title: Improving Adiponectin Levels in Individuals With Diabetes and Obesity: Insights From Look AHEAD.
abstract: OBJECTIVE
  This study investigated whether fitness changes resulting from lifestyle interventions for weight loss may independently contribute to the improvement of low adiponectin levels in obese individuals with diabetes.
  
  
  METHODS
  Look AHEAD (Action for Health in Diabetes) randomized overweight/obese individuals with type 2 diabetes to intensive lifestyle intervention (ILI) for weight loss or to diabetes support and education (DSE). Total and high-molecular weight adiponectin (adiponectins), weight, and cardiorespiratory fitness (submaximal exercise stress test) were measured in 1,397 participants at baseline and at 1 year, when ILI was most intense. Regression analyses examined the associations of 1-year weight and fitness changes with change in adiponectins.
  
  
  RESULTS
  ILI resulted in greater improvements in weight, fitness, and adiponectins at 1 year compared with DSE (P < 0.0001). Weight loss and improved fitness were each associated with changes in adiponectins in men and women (P < 0.001 for all), after adjusting for baseline adiponectins, demographics, clinical variables, and treatment arm. Weight loss contributed an additional 4-5% to the variance of change in adiponectins than did increased fitness in men; in women, the contributions of improved fitness (1% greater) and of weight loss were similar. When weight and fitness changes were both accounted for, weight loss in men and increased fitness in women retained their strong associations (P < 0.0001) with adiponectin change.
  
  
  CONCLUSIONS
  Improvements in fitness and weight with ILI were favorably but distinctly associated with changes in adiponectin levels in overweight/obese men and women with diabetes. Future studies need to investigate whether sex-specific biological determinants contribute to the observed associations.
authors.affiliation: Department of Medicine, University of Texas Medical Branch at Galveston, Galveston, TX lmbelalc@utmb.edu.
authors.forename: L Maria
authors.initials: LM
authors.lastname: Belalcazar
authors.affiliation: Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, NC.
authors.forename: Wei
authors.initials: W
authors.lastname: Lang
authors.affiliation: Department of Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Haffner
authors.affiliation: College of Nursing & Health Innovation, Arizona State University, Phoenix, AZ.
authors.forename: Dawn C
authors.initials: DC
authors.lastname: Schwenke
authors.affiliation: Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Andrea
authors.initials: A
authors.lastname: Kriska
authors.affiliation: Department of Medicine, Baylor College of Medicine, Houston, TX.
authors.forename: Ashok
authors.initials: A
authors.lastname: Balasubramanyam
authors.affiliation: Department of Medicine, Baylor College of Medicine, Houston, TX.
authors.forename: Ron C
authors.initials: RC
authors.lastname: Hoogeveen
authors.affiliation: Department of Medicine, Columbia University, St. Luke's-Roosevelt Hospital, New York, NY.
authors.forename: F Xavier
authors.initials: FX
authors.lastname: Pi-Sunyer
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Vermont, Burlington, VT.
authors.forename: Russell P
authors.initials: RP
authors.lastname: Tracy
authors.affiliation: Department of Medicine, Baylor College of Medicine, Houston, TX Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart & Vascular Center, Houston, TX.
authors.forename: Christie M
authors.initials: CM
authors.lastname: Ballantyne
mesh_terms: D052242:Adiponectin / Q000378:metabolism*; D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000517:prevention & control; D003925:Diabetic Angiopathies / Q000097:blood* / Q000517:prevention & control; D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood; D050177:Overweight / Q000097:blood* / Q000517:prevention & control; D010809:Physical Fitness / Q000502:physiology; D040242:Risk Reduction Behavior; D015431:Weight Loss / Q000502:physiology*
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin