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This study investigated the effect of concurrent training (CT) sequences on fibroblast growth factor 21 (FGF21), irisin, myostatin (MSTN), and follistatin (FST) among adults with type 2 diabetes mellitus (T2DM). Fifty-one diabetic men were randomly selected and assigned to concurrent aerobic-resistance (A-R) training and concurrent resistance-aerobic (R-A) training, and non-exercise control (CON) groups. The training protocols consisted of three sessions per week for 12 weeks. The A-R and R-A groups received the same CT protocols and performed with different sequences. The subjects’ blood samples were obtained at baseline and 48 hours after the last session of the intervention. The results showed that the concentration of FGF21 did not change significantly after the 12 weeks of CT with different sequences ( p  &gt; .05,  η2  = 0.123), but the serum concentration of irisin (A-R = 2.93 μg.L –1  (95% CI = 1.45–4.42,  d  = −0.57) and R-A = 3.31 μg.L –1  (95% CI = 1.13–5.49,  d  = −0.68)) and FST (A-R = 4.96 ng.mL –1  (95% CI = 3.41–6.5,  d  = −0.39) and R-A = 4.19 ng.mL –1  (95% CI = 2.82–5.56,  d  = –0.55)) significantly increased while the serum MSTN concentration (A-R = 152.32 ng.L –1  (95% CI = 61.83–242.82,  d  = 1.31) and R-A = 173 ng.L –1  (95% CI = 35.89–227.5,  d  = 0.83)) of both A-R and R-A groups mainly decreased ( p  &lt; .01). There was no significant difference between A-R and R-A groups’ irisin, FST, and MSTN concentration ( p  &gt; .05), though the CT improved the body compositions, strength, and peak oxygen uptake in both groups ( p  &lt; .01). Regardless of the CT sequences, it was found that CT acted as a therapeutic modality of training for T2DM patients by increasing their irisin and FST and decreasing their MSTN concentrations.

archives of physiology and biochemistry

The effect of two concurrent exercise modalities on serum concentrations of FGF21, irisin, follistatin, and myostatin in men with type 2 diabetes mellitus