Comparision the Effects of High and Average Intensity Combined Training on Levels of Serum Heat Shock Proteins 70 and Glycemic Control in Obese Women with Type 2 Diabetes

Document Type : Original Article


1 MSc in Exercise Physiology.Department of Sport Science, School of Sport Sciences, Hakim Sabzevari University, Sabzevar, Iran.

2 Assistant Professor of Sport Science. Department of Sport Science, School of Sport Sciences, Hakim Sabzevari University, Sabzevar, Iran.

3 Associate Professor of Sport Science.Department of Sport Science, School of Sport Sciences, Hakim Sabzevari University, Sabzevar, Iran.


Background and Objectives: In addition to medical and nutritional interventions, exercise is one component in the treatment of type II diabetes. The aim of this study was to compare the effects of high and average intensity combined training on levels of serum heat shock proteins 70 and glycemic control in obese women with type 2 diabetes.
Subjects and Methods: In quasi-experimental study, 24 women with type II diabetes and time duration less than 10 years, were selected by purposive sampling method and randomly divided into three groups: high intensity combined training, moderate-intensity combined training and control group. Moderate intensity combined training (resistance training by 50-74 1RM + aerobic interval by 50-70 HRR) and high intensity combined training (resistance training by 70-85 1RM + aerobic interval by 70-85 HRR) were conducted for12 weeks. t-tests and 2-way ANOVA were used for data analysis (P ≤ 0.05).
Results: The results showed a significant decrease in the levels of Hsp70, HbA1c and insulin resistance in moderate and high intensity combined training groups compared to the control group (P<0.05), but no significant difference was observed between the two exercise intervention groups (P>0.05).
Conclusion: The findings of this research demonstrated that combined trainings (resistance-aerobic interval), irrespective of their intensities, are effective on glycemic control and Hsp70 in women with type II diabetes, But the intensity of exercise, is not effective.


