Objectives: Metabolic syndrome (MetS) is linked to the development of type 2 diabetes and increased risk of cardiovascular disease (CVD). Physical inactivity is one of the main pathophysiological factors of MetS subjects. The aim of this study was to evaluate if 4-week supervised aerobic training had any impact on anthropometric, metabolic, hemodynamic and arterial wall parameters in MetS subjects.
Design and methods: 57 MetS subjects were randomly selected from a Lithuanian High Cardiovascular Risk (LitHiR) national primary prevention programme. Hemodynamic, cardiometabolic risk and arterial wall parameters were evaluated after the 4-week supervised aerobic training.
Results: After 4 weeks of aerobic training there was statistically significant decrease in body mass index from 30.58 ± 3.7 to 30.3 ± 3.55 kg/m2 (p = 0.010), waist circumference from 104.24 ± 9.46 to 102.9 ± 9.48 cm (p = 0.003), decrease of LDL cholesterol from 4.21 ± 1.15 to 3.78 ± 1 mmol/l (p = 0.032) and high sensitivity C-reactive protein from 2.01 ± 2.36 to 1.64 ± 1.92 mg/l (p = 0.009), decrease of diastolic blood pressure (BP) from 83.06 ± 10.18 to 80.38 ± 8.98 mmHg (p = 0.015), mean BP from 100.03 ± 10.70 to 97.31 ± 8.88 mmHg (p = 0.027) and aortic stiffness, assessed as carotid-femoral pulse wave velocity, from 8.34 ± 1.26 to 7.91 ± 1.15 m/s (p = 0.034).
Conclusions: In subjects with MetS even short-duration (4-week) supervised aerobic exercise training is associated with improvement of some anthropometric, metabolic and hemodynamic parameters as well as the decrease in aortic stiffness. This training modality could be recommended for initiation of physical training and could increase motivation for further physical activity.
 Ford ES, Li C, Sattar N. Metabolic syndrome and incident diabetes: current state of the evidence. Diabetes Care 2008;31(9):1898–904.
 Malik S, Wong ND, Franklin SS, Kamath TV, L’Italien GJ, Pio JR, et al. Impact of the metabolic syndrome on mortality from coronary heart disease, cardiovascular disease, and all causes in United States adults. Circulation 2004;110(10):1245–50.
 Dunn AL, Marcus BH, Kampert JB, Garcia ME, Kohl HW 3rd, Blair SN. Reduction in cardiovascular disease risk factors: 6-month results from Project Active. Prev Med 1997;26(6):883–92.
 Lee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet 2012;380(9838):219–29.
 Laucevičius A, Rinkūnien ˙e E, Skujait ˙e A, Petrulionien ˙e Ž, Puronait ˙e R, Dženkevičiūt ˙e V, et al. Prevalence of cardiovascular risk factors in Lithuanian middle-aged subjects participating in the primary prevention program, analysis of the period 2009–2012. Blood Press 2015;24:41–7.
 Egidija Rinkūnien ˙e. The identification of patients at high-risk of cardiovascular disease and the optimization of methods of active primary prevention [in Lithuanian]. PhD thesis, Vilnius University, 2014.
 Vanhees L, Geladas N, Hansen D, Kouidi E, Niebauer J, Reiner Z, et al. Importance of characteristics and modalities of physical activity and exercise in the management of cardiovascular health in individuals with cardiovascular risk factors: recommendations from the EACPR. Part II. Eur J Prev Cardiol 2012;19(5):1005–33.
 Scuteri A, Najjar SS, Orru’ M, Usala G, Piras MG, Ferrucci L, et al. The central arterial burden of the metabolic syndrome is similar in men and women: the SardiNIA Study. Eur Heart J 2010;31(5): 602–13.
 Donley DA, Fournier SB, Reger BL, DeVallance E, Bonner DE, Olfert IM, et al. Aerobic exercise training reduces arterial stiffness in metabolic syndrome. J Appl Physiol (1985). 2014;116(11):1396–404.
 Mora-Rodriguez R, Ortega JF, Hamouti N, Fernandez-Elias VE, Cañete Garcia-Prieto J, Guadalupe-Grau A, et al. Time-course effects of aerobic interval training and de-training in patients with metabolic syndrome. Nutr Metab Cardiovasc Dis 2014;24(7):792–8.
 Landaeta-Díaz L, Fernández JM, Da Silva-Grigoletto M, Rosado-Alvarez D, Gómez-Garduño A, Gómez-Delgado F, et al. Mediterranean diet, moderate-to-high intensity training, and health-related quality of life in adults with metabolic syndrome. Eur J Prev Cardiol 2013;20(4):555–64.
 NCEP Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Final Report. Circulation 2002;106:3143–421.
 Fletcher GF, Ades PA, Kligfield P, Arena R, Balady GJ, Bittner VA, et al. Exercise standards for testing and training: a scientific statement from the American Heart Association. Circulation 2013;128(8):873–934.
 Tanaka H, Monahan KD, Seals DR. Age-predicted maximal heart rate revisited. J Am Coll Cardiol 2001;37(1):153–6.
 Laurent S, Cockcroft J, Van Bortel L, Boutouyrie P, Giannattasio C, Hayoz D, et al. Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J 2006;27(21):2588–605.
 Engelen L, Ferreira I, Stehouwer CD, Boutouyrie P, Laurent S. Reference intervals for common carotid intima-media thickness measured with echotracking: relation with risk factors. Eur Heart J 2013;34(30):2368–80.
