Jee Aee Im

Improved Insulin Sensitivity and Adiponectin Level after Exercise Training in Obese Korean Youth

Objective: The objective of this study was to investigate the association among adiposity, insulin resistance, and inflammatory markers [high‐sensitivity C‐reactive protein (hs‐CRP), interleukin (IL)‐6, and tumor necrosis factor (TNF)‐α] and adiponectin and to study the effects of exercise training on adiposity, insulin resistance, and inflammatory markers among obese male Korean adolescents.

Effects of a 6-month lifestyle modification intervention on the cardiometabolic risk factors and health-related qualities of life in women with metabolic syndrome

Although therapeutic lifestyle modification (TLM) has been recommended as a cornerstone treatment of metabolic syndrome (MetS), little is known about the biobehavioral effects of a TLM program for patients in a community. The purpose of this study was to examine the effects of a 6-month TLM program on MetS risk factors and health-related qualities of life (HRQOL) among middle-aged and older women in a community in Korea. Fifty-two women (mean age, 62.7 +/- 9.0 years) with MetS were recruited from 3 community health centers and were randomly assigned to the intervention (n = 31) or control (n = 21) groups. The patients in the intervention group participated in supervised TLM sessions for 6 months. The TLM program included health monitoring, counseling, health education, exercise, and dieting. Metabolic risk factors and HRQOL were measured at baseline, during the study (month 3), at completion (month 6), and post completion (month 12) of the TLM program. Compared with the control group, the TLM group showed significantly greater reductions in body weight (P < .001) and waist circumference (P < .001); these effects were sustained for 6 months after intervention. With regard to HRQOL, the TLM group showed greater improvements in physical function (P = .017), general health (P < .001), vitality (P = .008), and mental health (P = .027). These improvements, however, were not sustained after the intervention. The results indicate that a nurse-led systematic TLM program may be an effective strategy for managing middle-aged and older women with MetS at a community level.

Reduced serum vaspin concentrations in obese children following short-term intensive lifestyle modification

BACKGROUNDnRecently, visceral adipose tissue-derived serpin (vaspin) was identified as a potential insulin sensitizing adipokine, however, the factors determining the levels of circulating vaspin levels have not been fully understood. We investigated the association between adiposity, insulin resistance, lipid profiles and inflammatory markers including vaspin levels, and the effects of short-term intensive lifestyle modification on circulating vaspin levels in overweight or obese children.nnnMETHODSnA total of 50 (25 boys, 25 girls) overweight or obese children aged 11 to 13 years (average age: 12.0+/-0.9 y, BMI: 25.35+/-86 kg/m(2)) who complied with inclusion criteria participated in our study. To determine the association between adiposity, insulin resistance, lipid profiles and inflammatory markers including vaspin levels, cross-sectional analyses were performed. Thereafter, subjects underwent a tightly controlled seven-day intensive lifestyle modification including physical activity, dietary modification, and behavioral modification education in residence of a local university dormitory.nnnRESULTSnThere was a negative correlation between vaspin concentration and fasting insulin (r=-.325, p<0.05) and homeostasis model assessment of insulin resistance (HOMA-IR) (r=-.331, p<0.05) when percent body fat was controlled. Multivariate linear regression analysis found serum vaspin level to be an independent predictor of insulin and HOMA-IR. Short-term intensive lifestyle modification significantly decreased vaspin levels by 39.28% (pre: .84+/-1.0, post: .51+/-1.0 ng/ml, p<0.001) while adiponectin levels increased by 11.2% (pre: 6.50+/-2.89, post: 7.28+/-2.98 ng/ml, p<0.01). In addition, short-term lifestyle modification significantly improved HOMA-IR (pre: 3.58+/-1.93, post 1.30+/-1.9, p<0.001) and lipid profiles.nnnCONCLUSIONSnSerum vaspin level is one of the predictors for insulin resistance and was significantly reduced following short-term lifestyle modification.

The association between chemerin and homeostasis assessment of insulin resistance at baseline and after weight reduction via lifestyle modifications in young obese adults

BACKGROUNDnChemerin is a recently discovered adipocytokine, associated with adiposity and insulin sensitivity. The current study investigated the effects of lifestyle intervention on circulating chemerin level and its association with insulin resistance and adiponectin in human.nnnMETHODSnForty male and 20 female obese adults (mean age: 29.7±5.7 y, mean BMI: 29.3±4.5 kg/m(2)) completed an 8-week lifestyle intervention program, which consisted of a home-based diet and exercise program. Anthropometric measurements and biomarkers were assessed at the baseline and at the end of the study.nnnRESULTSnEight weeks of lifestyle intervention reduced body weight, visceral fat and subcutaneous fat by 3.8%, 15.3% and 11.5%, respectively. The lifestyle intervention further reduced fasting insulin (10.9±6.6 vs. 7.6±5.3 μU/ml, p<0.001) and homeostasis assessment of insulin resistance (HOMA-IR) (2.3±1.5 vs. 1.6±1.2, p<0.001), chemerin (103.3±20.7 vs. 96.5±19.5 ng/ml, p<0.001) and hs-CRP levels (1.3±1.8 vs. 0.2±0.2 mg/dl, p<0.001) while it increased fasting pentraxin (PTX) 3 (0.6±0.7 vs. 0.7±0.4 ng/ml, p=0.049) level. The Δ chemerin levels correlated with Δ insulin (r=0.349, p=0.024) and HOMA-IR (r=0.333, p=0.36) even after adjusting for age and gender.nnnCONCLUSIONnThe lifestyle intervention reduced circulating chemerin levels independent of visceral fat mass and adiponectin. Chemerin levels are associated with insulin resistance at the baseline and after the lifestyle intervention.

