ORIGINAL ARTICLE   

Minerva Medica 2019 February;110(1):3-11

DOI: 10.23736/S0026-4806.18.05589-1

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Effects of chronic exercise on gut microbiota and intestinal barrier in human with type 2 diabetes

Evasio PASINI ¹, Giovanni CORSETTI ² ✉, Deodato ASSANELLI ³, Cristian TESTA ⁴, Claudia ROMANO ², Francesco S. DIOGUARDI ⁵, Roberto AQUILANI ⁶

¹ Division of Cardiac Rehabilitation, Maugeri Scientific Clinical Institutes for Research and Care, Lumezzane, Brescia, Italy; ² Division of Human Anatomy and Physiopathology, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy; ³ Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy; ⁴ Laboratory of Clinical Microbiology and Virology, Functional Point Ltd., Bergamo, Italy; ⁵ Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; ⁶ Department of Biology and Biotechnology, University of Pavia, Pavia, Italy

BACKGROUND: Intestinal dysbiosis has been proposed as a possible contributor of the development of type 2 diabetes (T2D). Indeed, commensal fungi and opportunistic bacteria stimulate the local immune system, altering intestinal permeability with consequent leaky gut, which in turn activates systemic inflammation responsible for insulin resistance. It is also well known that chronic exercise improves glucose control and diabetes-induced damage. The aim of this study was to evaluate the role of chronic exercise on gut flora composition and leaky gut in T2D stable patients.
METHODS: Thirty clinically stable patients with T2D were studied before and after a six months program of endurance, resistance and flexibility training. Metabolic and anthropometric evaluations were carried out. Gut flora and intestinal permeability were measured in stools by selective agar culture medium and molecular biology measurements of zonulin, which is the protein that modulates enterocyte tight junctions.
RESULTS: Diabetes causes significant intestinal mycetes overgrowth, increased intestinal permeability and systemic low-grade inflammation. However, exercise improved glycemia, functional and anthropometric variables. Moreover, chronic exercise reduced intestinal mycetes overgrowth, leaky gut, and systemic inflammation. Interestingly, these variables are closely correlated.
CONCLUSIONS: Exercise controls diabetes by also modifying intestinal microbiota composition and gut barrier function. This data shows an additional mechanism of chronic exercise and suggests that improving gut flora could be an important step in tailored therapies of T2D.

KEY WORDS: Exercise - Type 2 diabetes mellitus - Microbiota - Fungi - Dysbiosis - Zonulin