 Aguilar M, Bhuket T, Torres S, Liu B, Wong RJ. Prevalence of the metabolic syndrome in the United States, 2003–2012. JAMA 2015;313(19)1973–4.
 Scuteri A, Laurent S, Cucca F, Cockcroft J, Cunha PG, Mañas LR, et al. Metabolic syndrome across Europe: different clusters of risk factors. Eur J Prev Cardiol 2015; 22(4): 486–491.
 Ekblom Ö, Ekblom-Bak E, Rosengren A, Hallsten M, Bergström G, Börjesson M. Cardiorespiratory fitness, sedentary behaviour and physical activity are independently associated with the metabolic syndrome, results from the SCAPIS pilot study. PLoS One 2015;10(6):e0131586.
 Greer AE, Sui X, Maslow AL, Greer BK, Blair SN. The effects of sedentary behavior on metabolic syndrome independent of physical activity and cardiorespiratory fitness. J Phys Act Health 2015;12(1):68–73.
 Edwardson CL, Gorely T, Davies MJ, Gray LJ, Khunti K, Wilmot EG, et al. Association of sedentary behaviour with metabolic syndrome: a meta-analysis. PLoS One 2012;7(4):e34916.
 Kim D, Yoon SJ, Lim DS, Gong YH, Ko S, Lee YH, et al. The preventive effects of lifestyle intervention on the occurrence of diabetes mellitus and acute myocardial infarction in metabolic syndrome. Public Health 2016;139:178–82.
 Huffman KM, Sun JL, Thomas L, Bales CW, Califf RM, Yates T, et al. Impact of baseline physical activity and diet behavior on metabolic syndrome in a pharmaceutical trial: results from NAVIGATOR. Metabolism 2014;63(4):554–61.
 Hansel B, Bonnefont-Rousselot D, Orsoni A, Bittar R, Giral P, Roussel R, et al. Lifestyle intervention enhances high-density lipoprotein function among patients with metabolic syndrome only at normal low-density lipoprotein cholesterol plasma levels. J Clin Lipidol 2016;10(5):1172–81.
 Katzmarzyk PT, Leon AS, Wilmore JH, Skinner JS, Rao DC, Rankinen T, et al. Targeting the metabolic syndrome with exercise: evidence from the HERITAGE Family Study. Med Sci Sports Exerc 2003;35(10):1703–9.
 Durstine JL, Grandjean PW, Cox CA, Thompson PD. Lipids, lipoproteins, and exercise. J Cardiopulm Rehabil 2002;22(6):385–98.
 Gordon B, Chen S, Durstine JL. The Effects of Exercise Training on the Traditional Lipid Profile and Beyond. Curr Sports Med Rep 2014;13(4):253–9.
 Ho SS, Dhaliwal SS, Hills AP, Pal S. The effect of 12 weeks of aerobic, resistance or combination exercise training on cardiovascular risk factors in the overweight and obese in a randomized trial. BMC Public Health 2012;12:704.
 Mann S, Beedie C, Jimenez A. Differential effects of aerobic exercise, resistance training and combined exercise modalities on cholesterol and the lipid profile: review, synthesis and recommendations. Sports Med 2014;44(2):211–21.
 Pattyn N, Cornelissen VA, Eshghi SR, Vanhees L. The effect of exercise on the cardiovascular risk factors constituting the metabolic syndrome. Sports Med 2013;43(2):121–33.
 Libby P, Ridker PM, Maseri A. Inflammation and atherosclerosis. Circulation 2002;105:1135–1143.
 Andersson J, Boman K, Jansson JH, Nilsson TK, Lindahl B. Effect of intensive lifestyle intervention on C-reactive protein in subjects with impaired glucose tolerance and obesity. Results from a randomized controlled trial with 5-year follow-up. Biomarkers 2008;13(7):671–9.
 Nilsson PM. Early vascular aging (EVA): consequences and prevention. Vasc Health Risk Manag 2008;4(3):547–552.
 Vlachopoulos C, Aznaouridis K, Stefanadis C. Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. J Am Coll Cardiol 2010;55(13):1318–27.
 Lorenz MW, Markus HS, Bots ML, Rosvall M, Sitzer M. Prediction of clinical cardiovascular events with carotid intima-media thickness: a systematic review and meta-analysis. Circulation 2007;115(4):459–67.
 Cameron JD, Dart AM. Exercise training increases total systemic arterial compliance in humans. Am J Physiol 1994;266:H693–701.
 Radhakrishnan J, Swaminathan N, Pereira NM, Henderson K, Brodie DA. Acute changes in arterial stiffness following exercise in people with metabolic syndrome. Diabetes Metab Syndr 2016;11:237–43.
 Ashor AW, Lara J, Siervo M, Celis-Morales C, Mathers JC. Effects of exercise modalities on arterial stiffness and wave reflection: a systematic review and meta-analysis of randomized controlled trials. PLoS One 2014;9(10):e110034.
 Cheng HG, Patel BS, Martin SS, Blaha M, Doneen A, Bale B, et. al. Effect of comprehensive cardiovascular disease risk management on longitudinal changes in carotid artery intima-media thickness in a community-based prevention clinic. Arch Med Sci 2016;12(4):728–35.
 Jhamnani S, Patel D, Heimlich L, King F, Walitt B, Lindsay J. Meta-analysis of the effects of lifestyle modifications on coronary and carotid atherosclerotic burden. Am J Cardiol 2015;115:268–75.