Age, Lifestyle, Muscle Mechanisms in Insulin Resistance

• Insulin stimulated glucose disposal [ Time Frame: Baseline and 6 months ] [ Designated as safety issue: Yes ]
  
• Content and activity of insulin signaling proteins from muscle biopsies [ Time Frame: Baseline and 6 months ] [ Designated as safety issue: Yes ]
  
• Glucose tolerance [ Time Frame: Baseline and 6 months ] [ Designated as safety issue: Yes ]
  

• Aerobic capacity [ Time Frame: Baseline and 6 months ] [ Designated as safety issue: Yes ]
  
• Body weight/Composition [ Time Frame: Baseline and 6 months ] [ Designated as safety issue: Yes ]
  
• Cytokines [ Time Frame: Baseline and 6 months ] [ Designated as safety issue: Yes ]
  
• Other biomarkers (such as glucose, insulin etc) [ Time Frame: Baseline and 6 months ] [ Designated as safety issue: Yes ]
  

Aging is associated with a progressive development of impaired glucose tolerance (IGT), due to an increased peripheral tissue resistance to the action of insulin. Insulin resistance, a common state in both obese and sedentary individuals, eventually leads to the development of glucose intolerance, and type 2 diabetes with aging. Even in the absence of diabetes, insulin resistance is a key feature in various metabolic abnormalities that increase the risk for developing cardiovascular disease (CVD). Previous studies demonstrate improvements in glucose tolerance and glucose utilization following moderate energy restriction coupled with moderate intensity AEX. WL, through behavioral modification of diet and aerobic exercise (AEX), is perhaps the most effective way to treat as well as prevent insulin resistance and its associated metabolic complications of IGT and type 2 diabetes. Although these studies demonstrate the beneficial effect of weight loss (WL) and AEX on glucose tolerance and insulin action, not much is known about the cellular and molecular mechanisms by which these nonpharmacologic treatments improve glucose utilization in high-risk obese older individuals.

This study seeks to determine the cellular mechanisms by which aerobic exercise and weight loss alter skeletal muscle insulin signaling to improve insulin action in older glucose intolerant individuals. A second purpose is to determine whether certain genes (hereditary information) affect the way the body utilizes glucose in response to exercise and weight loss. In addition, adipose tissue is increasingly recognized as more than an inert depot serving not only to accept and store excess energy in the form of triglycerides, but also to secrete hormones and adipokines that have substantial effects on lipid and glucose metabolism. Furthermore, there are depot differences in metabolic function, as well as adipokine content. However, the physiology both underlying and consequential to these observations remains unknown. Thus, a third aim is to examine the effects of obesity on regional adipokine secretion and expression, and the relationship of adipokines to insulin resistance and the metabolic syndrome.