title: Aerobic exercise and weight loss reduce vascular markers of inflammation and improve insulin sensitivity in obese women.
abstract: OBJECTIVE
  To examine the relationships between plasma and tissue markers of systemic and vascular inflammation and obesity and insulin resistance and determine the effects of aerobic exercise training plus weight loss (AEX+WL) and weight loss (WL) alone on these biomarkers.
  
  
  METHODS
  Prospective controlled study.
  
  
  METHODS
  Veterans Affairs Medical Center and University research setting.
  
  
  METHODS
  Overweight and obese sedentary postmenopausal women (N = 77).
  
  
  METHODS
  Six months, 3 d/wk AEX+WL (n = 37) or WL (n = 40).
  
  
  METHODS
  Total-body dual-energy X-ray absorptiometry, abdominal computed tomography, hyperinsulinemic-euglycemic clamps (a criterion standard method of assessing insulin sensitivity), adipose tissue biopsies (n = 28), and blood for homeostasis model assessment-insulin resistance, and soluble forms of intracellular adhesion molecule 1 (sICAM-1) and vascular cell adhesion molecule 1 (sVCAM-1), C-reactive protein (CRP), and serum amyloid A (SAA).
  
  
  RESULTS
  Body weight (P < .001), percentage of fat (P < .001), visceral fat (P < .005), triglyceride levels (P < .001), and systolic blood pressure decreased comparably after WL and AEX+WL (P = .04). Maximal oxygen consumption increased 16% after AEX+WL (P < .001). Insulin resistance decreased in both groups (P = .005). Glucose utilization according to the clamp increased 10% (P = .04) with AEX+WL and 8% with WL (P = .07). AEX+WL decreased CRP by 29% (P < .001) and WL by 21% (P = .02). SAA levels decreased twice as much after AEX+WL (-19%, P = .02) as after WL (-9%, P = .08). Plasma sICAM-1 and sVCAM-1 levels did not change, but women with the greatest reduction in plasma sICAM-1 levels had the greatest reductions in fasting glucose (P = .02), insulin (P = .02), and insulin resistance (P = .004). Gluteal ICAM messenger ribonucleic acid levels decreased 27% after AEX+WL (P = .02) and did not change after WL.
  
  
  CONCLUSIONS
  Obesity and insulin resistance worsen markers of systemic and vascular inflammation. A reduction in plasma sICAM-1 is important to improve insulin sensitivity. CRP, SAA, and tissue ICAM decrease with exercise and weight loss, suggesting that exercise training is a necessary component of lifestyle modification in obese postmenopausal women.
authors.affiliation: Baltimore Veterans Affairs Medical Center and Research and Development Service, Veterans Affairs Maryland Health Care System, Baltimore, Maryland; Division of Gerontology and Geriatric Medicine, Department of Medicine, School of Medicine, University of Maryland, Baltimore, Maryland; Baltimore Geriatric Research, Education and Clinical Center, Baltimore, Maryland.
authors.forename: Alice S
authors.initials: AS
authors.lastname: Ryan
authors.forename: Shealinna
authors.initials: S
authors.lastname: Ge
authors.forename: Jacob B
authors.initials: JB
authors.lastname: Blumenthal
authors.forename: Monica C
authors.initials: MC
authors.lastname: Serra
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Prior
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Goldberg
mesh_terms: D015502:Absorptiometry, Photon; D000273:Adipose Tissue / Q000378:metabolism; D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000378:metabolism* / Q000503:physiopathology; D007333:Insulin Resistance / Q000502:physiology*; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D008875:Middle Aged; D009765:Obesity / Q000378:metabolism / Q000503:physiopathology / Q000534:rehabilitation*; D017698:Postmenopause; D011379:Prognosis; D011446:Prospective Studies; D000685:Serum Amyloid A Protein / Q000378:metabolism; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood; D015431:Weight Loss / Q000502:physiology*
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D000685:Serum Amyloid A Protein; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1; D002097:C-Reactive Protein
keywords: diet; exercise; inflammation; insulin sensitivity