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Effects of Physical Exercise on Adiponectin, Leptin, and Inflammatory Markers in Childhood Obesity: Systematic Review and Meta-Analysis.

ABSTRACT: BACKGROUND:New findings on adipose tissue physiology and obesity-associated inflammation status suggest that modification of the adipokine level can be relevant for the long-term prevention of obesity-associated chronic disease. OBJECTIVES:The scope of the present study was to investigate the effectiveness of physical exercise in reducing the systemic inflammation related to obesity in children. METHODS:We conducted a systematic review with meta-analysis of controlled randomized trials, identified through electronic database search, which investigated the effect of physical exercise, without concomitant dietary intervention, on adiponectin, leptin, and/or other inflammatory markers in children up to age 18 years with a body mass index greater than the 95th percentile for age and sex. RESULTS:Seven trials were included in the meta-analysis, with a total of 250 participants. Compared with the control group without any lifestyle modification, the physical exercise resulted in a reduction in leptin [standardized mean difference (SMD) -1.13; 95% confidence interval (95%CI): -1.89 to -0.37; I2?=?79.9%] and interleukin-6 (SMD -0.84; 95%CI: -1.45 to -0.23, I2?=?0.9%) and an increase in adiponectin plasma concentration (SMD 0.69; 95%CI: 0.02-1.35; I2?=?74.3%). CONCLUSIONS:These results indicate that physical exercise improved the inflammatory state in children with obesity. It is unclear whether this effect can reduce the risk of cardiovascular and metabolic disease in adulthood. Clinical trials with a uniform intervention protocol and outcome measurements are required to put our knowledge on adipose tissue biology into a clinical perspective.

SUBMITTER: Sirico F

PROVIDER: S-EPMC5994661 | biostudies-literature | 2018 May/Jun

REPOSITORIES: biostudies-literature

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Effects of Physical Exercise on Adiponectin, Leptin, and Inflammatory Markers in Childhood Obesity: Systematic Review and Meta-Analysis.

Sirico Felice F Bianco Antonio A D'Alicandro Giovanni G Castaldo Clotilde C Montagnani Stefania S Spera Rocco R Di Meglio Franca F Nurzynska Daria D

Childhood obesity (Print) 20180515 4

<h4>Background</h4>New findings on adipose tissue physiology and obesity-associated inflammation status suggest that modification of the adipokine level can be relevant for the long-term prevention of obesity-associated chronic disease.<h4>Objectives</h4>The scope of the present study was to investigate the effectiveness of physical exercise in reducing the systemic inflammation related to obesity in children.<h4>Methods</h4>We conducted a systematic review with meta-analysis of controlled rando ...[more]

PMID: 29762052

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Project description:The effects of exercise training (Ex), dietary interventions (DIs), and a combination of Ex and DI (Ex + DI) on leptin and adiponectin have been established. However, less is known regarding the comparisons of Ex with DI and of Ex + DI with either Ex or DI alone. The aim of the present meta-analysis is to compare the effects of Ex with those of DI and those of Ex + DI with those of either Ex or DI alone on circulating leptin and adiponectin in individuals who are overweight and those with obesity. PubMed, Web of Science, and MEDLINE were searched to identify original articles, published through June 2022, that compared the effects of Ex with those of DI and/or the effects of Ex + DI with those of Ex and/or DI on leptin and adiponectin in individuals with BMIs (in kg/m2) of ≥25 and aged 7-70 y. Standardized mean differences (SMDs), weighted mean differences, and 95% CIs were calculated using random-effect models for outcomes. Forty-seven studies, comprising 3872 participants who were overweight and those with obesity, were included in the current meta-analysis. DI reduced the concentration of leptin (SMD: -0.30; P = 0.001) and increased the concentration of adiponectin (SMD: 0.23; P = 0.001) compared with Ex, as did Ex + DI (leptin: SMD: -0.34; P = 0.001; adiponectin: SMD: 0.37; P = 0.004) compared with Ex alone. However, Ex + DI did not affect the concentration of adiponectin (SMD: 0.10; P = 0.11) and led to inconsistent and nonsignificant changes in the concentration of leptin (SMD: -0.13; P = 0.06) compared with DI alone. Subgroup analyses showed that age, BMI, duration of intervention, type of supervision, quality of the study, and magnitude of energy restriction are sources of heterogeneity. Our results suggest that Ex alone was not as effective as DI or Ex + DI for decreasing leptin and increasing adiponectin in individuals with overweight and obesity. However, Ex + DI was not more effective than DI alone, suggesting that diet plays a critical role in beneficially altering the concentrations of leptin and adiponectin. This review was registered at PROSPERO as CRD42021283532.

