Intermittent hypoxia as a means to improve aerobic capacity in type 2 diabetes.

Abstract:

:Physical inactivity and a low maximal aerobic capacity (VO2max) strongly predict morbidity and mortality in patients with type 2 diabetes (T2D). Patients with T2D have a reduced VO2max when compared with healthy individuals of similar age, weight, and physical activity levels, and this lower aerobic capacity is usually attributed to a reduced oxygen delivery to the working muscles. The oxygen carrying capacity of the blood, as well as increases in cardiac output and blood flow, contribute to the delivery of oxygen to the active muscles during exercise. Hemoglobin mass (Hb mass), a key determinant of oxygen carrying capacity, is suggested to be reduced in patients with T2D following the observation of a lower blood volume (BV) in combination with normal hematocrit levels in this population. Therefore, a lower Hb mass, in addition to a reported lower BV and impaired cardiovascular response to exercise, likely contributes to the reduced oxygen delivery and VO2max in patients with T2D. While exercise training increases Hb mass, BV, and consequently VO2max, the majority of patients with T2D are not physically active, highlighting the need for alternative methods to improve VO2max in this population. Exposure to hypoxia triggers the release of erythropoietin, the hormone regulating red blood cell production, which increases Hb mass and consequently BV. Exposure to mild intermittent hypoxia (IH), characterized by few and short episodes of hypoxia at a fraction of inspired oxygen ranging between 10 and 14% interspersed with cycles of normoxia, increased red blood cell volume, Hb mass, and plasma volume in patients with coronary artery disease or chronic obstructive pulmonary disease, which resulted in an improved VO2max in both populations. We hypothesize that 12 exposures to mild IH over a period of 4weeks will increase Hb mass, BV, cardiac function, and VO2max in patients with T2D. Therefore, exposures to mild IH may increase oxygen delivery and VO2max without the need to perform exercise in patients with T2D.

journal_name

Med Hypotheses

journal_title

Medical hypotheses

authors

Leone RJ,Lalande S

doi

10.1016/j.mehy.2017.01.010

subject

Has Abstract

pub_date

2017-03-01 00:00:00

pages

59-63

eissn

0306-9877

issn

1532-2777

pii

S0306-9877(16)30621-1

journal_volume

100

pub_type

杂志文章
  • Impact-driven, pulmonary emboli of osseous fat in exercise-induced bronchospasm.

    abstract::Exercise induced bronchospasm (EIB) affects approximately 10% of normal individuals with higher prevalence rates among children, obese adults, and competitive athletes. Although hyperpnea with dry air is the best known cause, the problem is multifactorial with atopy, asthma and chlorine all playing established roles. ...

    journal_title:Medical hypotheses

    pub_type: 杂志文章,评审

    doi:10.1016/j.mehy.2015.08.014

    authors: Simkin PA,Snitily BK

    更新日期:2015-11-01 00:00:00

  • Treating Chronic Fatigue states as a disease of the regulation of energy metabolism.

    abstract::Chronic Fatigue Syndrome is a physiological state in which the patient feels high levels of fatigue without an obvious organic cause, which affects around 1 in 400 people in the developed world. A wide range of causes have been suggested, including immune or hormonal dysfunction, viral or bacterial infection, and psyc...

    journal_title:Medical hypotheses

    pub_type: 杂志文章

    doi:10.1016/j.mehy.2008.02.022

    authors: Bains W

    更新日期:2008-10-01 00:00:00

  • IGF-I activity may be a key determinant of stroke risk--a cautionary lesson for vegans.

    abstract::IGF-I acts on vascular endothelium to activate nitric oxide synthase, thereby promoting vascular health; there is reason to believe that this protection is especially crucial to the cerebral vasculature, helping to ward off thrombotic strokes. IGF-I may also promote the structural integrity of cerebral arteries, there...

    journal_title:Medical hypotheses

    pub_type: 杂志文章

    doi:10.1016/s0306-9877(02)00241-4

    authors: McCarty MF

    更新日期:2003-09-01 00:00:00

  • Rapid reduction in uric acid by a urate-lowering agent is associated with recurrent cardiovascular events.

