MOBILIZATION OF VISCERAL ADIPOSE-TISSUE RELATED TO THE IMPROVEMENT ININSULIN SENSITIVITY IN RESPONSE TO PHYSICAL-TRAINING IN NIDDM - EFFECTS OF BRANCHED-CHAIN AMINO-ACID SUPPLEMENTS

OBJECTIVE - To evaluate the effects of an intense physical training pr ogram on abdominal fat distribution, glycemic control, and insulin sen sitivity in patients with NIDDM and to determine whether branched-chai n amino acid (BCAA) supplements influence these effects. RESEARCH DESI GN AND METHODS - Twenty-four patients (ages 45 +/- 2 [mean +/- SE] yea rs, BMI 30.2 +/- 0.9 kg/m(2) HbA(1c) 7.9 +/- 0.3%) were randomly assig ned to four groups: training plus BCAA supplement (n = 6), training pl us placebo (n = 6), sedentary plus BCAA supplement (n = 6), and sedent ary plus placebo (n = 6). Physical training consisted of a supervised 45-min cycling exercise at 75% of their oxygen uptake peak (Vo(2) peak ) two times per week and an intermittent exercise one time per week fo r 2 months. RESULTS - Patients who exercised increased their Vo(2) pea k by 41% and their insulin sensitivity by 46%. Physical training signi ficantly decreased abdominal fat evaluated by magnetic resonance imagi ng (umbilicus), with a greater loss of visceral adipose tissue (VAT) ( 48%) in comparison with the loss of subcutaneous adipose tissue (18%), but did not significantly affect body weight. The change in visceral abdominal fat was associated with the improvement in insulin sensitivi ty (r = 0.84, P = 0.001). BCAA supplementation had no effect on abdomi nal fat and glucose metabolism. CONCLUSIONS - Physical training result ed in an improvement in insulin sensitivity with concomitant loss of V AT and should be included in the treatment program for patients with N IDDM.