***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Carotid intima-media thickness ( C-IMT ) is a reliable predictor of cardiovascular events . We Investigated the relationship between markers of glycemia and C-IMT in intermediate-risk cardiovascular patients . Methods This study analyzed 427 subjects , aged 35 to 74 years ( mean , 60.3 ± 8.5 years ) , 55 % women , enrolled into the MARK study . Including 231 subjects defined as normal glucose , 104 subjects classified as prediabetes and 92 with type 2 diabetes mellitus .  Carotid ultrasound was used to measure C-IMT and the presence of plaques .  Fasting plasma glucose ( mg/dl ) and glycated hemoglobin ( % ) ( HbA1c ) were measured using st and ard enzymatic automated methods . Postpr and ial glucose ( mg/dl ) was self-measured by patients at home 2 h after meals ( breakfast , lunch and dinner ) for 1 day . Results The C-IMT shows a positive correlation with fasting plasma glucose , postpr and ial glucose and HbA1c . Multiple linear regression analysis showed a positive association between HbA1c and C-IMT , with a 0.016 mm and 0.019 mm increase in mean and maximum C-IMT per 1 % increase in HbA1c . In addition , an association between fasting plasma glucose and C-IMT was found with an increase of 0.004 and 0.005 mm in mean and maximum C-IMT per 10 mg/dl in fasting plasma glucose . We also observed a grade d association between fasting plasma glucose , postpr and ial glucose and HbA1c and the presence of carotid target organ damage ( TOD ) , with an odds ratio of 1.013 , 1.010 and 1.425 , respectively . Conclusion The results of this study suggest that the fasting plasma glucose and HbA1c , but not postpr and ial glucose , are associated with C-IMT media and maximum . The patients who present with a metabolic glucose alteration have more risk of developing carotid TOD.Trial registration Clinical Trials.gov ; Identifier : NCT01428934 Recent guidelines on exercise for weight loss and weight maintenance include resistance training as part of the exercise prescription . Yet few studies have compared the effects of similar amounts of aerobic and resistance training on body mass and fat mass in overweight adults . STRRIDE AT/RT , a r and omized trial , compared aerobic training , resistance training , and a combination of the two to determine the optimal mode of exercise for obesity reduction . Participants were 119 sedentary , overweight or obese adults who were r and omized to one of three 8-mo exercise protocol s : 1 ) RT : resistance training , 2 ) AT : aerobic training , and 3 ) AT/RT : aerobic and resistance training ( combination of AT and RT ) . Primary outcomes included total body mass , fat mass , and lean body mass . The AT and AT/RT groups reduced total body mass and fat mass more than RT ( P < 0.05 ) , but they were not different from each other . RT and AT/RT increased lean body mass more than AT ( P < 0.05 ) . While requiring double the time commitment , a program of combined AT and RT did not result in significantly more fat mass or body mass reductions over AT alone . Balancing time commitments against health benefits , it appears that AT is the optimal mode of exercise for reducing fat mass and body mass , while a program including RT is needed for increasing lean mass in middle-aged , overweight/obese individuals Background — Exercise training reduces the symptoms of chronic heart failure . Which exercise intensity yields maximal beneficial adaptations is controversial . Furthermore , the incidence of chronic heart failure increases with advanced age ; it has been reported that 88 % and 49 % of patients with a first diagnosis of chronic heart failure are > 65 and > 80 years old , respectively . Despite this , most previous studies have excluded patients with an age > 70 years . Our objective was to compare training programs with moderate versus high exercise intensity with regard to variables associated with cardiovascular function and prognosis in patients with postinfa rct ion heart failure . Methods and Results — Twenty-seven patients with stable postinfa rct ion heart failure who were undergoing optimal medical treatment , including & bgr;-blockers and angiotensin-converting enzyme inhibitors ( aged 75.5±11.1 years ; left ventricular [ LV ] ejection fraction 29 % ; & OV0312;o2peak 13 mL · kg−1 · min−1 ) were r and omized to either moderate continuous training ( 70 % of highest measured heart rate , ie , peak heart rate ) or aerobic interval training ( 95 % of peak heart rate ) 3 times per week for 12 weeks or to a control group that received st and ard advice regarding physical activity . & OV0312;o2peak increased more with aerobic interval training than moderate continuous training ( 46 % versus 14 % , P<0.001 ) and was associated with reverse LV remodeling . LV end-diastolic and end-systolic volumes declined with aerobic interval training only , by 18 % and 25 % , respectively ; LV ejection fraction increased 35 % , and pro-brain natriuretic peptide decreased 40 % . Improvement in brachial artery flow-mediated dilation ( endothelial function ) was greater with aerobic interval training , and mitochondrial function in lateral vastus muscle increased with aerobic interval training only . The MacNew global score for quality of life in cardiovascular disease increased in both exercise groups . No changes occurred in the control group . Conclusions — Exercise intensity was an important factor for reversing LV remodeling and improving aerobic capacity , endothelial function , and quality of life in patients with postinfa rct ion heart failure . These findings may have important implication s for exercise training in rehabilitation programs and future studies BACKGROUND Although it is known that plasma leptin concentrations correlate with the amount of adipose tissue in the body , little information is available on the long-term effects on leptin concentrations of changes in diet and exercise . OBJECTIVE We wanted to examine whether changes in dietary energy sources and exercise-mediated energy expenditure , alone or in combination , affect plasma leptin concentrations . DESIGN In a r and omized , 2 x 2 factorial trial , 186 men with metabolic syndrome were divided into 4 groups : diet , exercise , a combination of diet and exercise , and control . Data on dietary intake , physical fitness , and demographics were collected and plasma leptin concentrations were measured