    abstract:OBJECTIVES:Results from a recent study showed that the risk of cardiovascular and all-cause mortality was higher in patients who received febuxostat, a potent urate-lowering agent, than that in patients who received allopurinol. Therefore, we hypothesized that an abrupt change in serum urate levels caused by urate-lowe...

    journal_title:Medical hypotheses

    pub_type: 杂志文章

    doi:10.1016/j.mehy.2020.109740

    authors: Lee JS,Oh JS,Kim YG,Lee CK,Yoo B,Hong S

    更新日期:2020-08-01 00:00:00

  • Multi-anticancer drugs encapsulated in the micelle: a novel chemotherapy to cancer.

    abstract::Micelle is a stable, passively targetable and solubilizing minute particle, and plays a key role to anticancer drug delivery for chemotherapy. With an increasing number of novel polymeric micelles synthesized, many anticancer drugs have been core-encapsulated in the micelles. However, only single drug was studied as t...

    journal_title:Medical hypotheses

    pub_type: 杂志文章

    doi:10.1016/j.mehy.2008.05.002

    authors: Liu P,Wang B,Weili Qiao JL

    更新日期:2008-09-01 00:00:00

  • The functional conversion hypothesis: a contributor to exercise-induced asthma?

    abstract::Studies on receptor stability suggest that functional conversion of adrenoceptors between alpha and beta can occur in mammalian myocardium due to variations in the environment such as temperature changes, pH or hormonal changes. If adrenoceptors of the respiratory system behave similarly, heat and water loss of airway...

    journal_title:Medical hypotheses

    pub_type: 杂志文章

    doi:10.1016/0306-9877(88)90011-4

    authors: Venugopalan CS,Jenkins HJ,Drazen JM

    更新日期:1988-12-01 00:00:00

  • Perfluorocarbon as an adjuvant for tumor anti-angiogenic therapy: Relevance to hypoxia and HIF-1.

    abstract::Lack of vascularization results in increased demand for oxygen and creates a defined feature of the tumor microenvironment known as tumor hypoxia. It is well established that in response to hypoxia, hypoxia-inducible factor-1 α (HIF-1α) is induced which is an important factor in angiogenesis, invasion and metastasis. ...

    journal_title:Medical hypotheses

    pub_type: 杂志文章

    doi:10.1016/j.mehy.2020.110357

    authors: Farhadi P,Yarani R,Kiani S,Mansouri K

    更新日期:2021-01-01 00:00:00

  • Does the measurement of the difference of resistive indexes in spleen and kidney might be used for characterization of intrarenal tardus parvus phenomenon in chronic kidney disease?

    abstract::Doppler sonography is used as a routine test for detection of renal artery stenosis (RAS). Although increased peak systolic velocity at the site of the narrowing is a widely accepted method for assessing main renal artery stenosis, tardus parvus phenomenon detected on the downstream blood flow has been used as an alte...

    journal_title:Medical hypotheses

    pub_type: 杂志文章

    doi:10.1016/j.mehy.2019.01.016

    authors: Cavalcante Araújo N

    更新日期:2019-03-01 00:00:00

  • Design of novel Geldanamycin analogue hsp90 alpha-inhibitor in silico for breast cancer therapy.

    abstract:BACKGROUND:Geldanamycin, which is one of the most potent and effective hsp90 alpha inhibitor until date, is normally used to target breast cancer. Inhibition of hsp90 alpha leads to the degradation of client proteins involved in the initiation and progress of breast cancer pathogenesis. Hence, Geldanamycin has been wid...

    journal_title:Medical hypotheses

    pub_type: 杂志文章

    doi:10.1016/j.mehy.2013.06.012

    authors: Mahanta S,Pilla S,Paul S

    更新日期:2013-09-01 00:00:00

  • Prolactin fragmentation by trophoblastic matrix metalloproteinases as a possible contributor to peripartum cardiomyopathy and pre-eclampsia.

    abstract::Although peripartum cardiomyopathy (PPCM) is a rare disease, it has very serious consequences for both mother and child. No single cause has been held responsible for the pathogenesis. Recent studies have indicated that increased proteolytic cathepsin D activity in cardiomyocytes results in16kDa prolactin fragments wi...

