# Biochemical profiling to identify cardiometabolic responsiveness to an endurance exercise intervention

> **NIH NIH R01** · BETH ISRAEL DEACONESS MEDICAL CENTER · 2024 · $512,548

## Abstract

Project Summary/Abstract
Regular exercise improves numerous metabolic and cardiovascular health traits and prevents or delays the
development of cardiometabolic disease. Despite the pleiotropic health effects of exercise, there are
substantial inter-individual differences in the cardiometabolic responses to regular exercise, even to rigorously
standardized exercise programs. The ability to systematically interrogate metabolites and proteins that are
downstream of the genome makes plasma metabolomics and proteomics well-suited for investigating exercise-
induced cardiometabolic adaptations. Recently, our group leveraged a non-targeted metabolite profiling
method to identify dimethylguanidino valeric acid (DMGV) as a novel, early biomarker of cardiometabolic
disease. DMGV lies in a biochemical pathway catalyzed by the enzyme alanine-glyoxylate aminotransferase 2
(AGXT2) that features multiple bioactive substrates and products that are stimulated by exercise, regulate
exercise metabolism, or affect cardiovascular physiology. These findings motivated our recent investigation of
DMGV as a biomarker of metabolic responsiveness to exercise training (ET), in which we demonstrated that
individuals with higher baseline levels of DMGV are less responsive to improvements in lipid traits and insulin
sensitivity with ET. However, few data are available for other metabolites and proteins related to this novel
pathway in the context of exercise responsiveness.
The HEalth, RIsk factors, exercise Training And GEnetics (HERITAGE) Family Study provides an excellent
resource for a comprehensive study of DMGV and additional molecular correlates of the cardiometabolic
responses to aerobic ET. We hypothesize that bioactive AGXT2 pathway members will be associated with
exercise trait responsiveness (i.e. VO2max, insulin sensitivity, visceral fat, and HDL-cholesterol) based on
plausible biologic relationships. We further hypothesize that integrating large-scale metabolomics and
proteomics with these key phenotypes will identify additional plasma biomarkers that help determine which
individuals benefit most from regular exercise.
In Specific Aim 1, we will relate AGXT2 pathway participants to ET-induced outcomes of VO2max, insulin
sensitivity, visceral fat, and HDL-cholesterol. We will then extend our investigations to a full panel of ~800
known metabolites/lipids and ~5000 proteins to create comprehensive plasma biochemical/molecular
signatures of exercise responsiveness for each of the four clinical traits. We will validate top findings in the
NIH's Molecular Transducers of Physical Activity (MoTrPAC) Study of over 800 healthy adults assigned to an
endurance ET program. In Specific Aim 2, we will identify the genetic determinants of “exercise response”
metabolites and proteins. These genetic loci will then be interrogated in: 1) HERITAGE to test for their
relationship with exercise trait responses; and 2) large genetics meta-analyses for associations with
cardiometabolic...

## Key facts

- **NIH application ID:** 10757387
- **Project number:** 5R01NR019628-04
- **Recipient organization:** BETH ISRAEL DEACONESS MEDICAL CENTER
- **Principal Investigator:** ROBERT E GERSZTEN
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $512,548
- **Award type:** 5
- **Project period:** 2021-03-03 → 2025-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10757387

## Citation

> US National Institutes of Health, RePORTER application 10757387, Biochemical profiling to identify cardiometabolic responsiveness to an endurance exercise intervention (5R01NR019628-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10757387. Licensed CC0.

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