Project description:ContextIntermittent fasting (IF) and exercise training (Exe) have been evaluated in several studies for improving cardiometabolic biomarkers related to weight loss. However, further investigation is required to understand the potential effects on leptin and adiponectin concentrations. IF protocols have been shown to be efficient in improving adipokines, but further research is required to determine whether or not IF regimens combined with Exe are superior to Exe alone.ObjectiveThe aim of this study was to determine whether or not interventions combining IF plus Exe are more effective than Exe only for improving serum leptin and adiponectin in adults with and without obesity.Data extractionA systematic review and meta-analysis was performed by searching PubMed, Scopus, and Web of Science databases up to August 2023 for randomized clinical trials that determined the effects of IF plus Exe vs. Exe alone (control) on body weight, serum leptin, and serum adiponectin. Analyses were conducted for IF plus Exe vs. Exe alone to calculate weighted mean differences (WMD) and standardized mean differences (SMD).AnalysisThe current meta-analysis included 6 studies with a total sample of 153 participants, with intervention durations ranging from three days to 52 weeks. IF plus Exe elicited significantly larger decreases in leptin levels [SMD = -0.47, p = 0.03], which were accompanied by weight loss [WMD = -1.25 kg, p = 0.05], as compared with exercise-only interventions, but adiponectin did not differ between the two [SMD = 0.02, p = 0.9].ConclusionIF combined with Exe reduced leptin significantly, but did not change adiponectin levels, when compared to exercise only. Perhaps these reductions in leptin levels may have been associated with weight loss; however, due to the small number of included studies and the high heterogeneity in the weight loss outcomes, this result is uncertain.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42023460735.

Project description:BackgroundExcess adiposity is characterized by alterations in adipokine secretion such that circulating leptin concentrations are increased with reductions in adiponectin. An emerging biomarker for the assessment of this adipose tissue (AT) dysfunction is the adiponectin:leptin (AL) ratio. A low AL ratio may be suggestive of dysfunctional AT and, consequently, a heightened cardiometabolic disease risk. This ancillary study investigated the relationship between the AL ratio and cardiometabolic health among community-dwelling older adults with obesity, as well as the effects of a 12-month exercise and diet intervention on changes in the AL ratio.MethodsParticipants (n = 163, 70.2 ± 4.7 years, 38.0% male) were randomized to the exercise only group, exercise + nutrient-dense weight maintenance group (exercise + weight maintenance), or exercise + nutrient-dense caloric restriction of 500 kcal/d group (exercise + intentional weight loss) (clinicaltrials.gov #NCT00955903). Total and regional adiposity as determined by magnetic resonance imaging (MRI) and dual-energy X-ray absorptiometry (DXA), anthropometrics, and cardiometabolic biomarkers were assessed at baseline and 12 months.ResultsThe AL ratio was significantly (p < 0.05) inversely correlated with body mass index, waist circumference, measures of adiposity, and insulin among all participants at baseline. Among females only, significant positive and inverse correlations were also observed between this ratio and high-density lipoprotein cholesterol and the inflammatory biomarkers high sensitivity C-reactive protein and interleukin-6, respectively. While controlling for biological sex, a significant time by intervention group interaction effect (p < 0.05) was observed such that the AL ratio significantly increased from baseline to study completion among participants in the exercise + weight maintenance group and exercise + intentional weight loss group. Post hoc analysis revealed that the exercise + intentional weight loss group exhibited a significantly greater AL ratio at study completion compared to other groups (p < 0.05 all).ConclusionsResults are in support of the AL ratio as a measure of AT dysfunction among older adults. Furthermore, results suggest that a 12-month exercise and diet intervention with intentional weight loss assists in improving the AL ratio in this population.

