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Obesity and inflammation: the effects of weight loss

  • L. Kirsty Forsythe (a1), Julie M. W. Wallace (a1) and M. Barbara E. Livingstone (a1)
Abstract

Following the discovery of TNF-α and leptin as secretory products of adipocytes in the early 1990s, subsequent obesity research focused on the new functional role of adipose tissue, as an active endocrine organ. Many more inflammatory peptides have been linked to adiposity, which ultimately characterised obesity as a state of low-grade systemic inflammation, or ‘metaflammation’ which may link obesity to its co-morbidities. The aim of the present review is to examine the effects of weight loss on inflammation in overweight and obese, but otherwise healthy, populations. Studies were broadly classified into four types (diet, physical activity, diet and physical activity combined, and surgical interventions) and discussed according to the method used to induce weight loss. All studies measured at least one obesity-related inflammatory marker (ORIM). The overall finding from the present review is that weight loss does improve inflammation in terms of both the inflammatory (C-reactive protein, TNF-α, IL-6 and leptin) and anti-inflammatory (adiponectin) ORIM. Within this, the greatest improvements in ORIM are observed in studies achieving a weight loss of at least 10 %. However, a number of methodological issues have been identified as potential limitations within the literature including the sex and age of subjects, sample size, study duration and the assessment of body composition. In conclusion, although a period of weight loss per se is capable of reversing the unfavourable inflammatory profile evident in the obese state, further studies are required to determine the time needed, in which a reduced weight is maintained, in order to benefit from improved inflammatory status long term.

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Corresponding author
*Corresponding author: Professor Barbara Livingstone, fax +44 28 7032 3059, email mbe.livingstone@ulster.ac.uk
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This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

3J Wardle & D Boniface (2008) Changes in the distributions of body mass index and waist circumference in English adults, 1993/1994 to 2002/2003. Int J Obes (Lond) 32, 527532.

5GS Hotamisligil , NS Shargill & BM Spiegelman (1993) Adipose expression of tumor necrosis factor-α: direct role in obesity-linked insulin resistance. Science 259, 8791.

8Y Zhang , R Proenca , M Maffei , . (1994) Positional cloning of the mouse obese gene and its human homologue. Nature 372, 425432.

12PE Scherer , S Williams , M Fogliano , . (1995) A novel serum protein similar to C1q, produced exclusively in adipocytes. J Biol Chem 270, 2674626749.

13JS Yudkin , CD Stehouwer , JJ Emeis , . (1999) C-reactive protein in healthy subjects: associations with obesity, insulin resistance, and endothelial dysfunction: a potential role for cytokines originating from adipose tissue? Arterioscler Thromb Vasc Biol 19, 972978.

16UN Das (2001) Is obesity an inflammatory condition? Nutrition 17, 953966.

17G Engstrom , B Hedblad , L Stavenow , . (2003) Inflammation-sensitive plasma proteins are associated with future weight gain. Diabetes 52, 20972101.

18G Fantuzzi (2005) Adipose tissue, adipokines, and inflammation. J Allergy Clin Immunol 115, 911919.

19G Hotamisligil (2006) Inflammation and metabolic disorders. Nature 444, 860867.

20RS Ahima & JS Flier (2000) Adipose tissue as an endocrine organ. Trends Endocrinol Metab 11, 327332.

21A Festa , R D'Agostino Jr, K Williams , . (2001) The relation of body fat mass and distribution to markers of chronic inflammation. Int J Obes Relat Metab Disord 25, 14071415.

22DR Cottam , SG Mattar , E Barinas-Mitchell , . (2004) The chronic inflammatory hypothesis for the morbidity associated with morbid obesity: implications and effects of weight loss. Obes Surg 14, 589600.

23KE Wellen & GS Hotamisligil (2005) Inflammation, stress, and diabetes. J Clin Invest 115, 11111119.

