title: Obesity, macrophage migration inhibitory factor, and weight loss.
abstract: OBJECTIVE
  Elevated macrophage migration inhibitory factor (MIF) has been implicated as a causal mechanism in a number of disease conditions including cardiovascular disease (CVD), diabetes, and cancer. Excess body fat is associated with an increased risk of numerous health conditions including CVD, diabetes, and cancer. To our knowledge, the association between MIF and obesity status and the effect of weight loss on serum MIF concentrations have not been reported. In this study, we examined the effects of participation in a behavior-based weight loss program on MIF concentrations in obese individuals.
  
  
  METHODS
  Study participants were 71 men and women enrolled in The Cooper Institute Weight Management Program. Participants were predominantly female (68%, n=48), middle-aged (46.5+/-9.8 y), and severely obese (BMI=43.0+/-8.6).
  
  
  METHODS
  Plasma MIF concentrations and other standard risk factors were measured before and after participation in a diet and physical activity based weight management program.
  
  
  RESULTS
  The mean follow-up was 8.5+/-3.0 months with an average weight loss of 14.4 kg (P<0.001). The majority of clinical risk factors significantly improved at follow-up. Median levels of plasma MIF concentration were significantly lower at follow-up (median [IQR]; 5.1[3.6-10.3]) compared to baseline (8.4 [4.3-48.8]; P=0.0005). The percentage of participants with plasma MIF concentration > or =19.5 mg/nl (highest tertile at baseline) decreased from 33.8 to 5.6% (P<0.001). Further, elevated baseline plasma MIF concentration was associated with markers of beta-cell dysfunction and reductions in MIF were associated with improvements in beta-cell function.
  
  
  CONCLUSIONS
  Circulating MIF concentrations are elevated in obese but otherwise healthy individuals; however, this elevation in MIF is not uniform across individuals. In obese individuals with elevated circulating MIF concentrations, participation in physical activity and a dietary-focused weight management program resulted in substantial reduction in MIF.
authors.affiliation: The Cooper Institute, 12330 Preston Road, Dallas, TX 75230, USA. tschurch@cooperinst.org
authors.forename: T S
authors.initials: TS
authors.lastname: Church
authors.forename: M S
authors.initials: MS
authors.lastname: Willis
authors.forename: E L
authors.initials: EL
authors.lastname: Priest
authors.forename: M J
authors.initials: MJ
authors.lastname: Lamonte
authors.forename: C P
authors.initials: CP
authors.lastname: Earnest
authors.forename: W J
authors.initials: WJ
authors.lastname: Wilkinson
authors.forename: D A
authors.initials: DA
authors.lastname: Wilson
authors.forename: B P
authors.initials: BP
authors.lastname: Giroir
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D016009:Chi-Square Distribution; D004038:Diet, Reducing; D015914:Estrogen Replacement Therapy; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007328:Insulin / Q000097:blood; D016014:Linear Models; D008263:Macrophage Migration-Inhibitory Factors / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood* / Q000628:therapy*; D012307:Risk Factors; D015431:Weight Loss
chemical_list: D001786:Blood Glucose; D007328:Insulin; D008263:Macrophage Migration-Inhibitory Factors