Journal of Nutrition,Fasting and Health

Journal of Nutrition,Fasting and Health

Evaluating the Effect of Combined Exercise with Broccoli Consumption on Fetuin A and B in Men with Type 2 Diabetes

Document Type : Research Paper

Authors
Fazlali Karimi 1
Hossein Abednatanzi 1
Shahram Soheily 2
Mandana Gholami 1
1 Department of Physical Education and Sport Science, Science and Research Branch, Islamic Azad University, Tehran, Iran
2 Department of Physical Education and Sport Sciences, Shahr-e-Qods Branch, Islamic Azad University, Tehran, Iran
10.22038/jnfh.2024.82982.1538
Abstract
Introduction: Hepatokines are liver-derived proteins that play critical roles in regulating metabolic processes. In individuals with type 2 diabetes, dysregulation of hepatokines, particularly fetuin-A and fetuin-B, has been associated with insulin resistance and increased inflammation. The present study aimed to investigate the effects of a 12-week combined exercise regimen coupled with broccoli consumption on the serum levels of fetuin-A and fetuin-B in men with type 2 diabetes. Method: This quasi-experimental and applied pre-test and post-test research was conducted on 44 male participants with type 2 diabetes. Participants were randomly assigned to one of four groups (n=11 per group): exercise-supplement group, exercise-placebo group, control-supplement group, and control-placebo group based on individual characteristics. The training protocol involved 45 minutes of resistance exercise at an intensity of 60-70% of one repetition maximum, followed by 30 minutes of aerobic exercise (running) at an intensity of 60-70% of the maximum heart rate. Broccoli was administered in powdered form, with each participant receiving 10 grams per day for a duration of 12 weeks. Blood samples were collected 48 hours prior to the initiation of the training program and again 48 hours after the completion of the final training session to analyze the relevant biomarkers. Intergroup comparisons were conducted using a two-way analysis of variance, while intragroup differences were evaluated using a paired t-test. Results: The results demonstrated that exercise had a statistically significant impact on plasma levels of fetuin A (p=0.004) and fetuin B (p=0.029) in men with type 2 diabetes. Moreover, broccoli supplementation also significantly affected plasma levels of fetuin A (p=0.001) and fetuin B (p=0.001). Additionally, the interaction effect between exercise and broccoli supplementation on the plasma levels of both fetuin A (p=0.002) and fetuin B (p=0.015) was statistically significant (p<0.05). Conclusion: Regular aerobic exercise significantly reduced fetuin A levels, thereby enhancing insulin sensitivity and improving overall metabolic health. Supplementing the diet with broccoli further supported these benefits by reducing insulin resistance and potentially lowering inflammation through its bioactive compounds. In conclusion, combining aerobic exercise with broccoli supplementation presents an effective strategy to improve metabolic health in men with type 2 diabetes, particularly by modulating key proteins such as fetuin A and fetuin B.
Keywords
Combined exercise
Broccoli
Type 2 diabetes
Fetuin A
Fetuin B
Subjects
  1. Kusminski CM, Bickel PE, Scherer PE. Targeting adipose tissue in the treatment of obesity-associated diabetes. Nature Reviews Drug Discovery. 2016;15(9):639.
  2. Maritim A, Sanders a, Watkins Iii J. Diabetes, oxidative stress, and antioxidants: a review. Journal of Biochemical and Molecular Toxicology. 2003;17(1):24-38.
  3. Bell JA, Kivimaki M, Hamer M. Metabolically healthy obesity and risk of incident type 2 diabetes: a meta‐analysis of prospective cohort studies. Obesity Reviews. 2014;15(6):504-15.
  4. Falcão-Pires I, Castro-Chaves P, Miranda-Silva D, Lourenco AP, Leite-Moreira AF. Physiological, pathological and potential therapeutic roles of adipokines. Drug Discovery Today. 2012;17(15-16):880-9.
  5. Blüher M. Adipokines–removing road blocks to obesity and diabetes therapy. Molecular Metabolism. 2014;3(3):230-40.