1-Ghalavand A, Delaramnasab M, Afshounpour M, Zare A. Effects of continuous aerobic exercise and circuit resistance training on fasting blood glucose control and plasma lipid profile in male patients with type II diabetes mellitus. Journal of diabetes and nursing. 2016;4(1):8-19.
2-Tavakolizadeh J, Moghadas M, Ashraf H. Effect of Self-regulation Training on Management of Type 2 Diabetes. Iranian Red Crescent Medical Journal. 2014;16(4).
3-Krause M, Heck TG, Bittencourt A, Scomazzon SP, Newsholme P, Curi R, et al. The chaperone balance hypothesis: the importance of the extracellular to intracellular HSP70 ratio to inflammation-driven type 2 diabetes, the effect of exercise, and the implications for clinical management. Mediators of inflammation. 2015;2015.
4-Molvarec A, Rigó J, Nagy B, Walentin S, Szalay J, Füst G, et al. Serum heat shock protein 70 levels are decreased in normal human pregnancy. Journal of reproductive immunology. 2007;74(1):163-9.
5-Özcan U, Yilmaz E, Özcan L, Furuhashi M, Vaillancourt E, Smith RO, et al. Chemical chaperones reduce ER stress and restore glucose homeostasis in a mouse model of type 2 diabetes. Science. 2006;313(5790):1137-40.
6-Chung J, Nguyen A-K, Henstridge DC, Holmes AG, Chan MS, Mesa JL, et al. HSP72 protects against obesity-induced insulin resistance. Proceedings of the National Academy of Sciences. 2008;105(5):1739-44.
7-Yabunaka N, Ohtsuka Y, Watanabe I, Noro H, Fujisawa H, Agishi Y. Elevated levels of heat-shock protein 70 (HSP70) in the mononuclear cells of patients with non-insulin-dependent diabetes mellitus. Diabetes research and clinical practice. 1995;30(2):143-7.
8-Nakhjavani M, Morteza A, Khajeali L, Esteghamati A, Khalilzadeh O, Asgarani F, et al. Increased serum HSP70 levels are associated with the duration of diabetes. Cell Stress and Chaperones. 2010;15(6):959-64.
9-Mathur N, Pedersen BK. Exercise as a mean to control low-grade systemic inflammation. Mediators of inflammation. 2009;2008.
10-Gurley JM, Griesel BA, Olson AL. Increased Skeletal Muscle Glut4 Expression in Obese Mice after Voluntary Wheel Running Exercise is Post-Transcriptional. Diabetes. 2016:db160305.
11-Colberg SR, Sigal RJ, Yardley JE, Riddell MC, Dunstan DW, Dempsey PC, et al. Physical activity/exercise and diabetes: a Position Statement of the American Diabetes Association. Diabetes Care. 2016;39(11):2065-79.
12-Ogawa K, Sanada K, Machida S, Okutsu M, Suzuki K. Resistance exercise training-induced muscle hypertrophy was associated with reduction of inflammatory markers in elderly women. Mediators of inflammation. 2010;2010.
13-De Matos MA, de Oliveira Ottone V, Duarte TC, da Matta Sampaio PF, Costa KB, Fonseca CA, et al. Exercise reduces cellular stress related to skeletal muscle insulin resistance. Cell Stress and Chaperones. 2014;19(2):263-70.
14-Paulsen G, Hanssen K, Rønnestad B, Kvamme N, Ugelstad I, Kadi F, et al. Strength training elevates HSP27, HSP70 and αB-crystallin levels in musculi vastus lateralis and trapezius. European journal of applied physiology. 2012;112(5):1773-82.
15-Isanejad A, HasanSarraf z, Mahdavi M, Gharakhanlou R. The Effect of Aerobic Exercise Training on Serum Levels of TNF-α, IL - 1β, IL-6 and Hsp70 in Rats. Journal of sport biosciences. 2013;4(15):91-106.
16-Sigal RJ, Kenny GP, Boulé NG, Wells GA, Prud'homme D, Fortier M, et al. Effects of aerobic training, resistance training, or both on glycemic control in type 2 diabetesa randomized trial. Annals of internal medicine. 2007;147(6):357-69.
17-Marcus RL, Smith S, Morrell G, Addison O, Dibble LE, Wahoff-Stice D, et al. Comparison of combined aerobic and high-force eccentric resistance exercise with aerobic exercise only for people with type 2 diabetes mellitus. Physical therapy. 2008;88(11):1345.
18-Oliveira C, Simões M, Carvalho J, Ribeiro J. Combined exercise for people with type 2 diabetes mellitus: a systematic review. Diabetes research and clinical practice. 2012;98(2):187-98.
19-Banaei P, Tadibi V, Rahimi M. Comparing the effect of two protocols concurrent training (strength-aerobic) on fasting blood glucose, glycosylated hemoglobin, high-sensitivity C - reactive protein and insulin resistance in women with type 2 diabetes. exercise physiology. 2014(25):99-108.
20-Milne KJ, Noble EG. Exercise-induced elevation of HSP70 is intensity dependent. Journal of Applied Physiology. 2002;93(2):561-8.
21-American Diabetes Association. Standards of medical care in diabetes—2012. Diabetes care. 2012;35(Supplement 1):S11-S63.
22-Reinehr T, Karges B, Meissner T, Wiegand S, Stoffel-Wagner B, Holl RW, et al. Inflammatory markers in obese adolescents with type 2 diabetes and their relationship to hepatokines and adipokines. The Journal of pediatrics. 2016;173:131-5.
23-Yousefipoor P, Tadibi V, Behpoor N, Parnow A, Delbari E, Rashidi S. The Effect of 8-week Aerobic and Concurrent (aerobic- resistance) Exercise Training on Serum IL-6 Levels and Insulin Resistance in Type 2 Diabetic Patients. JSSU. 2013;21(5):619-31.
24-Zamanpour L, Banitalebi E, Amirhosseini S. The effect of sprint training and combaned aerobic and strenght training on som inflammatory markers and insulin resistance in women with type 2 diabetes mellitus (T2DM). Iranian journal of Diabetes and Metabolism. 2016;15(5):300-11.
25-Bazyar F, Banitalebi E, Amirhosseini S. The Comparison of Two Methods of Exercise (intense interval training and concurrent resistance- endurance training) on Fasting Sugar, Insulin and Insulin Resistance in Women with Mellitus Diabetes. Armaghane danesh. 2016;21(2):123-34.
26-Cuff DJ, Meneilly GS, Martin A, Ignaszewski A, Tildesley HD, Frohlich JJ. Effective exercise modality to reduce insulin resistance in women with type 2 diabetes. Diabetes care. 2003;26(11):2977-82.
27-Shaban N, Kenno K, Milne K. The effects of a 2 week modified high intensity interval training program on the homeostatic model of insulin resistance (HOMA-IR) in adults with type 2 diabetes. The Journal of sports medicine and physical fitness. 2014;54(2):203-9.
28-Cheraghpour M, Ehrampoush E, Homayounfar R, Davoodi H, Zand H, Mimmiran P. The relationship between the immune system and the inflammatory mechanisms in obesity with insulin resistance. Iranian Journal of Nutrition Sciences & Food Technology. 2013;7(5):723-35.
29-Conn VS, Koopman RJ, Ruppar TM, Phillips LJ, Mehr DR, Hafdahl AR. Insulin sensitivity following exercise interventions: systematic review and meta-analysis of outcomes among healthy adults. Journal of primary care & community health. 2014;5(3):211-22.
30-Church TS, Blair SN, Cocreham S, Johannsen N, Johnson W, Kramer K, et al. Effects of aerobic and resistance training on hemoglobin A1c levels in patients with type 2 diabetes: a randomized controlled trial. Jama. 2010;304(20):2253-62.
31-Tan S, Li W, Wang J. Effects of six months of combined aerobic and resistance training for elderly patients with a long history of type 2 diabetes. J Sports Sci Med. 2012;11(3):495-501.
32-Holten MK, Zacho M, Gaster M, Juel C, Wojtaszewski JF, Dela F. Strength training increases insulin-mediated glucose uptake, GLUT4 content, and insulin signaling in skeletal muscle in patients with type 2 diabetes. Diabetes. 2004;53(2):294-305.
33-Rice B, Janssen I, Hudson R, Ross R. Effects of aerobic or resistance exercise and/or diet on glucose tolerance and plasma insulin levels in obese men. Diabetes care. 1999;22(5):684-91.
34-Eriksson J, Taimela S, Eriksson K, Parviainen S, Peltonen J, Kujala U. Resistance training in the treatment of non-insulin-dependent diabetes mellitus. International journal of sports medicine. 1997;18(04):242-6.
35-Kjøbsted R, Pedersen AJ, Hingst JR, Sabaratnam R, Birk JB, Kristensen JM, et al. Intact Regulation of the AMPK Signaling Network in Response to Exercise and Insulin in Skeletal Muscle of Male Patients With Type 2 Diabetes: Illumination of AMPK Activation in Recovery From Exercise. Diabetes. 2016;65(5):1219-30.
36-Greenberg AS, Obin MS. Obesity and the role of adipose tissue in inflammation and metabolism. The American journal of clinical nutrition. 2006;83(2):461S-5S.