Specifically, exercise has been shown to cause hypomethylation of metabolic genes promoters such as peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α), mitochondrial transcription factor A (TFAM), peroxisome proliferator-activated receptor delta (PPARD), pyruvate dehydrogenase lipoamide kinase isozyme 4 (PDK4), citrate synthase, and myocyte enhancer factor 2A (MEF2A), many of which are hypermethylated in T2D patients [78]. This evidence concerns the gene PPARD and type 2 diabetes mellitus.