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J Am Geriatr Soc. 2014 Apr;62(4):607-14. doi: 10.1111/jgs.12749. Epub 2014 Mar 17.

Aerobic exercise and weight loss reduce vascular markers of inflammation and improve insulin sensitivity in obese women.

Author information

1
Baltimore Veterans Affairs Medical Center and Research and Development Service, Veterans Affairs Maryland Health Care System, Baltimore, Maryland; Division of Gerontology and Geriatric Medicine, Department of Medicine, School of Medicine, University of Maryland, Baltimore, Maryland; Baltimore Geriatric Research, Education and Clinical Center, Baltimore, Maryland.

Abstract

OBJECTIVES:

To examine the relationships between plasma and tissue markers of systemic and vascular inflammation and obesity and insulin resistance and determine the effects of aerobic exercise training plus weight loss (AEX+WL) and weight loss (WL) alone on these biomarkers.

DESIGN:

Prospective controlled study.

SETTING:

Veterans Affairs Medical Center and University research setting.

PARTICIPANTS:

Overweight and obese sedentary postmenopausal women (N = 77).

INTERVENTIONS:

Six months, 3 d/wk AEX+WL (n = 37) or WL (n = 40).

MEASUREMENTS:

Total-body dual-energy X-ray absorptiometry, abdominal computed tomography, hyperinsulinemic-euglycemic clamps (a criterion standard method of assessing insulin sensitivity), adipose tissue biopsies (n = 28), and blood for homeostasis model assessment-insulin resistance, and soluble forms of intracellular adhesion molecule 1 (sICAM-1) and vascular cell adhesion molecule 1 (sVCAM-1), C-reactive protein (CRP), and serum amyloid A (SAA).

RESULTS:

Body weight (P < .001), percentage of fat (P < .001), visceral fat (P < .005), triglyceride levels (P < .001), and systolic blood pressure decreased comparably after WL and AEX+WL (P = .04). Maximal oxygen consumption increased 16% after AEX+WL (P < .001). Insulin resistance decreased in both groups (P = .005). Glucose utilization according to the clamp increased 10% (P = .04) with AEX+WL and 8% with WL (P = .07). AEX+WL decreased CRP by 29% (P < .001) and WL by 21% (P = .02). SAA levels decreased twice as much after AEX+WL (-19%, P = .02) as after WL (-9%, P = .08). Plasma sICAM-1 and sVCAM-1 levels did not change, but women with the greatest reduction in plasma sICAM-1 levels had the greatest reductions in fasting glucose (P = .02), insulin (P = .02), and insulin resistance (P = .004). Gluteal ICAM messenger ribonucleic acid levels decreased 27% after AEX+WL (P = .02) and did not change after WL.

CONCLUSION:

Obesity and insulin resistance worsen markers of systemic and vascular inflammation. A reduction in plasma sICAM-1 is important to improve insulin sensitivity. CRP, SAA, and tissue ICAM decrease with exercise and weight loss, suggesting that exercise training is a necessary component of lifestyle modification in obese postmenopausal women.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT00882141.

KEYWORDS:

diet; exercise; inflammation; insulin sensitivity

PMID:
24635342
PMCID:
PMC3989409
DOI:
10.1111/jgs.12749
[Indexed for MEDLINE]
Free PMC Article
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