    journal_title:Medical hypotheses

    pub_type: 杂志文章

    doi:10.1016/j.mehy.2009.08.029

    authors: Reuwer AQ,Reuwer PJ,van der Post JA,Cramer MJ,Kastelein JJ,Twickler MT

    更新日期:2010-02-01 00:00:00

  • In lupus nephritis, how do extracellular DNAs trigger type I interferon secretion: Under the assistance of HMGB1-cGAS?

    abstract::Systemic lupus erythematosus (SLE) is an autoimmune disease with multiple organs involved. Kidney damage is common among SLE patients. In lupus nephritis, extracellular DNA accumulation from necrosis cells and activated cells is perceived as initial step of inflammation. The up-regulated type I IFN is one pivotal cyto...

    journal_title:Medical hypotheses

    pub_type: 杂志文章

    doi:10.1016/j.mehy.2018.09.015

    authors: Zheng L,Zhang H,Tang Y

    更新日期:2018-12-01 00:00:00

  • Period and cohort trends in mortality from cancers of the uterus in England and Wales. A new theory of changing gene frequencies.

    abstract::Analysis of the age distribution of cancers of the uterus reveals three clearly distinctive types: early- and late-onset cancers of the cervix and one form of cancer of the corpus. England and Wales mortality data are available for the three types combined from 1911; cancers of the cervix and corpus have been listed s...

    journal_title:Medical hypotheses

    pub_type: 杂志文章

    doi:10.1016/0306-9877(86)90086-1

    authors: Burch PR

    更新日期:1986-05-01 00:00:00

  • Does hyperglycemia downregulate glucose transporters in the brain?

    abstract::Diabetes is a metabolic condition associated with hyperglycemia manifested by the elevation of blood glucose levels occurring when the pancreas decreases or stops the production of insulin, in case of insulin resistance or both. The current literature supports that insulin resistance may be responsible for the memory ...

    journal_title:Medical hypotheses

    pub_type: 杂志文章

    doi:10.1016/j.mehy.2020.109614

    authors: Leão LL,Tangen G,Barca ML,Engedal K,Santos SHS,Machado FSM,de Paula AMB,Monteiro-Junior RS

    更新日期:2020-06-01 00:00:00

  • Leukaemogenesis: a postulated mechanism involving tyrosine protein kinase and DNA topoisomerase.

    abstract::The weight of available evidence suggests that leukaemogenesis is a multi-step, complex process. Since there are different types of leukaemia, it seems likely that a variety of distinct molecular mechanisms are involved, arising from different combinations of genetic defects. It is not therefore surprising that studie...

    journal_title:Medical hypotheses

    pub_type: 杂志文章

    doi:10.1016/0306-9877(87)90188-5

    authors: Francis GE

    更新日期:1987-03-01 00:00:00

  • A hypothesis on the pathogenesis of rheumatoid and other non-specific synovitides based on a combination of observations often overlooked.

    abstract::In early synovitides the tissue inflammatory cell reaction is often weak and sometimes absent, many alterations being consistent with nonvasculitic exudation (I). Increased permeability to protein may require little, if any, endothelial damage. In rheumatoid arthritis (RA) increased transfer of fluid and protein from ...

    journal_title:Medical hypotheses

    pub_type: 杂志文章

    doi:10.1016/0306-9877(82)90063-9

    authors: Ahlqvist J

    更新日期:1982-07-01 00:00:00

  • Sudden infant death syndrome (SIDS): disordered brown fat metabolism and thermogenesis.

    abstract::Foster found areas with the highest incidence of SIDS in USA in 1983-1984 coincided with the highest areas recorded with the highest incidence of goitre in First World War troops (1). Reid compared the two populations described as having the highest incidence of SIDS worldwide. Both were selenium deficient areas (King...

    journal_title:Medical hypotheses

    pub_type: 杂志文章

    doi:10.1016/0306-9877(94)90124-4

    authors: Reid G,Tervit H

    更新日期:1994-04-01 00:00:00

  • Pellagra: A clue as to why energy failure causes diseases?