  6. Oh K-J, Lee DS, Kim WK, Han BS, Lee SC, Bae K-H. Metabolic adaptation in obesity and type II diabetes: myokines, adipokines and hepatokines. International Journal of Molecular Sciences. 2017;18(1):8.
  7. Sun Q, Cornelis MC, Manson JE, Hu FB. Plasma levels of fetuin-A and hepatic enzymes and risk of type 2 diabetes in women in the US. Diabetes. 2013;62(1):49-55.
  8. Stefan N, Hennige AM, Staiger H, Machann J, Schick F, Kröber SM, et al. α2-Heremans-Schmid glycoprotein/fetuin-A is associated with insulin resistance and fat accumulation in the liver in humans. Diabetes Care. 2006;29(4):853-7.
  9. Jialal I, Pahwa R. Fetuin-A is also an adipokine. Lipids in Health and Disease. 2019;18(1):1-2.
  10. Dabrowska AM, Tarach JS, Wojtysiak-Duma B, Duma D. Fetuin-A (AHSG) and its usefulness in clinical practice. Review of the literature. Biomed Pap Med FacUnivPalacky Olomouc Czech Repub. 2015;159(3):352-9.
  11. Schinke T, Amendt C, Trindl A, Pöschke O, Müller-Esterl W, Jahnen-Dechent W. The serum protein α2-HS glycoprotein/fetuin inhibits apatite formation in vitro and in mineralizing calvaria cells: a possible role in mineralization and calcium homeostasis. Journal of Biological Chemistry. 1996;271(34):20789-96.
  12. Jung TW, Ahn SH, Shin JW, Kim HC, Park ES, Abd El‐Aty A, et al. Protectin DX ameliorates palmitate‐induced hepatic insulin resistance through AMPK/SIRT 1‐mediated modulation of fetuin‐A and SeP expression. Clinical and Experimental Pharmacology and Physiology. 2019;46(10):898-909.
  13. Karajibani M, Montazerifar F, Sadeghi M B , Keikhaie M A , Dashipour A . Serum Fetuin-A and Adipsin Levels in Type II Diabetes Patients. Int J High Risk Behav Addict. 2019;8(3):e91963. 
  14. Saeidi A, Soltani M, Daraei A, Nohbaradar H, Haghighi MM, Khosravi N, Johnson KE, Laher I, Hackney AC, VanDusseldorp TA, Zouhal H. The Effects of Aerobic-Resistance Training and Broccoli Supplementation on Plasma Dectin-1 and Insulin Resistance in Males with Type 2 Diabetes. Nutrients. 2021;13(9):3144.
  15. Meex RC, Hoy AJ, Morris A, Brown RD, Lo JC, Burke M, et al. Fetuin B is a secreted hepatocyte factor linking steatosis to impaired glucose metabolism. Cell Metabolism. 2015;22(6):1078-89.
  16. Kralisch S, Hoffmann A, Lössner U, Kratzsch J, Blüher M, Stumvoll M, et al. Regulation of the novel adipokines/hepatokines fetuin A and fetuin B in gestational diabetes mellitus. Metabolism. 2017;68:88-94.
  17. El-Ashmawy HM, Ahmed AM. Serum fetuin-B level is an independent marker for nonalcoholic fatty liver disease in patients with type 2 diabetes. European Journal of Gastroenterology & Hepatology. 2019;31(7):859-64.
  18. gelardi n, farzanegi p, abaszade h. Exploring the effect of broccoli on some cardiovascular risk factors and insulin resistance with combined aerobic-resistance exercise training in men with type 2 diabetes. Journal of Jiroft University of Medical Sciences. 2020;7(1):292-301.
  19. Ramírez-Vélez R, García-Hermoso A, Hackney AC, Izquierdo M. Effects of exercise training on Fetuin-a in obese, type 2 diabetes and cardiovascular disease in adults and elderly: a systematic review and Meta-analysis. Lipids Health Dis. 2019;18(1):23.
  20. Seo DY, Park SH, Marquez J, Kwak HB, Kim TN, Bae JH, Koh JH, Han J. Hepatokines as a Molecular Transducer of Exercise. J Clin Med. 2021;10(3):385.
  21. Ennequin G, Sirvent P, Whitham M. Role of exercise-induced hepatokines in metabolic disorders. American Journal of Physiology-Endocrinology and Metabolism, 2019;317(1): E11-24.
  22. Tresierras MA, Balady GJ. Resistance training in the treatment of diabetes and obesity: mechanisms and outcomes. Journal of cardiopulmonary rehabilitation and prevention. 2009;29(2):67-75.
  23. Li Z, Lin M, Liu C, Wang D, Shi X, Chen Z, et al. Fetuin-B links nonalcoholic fatty liver disease to type 2 diabetes via inducing insulin resistance: association and path analyses. Cytokine. 2018;108:145-50.
  24. Nascimento MA, Cyrino ES, Nakamura FY, Romanzini M, Pianca HJ, Queiróga MR. Validation of the Brzycki equation for the estimation of 1-RM in the bench press. Revista Brasileira de Medicina do Esporte. 2007;13:47-50.
