Diabetes, Metabolic Syndrome and Obesity (Dec 2018)
Physical activity increases the resistin concentration in hemodialyzed patients without metabolic syndrome
Abstract
Beata Hornik,1 Jan Duława,2 Jan Szewieczek,3 Jacek Durmała4 1Department of Internal Nursing, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland; 2Department of Internal Medicine and Metabolic Diseases, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland; 3Department of Geriatrics, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland; 4Department of Rehabilitation, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland Background: Resistin (RES) concentration increases in end-stage renal disease patients. However, there have been no studies defining the role of physical activity in RES concentrations in hemodialyzed (HD) patients. This study was aimed to determine metabolic and inflammatory effects, including RES, of 4-week supervised rehabilitation program in HD patients, with or without metabolic syndrome (MS). Methods: The study was completed by 28 patients aged 56.9±13.3 years (x̅ ± SD) who were HD for 50.6±73.4 months, and 30 controls aged 61.5±8.3 years with normal renal function. Both the groups were divided into two subgroups with respect to MS. Individualized supervised rehabilitation program based on physiotherapy, including exercises, was provided to each subject for 4 weeks. Baseline and post-intervention complete blood count, glycated hemoglobin (HbA1c) and levels of serum RES, leptin, adiponectin, cystatin C, erythropoietin, high sensitivity C-reactive protein (hs-CRP), tumor necrosis factor alpha (TNF-α), interleukin-6, transforming growth factor- β1, plasminogen activator inhibitor-1 homocysteine, insulin, albumin, parathyroid hormone (PTH), and phosphorus were measured. Results: Compared to controls, HD patients showed higher baseline leucocytes count and higher serum concentrations of RES, leptin, cystatin C, hs-CRP, TNF-α, homocysteine, phosphorus, PTH while hemoglobin, glucose, and albumin concentrations. A positive correlation between serum albumin and RES concentrations was observed in HD patients. Post-intervention RES increase was observed in HD patients without MS (post-intervention 34.22±8.89 vs baseline 30.16±11.04 ng/mL; P=0.046) while no change was observed in patients with MS and in the control group. Conclusion: MS modifies a RES response to the rehabilitation program in HD patients. Keywords: metabolic syndrome, hemodialysis, resistin, physical activity, cytokines
