All training sessions were carried out under the supervision of exercise specialists. Participants exercised for 60 minutes per session at Decitabine manufacturer 60%-65% of heart rate reserve, as estimated by the Karvonen formula.[11] Aerobic activities were performed on treadmill, cycle, or elliptical machines and participants were free to change the cardiovascular equipment used from one session to the next. Heart rate monitors were used to standardize exercise intensity. Participants performed nine different exercises involving the major muscle groups on weight machines (chest press, shoulder press, vertical traction, leg press, leg extension, leg curl, abdominal crunch) and free weight

(biceps, abdominal). After a learning phase, participants performed 3 series of 10 repetitions at 70%-80% 1-RM, with 1 minute of recovery between series. All participants met a single nutritionist for nutritional counseling at least 2 months before the study. Participants were encouraged to follow a healthy diet, according to standard recommendations for people with type 2 diabetes. Thereafter, participants were instructed to maintain

their baseline calorie intake by consuming self-selected Selleck Roxadustat foods. The same nutritionist met the participants of both groups on two occasions, just before and at the end of the intervention, to record and analyze their 3-day food recalls. Weight was recorded on an electronic scale (Tanita BWB-800, MA, USA), height was measured with a Harpenden stadiometer, and BMI was calculated as weight (kg)/height[2] (m). Total body fat mass was evaluated by dual-energy x-ray absorptiometry (DXA) using a total body scanner (QDR Explorer W, Hologic, Waltham, MA). HbA1c was measured

上海皓元医药股份有限公司 by a Diabetes Control Complications Trial (DCCT)-aligned method, with an automated high-performance liquid chromatography analyzer (Bio-Rad Diamat, Milan, Italy). Serum lipids and transaminase levels were determined by standard laboratory procedures (DAX 96; Bayer Diagnostics, Milan, Italy). Low-density lipoprotein (LDL)-cholesterol was calculated using the Friedewald equation.[12] MRI was used to measure the amount of fat at the level of the liver and abdomen. A single radiologist, who was blinded to participants’ clinical details, performed all MRI examinations by using a 1.5-T magnet (Magnetom Vision; Siemens Medical, Erlangen, Germany). Liver fat accumulation was measured by comparing the in- and out-of-phase images of tissues according to Dixon’s two-point method.[13-15] To obtain these data, patients were positioned supine using a phased array coil. Axial T1-weighted gradient echo images and in-phase and out-of-phase images were obtained from the upper abdomen and the thighs. Scan parameters were the following: TR/TE 160/2.l msec (out-of-phase) and 4.2 msec (in-phase), flip angle 80°, slice thickness 8 mm with 1 mm interslice gap. Image postprocessing was performed using a workstation (MV-1000; Siemens Medical).