    abstract::Pellagra is a curable dietary illness that unchecked leads to dementia, diarrhoea, dermatitis and death due to lack of the precursors for NAD(H). In addition it caused a wide range of monosyndromic degenerative and functional neurological disorders as well as profound developmental, premature aging and metabolic syndr...

    journal_title:Medical hypotheses

    pub_type: 杂志文章

    doi:10.1016/j.mehy.2007.01.029

    authors: Williams AC,Ramsden DB

    更新日期:2007-01-01 00:00:00

  • Ovarian interleukin-1-induced gene expression: privileged genes threshold theory.

    abstract::Interleukin (IL)-1, an established mediator of inflammation, is also a mediator of ovulation (a cyclic inflammatory-like process). We have shown that IL-1 beta induces the in vitro expression of genes believed to play important role in ovulation (IL-1 beta itself, its receptors, IL-1 beta receptor antagonist, glucose ...

    journal_title:Medical hypotheses

    pub_type: 杂志文章

    doi:10.1054/mehy.2001.1389

    authors: Kol S,Kehat I,Adashi EY

    更新日期:2002-01-01 00:00:00

  • Can the 'yin and yang' BDNF hypothesis be used to predict the effects of rTMS treatment in neuropsychiatry?

    abstract::Repetitive transcranial magnetic stimulation (rTMS) is a novel technique of non-invasive brain stimulation which has been used to treat several neuropsychiatric disorders such as major depressive disorder, chronic pain and epilepsy. Recent studies have shown that the therapeutic effects of rTMS are associated with pla...

    journal_title:Medical hypotheses

    pub_type: 杂志文章

    doi:10.1016/j.mehy.2008.02.011

    authors: Brunoni AR,Boggio PS,Fregni F

    更新日期:2008-08-01 00:00:00

  • Reduction of stuttering: the dual inhibition hypothesis.

    abstract::Treatment for stuttering attempts to reduce or eliminate the observable core markers of the disorder, specifically repetitions and prolongation. In this hypothesis, it is proposed that stuttering may be inhibited by two distinct yet related procedures: active inhibition and passive inhibition. Active inhibition is bro...

    journal_title:Medical hypotheses

    pub_type: 杂志文章

    doi:10.1054/mehy.2001.1452

    authors: Saltuklaroglu T,Dayalu VN,Kalinowski J

    更新日期:2002-01-01 00:00:00

  • Reposition of montelukast either alone or in combination with levocetirizine against SARS-CoV-2.

    abstract::It has been hypothesised that antiallergic medications (AAMs) like montelukast and levocetirizine both the two bitter chloro compounds could be repurposed either alone or combinedly as an antiviral against SARS-CoV-2, like chloroquine/hydroxychloroquine (CQ/HCQ), another two bitter chloro compounds. Both AAMs and CQ/H...

    journal_title:Medical hypotheses

    pub_type: 信件

    doi:10.1016/j.mehy.2020.110046

    authors: Bhattacharyya D

    更新日期:2020-11-01 00:00:00

  • Treatment of osteonecrosis of the femoral head: combination of operation and multiple cellular mediators.

    abstract::The goal in the treatment of osteonecrosis of the femoral head is to preserve, not replace, the femoral head. Although many methods have been proposed, none has proved completely satisfactory. Cellular mediators as a supplement to bone grafting and decompression is an attractive approach to this problem because it com...

    journal_title:Medical hypotheses

    pub_type: 杂志文章

    doi:10.1016/j.mehy.2006.08.024

    authors: Yuan B,Liu Z

    更新日期:2007-01-01 00:00:00

  • Season of birth in schizophrenia: a maternal-fetal chronobiological hypothesis.

    abstract::Being born in the winter and spring significantly increases one's risk for developing schizophrenia. This birth seasonality may account for as many as 10% of all cases of schizophrenia. Maternal third trimester infections or vitamin D deficiencies are hypothesized to be the most likely cause and can account for many o...

    journal_title:Medical hypotheses

    pub_type: 杂志文章

    doi:10.1016/j.mehy.2011.02.019

    authors: Schwartz PJ

    更新日期:2011-06-01 00:00:00

  • Deep brain stimulation of the pedunculopontine tegmental nucleus may influence renal function.

