title: Changes induced by physical activity and weight loss in the morphology of intermyofibrillar mitochondria in obese men and women.
abstract: BACKGROUND
  In obesity, skeletal muscle insulin resistance may be associated with smaller mitochondria.
  
  
  OBJECTIVE
  Our objective was to examine the effect of a lifestyle-modification intervention on the content and morphology of skeletal muscle mitochondria and its relationship to insulin sensitivity in obese, insulin-resistant subjects.
  
  
  METHODS
  In this prospective interventional study, intermyofibrillar mitochondrial content and size were quantified by transmission electron microscopy with quantitative morphometric analysis of biopsy samples from vastus lateralis muscle. Systemic insulin sensitivity was measured with euglycemic hyperinsulinemic clamps.
  
  
  METHODS
  The study took place at a university-based clinical research center.
  
  
  METHODS
  Eleven sedentary, overweight/obese volunteers without diabetes participated in the study.
  
  
  METHODS
  Intervention included 16 wk of aerobic training with dietary restriction of 500-1000 kcal/d.
  
  
  METHODS
  We assessed changes in mitochondrial content and size and changes in insulin sensitivity.
  
  
  RESULTS
  The percentage of myofiber volume occupied by mitochondria significantly increased from 3.70 +/- 0.31 to 4.87 +/- 0.33% after intervention (P = 0.01). The mean individual increase was 42.5 +/- 18.1%. There was also a change in the mean cross-sectional mitochondrial area, increasing from a baseline of 0.078 +/- 0.007 to 0.091 +/- 0.007 microm(2) (P < 0.01), a mean increase of 19.2 +/- 6.1% per subject. These changes in mitochondrial size and content highly correlated with improvements in insulin resistance (r = 0.68 and 0.72, respectively; P = 0.01).
  
  
  CONCLUSIONS
  A combined intervention of weight loss and physical activity in previously sedentary obese adults is associated with enlargement of mitochondria and an increase in the mitochondrial content in skeletal muscle. These findings indicate that in obesity with insulin resistance, ultrastructural mitochondrial plasticity is substantially retained and, importantly, that changes in the morphology of mitochondria are associated with improvements in insulin resistance.
authors: Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh School of Medicine, 807N Montefiore Hospital, 3459 5th Avenue, Pittsburgh, PA 15213, USA. toledofs@upmc.edu
authors: Frederico G S
authors: FG
authors: Toledo
authors: Simon
authors: S
authors: Watkins
authors: David E
authors: DE
authors: Kelley