Circulation. 2002;105:804-809
Published online before print January 14, 2002, doi: 10.1161/hc0702.104279
Published online before print January 14, 2002, doi: 10.1161/hc0702.104279
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(Circulation. 2002;105:804.)
© 2002 American Heart Association, Inc.
Clinical Investigation and Reports |
Reduction of Inflammatory Cytokine Concentrations and Improvement of Endothelial Functions in Obese Women After Weight Loss Over One Year
From the Department of Geriatrics and Metabolic Diseases, Chair of Metabolic Diseases (P.Z., F.N., R.M., D.G.), Chair of Plastic Surgery (G.G., F.D.), and the Department of General Pathology, Chair of Clinical Pathology (K.E., M.C., A.M.M.), Second University of Naples, Italy.
Correspondence to Dario Giugliano, MD, Dept of Geriatrics and Metabolic Diseases, Policlinico della Seconda Università di Napoli, Piazza Miraglia, 80138 Napoli, Italy. E-mail dario.giugliano{at}unina2.it
Background— Visceral fat is a key regulator site for the process of inflammation, and atherosclerotic lesions are essentially an inflammatory response.
Methods and Results— Fifty-six healthy premenopausal obese women (age range 25 to 44 years, body mass index 37.2±2.2, waist to hip ratio range 0.78 to 0.92) and 40 age-matched normal weight women were studied. Compared with nonobese women, obese women had increased basal concentrations of tumor necrosis factor-
(TNF-, P<0.01), interleukin-6 (IL-6, P<0.01), P-selectin (P<0.01), intercellular adhesion molecule-1 (ICAM-1, P<0.02), and vascular adhesion molecule-1 (VCAM-1, P<0.05). Vascular responses to L-arginine (3 g IV), the natural precursor of nitric oxide, were impaired in obese women: reductions in mean blood pressure (P<0.02), platelet aggregation to adenosine diphosphate (P<0.05), and blood viscosity (P<0.05) were significantly lower as compared with those in the nonobese group. Concentrations of TNF- and IL-6 were related (P<0.01) to visceral obesity, as well as to adhesin levels and responses to L-arginine. After 1 year of a multidisciplinary program of weight reduction (diet, exercise, behavioral counseling), all obese women lost at least 10% of their original weight (9.8±1.5 kg, range 7.5 to 13 kg). Compared with baseline, sustained weight loss was associated with reduction of cytokine (P<0.01) and adhesin (P<0.02) concentrations and with improvement of vascular responses to L-arginine.
Conclusion— In obese women, endothelial activation correlates with visceral body fat, possibly through inappropriate secretion of cytokines. Weight loss represents a safe method for downregulating the inflammatory state and ameliorating endothelial dysfunction in obese women.
Key Words: obesity • weight loss • cell adhesion molecules • interleukins • endothelium
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