EXERCISE TRAINING REDUCES CENTRAL ADIPOSITY AND IMPROVES METABOLIC INDICES

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Body fat redistribution (BFR) and metabolic disorders, reported in highly active antiretroviral therapy (HAART) -treated HIV patients have been associated with increased cardiovascular disease and diabetes risks. As HAART becomes more accessible, one challenge is how to manage HIV- and HAART-metabolic syndromes. Despite the benefits of exercise in HIV seronegative population at risk of metabolic and body composition disorders, few trials have studied the effects of exercise in HAART-treated HIV patients with BFR. We conducted a 6-month, randomized controlled trial to test whether exercise training improves metabolic and body composition parameters, and enhances cardiorespiratory fitness in HAART-treated HIV patients with BFR. At 6 months, the exercise group experienced a significant decrease in waist circumference (7.13 ¿ 4.4 cm, p<0.0001), WHR (0.10 ¿ 0.1, p<0.0001), sum skinfold thickness (6.15 ¿ 8.2 mm, p<0.0001) and % BFM (1.5 ¿ 3.3, p<0.0001). Hip circumference was unchanged in all groups. Exercise training significantly reduced fasting total cholesterol [-0.03 ¿1.11 mM, p<0.05] triglycerides [-0.22 ¿0.48 mM, p<0.05] and glucose levels [(-0.21¿0.71mM, p<0.05] (p<0.0001). HDL-, LDL-cholesterol and HOMA values were unchanged after exercise training. Interestingly, HIV-infected subjects in non-exercising groups exhibited significant increases in fasting glucose levels, whereas HIV seronegative controls did not (p<0.001). Predicted VO2 peak increased more in the exercise group than in all other groups (4.7¿3.9 ml/kg/min, p<0.0001). Exercise training positively modulated body composition and metabolic profiles, and improved cardiorespiratory fitness. The findings provide evidence for improved cardiovascular and diabetic profile, contributing to decreased morbidity and mortality rates. Our findings underpin the benefits of exercise training in HAART-treated HIV patients, mainly in resource-limited sub-Saharan and other countries, where HIV treatment is improving but with minimal resources to manage HIV- and HAART-associated disorders.