25LO Ohlson , B Larsson , K Svardsudd , . (1985) The influence of body fat distribution on the incidence of diabetes mellitus. 13·5 years of follow-up of the participants in the study of men born in 1913. Diabetes 34, 10551058.

27KM Rexrode , VJ Carey , CH Hennekens , . (1998) Abdominal adiposity and coronary heart disease in women. JAMA 280, 18431848.

28I Janssen , PT Katzmarzyk & R Ross (2002) Body mass index, waist circumference, and health risk: evidence in support of current National Institutes Of Health guidelines. Arch Intern Med 162, 20742079.

29FE von Eyben , E Mouritsen , J Holm , . (2003) Intra-abdominal obesity and metabolic risk factors: a study of young adults. Int J Obes Relat Metab Disord 27, 941949.

30MB Snijder , RM van Dam , M Visser , . (2006) What aspects of body fat are particularly hazardous and how do we measure them? Int J Epidemiol 35, 8392.

31JN Fain (2006) Release of interleukins and other inflammatory cytokines by human adipose tissue is enhanced in obesity and primarily due to the nonfat cells. Vitam Horm 74, 443477.

32J Hirsch & B Batchelor (1976) Adipose tissue cellularity in human obesity. Clin Endocrinol Metab 5, 299311.

33K Powell (2007) Obesity: the two faces of fat. Nature 447, 525527.

34S de Ferranti & D Mozaffarian (2008) The perfect storm: obesity, adipocyte dysfunction, and metabolic consequences. Clin Chem 54, 945955.

35KL Spalding , E Arner , PO Westermark , . (2008) Dynamics of fat cell turnover in humans. Nature 453, 783787.

37SP Weisberg , D McCann , M Desai , . (2003) Obesity is associated with macrophage accumulation in adipose tissue. J Clin Invest 112, 17961808.

38H Xu , GT Barnes , Q Yang , . (2003) Chronic inflammation in fat plays a crucial role in the development of obesity-related insulin resistance. J Clin Invest 112, 18211830.

39JN Fain , AK Madan , ML Hiler , . (2004) Comparison of the release of adipokines by adipose tissue, adipose tissue matrix, and adipocytes from visceral and subcutaneous abdominal adipose tissues of obese humans. Endocrinology 145, 22732282.

40SS Bassuk , N Rifai & PM Ridker (2004) High-sensitivity C-reactive protein: clinical importance. Curr Probl Cardiol 29, 439493.

41CJ Lyon , RE Law & WA Hsueh (2003) Minireview: adiposity, inflammation, and atherogenesis. Endocrinology 144, 21952200.

42AR Nawrocki & PE Scherer (2004) The delicate balance between fat and muscle: adipokines in metabolic disease and musculoskeletal inflammation. Curr Opin Pharmacol 4, 281289.

44M Dietrich & I Jialal (2005) The effect of weight loss on a stable biomarker of inflammation, C-reactive protein. Nutr Rev 63, 2228.

45S Devaraj , S Kasim-Karakas & I Jialal (2006) The effect of weight loss and dietary fatty acids on inflammation. Curr Atheroscler Rep 8, 477486.

46E Selvin , NP Paynter & TP Erlinger (2007) The effect of weight loss on C-reactive protein: a systematic review. Arch Intern Med 167, 3139.

47T You , DM Berman , AS Ryan , . (2004) Effects of hypocaloric diet and exercise training on inflammation and adipocyte lipolysis in obese postmenopausal women. J Clin Endocrinol Metab 89, 17391746.

49G Davì , MT Guagnano , G Ciabattoni , . (2002) Platelet activation in obese women: role of inflammation and oxidant stress. JAMA 288, 20082014.

50T McLaughlin , F Abbasi , C Lamendola , . (2002) Differentiation between obesity and insulin resistance in the association with C-reactive protein. Circulation 106, 29082912.

51M Bougoulia , A Triantos & G Koliakos (2006) Effect of weight loss with or without orlistat treatment on adipocytokines, inflammation, and oxidative markers in obese women. Hormones (Athens) 5, 259269.

