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Submitted on October 4, 2004
Accepted on March 4, 2005
Department of Medicine, Metabolism and Endocrinology, Juntendo University School of Medicine, Tokyo, Japan; Department of Radiology, Juntendo University School of Medicine, Tokyo, Japan
* To whom correspondence should be addressed. E-mail: y-tanaka{at}med.juntendo.ac.jp.
Insulin resistance is associated with the circulating FFA level and intracellular lipid content in muscle and liver. We investigated the effect of 2-week diet and exercise therapy on total adiposity, circulating FFA, intracellular lipid content in muscle and liver and peripheral insulin sensitivity. Type 2 diabetic patients were divided into a diet group (D-group, n = 7) and a diet plus exercise group (D+E group, n = 7). We performed a hyperinsulinemic-euglycemic clamp study before and after treatment. Intramyocellular lipid (IMCL) in the tibialis anterior muscle and intrahepatic lipid (IHL) were evaluated by 1H-magnetic resonance spectroscopy. Fasting FFA were not altered and total body fat showed a slight but significant decrease in both groups after treatments. IMCL was decreased by 19% and the glucose infusion rate (GIR) was increased by 57% in the D+E group, whereas both IMCL and GIR were not significantly altered in the D group. However, IHL showed significant decrease in both groups. In summary, we found that 2-week of diet and exercise decreased IMCL and increased muscle insulin-mediated glucose uptake, while diet with or without exercise decreased IHL. These effects were evident despite a small decrease in body fat, and were observed independently of fasting FFA levels.
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