Combined effects of exercise and different levels of acute hypoxic severity : A randomized crossover study on glucose regulation in adults with overweight

Journal article


Tee, Chris Chow Li, Parr, Evelyn B., Cooke, Matthew B., Chong, Mee Chee, Rahmat, Nurhamizah, Md Razali, Mohd Rizal, Yeo, Wee Kian and Camera, Donny M.. (2023). Combined effects of exercise and different levels of acute hypoxic severity : A randomized crossover study on glucose regulation in adults with overweight. Frontiers in Physiology. 14, p. Article 1174926. https://doi.org/10.3389/fphys.2023.1174926
AuthorsTee, Chris Chow Li, Parr, Evelyn B., Cooke, Matthew B., Chong, Mee Chee, Rahmat, Nurhamizah, Md Razali, Mohd Rizal, Yeo, Wee Kian and Camera, Donny M.
Abstract

Purpose: The aim of this study was to investigate the influence of manipulating hypoxic severity with low-intensity exercise on glucose regulation in healthy overweight adults.

Methods: In a randomized crossover design, 14 males with overweight (age: 27 ± 5 years; body mass index (BMI) 27.1 ± 1.8 kg⋅m2) completed three exercise trials involving 60 min aerobic exercise cycling at 90% lactate threshold in normoxia (NM, FiO2 = 20.9%), moderate hypoxia (MH, FiO2 = 16.5%) and high hypoxia (HH, FiO2 = 14.8%). A post-exercise oral glucose tolerance test (OGTT) was performed. Venous blood samples were analyzed for incremental area under the curve (iAUC), plasma glucose and insulin, as well as exerkine concentrations (plasma apelin and fibroblast growth factor 21 [FGF-21]) pre- and post-exercise. A 24-h continuous glucose monitoring (CGM) was used to determine interstitial glucose concentrations. Heart rate, oxygen saturation (SpO2) and perceptual measures were recorded during exercise.

Results: Post-exercise OGTT iAUC for plasma glucose and insulin concentrations were lower in MH vs. control (p = 0.02). Post-exercise interstitial glucose iAUC, plasma apelin and FGF-21 were not different between conditions. Heart rate was higher in HH vs. NM and MH, and MH vs. NM (p < 0.001), while SpO2 was lower in HH vs. NM and MH, and MH vs. NM (p < 0.001). Overall perceived discomfort and leg discomfort were higher in HH vs. NM and MH (p < 0.05), while perceived breathing difficulty was higher in HH vs. NM only (p = 0.003).

Conclusion: Compared to higher hypoxic conditions, performing acute aerobic-based exercise under moderate hypoxia provided a more effective stimulus for improving post-exercise glucose regulation while concomitantly preventing excessive physiological and perceptual stress in healthy overweight adults.

Keywordshypoxia; low-intensity exercise; exerkines; apelin; FGF-21
Year2023
JournalFrontiers in Physiology
Journal citation14, p. Article 1174926
PublisherFrontiers Media S.A.
ISSN1664-042X
Digital Object Identifier (DOI)https://doi.org/10.3389/fphys.2023.1174926
PubMed ID37123278
Scopus EID2-s2.0-85153779410
PubMed Central IDPMC10133678
Open accessPublished as ‘gold’ (paid) open access
Page range1-9
FunderNational Sports Institute of Malaysia
Swinburne University of Technology
Publisher's version
License
File Access Level
Open
Output statusPublished
Publication dates
Online13 Apr 2023
Publication process dates
Accepted05 Apr 2023
Deposited29 Apr 2025
Grant IDISNRG 003/2020
Additional information