52LK Heilbronn , M Noakes & PM Clifton (2001) Energy restriction and weight loss on very-low-fat diets reduce C-reactive protein concentrations in obese, healthy women. Arterioscler Thromb Vasc Biol 21, 968970.

53SM Hannum , L Carson , EM Evans , . (2004) Use of portion-controlled entrees enhances weight loss in women. Obes Res 12, 538546.

54RV Considine , MK Sinha , ML Heiman , . (1996) Serum immunoreactive-leptin concentrations in normal-weight and obese humans. N Eng J Med 334, 292295.

55JM Bruun , C Verdich , S Toubro , . (2003) Association between measures of insulin sensitivity and circulating levels of interleukin-8, interleukin-6 and tumor necrosis factor-α. Effect of weight loss in obese men. Eur J Endocrinol 148, 535542.

56A Tchernof , A Nolan , CK Sites , . (2002) Weight loss reduces C-reactive protein levels in obese postmenopausal women. Circulation 105, 564569.

57K Clément , N Viguerie , C Poitou , . (2004) Weight loss regulates inflammation-related genes in white adipose tissue of obese subjects. FASEB J 18, 16571669.

58JP Bastard , C Jardel , E Bruckert , . (2000) Elevated levels of interleukin 6 are reduced in serum and subcutaneous adipose tissue of obese women after weight loss. J Clin Endocrinol Metab 85, 33383342.

59M Raitakari , T Ilvonen , M Ahotupa , . (2004) Weight reduction with very-low-caloric diet and endothelial function in overweight adults: role of plasma glucose. Arterioscler Thromb Vasc Biol 24, 124128.

61HK Brekke , RA Lenner , MR Taskinen , . (2005) Lifestyle modification improves risk factors in type 2 diabetes relatives. Diabetes Res Clin Pract 68, 1828.

63KD O'Brien , BJ Brehm , RJ Seeley , . (2005) Diet-induced weight loss is associated with decreases in plasma serum amyloid a and C-reactive protein independent of dietary macronutrient composition in obese subjects. J Clin Endocrinol Metab 90, 22442249.

64RJ Wood , JS Volek , SR Davis , . (2006) Effects of a carbohydrate-restricted diet on emerging plasma markers for cardiovascular disease. Nutr Metab 3, 19.

65N Viguerie , H Vidal , P Arner , . (2005) Adipose tissue gene expression in obese subjects during low-fat and high-fat hypocaloric diets. Diabetologia 48, 123131.

66E Arvidsson , N Viguerie , I Andersson , . (2004) Effects of different hypocaloric diets on protein secretion from adipose tissue of obese women. Diabetes 53, 19661971.

68MA Pereira , J Swain , AB Goldfine , . (2004) Effects of a low-glycemic load diet on resting energy expenditure and heart disease risk factors during weight loss. JAMA 292, 24822490.

69TP Olson , DR Dengel , AS Leon , . (2007) Changes in inflammatory biomarkers following one-year of moderate resistance training in overweight women. Int J Obes (Lond) 31, 9961003.

70S Tsukui , T Kanda , M Nara , . (2000) Moderate-intensity regular exercise decreases serum tumor necrosis factor-α and HbA1c levels in healthy women. Int J Obes Relat Metab Disord 24, 12071211.

71M Strączkowski , I Kowalska , S Dzienis-Straczkowska , . (2001) Changes in tumor necrosis factor-α system and insulin sensitivity during an exercise training program in obese women with normal and impaired glucose tolerance. Eur J Endocrinol 145, 273280.

72K Okita , H Nishijima , T Murakami , . (2004) Can exercise training with weight loss lower serum C-reactive protein levels? Arterioscler Thromb Vasc Biol 24, 18681873.

74GR Hunter , NM Byrne , B Sirikul , . (2008) Resistance training conserves fat-free mass and resting energy expenditure following weight loss. Obesity 16, 10451051.