Project description:Background Individuals with normal weight could suffer from obesity based on their body fat percentage (also known as normal weight obesity (NWO)), thus being at risk of significant morbidity and mortality compared to the general population. It seems that inflammatory pathways and chronic inflammation are significant contributors to the pathogenicity of NWO. This study aimed to assess and pool the association of proinflammatory and anti-inflammatory cytokines with NWO. Methods In this systematic review and meta-analysis, online international databases (PubMed, Scopus, EMBASE, Web of Science, and Google Scholar) were searched until August 2022. All observational studies with an English full text comparing the mean levels of proinflammatory and anti-inflammatory cytokines (e.g., C-reactive protein (CRP), various types of interleukins (IL) s, tumor necrosis factor-alpha (TNF)) and white blood cell (WBC) count, in subjects with NWO and “normal weight non-obese (NWNO)” were included. Two researchers independently screened, reviewed and assessed the quality of included studies. The remaining articles’ data were extracted post-screening. The heterogeneity between studies was assessed using the I2 and Cochran’s Q tests. A random effect model meta-analysis was used to pool the standardized mean difference (SMD) as an effect size. Results From the initial 559 studies, 21 and 19 were included in the qualitative and quantitative synthesis, respectively. In the systematic review, 8 studies reported a significant association between various proinflammatory cytokines (CRP, IL6, IL1β, and TNFα) and NWO. According to random-effect meta-analysis, the association between NWO with CRP (SMD: 0.60, 95% CI: 0.30, 0.91) and IL6 (SMD: 0.90, 95%CI: 0.14, 1.66) was statistically significant. Moreover, the mean level of TNFα in subjects with NWO and NWNO did not differ significantly (SMD: 0.67, 95% CI: -0.36, 1.70). Conclusion The findings of this study show that NWO was associated with high levels of CRP and IL6. Therefore, inflammatory pathways may play a role in the pathogenicity of NWO.

Project description:Background/objectiveAdiponectin exerts beneficial effects by reducing inflammation and improving lipid metabolism and insulin sensitivity. Although the adiponectin level is lower in obese individuals, whether weight gain reduces adiponectin expression in humans is controversial. We sought to investigate the role of weight gain, and consequent changes in leptin, on altering adiponectin expression in humans.Methods/resultsForty-four normal-weight healthy subjects were recruited (mean age 29 years; 14 women) and randomized to either gain 5% of body weight by 8 weeks of overfeeding (n=34) or maintain weight (n=10). Modest weight gain of 3.8±1.2 kg resulted in increased adiponectin level (P=0.03), whereas weight maintenance resulted in no changes in adiponectin. Further, changes in adiponectin correlated positively with changes in leptin (P=0.0085). In-vitro experiments using differentiated human white preadipocytes showed that leptin increased adiponectin mRNA and protein expression, whereas a leptin antagonist had opposite effects. To understand the role of leptin in established obesity, we compared adipose tissue samples obtained from normal-weight versus obese subjects. We noted, first, that leptin activated cellular signaling pathways and increased adiponectin mRNA in the adipose tissue from normal-weight participants, but did not do so in the adipose tissue from obese participants. Second, we noted that obese subjects had increased caveolin-1 expression, which attenuates leptin-dependent increases in adiponectin.ConclusionsModest weight gain in healthy individuals is associated with increases in adiponectin levels, which correlate positively with changes in leptin. In vitro, leptin induces adiponectin expression, which is attenuated by increased caveolin-1 expression. In addition, the adipose tissue from obese subjects shows increased caveolin-1 expression and impaired leptin signaling. This leptin signal impairment may prevent concordant increases in adiponectin levels in obese subjects despite their high levels of leptin. Therefore, impaired leptin signaling may contribute to low adiponectin expression in obesity and may provide a target for increasing adiponectin expression, hence improving insulin sensitivity and cardio-metabolic profile in obesity.

Dataset Information

Effects of Physical Exercise on Adiponectin, Leptin, and Inflammatory Markers in Childhood Obesity: Systematic Review and Meta-Analysis.

Publications

Effects of Physical Exercise on Adiponectin, Leptin, and Inflammatory Markers in Childhood Obesity: Systematic Review and Meta-Analysis.

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