PMID- 12684358
OWN - NLM
STAT- MEDLINE
DCOM- 20030501
LR  - 20220408
IS  - 0098-7484 (Print)
IS  - 0098-7484 (Linking)
VI  - 289
IP  - 14
DP  - 2003 Apr 9
TI  - Effect of weight loss and lifestyle changes on vascular inflammatory markers in 
      obese women: a randomized trial.
PG  - 1799-804
AB  - CONTEXT: Obesity is an independent risk factor for cardiovascular disease, which 
      may be mediated by increased secretion of proinflammatory cytokines by adipose 
      tissue. OBJECTIVE: To determine the effect of a program of changes in lifestyle 
      designed to obtain a sustained reduction of body weight on markers of systemic 
      vascular inflammation and insulin resistance. DESIGN AND SETTING: Randomized 
      single-blind trial conducted from February 1999 to February 2002 at a university 
      hospital in Italy. PATIENTS: One hundred twenty premenopausal obese women (body 
      mass index > or =30) aged 20 to 46 years without diabetes, hypertension, or 
      hyperlipidemia. INTERVENTIONS: The 60 women randomly assigned to the intervention 
      group received detailed advice about how to achieve a reduction of weight of 10% 
      or more through a low-energy Mediterranean-style diet and increased physical 
      activity. The control group (n = 60) was given general information about healthy 
      food choices and exercise. MAIN OUTCOME MEASURES: Lipid and glucose intake; blood 
      pressure; homeostatic model assessment of insulin sensitivity; and circulating 
      levels of interleukin 6 (IL-6), interleukin 18 (IL-18), C-reactive protein (CRP), 
      and adiponectin. RESULTS: After 2 years, women in the intervention group consumed 
      more foods rich in complex carbohydrates (9% corrected difference; P<.001), 
      monounsaturated fat (2%; P =.009), and fiber (7 g/d; P<.001); had a lower ratio 
      of omega-6 to omega-3 fatty acids (-5; P<.001); and had lower energy (-310 
      kcal/d; P<.001), saturated fat (-3.5%; P =.007), and cholesterol intake (-92 
      mg/d; P<.001) than controls. Body mass index decreased more in the intervention 
      group than in controls (-4.2; P<.001), as did serum concentrations of IL-6 (-1.1 
      pg/mL; P =.009), IL-18 (-57 pg/mL; P =.02), and CRP (-1.6 mg/L; P =.008), while 
      adiponectin levels increased significantly (2.2 microg/mL; P =.01). In 
      multivariate analyses, changes in free fatty acids (P =.008), IL-6 (P =.02), and 
      adiponectin (P =.007) levels were independently associated with changes in 
      insulin sensitivity. CONCLUSION: In this study, a multidisciplinary program aimed 
      to reduce body weight in obese women through lifestyle changes was associated 
      with a reduction in markers of vascular inflammation and insulin resistance.
FAU - Esposito, Katherine
AU  - Esposito K
AD  - Center for Obesity Management, Department of Geriatrics and Metabolic Diseases, 
      Second University of Naples, Naples, Italy. katherine.esposito@unina2.it
FAU - Pontillo, Alessandro
AU  - Pontillo A
FAU - Di Palo, Carmen
AU  - Di Palo C
FAU - Giugliano, Giovanni
AU  - Giugliano G
FAU - Masella, Mariangela
AU  - Masella M
FAU - Marfella, Raffaele
AU  - Marfella R
FAU - Giugliano, Dario
AU  - Giugliano D
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - JAMA
JT  - JAMA
JID - 7501160
RN  - 0 (Adiponectin)
RN  - 0 (Biomarkers)
RN  - 0 (Intercellular Signaling Peptides and Proteins)
RN  - 0 (Interleukin-18)
RN  - 0 (Interleukin-6)
RN  - 0 (Proteins)
RN  - 9007-41-4 (C-Reactive Protein)
SB  - IM
MH  - Adiponectin
MH  - Adult
MH  - Biomarkers/blood
MH  - Body Mass Index
MH  - C-Reactive Protein/*metabolism
MH  - Cardiovascular Diseases
MH  - Diet, Reducing
MH  - Exercise
MH  - Female
MH  - Humans
MH  - Insulin Resistance
MH  - *Intercellular Signaling Peptides and Proteins
MH  - Interleukin-18/*blood
MH  - Interleukin-6/*blood
MH  - *Life Style
MH  - Obesity/*blood/*therapy
MH  - Premenopause
MH  - Proteins/*metabolism
MH  - Risk Factors
MH  - *Risk Reduction Behavior
MH  - Single-Blind Method
MH  - Weight Loss/*physiology
EDAT- 2003/04/10 05:00
MHDA- 2003/05/02 05:00
CRDT- 2003/04/10 05:00
PHST- 2003/04/10 05:00 [pubmed]
PHST- 2003/05/02 05:00 [medline]
PHST- 2003/04/10 05:00 [entrez]
AID - 289/14/1799 [pii]
AID - 10.1001/jama.289.14.1799 [doi]
PST - ppublish
SO  - JAMA. 2003 Apr 9;289(14):1799-804. doi: 10.1001/jama.289.14.1799.