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. 2024 Apr 25:15:1328470.
doi: 10.3389/fphys.2024.1328470. eCollection 2024.

Effects of aerobic and resistance exercise for 9 months on serum free light chains in type 2 diabetes

Youyoung Kim  1 , John P Campbell  2   3 , Neil M Johannsen  1   4 , Timothy S Church  4 , Eunhan Cho  1 , Jennifer Heaney  5 , Guillaume Spielmann  1   4
Affiliations

Effects of aerobic and resistance exercise for 9 months on serum free light chains in type 2 diabetes

Youyoung Kim et al. Front Physiol. .

Abstract

Background and aims: Serum polyclonal free light chains (FLCs) levels are associated with overall survival in the general population, reflecting their utility as a biomarker of underlying immune activation and inflammation. Regular exercise is known to ameliorate low-grade inflammation in chronic diseases such as type 2 diabetes; however, the effects of different exercise training modalities on FLCs in adults with type 2 diabetes is unknown. This study investigated the effects of 9-month of aerobic, resistance or combined supervised exercise on serum FLCs in 164 patients with type 2 diabetes (age 58 ± 8 years; 63% female). Methods: 164 participants from the Health Benefits of Aerobic and Resistance Training in individuals with type 2 diabetes trial (HART-D) were randomly assigned to no exercise (n = 27), aerobic exercise alone (n = 41), resistance exercise alone (n = 49), or a combination of aerobic and resistance exercise (n = 47). Fasting serum samples were collected before and after completion of the intervention to quantify changes in kappa and lambda FLCs, and serum creatinine, using commercially-available ELISAs. Results: At baseline, combined kappa and lambda FLCs (FLC sum; calculated as kappa + lambda FLCs) were positively correlated with high-sensitive C-reactive protein (hs-CRP) (r = 0.237, p < 0.05) and fat mass (r = 0.162, p < 0.05), and negatively associated with aerobic fitness (r = -0.238, p < 0.05). While non-exercise controls exhibited an increase in FLCs over the 9-month study, exercise training blunted this increase (Δ FLC sum control arm: 3.25 ± 5.07 mg∙L-1 vs. all exercise arms: -0.252 ± 6.60 mg∙L-1, p < 0.05), regardless of exercise modality. Conclusion: Serum FLCs were associated with physical fitness and body composition in patients with type 2 diabetes. 9-month of exercise training prevented the accumulation of FLCs, regardless of exercise modality. Unlike hs-CRP-which did not change during the trial-serum FLCs may serve as a more sensitive biomarker of chronic low-grade inflammation in this population.

Keywords: 9-month intervention; exercise training; free light chains; inflammation; type 2 diabetes.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
The correlation between FLCs and hs-CRP (n = 164). Combined FLC (r = 0.237, p < 0.05 (A). Kappa FLC (r = 0.266, p < 0.05 (B). Lambda FLC (r = 0.112, p > 0.05 (C).
FIGURE 2
FIGURE 2
Changes in hs-CRP (A), Combined FLC (B), Kappa FLC (C), and Lambda FLC (D) over the 9-month intervention in the control group (n = 27). *9-month different from baseline (p < 0.05). Data are presented as mean ± SD.
FIGURE 3
FIGURE 3
Changes in inflammatory biomarkers between the control in white (n = 27) and exercise groups in black (n = 137). ∆ values were calculated as 9-month value - baseline. ∆ hs-CRP (A), ∆ Combined FLC (B), ∆ Kappa FLC (C), and ∆ Lambda FLC (D) in the control group. *Exercise group was a significant difference compared to the control group (p < 0.05). Data are presented as mean ± SD.
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