaluated the impact on patient motivation and health outcomes in field studies. Patients were able to adhere to medication prescriptions, manage their physical exercises, monitor their progress and gained better self-awareness on how they achieved their rehabilitation targets. Patients confirmed that the intelligible visualizations motivated them to achieve their targets better. We observed an improvement in overall physical activity levels and health outcomes of patients. Research Highlights Presents challenges currently faced in cardiac tele-rehabilitation. Demonstrates how intelligibility was applied to two core aspects of cardiac rehabilitation- promoting medication adherence and physical exercise training. Lab., field and clinical studies to demonstrate efficacy of intelligible visualization, impact on patient motivation and resultant health outcomes. Reflection on how similar HCI approaches could be leveraged for technology-supported management of critical health conditions such as cardiac diseases.

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