75K Itoh , K Imai , T Masuda , . (2002) Relationship between changes in serum leptin levels and blood pressure after weight loss. Hypertens Res 25, 881886.

76WH Sheu , T Chang , W Lee , . (2008) Effect of weight loss on proinflammatory state of mononuclear cells in obese women. Obesity 16, 10331038.

77AS Ryan & BJ Nicklas (2004) Reductions in plasma cytokine levels with weight loss improve insulin sensitivity in overweight and obese postmenopausal women. Diabetes Care 27, 16991705.

78A Dvořáková-Lorenzová , P Suchanek , PJ Havel , . (2006) The decrease in C-reactive protein concentration after diet and physical activity induced weight reduction is associated with changes in plasma lipids, but not interleukin-6 or adiponectin. Metabolism 55, 359365.

79J Salas-Salvadó , M Bullo , P Garcia-Lorda , . (2006) Subcutaneous adipose tissue cytokine production is not responsible for the restoration of systemic inflammation markers during weight loss. Int J Obes (Lond) 30, 17141720.

80TS Church , MS Willis , EL Priest , . (2005) Obesity, macrophage migration inhibitory factor, and weight loss. Int J Obes (Lond) 29, 675681.

81K Esposito , F Giugliano , C Di Palo , . (2004) Effect of lifestyle changes on erectile dysfunction in obese men: a randomized controlled trial. JAMA 291, 29782984.

82K Esposito , A Pontillo , C Di Palo , . (2003) Effect of weight loss and lifestyle changes on vascular inflammatory markers in obese women. JAMA 289, 17991804.

83M St-Onge , R Desmond , G Hunter , . (2008) Baseline inflammatory markers do not modulate the lipid response to weight loss. Metabolism 57, 598604.

84B Zahorska-Markiewicz , J Janowska , M Olszanecka-Glinianowicz , . (2000) Serum concentrations of TNF-α and soluble TNF-α receptors in obesity. Int J Obes Relat Metab Disord 24, 13921395.

85P Ziccardi , F Nappo , G Giugliano , . (2002) Reduction of inflammatory cytokine concentrations and improvement of endothelial functions in obese women after weight loss over one year. Circulation 105, 804809.

86G Nicoletti , G Giugliano , A Pontillo , . (2003) Effect of a multidisciplinary program of weight reduction on endothelial functions in obese women. J Endocrinol Invest 26, R5R8.

87R Marfella , K Esposito , M Siniscalchi , . (2004) Effect of weight loss on cardiac synchronization and proinflammatory cytokines in premenopausal obese women. Diabetes Care 27, 4752.

88P Dandona , R Weinstock , K Thusu , . (1998) Tumor necrosis factor-α in sera of obese patients: fall with weight loss. J Clin Endocrinol Metab 83, 29072910.

89TO Obisesan , C Leeuwenburgh , T Phillips , . (2004) C-reactive protein genotypes affect baseline, but not exercise training-induced changes, in C-reactive protein levels. Arterioscler Thromb Vasc Biol 24, 18741879.

90G Giugliano , G Nicoletti , E Grella , . (2004) Effect of liposuction on insulin resistance and vascular inflammatory markers in obese women. Br J Plast Surg 57, 190194.

91S Klein , L Fontana , VL Young , . (2004) Absence of an effect of liposuction on insulin action and risk factors for coronary heart disease. N Engl J Med 350, 25492557.

92L Busetto , F Bassetto , M Zocchi , . (2008) The effects of the surgical removal of subcutaneous adipose tissue on energy expenditure and adipocytokine concentrations in obese women. Nutr Metab Cardiovasc Dis 18, 112120.

93K Krzyzanowska , F Mittermayer , HP Kopp , . (2004) Weight loss reduces circulating asymmetrical dimethylarginine concentrations in morbidly obese women. J Clin Endocrinol Metab 89, 62776281.