© 2023 Tee, Parr, Cooke, Chong, Rahmat, Md Razali, Yeo and Camera.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Parr, Evelyn Bridget. (2015). Exercise and nutrient interactions: Effects on skeletal muscle and body fat mass [Thesis]. https://doi.org/10.4226/66/5a9cbd34b0b99
Need for measures of satellite cell activation along with muscle protein synthesis?
Camera, Donny and Hawley, John. (2015). Need for measures of satellite cell activation along with muscle protein synthesis? Journal of Applied Physiology. 118(4), pp. 500 - 500. https://doi.org/10.1152/japplphysiol.00609.2014.
Alcohol ingestion impairs maximal post-exercise rates of myofibrillar protein synthesis following a single bout of concurrent training
Parr, Evelyn, Camera, Donny, Areta, José, Burke, Louise, Phillips, Stuart, Hawley, John A. and Coffey, Vernon. (2014). Alcohol ingestion impairs maximal post-exercise rates of myofibrillar protein synthesis following a single bout of concurrent training. PLoS ONE. 9(2), pp. 1 - 9. https://doi.org/10.1371/journal.pone.0088384
Beyond muscle hypertrophy: Why dietary protein is important for endurance athletes
Moore, Daniel, Camera, Donny, Areta, José and Hawley, John A.. (2014). Beyond muscle hypertrophy: Why dietary protein is important for endurance athletes. Applied Physiology, Nutrition and Metabolism. 39(9), pp. 987 - 997. https://doi.org/10.1139/apnm-2013-0591
Reduced resting skeletal muscle protein synthesis is reduced by resistance exercise and protein ingestion following short-term energy deficit
Areta, José, Burke, Louise, Camera, Donny, West, Daniel, Crawshay, Siobhan, Moore, Daniel, Stellingwerff, Trent, Phillips, Stuart, Hawley, John A. and Coffey, Vernon. (2014). Reduced resting skeletal muscle protein synthesis is reduced by resistance exercise and protein ingestion following short-term energy deficit. American Journal of Physiology: Endocrinology and Metabolism. 306(8), pp. E989 - E997. https://doi.org/10.1152/ajpendo.00590.2013
Meteorin-like is a hormone that regulates immune-adipose interactions to increase beige fat thermogenesis
Rao, Rajesh, Long, Jonathan, White, James, Svensson, Katrin, Lou, Jesse, Lokurkar, Isha, Jedrychowski, Mark, Ruas, Jorge, Wrann, Christiane, Lo, James, Camera, Donny, Lachey, Jenn, Gygi, Steven, Seehra, Jasbir, Hawley, John and Spiegelman, Bruce. (2014). Meteorin-like is a hormone that regulates immune-adipose interactions to increase beige fat thermogenesis. Cell. 157(6), pp. 1279 - 1291. https://doi.org/10.1016/j.cell.2014.03.065
Meteorin-like Is a Hormone that Regulates Immune-Adipose Interactions to Increase Beige Fat Thermogenesis
Rao, Rajesh, Long, Jonathan Z., White, James P., Svensson, Katrin J., Lou, Jesse, Lokurkar, Isha, Jedrychowski, Mark P., Ruas, Jorge L., Wrann, Christine D., Camera, Donny, Lachey, Jenn, Gygi, Steven, Seehra, Jasbir, Hawley, John and Spiegelman, Bruce M.. (2014). Meteorin-like Is a Hormone that Regulates Immune-Adipose Interactions to Increase Beige Fat Thermogenesis. Cell. 157(6), pp. 1279 - 1291. https://doi.org/10.1016/j.cell.2014.03.065
ERK1/2 in the brain mediates the effects of central resistin on reducing thermogenesis in brown adipose tissue
Kosari, Samin, Camera, Donny Michael, Hawley, John Alan, Stebbing, Martin and Badoer, Emilio. (2013). ERK1/2 in the brain mediates the effects of central resistin on reducing thermogenesis in brown adipose tissue. International Journal of Physiology, Pathophysiology and Pharmacology. 5(3), pp. 184 - 189.
Timing and distribution of protein ingestion during prolonged recovery from resistance exercise alters myofibrillar protein synthesis
Areta, José, Burke, Louise, Ross, M, Camera, Donny, West, D, Broad, E, Jeacocke, N, Moore, Daniel, Stellingwerff, T and Phillips, S. (2013). Timing and distribution of protein ingestion during prolonged recovery from resistance exercise alters myofibrillar protein synthesis. The Journal of Physiology. https://doi.org/10.1113/jphysiol.2012.244897
Skeletal muscle respiratory capacity is enhanced in rats consuming an obesogenic Western diet
Stephenson, E, Camera, Donny, Jenkins, T, Kosari, S, Lee, Joohyung, Hawley, John and Stepto, N. (2012). Skeletal muscle respiratory capacity is enhanced in rats consuming an obesogenic Western diet. American Journal of Physiology: Endocrinology and Metabolism. 302(12), pp. E1541 - E1549. https://doi.org/10.1152/ajpendo.00590.2011
Sex-based comparisons of myofibrillar protein synthesis after resistance exercise in the fed state
West, D, Burd, N, Churchward-Venne, T, Camera, Donny, Mitchell, Cameron, Baker, S, Hawley, John, Coffey, Vernon and Phillips, S. (2012). Sex-based comparisons of myofibrillar protein synthesis after resistance exercise in the fed state. Journal of Applied Physiology. 112(11), pp. 1805 - 1813. https://doi.org/10.1152/japplphysiol.00170.2012
Low muscle glycogen concentration does not suppress the anabolic response to resistance exercise
Camera, Donny, West, D, Burd, N, Phillips, S, Garnham, A, Hawley, John and Coffey, Vernon. (2012). Low muscle glycogen concentration does not suppress the anabolic response to resistance exercise. Journal of Applied Physiology. 113(2), pp. 206 - 214. https://doi.org/10.1152/japplphysiol.00395.2012
No role for early IGF-1 signalling in stimulating acute 'muscle building' responses
Burd, Nicholas A., West, D. W., Camera, Donny and Breen, L.. (2011). No role for early IGF-1 signalling in stimulating acute 'muscle building' responses. The Journal of Physiology. https://doi.org/10.1113/jphysiol.2011.207332
Early time course of akt phosphorylation after endurance and resistance exercise
Camera, Donny, Edge, J, Short, M, Hawley, John and Coffey, Vernon. (2010). Early time course of akt phosphorylation after endurance and resistance exercise. Medicine and Science in Sports and Exercise. 42(10), pp. 1843 - 1852. https://doi.org/10.1249/MSS.0b013e3181d964e4
Short-term endurance training does not alter the oxidative capacity of human subcutaneous adipose tissue
Camera, Donny, Anderson, Malcolm, Hawley, John and Carey, A. (2010). Short-term endurance training does not alter the oxidative capacity of human subcutaneous adipose tissue. European Journal of Applied Physiology. 109(2), pp. 307 - 316. https://doi.org/10.1007/s00421-010-1356-3