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Obesity significantly alters the pharmacokinetic processes of drug absorption and distribution, presenting unique challenges in medical treatment. The increased fat tissue and decreased lean muscle in obese individuals can significantly affect how drugs are absorbed into the body and distributed across different tissues. This alteration can lead to variances in the effectiveness and safety of medications, necessitating adjustments in dosing or drug selection for obese patients.One notable...
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Drug metabolism, a critical process in the liver, involves two primary phases: Phase I reactions and Phase II conjugation. Obesity introduces significant alterations in this metabolic process, primarily due to fatty infiltration of the liver, leading to conditions such as nonalcoholic fatty liver disease (NAFLD). This condition can modify the activities of both Phase I and II enzymes, impacting how drugs are metabolized in obese patients.Phase I metabolism sees variable effects across...
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Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
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Lifestyle-induced decrease in fat mass improves adiponectin secretion in obese adults.

Karen R Kelly1, Sankar D Navaneethan, Thomas P J Solomon

  • 11Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH; 2Department of Nutrition, Case Western Reserve University, School of Medicine, Cleveland, OH; 3Department of Nephrology and Hypertension, Cleveland Clinic, Cleveland, OH; 4Department of Physiology, Case Western Reserve University, School of Medicine, Cleveland, OH; and 5Metabolic Translational Research Center, Cleveland Clinic, Cleveland, OH.

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Aerobic exercise combined with low- or high-glycemic diets improved adipokine levels and reduced body fat in older obese adults. Exercise training, regardless of diet, favorably altered leptin and high molecular weight adiponectin.

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Area of Science:

  • Endocrinology
  • Metabolic Health
  • Exercise Physiology

Background:

  • Adipokines like leptin and adiponectin play crucial roles in metabolic regulation.
  • Weight loss interventions often impact adipokine profiles, but the combined effects of exercise and diet glycemic index are less understood.
  • Understanding these interactions is vital for managing obesity and related metabolic disorders in older adults.

Purpose of the Study:

  • To investigate the combined effects of 12 weeks of aerobic exercise with either a low-glycemic index (LoGIX) or high-glycemic index (HiGIX) diet on plasma leptin and adiponectin (total and high molecular weight [HMW]) levels.
  • To assess changes in body composition, including total, subcutaneous, and visceral abdominal adiposity.
  • To examine the relationship between adipokine levels and body fat distribution.

Main Methods:

  • A 12-week intervention involving aerobic exercise combined with either a LoGIX or HiGIX diet in 27 older obese adults.
  • Measurement of plasma leptin and HMW adiponectin before and after the intervention.
  • Assessment of body composition using dual-energy x-ray absorptiometry and computerized tomography.
  • Calculation of insulin sensitivity via an oral glucose tolerance test.

Main Results:

  • Significant reductions in fasting leptin and significant increases in HMW adiponectin were observed in both the LoGIX and HiGIX groups post-intervention.
  • Total body fat was reduced in both intervention groups.
  • Visceral fat mass showed an inverse correlation with HMW adiponectin, while subcutaneous fat correlated with leptin.

Conclusions:

  • Aerobic exercise training favorably alters leptin and HMW adiponectin secretion, independent of the dietary glycemic index.
  • Reduction in visceral fat mass is a key factor influencing HMW adiponectin levels in older obese individuals.
  • These findings highlight the importance of exercise in conjunction with diet for improving metabolic markers in this population.