The role of physical exercise in endothelial dysfunction of patients with Metabolic Syndrome and Diabetes Mellitus

Abstract

Patients with metabolic syndrome and diabetes mellitus have an increased cardiovascular morbidity and mortality. The endothelial dysfunction has been implicated in the pathogenesis of the vascular diabetic disease. This abnormal function occurs prematurely before the cardiovascular disease, manifestation being characterized by a reduction of the vasorelaxation dependent of the endothelium. Therein, interventions as L-arginine, drugs to lowering lipids, (statins), antioxidants (vitamin C) and physical exercise seem to restore the abnormal endothelial function. Physical exercise increases the synthesis of nitric oxide, improving the vascular vasorelaxation in these patients. The objective of this study was to approach the injured endothelial function in the patient with metabolic syndrome and diabetes mellitus, highlighting the role of physical exercise on its recovery. Methodologically, a review of the literature was accomplished by means of a research in Medline databases, searching specifically for studies directly related to the objective of this work. Two hundred eighty-seven studies were listed, from which 79 were selected. The criteria used were: randomized studies with control groups; with at least four weeks of intervention; in populations with metabolic syndrome, insulin resistant and diabetics; complete examined and revised publication in journal; all measures of endothelial evaluation before, during and after the intervention were available; as well as review studies. From the studied researches, it is concluded that the patients with metabolic syndrome and diabetes mellitus have endothelial dysfunction and it is considered to precede cardiovascular disease. Physical exercise is considered a good intervention because improves artery vasodilatation.