The association between pentraxin 3 and insulin resistance in obese children at baseline and after physical activity intervention.

BACKGROUNDnThe role of pentraxin-3 (PTX3) in the development of insulin resistance is still not clear. We aimed to test 1) whether circulating PTX3 levels are associated with insulin resistance and 2) whether changes in PTX3 levels after the physical activity are associated with changes in insulin resistance.nnnMETHODSnFifty-seven overweight or obese children (39 boys, 18 girls; age: 12.04±0.82y, BMI: 26.5±1.2 kg/m²) participated in the study. All participants were housed together and their amount of physical activity (1823.5±1.34 kcal/day) and food intake (1882±68.8 kcal/day) were tightly controlled.nnnRESULTSnCirculating PTX3 levels at baseline were negatively associated with fasting insulin (r=-.336, p=0.012) and homeostasis model assessment of insulin resistance (HOMA-IR) (r=-.334, p=0.014) even after adjustment for BMI and Tanner stage. The degree of change in PTX3 levels notably associated with changes in fasting insulin (r=-.280, p=0.035) and HOMA-IR (r=-.281, p=.034) in response to the physical activity intervention. Subgroup analysis further indicates that HOMA-IR was improved more in subjects whose PTX3 levels were increased compared with subjects who PTX3 levels were decreased (HOMA-IR delta: -2.33±1.3 vs -1.46±0.70, p=0.004).nnnCONCLUSIONnPTX3 is negatively associated with insulin resistance and associated with changes in insulin resistance induced by physical activity in overweight and obese children.

Therapeutic Lifestyle Modification Program Reduces Plasma Levels of the Chemokines CRP and MCP-1 in Subjects With Metabolic Syndrome

Objective: The purpose of this study was to examine the effects of a 6-month therapeutic lifestyle modification (TLM) program on chemokines related to oxidative stress, inflammation, endothelial dysfunction, and arterial stiffness in subjects with metabolic syndrome (MetS). Methods: The authors performed a randomized controlled trial, assigning 52 women (mean age 62.7 ± 9.0 years) with MetS to a TLM intervention group (n = 31) or a control group (n = 21). The authors provided the TLM intervention group with health screening, exercise, low-calorie diet, and health education and counseling for 6 months and instructed the control group to maintain their usual lifestyle behaviors. Outcome variables included levels of myeloperoxidase (MPO), oxidized low-density lipoprotein (LDL), adiponectin, leptin, resistin, high-sensitivity C-reactive protein (hs-CRP), interleukin-1β, interleukin-6, tumor necrosis factor-alpha (TNF-α), CD40L, monocyte chemotactic protein-1 (MCP-1), retinol-binding protein 4 (RBP-4), endothelin-1, and brachial-ankle pulse wave velocity. The authors used generalized estimating equation (GEE) analyses to estimate the effects of the TLM program. Results: After the 6-month TLM program, hs-CRP levels decreased significantly, and MCP-1 levels increased at a significantly slower rate in the TLM group than they did in the control group (all p < .05). Conclusion: These results indicate that a TLM program could be effective for improving patient inflammatory states and may also be effective in preventing cardiovascular complications in subjects with MetS.

Association between cardiorespiratory fitness and the prevalence of metabolic syndrome among Korean adults: a cross sectional study

BackgroundThe purpose of the current study was to investigate the association between cardiorespiratory fitness (CRF), measured by a simple step test, and the prevalence of metabolic syndrome among Korean adults, in a cross sectional design.MethodsA total of 1,007 Korean adults (488 men and 519 women) who underwent routine health checkups were recruited. CRF was measured by Tecumseh step test. The National Cholesterol Education Program’s Adult Treatment Panel III guideline was used to determine the prevalence of metabolic syndrome. A logistic regression was performed to reveal possible associations.ResultsThe results of the study showed that a lower level of CRF was significantly associated with a higher prevalence of metabolic syndrome in men, but not in women. On the other hand, higher BMI was associated with a higher prevalence of metabolic syndrome in both men and women. However, BMI was not associated with fasting glucose nor hemoglobinA1c in men. When the combined impact of BMI and CRF on the prevalence of metabolic syndrome was analyzed, a significantly increased prevalence of metabolic syndrome was found in both men (odds ratio [OR]: 18.8, 95% Confidence Interval [CI]: 5.0 - 70.5) and women (OR: 8.1, 95% CI: 2.8 - 23.9) who had high BMI and low cardiorespiratory fitness. On the other hand, the prevalence of metabolic syndrome was only increased 7.9 times (95% CI: 2.0 - 31.2) in men and 5.4 times (95% CI: 1.9 - 15.9) in women who had high level of CRF and high BMI.ConclusionIn conclusion, the current study demonstrated the low CRF and obesity was a predictor for metabolic syndrome in Korean adults.

