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
- 1Department of Nursing, Chang Gung Institute of Technology, Kuei-Shan, Tao-Yan and Department of Nursing, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung, Taiwan
- 2Department of Medical Research, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University, Kaohsiung, Taiwan
- 3College of Nursing, Deakin University, Burwood, Australia
- 4School of Nursing, Tzu-Hui Institute of Technology, Ping-Tung, Taiwan
- 5Division 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;
- Accepted 22 January 2008
- Published Online First 2 April 2008
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.
Funding This study was supported by grants CMRPF850041 and CMRPG83038 from Chang Gung Memorial Hospital and NSC95-2314-B-255-001-MY2 from the National Science Council, Taiwan.
Competing interests None declared.
Ethics approval The study protocol was approved by the Institutional Review Board of Chang Gung Memorial Hospital. Informed consent was obtained from each of the participants who agreed to participate in the exercise programme and the pre- and post-exercise blood immune function tests. The participants also agreed to keep taking their diabetic medications and to follow their diets over the exercise programme.