Exercise training favors increased insulin-stimulated glucose uptake in skeletal muscle in contrast to adipose tissue: a randomized study using FDG PET imaging

Am J Physiol Endocrinol Metab. 2013 Aug 15;305(4):E496-506. doi: 10.1152/ajpendo.00128.2013. Epub 2013 Jun 25.


Physical exercise increases peripheral insulin sensitivity, but regional differences are poorly elucidated in humans. We investigated the effect of aerobic exercise training on insulin-stimulated glucose uptake in five individual femoral muscle groups and four different adipose tissue regions, using dynamic (femoral region) and static (abdominal region) 2-deoxy-2-[¹⁸F]fluoro-d-glucose (FDG) PET/CT methodology during steady-state insulin infusion (40 mU·m⁻²·min⁻¹). Body composition was measured by dual X-ray absorptiometry and MRI. Sixty-one healthy, sedentary [V(O2max) 36(5) ml·kg⁻¹·min⁻¹; mean(SD)], moderately overweight [BMI 28.1(1.8) kg/m²], young [age: 30(6) yr] men were randomized to sedentary living (CON; n = 17 completers) or moderate (MOD; 300 kcal/day, n = 18) or high (HIGH; 600 kcal/day, n = 18) dose physical exercise for 11 wk. At baseline, insulin-stimulated glucose uptake was highest in femoral skeletal muscle followed by intraperitoneal visceral adipose tissue (VAT), retroperitoneal VAT, abdominal (anterior + posterior) subcutaneous adipose tissue (SAT), and femoral SAT (P < 0.0001 between tissues). Metabolic rate of glucose increased similarly (~30%) in the two exercise groups in femoral skeletal muscle (MOD 24[9, 39] μmol·kg⁻¹·min⁻¹, P = 0.004; HIGH 22[9, 35] μmol·kg⁻¹·min⁻¹, P = 0.003) (mean[95% CI]) and in five individual femoral muscle groups but not in femoral SAT. Standardized uptake value of FDG decreased ~24% in anterior abdominal SAT and ~20% in posterior abdominal SAT compared with CON but not in either intra- or retroperitoneal VAT. Total adipose tissue mass decreased in both exercise groups, and the decrease was distributed equally among subcutaneous and intra-abdominal depots. In conclusion, aerobic exercise training increases insulin-stimulated glucose uptake in skeletal muscle but not in adipose tissue, which demonstrates some interregional differences.

Keywords: metabolism; obesity; overweight.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adipose Tissue, White / diagnostic imaging
  • Adipose Tissue, White / drug effects
  • Adipose Tissue, White / metabolism*
  • Adiposity
  • Adult
  • Biological Transport / drug effects
  • Body Mass Index
  • Contrast Media / metabolism
  • Exercise*
  • Fluorodeoxyglucose F18 / metabolism
  • Glucose / metabolism*
  • Glucose Clamp Technique
  • Glucose Transporter Type 4 / biosynthesis
  • Glucose Transporter Type 4 / metabolism*
  • Humans
  • Hypoglycemic Agents / metabolism
  • Hypoglycemic Agents / pharmacology
  • Insulin / metabolism
  • Insulin / pharmacology
  • Insulin Resistance*
  • Longitudinal Studies
  • Male
  • Multimodal Imaging
  • Muscle, Skeletal / diagnostic imaging
  • Muscle, Skeletal / drug effects
  • Muscle, Skeletal / metabolism*
  • Overweight / metabolism
  • Overweight / therapy*
  • Positron-Emission Tomography
  • Tomography, X-Ray Computed
  • Up-Regulation
  • Young Adult


  • Contrast Media
  • Glucose Transporter Type 4
  • Hypoglycemic Agents
  • Insulin
  • SLC2A4 protein, human
  • Fluorodeoxyglucose F18
  • Glucose