Original articles

Regular Tai Chi Chuan exercise improves T cell helper function of patients with type 2 diabetes mellitus with an increase in T-bet transcription factor and IL-12 production

S-H Yeh¹, H Chuang², L-W Lin³, C-Y Hsiao⁴, P-W Wang⁵, R-T Liu⁵, K D Yang²

¹ Department of Nursing, Chang Gung Institute of Technology, Kuei-Shan, Tao-Yan and Department of Nursing, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung, Taiwan
² Department of Medical Research, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University, Kaohsiung, Taiwan
³ College of Nursing, Deakin University, Burwood, Australia
⁴ School of Nursing, Tzu-Hui Institute of Technology, Ping-Tung, Taiwan
⁵ Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University, Kaohsiung, Taiwan

^{Correspondence to} Dr K D Yang, Department of Medical Research, Chang Gung Memorial Hospital at Kaohsiung, Chang Gung University, Kaohsiung 833, Taiwan; yangkd{at}adm.cgmh.org.tw

Background: Exercise has been shown to be beneficial in the treatment of type 2 diabetes mellitus (DM); its benefit to immune function, however, remains to be determined.

Objective: This study investigated the effect of a 12-week course of Tai Chi Chuan (TCC) exercise on T cell helper (Th) reaction in patients with type 2 DM.

Methods: A case-control study was performed in 30 pairs of patients with type 2 DM and normal age-matched adults. Fasting blood glucose, HbA1c, mediators (interleukin (IL)-12, IL-4 and transforming growth factor (TGF)β) and transcription factors (T-bet, GATA-3 and FoxP3) of Th1/Th2/T regulatory (Treg) reaction were measured before and after a 12-week TCC exercise programme.

Results: Fasting glucose and HbA1c levels in the patients with type 2 DM were significantly higher than in age-matched controls before exercise. After TCC exercise, HbA1c levels in patients with type 2 DM significantly decreased (7.59 (0.32)% vs 7.16 (0.22)%; p = 0.047) and blood levels of IL-12 increased significantly (5.96 (1.10) vs 12.96 (3.07); p = 0.035). To study the molecular Th1/Th2/Treg reaction, patients with type 2 DM were found to have lower T-bet but not GATA-3 or FoxP3 expression than normal controls before TCC exercise. After the 12-week TCC exercise T-bet expression significantly increased in patients with type 2 DM.

Conclusions: A 12-week TCC exercise programme decreases HbA1c levels along with an increase in the Th1 reaction. A combination of TCC with medication may provide an even better improvement in both metabolism and immunity of patients with type 2 DM.

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