Abstract Background & Aims: Retinol-binding protein 4 (RBP4) as an adipokine is involved in regulating insulin function and glucose metabolism. Serum levels of RBP4 have been identified as one of the most effective factors in impaired glucose tolerance and diabetes. Studies have shown that exercise improves metabolic syndrome and hepatotoxicity. But the effects of Aqua training on liver Enzymes in diabetic patients are still unknown. Therefore, the aim of this study was to investigate the effect of Aqua training on RBP4, insulin resistance, and aspartate aminotransferase (AST) and alanine aminotransferase (ALT) enzymes in women with type 2 diabetes. Materials & Methods: Forty-four women with type 2 diabetes (57.83± 0.42 years) were selected through available sampling and divided into two groups of control and training. The training group performed the exercise in the water at 60-75% of maximum heart rate for 12 weeks (three sessions per week, 60 minutes each session). Data were analyzed with dependent and independent t-test at the significant level of p≤0.05. Results: The results show that 12 weeks of Aqua training significantly reduced RBP4, insulin resistance, and AST and ALT, and improved lipid profiles (p ≤0.05). Also, the result of Independent t-test showed that there is a significant difference between training groups with control in variables of RBP4, insulin resistance, liver enzymes and lipid profiles (p ≤0.05). Conclusion: Based on the results of the present study, the Aqua training decrease RBP4, that it is associated with improved insulin resistance. Also 12 weeks of Aqua training has an insulin-like effect on diabetic women with changes in liver and metabolic enzymes.
