“Mini Metabolomics” in the Context of Exercise in Subjects with Multimorbidity

Lifestyle-related diseases, such as overweight/obesity, diabetes mellitus type 2 (T2DM), cardiovascular disease, or osteoarthritis, are a major health burden in Western societies. Due to common risk factors, most patients suffer from multimorbidity, i.e. have been diagnosed with more than one of these diseases. Physical activity (PA) is known to have a positive effect on all of these diseases, however, little is known on the effects of PA on patients with multimorbidity. In particular, so far, there are no reliable biomarkers to predict and monitor the effects of PA-based lifestyle intervention programs on these subjects. Here, employing a “mini metabolomics” approach with dried blood spots, we analyzed concentrations of different metabolites in subjects with multimorbidity in the course of the lifestyle intervention program MultiPill-Exercise. We found increasing concentrations of all tested amino acids (AAs) and acylcarnitines (ACs) after 12 weeks (t1) and 24 weeks (t2) of the intervention. When correlating baseline (t0) metabolite concentrations with changes in physiological and clinical parameters, we observed strong associations of acylcarnitine levels and changes in metabolic and cardiovascular parameters. When analyzing metabolite acute reactions in response to exhaustive exercise (ergometer test), however, there were little overall changes. Nevertheless, there was a significant negative correlation between mobilization of medium-chain acylcarnitines (MC-ACs) at t2 and changes in peak power output (PPO) between t0 and t2. Taken together, these data suggest that AAs and ACs might be promising biomarkers to predict and monitor the effects of PA-based lifestyle intervention programs in subjects with multimorbidity.