    abstract::Deep brain stimulation of the pedunculopontine tegmental nucleus (PPTg) had usually been reported to improve the symptoms of advanced Parkinson's disease. Previous studies showed that neurons in the PPTg involved in the control of the sympathetic outflow to the kidneys. Our recent studies using transneuronal labeling ...

    journal_title:Medical hypotheses

    pub_type: 杂志文章

    doi:10.1016/j.mehy.2011.09.022

    authors: Xiang HB,Liu C,Guo QQ,Li RC,Ye DW

    更新日期:2011-12-01 00:00:00

  • Therapeutic implication of cocaine- and amphetamine-regulated transcript (CART) in the treatment of depression.

    abstract::Despite the fact that antidepressants represent the gold standard for the treatment of depression, not all patients treated with an antidepressant monotherapy achieve complete remission of depressive symptoms and functional recovery. Therefore, further examination of the components that may be involved in the action m...

    journal_title:Medical hypotheses

    pub_type: 杂志文章

    doi:10.1016/j.mehy.2006.11.009

    authors: Pae CU,Lee C,Paik IH

    更新日期:2007-01-01 00:00:00

  • Does chronic essential fatty acid deficiency constitute a pro-tumorigenic condition?

    abstract::Many experimental, clinical and epidemiological data indicate that n-3 and n-6 essential fatty acids are therapeutic nutrients which may delay the development as well as improve the course of cancer. The present hypothesis correlates well with these data and it is proposed that chronic essential fatty acid deficiency,...

    journal_title:Medical hypotheses

    pub_type: 杂志文章

    doi:10.1016/s0306-9877(97)90024-4

    authors: Eynard AR

    更新日期:1997-01-01 00:00:00

  • Static magnetic field combined with functional appliances: a new approach to enhance mandibular growth in Class II malocclusion.

    abstract::Class II malocclusion is one of the most common orthodontic problems. The main aetiology of Class II malocclusion is mandibular retrognathia. A variety of functional appliances have been used to stimulate mandibular growth in adolescence, however, the effects remain unsatisfactory. Therefore, new approaches are in nee...

    journal_title:Medical hypotheses

    pub_type: 杂志文章

    doi:10.1016/j.mehy.2008.08.029

    authors: Li Y,Yang P,Fan X,Wang J,Liu J,Zhao Z,Zhao M

    更新日期:2009-03-01 00:00:00

  • Does HIV disrupt a naturally occurring immune modulation system?

    abstract::An immune modulation complex is proposed which recognizes and is driven by an MHC presented epitope of the CD4 molecule present on the surface of up regulated CD4+ lymphocytes. Immune modulation is affected by both CD4 lymphocyte destruction and impairment of their potential for immune recognition. These two processes...

    journal_title:Medical hypotheses

    pub_type: 杂志文章

    doi:10.1016/0306-9877(93)90123-8

    authors: Kennedy JR

    更新日期:1993-11-01 00:00:00

  • A new approach to neonatal medical management that could transform the prevention of retinopathy of prematurity: Theoretical considerations.

    abstract::Retinopathy of prematurity (ROP) is a disease of the immature retina and is the leading global cause of blindness in children. Two postnatal phases of the disease are distinguished, the first phase is thought to be caused by hyperoxia. One of the most relevant ROP risk factor in routine clinical practice is blood tran...

    journal_title:Medical hypotheses

    pub_type: 杂志文章

    doi:10.1016/j.mehy.2019.109541

    authors: Podraza W

    更新日期:2020-04-01 00:00:00

  • Is ATP-sensitive K+ channel (K+ATP) recruitment a common mechanism for ECG-ST segment depression and elevation?

    abstract::ATP sensitive (K(+)(ATP)) potassium cardiac channels are recruited when ATP levels are low as in ischemic injury and acute trauma. Such activation results in ECG-ST elevation and cardiac arrhythmias. K(+)(ATP) channel recruitment may be blocked by the sulfonylurea glibenclamide, permitting a wide variety of animal exp...

    journal_title:Medical hypotheses

    pub_type: 杂志文章

    doi:10.1016/s0306-9877(03)00055-0

    authors: Hoffman I,Saltzman B

    更新日期:2003-04-01 00:00:00