Background: Recently, it was argued that low grade inflammation in the medio-basal hypothalamus may drive many diseases, and hypothalamic neuro-inflammation leads to T2DM in ways that
are independent of weight. Inflammatory cytokines, leptin and adiponectin, are reported to be crucial for linking the hypothalamus to T2DM. Although it was suggested that a decrease of leptin
concentrations and an increase of adiponectin are essential in the treating “metabolic syndrome”, but meta-analyses about exercise effects on them often report heterogeneities. Interestingly, the
hypothalamus is known to be sensitive to environmental enrichment, and the hypothesis presents itself that exercise may be more effective in T2DM whenever it contains more elements of environmental
enrichment (EE), such as social support, learning and exercise. However, this hypothesis was never tested yet. We herein reported an EE-like exercise program on postmenopausal women by observing
insulin sensitivity changes and its relationships with the changes of circulation leptin and adiponectin.
Methods: Chinese postmenopausal women with type 2 diabetes engaged in a 24 week program of 3-4 hours per week aerobic exercise plus resistance training (N = 15), versus no extra
physical activity (N = 12). Obesity-related variables were measured, as were lipids, leptin, adiponectin, insulin, and glucose. HOMA insulin resistance was calculated. To enhance compliance, we opted
for a relatively simple design. Subjects were all classmates in a senior people school. They underwent an exercise program with their familiar music and learning dance mainly in aerobic manner in a
gymnasium. Instructors also encouraged them to organize groups for competitions. The protocol took 24 weeks. In the first four weeks, there were three exercise sessions per week, thereafter four. For
each session, beside aerobic exercise, 15min resistance training also performed by using Thera-band. The control group was asked to maintain their current level of physical activity throughout the
Results: In the experimental group, participants attended 94% of all sessions. Time and Group interactions in the Repeated Measures ANOVAs suggested that the exercise program had been
effective. Majority of variables of the exercise group were improved, but not for WHR and three of the lipids (triglycerides, total cholesterol, and LDL-C). Obesity decreased, Compared to controls, we
found a significant effect of Time in HOMA IR, Group in Lipids in the exercise subjects. Leptin in the experimental group decreased, but with a p-value of 0.026, not enough to reach significance when
the Bonferoni correction was used. Adiponectin level increased after exercise training. Moreover, changes of the two cytokines were the best predictor of the increase of insulin sensitivity.
Conclusions: It is concluded that exercise led to an improvement of insulin sensitivity with decrease of leptin, and an increase of adiponectin. Orchestration of metabolic homeostasis
by the hypothalamus may be of considerable importance, since the hypothalamus is sensitive to environmental enrichment. Thus, exercise, containing of more elements of EE.