High-sensitivity C-reactive protein is independently associated with arterial stiffness in women with metabolic syndrome.

Background:Metabolic syndrome (MetS) is associated with higher incidences of cardiovascular events and with increased mortality from coronary heart disease. There is increasing evidence that MetS presents as a proinflammatory and prothrombotic state. Objectives:The purposes of this study were to investigate the relationships among adiponectin (a marker for adipocytokines), high-sensitivity C-reactive protein (hs-CRP, a marker for inflammation), and brachial-ankle pulse-wave velocity (ba-PWV, a marker for arterial stiffness) in MetS and to identify predictors of ba-PWV, which indicates subclinical atherosclerosis. Methods:The present study is a cross-sectional, secondary analysis of data collected as part of a longitudinal, randomized controlled trial that tested the effectiveness of a therapeutic lifestyle modification for Korean women with MetS (N = 52). We used the definition for MetS suggested by the National Cholesterol Education Program Adult Treatment Panel III. Results:Adiponectin was negatively correlated with hs-CRP (r = −0.316, P = .027) and ba-PWV (r = −0.284, P = .048), and hs-CRP was positively correlated with ba-PWV (r = 0.341, P = .016). Women with high hs-CRP and low adiponectin levels also had greater ba-PWV levels (P = .041). Levels of hs-CRP were independently associated with ba-PWV after adjusting for age, body mass index, and number of MetS components, whereas no independent association was identified for adiponectin. Conclusion:Levels of hs-CRP may provide important prognostic information in terms of future cardiovascular risk in women with MetS.

Effects of a Therapeutic Lifestyle Modification Program on Inflammatory Chemokines and Insulin Resistance in Subjects With Metabolic Syndrome

Background. Although therapeutic lifestyle modification (TLM) effectively improves the values of diagnostic biomarkers of metabolic syndrome, less is known about its effects on inflammatory chemokines and insulin resistance (IR) in patients with this syndrome. Objectives. To examine the effects of a short-term TLM program on inflammatory chemokines (monocyte chemoattractant protein-1 [MCP-1], retinol binding protein-4 [RBP-4]) and IR in subjects with metabolic syndrome. Method. Twenty-nine women (aged 66.5 ± 9.5 years) with metabolic syndrome were randomly assigned to the TLM intervention group (n = 16) or control group (n = 13). The TLM intervention group was provided with 4 weeks of health screening, education, exercise, diet, and counseling. Participants in the control group were instructed to maintain their usual lifestyle behavior. Outcome variables measured included MCP-1, RBP-4, fasting glucose, fasting insulin, and homeostasis model assessment (HOMA). An intention-to-treat strategy was not followed, and the final number of subjects in the analysis was 22 (14 in the TLM group and 8 in the control group). Results. After a 4-week TLM program, MCP-1, fasting insulin, and HOMA were significantly decreased in the TLM group compared to those in the control group (all p < .05). Conclusions. We conclude that a short-term TLM program could be effective for improving inflammatory state and IR, which are significant preceding biomarkers for cardiovascular complications in subjects with metabolic syndrome.

Relationship between non-alcoholic fatty liver disease, metabolic syndrome and insulin resistance in Korean adults: A cross-sectional study.

BACKGROUNDnWe investigated the independent and combined impact of obesity and nonalcoholic fatty liver disease (NAFLD) on components and prevalence of metabolic syndrome in Korean adults.nnnMETHODSnThis study included 1695 adults (500 males and 1,195 females), who took part in a regular health check-up at the community-based health promotion center. Participants were divided according to degree of adiposity and the presence of NAFLD. The components and prevalence of metabolic syndrome were compared.nnnRESULTSnFasting glucose was significantly higher in nonobese participants with NAFLD compared to obese participants without NAFLD. Logistic regression analysis revealed that the presence of NAFLD was associated with 3.63 times increased prevalence of metabolic syndrome (95% CI: 1.21-10.86) while obesity without NAFLD was associated with 3.84 times increased prevalence of metabolic syndrome (95% CI: 1.57-9.36) in male. In female, the presence of NAFLD was associated with 5.56 times higher prevalence of metabolic syndrome (95% CI: 2.53-12.23) while obesity without NAFLD had 3.46 times increased prevalence of metabolic syndrome (95% CI: 1.64-7.33).nnnCONCLUSIONSnNAFLD is associated with the prevalence of metabolic syndrome, independent of adiposity. In females, NAFLD may be a more important factor than obesity for risk of metabolic syndrome.