title: Effect of a multidisciplinary program of weight reduction on endothelial functions in obese women.
abstract: Obesity is associated with an increased risk of developing atherosclerosis and atherosclerotic lesions are essentially an inflammatory response. The aim of this study was to evaluate the effect of a medically supervised, multidisciplinary weight loss program on endothelial functions and circulating levels of proinflammatory cytokines in obese women. Twenty healthy pre-menopausal obese women and 20 age-matched normal weight women were studied. Endothelial functions were assessed by evaluating the response of blood pressure and platelet aggregation to an intravenous bolus of L-arginine (3 g), the natural precursor of nitric oxide. In obese women, the vascular and rheological responses to L-arginine were significantly lower (p < 0.05) at baseline, as compared with non-obese women, indicating endothelial dysfunction; on the contrary, basal concentrations of tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) were significantly higher (p < 0.01). After one year of a multidisciplinary program of weight reduction consisting of diet, exercise and liposuction surgery, all obese women lost at least 10% of their original weight (10.5 +/- 1.7 kg, range 7.9-13.9 kg). Compared with baseline, sustained weight loss was associated with reduction of cytokine (p < 0.01) concentrations and with improvement of vascular responses to L-arginine. In conclusion, a multidisciplinary approach aimed at inducing a sustained reduction of body weight in obese women is feasible and is associated with improvement of endothelial functions and reduction of circulating proinflammatory cytokine concentrations.
authors.affiliation: Chair of Plastic and Reconstructive Surgery, Second University of Naples, Naples, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Nicoletti
authors.forename: G
authors.initials: G
authors.lastname: Giugliano
authors.forename: A
authors.initials: A
authors.lastname: Pontillo
authors.forename: M
authors.initials: M
authors.lastname: Cioffi
authors.forename: F
authors.initials: F
authors.lastname: D'Andrea
authors.forename: D
authors.initials: D
authors.lastname: Giugliano
authors.forename: K
authors.initials: K
authors.lastname: Esposito
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003376:Counseling; D004730:Endothelium, Vascular / Q000503:physiopathology*; D015444:Exercise; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D015187:Lipectomy; D009747:Nutritional Physiological Phenomena; D009765:Obesity / Q000178:diet therapy / Q000503:physiopathology* / Q000628:therapy*; D010348:Patient Care Team; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis; D015431:Weight Loss
chemical_list: D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha