The relationships among fiber type, glucose transporter (GLUT-4) protein content, and glucose transport activity stimulated maximally with insulin and/or contractile activity were studied by use of the rat epitrochlearis (15% type I-20% type II2a-65% type IIb), soleus (84-16-0%), extensor digitorum longus (EDL, 3-57-40%), and flexor digitorum brevis (FDB, 7-92-1%) muscles. Insulin-stimulated 2-deoxy-D-glucose (2-DG) uptake was greatest in the soleus, followed (in order) by the FDB, EDL, and epitrochlearis. On the other hand, contractile activity induced the greatest increase in 2-DG uptake in the FDB, followed by the EDL, soleus, and epitrochlearis. The effects of insulin and contractile activity on 2-DG uptake were additive in all the muscle preparations, with the relative rates being FDB greater than soleus greater than EDL greater than epitrochlearis. Quantitation of the GLUT-4 protein content with the antiserum R820 showed the following pattern: FDB greater than soleus greater than EDL greater than epitrochlearis. Linear regression analysis showed that whereas a relatively low and nonsignificant correlation existed between GLUT-4 protein content and 2-DG uptake stimulated by insulin alone, significant correlations existed between GLUT-4 protein content and 2-DG uptake stimulated either by contractions alone (r = 0.950) or by insulin and contractions in combination (r = 0.992). These results suggest that the differences in maximally stimulated glucose transport activity among the three fiber types may be related to differences in their content of GLUT-4 protein.

The adaptive response of maximal aerobic power (VO2max) to endurance exercise training was compared in 53 men and 57 women, aged 60-71 yr. The subjects were healthy and had been sedentary for at least 2 yr. Pretraining VO2max was measured during graded treadmill walking on two occasions. These values were reproducible (24.4 +/- 4.7 vs. 24.4 +/- 4.6 (SD) ml.min-l.kg-1; r = 0.96). Subjects trained primarily by walking and running for 9-12 mo, averaging 3.9 +/- 0.6 days/wk and 45 +/- 5 min/day at 80 +/- 5% of maximal heart rate (HRmax). Average improvement in VO2max (ml.min-1.kg-1) was 24 +/- 12% (range 0-58%). Relative improvement was not significantly different in men and women (26 +/- 12 vs. 23 +/- 12%, ml.min-1.kg-1; 21 +/- 10 vs 19 +/- 10%, l/min). When subjects were divided into three groups by age (60-62, 63-66, 67-71 yr), there were no significant differences among the groups in the relative increase in VO2max (21% vs. 19% vs. 18%, 1/min). Correlation analysis also yielded a nonsignificant relationship between improvement and age (r = -0.13). To examine the effect of initial fitness level on the adaptive response to exercise, pretraining VO2max was correlated with the absolute improvement in VO2max. This relationship was not significant in either men (r = 0.04) or women (r = -0.23). In conclusion, in healthy people aged 60-71 yr, VO2max adapts to endurance exercise training to the same relative extent as in young people, and this adaptation is independent of gender, age, and initial level of fitness.

IntroductionWe examined the mechanisms of enhanced insulin sensitivity in 9 male healthy athletes (age, 25±1 yr; maximal aerobic power [V O2maxJ, 57.6±1.0 ml/kg per min) as compared with 10 sedentary control subjects (age, 28±2 yr; V02max, 44.1±2.3 ml/kg per min). In the athletes, whole body glucose disposal (240-min insulin clamp) was 32% (P < 0.01 ) and nonoxidative glucose disposal (indirect calorimetry) was 62% higher (P < 0.01 ) than in the controls. Muscle glycogen content increased by 39% in the athletes (P < 0.05) but did not change in the controls during insulin clamp. VO2max correlated with whole body (r = 0.60, P < 0.01) and nonoxidative glucose disposal (r = 0.64, P < 0.001). In the athletes forearm blood flow was 64% greater (P < 0.05) than in the controls, whereas their muscle capillary density was normal. Basal blood flow was related to VO2max (r = 0.63, P < 0.05) and glucose disposal during insulin infusion (r = 0.65, P < 0.05). The forearm glucose uptake in the athletes was increased by 3.3-fold (P < 0.01) in the basal state and by 73% (P < 0.05) during insulin infusion. Muscle glucose transport protein (GLUT4) concentration was 93% greater in the athletes than controls (P < 0.01 ) and it was related to VO2max (r = 0.61, P < 0.01 ) and to whole body glucose disposal (r = 0.60, P < 0.01). Muscle glycogen synthase activity was 33% greater in the athletes than in the controls (P < 0.05), and the basal glycogen synthase fractional activity was closely related to blood flow (r = 0.88, P < 0.001).In conclusion: (a) athletes are characterized by enhanced muscle blood flow and glucose uptake. (b) The cellular mechanisms of glucose uptake are increased GLUT4 protein content, glycogen synthase activity, and glucose storage as glycogen. (c) A close correlation between glycogen synthase fractional activity and blood flow suggests that they are causally related in promoting glucose disposal. (J.

Real-time prediction of glucose via the proposed NNM may provide a means of intelligent therapeutic guidance and direction.

Studies have shown that insulin resistance increases with age, independent of changes in total adiposity. However, there is growing evidence that the development of insulin resistance may be more closely related to abdominal adiposity. To evaluate the independent effects of aging and regional and total adiposity on insulin resistance, we performed hyperinsulinemic euglycemic clamps on 17 young (21-33 yr) and 67 older (60-72 yr) men and women. We assessed FFM and total and regional adiposity by hydrodensitometry and anthropometry. Insulin-stimulated GDRs at a plasma insulin concentration of approximately 450 pM averaged 45.6 +/- 3.3 mumol.kg FFM-1 x min-1 (mean +/- SE) in the young subjects, 45.6 +/- 10.0 mumol.kg FFM-1 x min-1 in 24 older subjects who were insulin sensitive, and 23.9 +/- 11.7 mumol.kg FFM-1 x min-1 in 43 older subjects who were insulin resistant. Few significant differences were apparent in skin-fold and circumference measurements between young and insulin-sensitive older subjects, but measurements at most central body sites were significantly larger in the insulin-resistant older subjects. Waist girth accounted for > 40% of the variance in insulin action, whereas age explained only 10-20% of the total variance and < 2% of the variance when the effects of waist circumference were statistically controlled. These results suggest that insulin resistance is more closely associated with abdominal adiposity than with age.