Mixed circuit training as a non-pharmacological strategy to improve platelet function and oxidative balance in type 2 diabetes: role of purinergic signaling

Abstract This study investigates the impact of a 16-week mixed circuit training (MCT) program on purinergic signaling and oxidative stress markers in women with type 2 diabetes mellitus (T2DM), focusing on its potential to modulate platelet-related purinergic signaling and oxidative stress markers that are mechanistically linked to platelet activation. A total of 21 women with T2DM and 23 non-diabetic controls, all sedentary and middle-aged, underwent MCT twice weekly. Biochemical, hemodynamic, and oxidative stress parameters, along with platelet ectonucleotidase activity and extracellular ATP levels, were assessed pre- and post-intervention. MCT significantly decreased ectonucleotidase diphosphohydrolase (E-NTPDase) activity for ADP hydrolysis in platelets, along with a reduction in extracellular ATP levels, indicating a modulation of purinergic signaling. Additionally, exercise enhanced antioxidant defenses, increasing glutathione-S-transferase (GST) activity and vitamin C levels, while reducing myeloperoxidase (MPO) activity, a key pro-oxidant enzyme. These changes suggest a shift toward a biochemical profile that may be relevant to thromboinflammatory pathways; however, no direct measures of platelet aggregation were performed. Mixed circuit training emerges as a valuable non-pharmacological strategy for improving oxidative balance and modulating purinergic markers in women with T2DM, warranting future studies including functional platelet assays and clinical outcomes.