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Exercise, exerkines, and cardiometabolic health: from individual players to a team sport
Jeremy M. Robbins, Robert E. Gerszten
Jeremy M. Robbins, Robert E. Gerszten
Published June 1, 2023
Citation Information: J Clin Invest. 2023;133(11):e168121. https://doi.org/10.1172/JCI168121.
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Review Article has an altmetric score of 62

Exercise, exerkines, and cardiometabolic health: from individual players to a team sport

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Abstract

Exercise confers numerous salutary effects that extend beyond individual organ systems to provide systemic health benefits. Here, we discuss the role of exercise in cardiovascular health. We summarize major findings from human exercise studies in cardiometabolic disease. We next describe our current understanding of cardiac-specific substrate metabolism that occurs with acute exercise and in response to exercise training. We subsequently focus on exercise-stimulated circulating biochemicals (“exerkines”) as a paradigm for understanding the global health circuitry of exercise, and discuss important concepts in this emerging field before highlighting exerkines relevant in cardiovascular health and disease. Finally, this Review identifies gaps that remain in the field of exercise science and opportunities that exist to translate biologic insights into human health improvement.

Authors

Jeremy M. Robbins, Robert E. Gerszten

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Figure 1

Substrate metabolism and fuel sources according to exercise intensity and duration.

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Substrate metabolism and fuel sources according to exercise intensity an...
Exercise stimulates lipolysis and liberates free fatty acids (FFAs) that become fuel sources for the working skeletal muscle. Similarly, hepatic glycogenolysis and gluconeogenesis promote fuel substrates for the working muscle, and gluconeogenesis helps recycle metabolic end products of exercise (e.g., lactate, alanine, pyruvate). Skeletal muscle itself contains glycogen. Short and maximal-power activity is preferentially fueled by anaerobic metabolism phosphocreatine stores, which are quickly depleted, and subsequent glucose and glycogen stores, whereas sustained activity at lower intensities is primarily fueled by fatty acid oxidation.

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