title: Changes in tumor necrosis factor-alpha system and insulin sensitivity during an exercise training program in obese women with normal and impaired glucose tolerance.
abstract: OBJECTIVE
  Tumor necrosis factor-alpha (TNFalpha) plays an important role in the pathogenesis of insulin resistance and type 2 diabetes. Plasma levels of the soluble (s) fractions of TNFalpha receptors, especially sTNFR2, are good indicators of TNFalpha system activation in obesity. The aim of the present study was to assess the effect of exercise training on the TNFalpha system and to evaluate the relationship with changes in insulin sensitivity.
  
  
  METHODS
  Sixteen obese women (body mass index (BMI)>27.8 kg/m(2)), 8 with normal (NGT) and 8 with impaired glucose tolerance (IGT), participated in an exercise training program which lasted for 12 weeks and included exercise performed on a bicycle ergometer at an individual intensity of 70% maximal heart rate, for 30 min, 5 days a week. Anthropometrical measurements and blood biochemical analyses were performed, and plasma TNFalpha, sTNFR1 and sTNFR2 levels were assessed. Insulin sensitivity was evaluated using the hyperinsulinemic euglycemic clamp technique (insulin infusion: 50 mU x kg(-1)xh(-1)).
  
  
  RESULTS
  At baseline, despite similar anthropometrical parameters, IGT subjects were markedly more insulin resistant and had higher TNFalpha and sTNFR2 concentrations. Exercise training increased insulin sensitivity and decreased TNFalpha and sTNFR2 levels, while sTNFR1 remained unchanged. The decrease in sTNFR2 was significantly related to the increase in insulin sensitivity; that relationship remained significant after adjustment for the concurrent changes in BMI, waist circumference, percentage of body fat, plasma glucose, insulin and free fatty acids.
  
  
  CONCLUSIONS
  Regular physical exercise decreases TNFalpha system activity and that decrease may be responsible for the concurrent increase in insulin sensitivity.
authors.affiliation: Department of Endocrinology, Medical Academy, M.C. Sklodowskiej 24a, 15-276 Bialystok, Poland. mstraczkowski@poczta.onet.pl
authors.forename: M
authors.initials: M
authors.lastname: Straczkowski
authors.forename: I
authors.initials: I
authors.lastname: Kowalska
authors.forename: S
authors.initials: S
authors.lastname: Dzienis-Straczkowska
authors.forename: A
authors.initials: A
authors.lastname: Stepién
authors.forename: E
authors.initials: E
authors.lastname: Skibińska
authors.forename: M
authors.initials: M
authors.lastname: Szelachowska
authors.forename: I
authors.initials: I
authors.lastname: Kinalska
mesh_terms: D000328:Adult; D015703:Antigens, CD / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D001823:Body Composition; D001824:Body Constitution; D015992:Body Mass Index; D015444:Exercise / Q000502:physiology*; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005260:Female; D015309:Glucose Clamp Technique; D018149:Glucose Intolerance / Q000628:therapy*; D006442:Glycated Hemoglobin / Q000032:analysis; D006339:Heart Rate; D006801:Humans; D007328:Insulin / Q000097:blood / Q000494:pharmacology*; D007333:Insulin Resistance; D008875:Middle Aged; D009765:Obesity / Q000628:therapy*; D018124:Receptors, Tumor Necrosis Factor / Q000097:blood; D047889:Receptors, Tumor Necrosis Factor, Type II; D012995:Solubility; D014409:Tumor Necrosis Factor-alpha / Q000502:physiology*
chemical_list: D015703:Antigens, CD; D001786:Blood Glucose; D005230:Fatty Acids, Nonesterified; D006442:Glycated Hemoglobin; D007328:Insulin; D018124:Receptors, Tumor Necrosis Factor; D047889:Receptors, Tumor Necrosis Factor, Type II; D014409:Tumor Necrosis Factor-alpha