before and after a 1-y intervention period . RESULTS Plasma leptin concentrations , body mass index , and fat mass decreased in association with long-term reductions in food intake as well as increased physical activity . By adjusting for either body mass index or fat mass , we observed a highly significant reduction in plasma leptin concentration after both the diet and the exercise interventions . There was no interaction between the interventions , suggesting a direct and additive effect of changes in diet and physical activity on plasma leptin concentrations . CONCLUSION Long-term changes in lifestyle consisting of decreased intake of dietary fat and increased physical activity reduced plasma leptin concentrations in humans beyond the reduction expected as a result of changes in fat mass Introduction : Several established tools are available to assess study quality and reporting of r and omized controlled trials ; however , these tools were design ed with clinical intervention trials in mind . In exercise training intervention trials some of the traditional study quality criteria , such as participant or research er blinding , are extremely difficult to implement . Methods : We developed the Tool for the assEssment of Study qualiTy and reporting in EXercise ( TESTEX ) – a study quality and reporting assessment tool , design ed specifically for use in exercise training studies . Our tool is a 15-point scale ( 5 points for study quality and 10 points for reporting ) and addresses previously unmentioned quality assessment criteria specific to exercise training studies . Results : There were no systematic differences between the summated TESTEX scores of each observer [ H(2 ) = 0.392 , P = 0.822 ] . There was a significant association between the summated TESTEX scores of the three observers , with almost perfect agreement between observers 1 and 2 [ intra-class correlation coefficient ( ICC ) = 0.93 , 95 % confidence interval ( CI ) 0.82–0.97 , P < 0.001 ] , observers 1 and 3 ( ICC = 0.96 , 95 % CI 0.89–0.98 , P < 0.001 ) and observers 2 and 3 ( ICC = 0.91 , 95 % CI 0.75–0.96 , P < 0.001 ) . Conclusions : The TESTEX scale is a new , reliable tool , specific to exercise scientists , that facilitates a comprehensive review of exercise training trials OBJECTIVES This study determined whether greater volumes of exercise were associated with greater reductions in clinical events . BACKGROUND The HF-ACTION ( Heart Failure : A Controlled Trial Investigating Outcomes of Exercise Training ) trial showed that among patients with heart failure ( HF ) , regular exercise confers a modest reduction in the adjusted risk for all-cause mortality or hospitalization . METHODS Patients r and omized to the exercise training arm of HF-ACTION who were event-free at 3 months after r and omization were included ( n = 959 ) . Median follow-up was 28.2 months . Clinical endpoints were all-cause mortality or hospitalization and cardiovascular mortality or HF hospitalization . RESULTS A reverse J-shaped association was observed between exercise volume and adjusted clinical risk . On the basis of Cox regression , exercise volume was not a significant linear predictor but was a logarithmic predictor ( p = 0.03 ) for all-cause mortality or hospitalization . For cardiovascular mortality or HF hospitalization , exercise volume was a significant ( p = 0.001 ) linear and logarithmic predictor . Moderate exercise volumes of 3 to < 5 metabolic equivalent (MET)-h and 5 to < 7 MET-h per week were associated with reductions in subsequent risk that exceeded 30 % . Exercise volume was positively associated with the change in peak oxygen uptake at 3 months ( r = 0.10 ; p = 0.005 ) . CONCLUSIONS In patients with chronic systolic HF , volume of exercise is associated with the risk for clinical events , with only moderate levels ( 3 to 7 MET-h per week ) of exercise needed to observe a clinical benefit . Although further study is warranted to confirm the relationship between volume of exercise completed and clinical events , our findings support the use of regular exercise in the management of these patients Objective : To identify the effects of a 1-year exercise intervention on myocardial dysfunction in patients with type 2 diabetes mellitus ( T2DM ) . Design : R and omised controlled trial , the Diabetes Lifestyle Intervention Study . Setting : University hospital . Patients : 223 T2DM patients without occult coronary artery disease , aged 18–75 were r and omised to an  exercise training group ( n = 111 ) or a usual care group ( n = 112 ) . Complete follow-up data were available in 176 ( 88 exercise , 88 usual care ) . Interventions : Exercise training consisted of gym , followed by telephone-monitored home-based exercise training . Main outcome measures : Tissue Doppler-derived myocardial velocities , strain-rate and strain , body composition , glycated haemoglobin ( HbA1c ) , maximum oxygen consumption ( VO2max ) and physical activity . Results : Overall changes in myocardial function were not different between groups despite improvements in waist circumference , fat mass , blood glucose , HbA1c , insulin sensitivity , VO2max and 6-minute walk distance in the intervention group ( p<0.05 ) . The latter also spent significantly more time in vigorous activity ( p<0.05 ) . A post-hoc analysis revealed that intervention patients who spent more time in both moderate and vigorous activity showed a significant improvement in myocardial tissue velocity ( p<0.01 ) , HbA1c ( p = 0.03 ) and VO2max ( p = 0.03 ) compared to controls . Myocardial strain rate ( p = 0.03 ) and HbA1c improved in intervention patients with the greatest increase in moderate activity ( p = 0.03 ) . Conclusions : In patients with T2DM , current exercise recommendations led to an improvement in metabolic function , but failed to improve myocardial function in the overall group . Patients with greater increases in both moderate and vigorous activity showed improvements in myocardial function , glycaemic control and cardiorespiratory fitness . Trial registration number : ACTRN12607000060448 
    Output:
    
We found no significant differences between outcome measures between the two exercise interventions .
Conclusions Exercise training  improves body composition , cardiovascular , and , metabolic outcomes in people with metabolic syndrome .
For some outcome measures , isolated aerobic exercise appears optimal