  25. Colberg SR, Sigal RJ, Fernhall B, Regensteiner JG, Blissmer BJ, Rubin RR, et al. Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement. Diabetes Care. 2010;33(12):e147-67.
  26. Praet SF, Van Loon LJ. Optimizing the therapeutic benefits of exercise in type 2 diabetes. Journal of Applied Physiology. 2007;103(4):1113-20.
  27. 1Mirmiran P, Mohtadinia J, Hedayati M, Shakeri N. Effects of broccoli sprout powder on fasting serum glucose and lipid profiles in type 2 diabetic patients. Iranian Journal of Endocrinology and Metabolism. 2011;13(1):18-25.
  28. Shahraki A, Vahidian-Rezazadeh M, Nikoofar M. Impact of aerobic and combined exercise training on serum levels of Fetuin-A and some metabolic syndrome indices of overweight and obese women: A clinical trial study. KAUMS Journal (FEYZ). 2020;24(3):322-31.
  29. Reinehr T, Roth CL. Fetuin-A and its relation to metabolic syndrome and fatty liver disease in obese children before and after weight loss. The Journal of Clinical Endocrinology & Metabolism. 2008;93(11):4479-85.
  30. Ramírez-Vélez R, García-Hermoso A, Hackney AC, Izquierdo M. Effects of exercise training on Fetuin-a in obese, type 2 diabetes and cardiovascular disease in adults and elderly: a systematic review and Meta-analysis. Lipids in Health and Disease. 2019;18(1):1-11.
  31. Srinivas P, Wagner AS, Reddy LV, Deutsch D, Leon MA, Goustin AS, et al. Serum alpha 2-HS-glycoprotein is an inhibitor of the human insulin receptor at the tyrosine kinase level. Molecular endocrinology. 1993;7(11):1445-55.
  32. Mathews ST, Singh GP, Ranalletta M, Cintron VJ, Qiang X, Goustin AS, et al. Improved insulin sensitivity and resistance to weight gain in mice null for the Ahsg gene. Diabetes. 2002;51(8):2450-8.
  33. Pal D, Dasgupta S, Kundu R, Maitra S, Das G, Mukhopadhyay S, et al. Fetuin-A acts as an endogenous ligand of TLR4 to promote lipid-induced insulin resistance. Nature Medicine. 2012;18(8):1279-85.
  34. Guo R, Liong EC, So KF, Fung M-L, Tipoe GL. Beneficial mechanisms of aerobic exercise on hepatic lipid metabolism in non-alcoholic fatty liver disease. Hepatobiliary & Pancreatic Diseases International. 2015;14(2):139-44.
  35. Gonzalez-Ruiz K, Ramirez-Velez R, Correa-Bautista JE, Peterson MD, Garcia-Hermoso A. The effects of exercise on abdominal fat and liver enzymes in pediatric obesity: a systematic review and meta-analysis. Childhood Obesity. 2017;13(4):272-82.
  36. Xu XJ, Valentine RJ, Ruderman NB. AMP-activated protein kinase (AMPK): does this master regulator of cellular energy state distinguish insulin sensitive from insulin resistant obesity?. Current Obesity Reports. 2014;3(2):248-55.
  37. Jung SH, Won K-J, Lee KP, Kim H-J, Seo E-H, Lee HM, et al. The serum protein fetuin-B is involved in the development of acute myocardial infarction. Clinical Science. 2015;129(1):27-38.
  38. Kralisch S, Hoffmann A, Klöting N, Bachmann A, Kratzsch J, Blüher M, et al. The novel adipokine/hepatokine fetuin B in severe human and murine diabetic kidney disease. Diabetes & Metabolism. 2017;43(5):465-8.
  39. Zhu K, Wang Y, Shu P, Zhou Q, Zhu J, Zhou W, et al. Increased serum levels of fetuin B in patients with coronary artery disease. Endocrine. 2017;58(1):97-105.
  40. Renard CB, Kramer F, Johansson F, Lamharzi N, Tannock LR, von Herrath MG, et al. Diabetes and diabetes-associated lipid abnormalities have distinct effects on initiation and progression of atherosclerotic lesions. The Journal of Clinical Investigation. 2004;114(5):659-68.
  41. Gorbanian B, Saberi Y. Changes in Fetuin-B and RBP4 During A Course of High-Intensity Interval Training in Women with Nonalcoholic Fatty Liver. Journal of Babol University of Medical Sciences. 2021;23(1):398-404.
  42. Keihanian A, Arazi H, Kargarfard M. Effects of aerobic versus resistance training on serum fetuin-A, fetuin-B, and fibroblast growth factor-21 levels in male diabetic patients. Physiology International. 2019;106(1):70-80.
Journal of Nutrition,Fasting and Health
Volume 13, Issue 2
Spring 2025
Pages 116-124

  • Receive Date 30 September 2024
  • Revise Date 10 November 2024
  • Accept Date 30 November 2024