94DG Haider , K Schindler , G Schaller , . (2006) Increased plasma visfatin concentrations in morbidly obese subjects are reduced after gastric banding. J Clin Endocrinol Metab 91, 15781581.

95W Yang , W Lee , T Funahashi , . (2001) Weight reduction increases plasma levels of an adipose-derived anti-inflammatory protein, adiponectin. J Clin Endocrinol Metab 86, 38153819.

97M Laimer , CF Ebenbichler , S Kaser , . (2002) Markers of chronic inflammation and obesity: a prospective study on the reversibility of this association in middle-aged women undergoing weight loss by surgical intervention. Int J Obes Relat Metab Disord 26, 659662.

98U Hanusch-Enserer , E Cauza , M Spak , . (2004) Improvement of insulin resistance and early atherosclerosis in patients after gastric banding. Obes Res 12, 284291.

99HP Kopp , K Krzyzanowska , M Mohlig , . (2005) Effects of marked weight loss on plasma levels of adiponectin, markers of chronic subclinical inflammation and insulin resistance in morbidly obese women. Int J Obes (Lond) 29, 766771.

100U Hanusch-Enserer , E Cauza , M Spak , . (2003) Acute-phase response and immunological markers in morbid obese patients and patients following adjustable gastric banding. Int J Obes Relat Metab Disord 27, 355361.

101HP Kopp , CW Hopp , A Festa , . (2003) Impact of weight loss on inflammatory proteins and their association with the insulin resistance syndrome in morbidly obese patients. Arterioscler Thromb Vasc Biol 23, 10421047.

102CW Kopp , HP Kopp , S Steiner , . (2003) Weight loss reduces tissue factor in morbidly obese patients. Obes Res 11, 950956.

103R Cancello , C Henegar , N Viguerie , . (2005) Reduction of macrophage infiltration and chemoattractant gene expression changes in white adipose tissue of morbidly obese subjects after surgery-induced weight loss. Diabetes 54, 22772286.

104M Manco , JM Fernandez-Real , F Equitani , . (2007) Effect of massive weight loss on inflammatory adipocytokines and the innate immune system in morbidly obese women. J Clin Endocrinol Metab 92, 483490.

105J Vendrell , M Broch , N Vilarrasa , . (2004) Resistin, adiponectin, ghrelin, leptin, and proinflammatory cytokines: relationships in obesity. Obes Res 12, 962971.

106M Faraj , PJ Havel , S Phelis , . (2003) Plasma acylation-stimulating protein, adiponectin, leptin, and ghrelin before and after weight loss induced by gastric bypass surgery in morbidly obese subjects. J Clin Endocrinol Metab 88, 15941602.

107JM Liou , JT Lin , WJ Lee , . (2008) The serial changes of ghrelin and leptin levels and their relations to weight loss after laparoscopic minigastric bypass surgery. Obes Surg 18, 8489.

108MW Hulver , D Zheng , CJ Tanner , . (2002) Adiponectin is not altered with exercise training despite enhanced insulin action. Am J Physiol Endocrinol Metab 283, E861E865.

109M Calvani , A Scarfone , L Granato , . (2004) Restoration of adiponectin pulsatility in severely obese subjects after weight loss. Diabetes 53, 939947.

110FM van Dielen , WA Buurman , M Hadfoune , . (2004) Macrophage inhibitory factor, plasminogen activator inhibitor-1, other acute phase proteins, and inflammatory mediators normalize as a result of weight loss in morbidly obese subjects treated with gastric restrictive surgery. J Clin Endocrinol Metab 89, 40624068.

111C Poitou , C Coussieu , C Rouault , . (2006) Serum amyloid A: a marker of adiposity-induced low-grade inflammation but not of metabolic status. Obesity (Silver Spring) 14, 309318.

112LA Vázquez , F Pazos , JR Berrazueta , . (2005) Effects of changes in body weight and insulin resistance on inflammation and endothelial function in morbid obesity after bariatric surgery. J Clin Endocrinol Metab 90, 316322.

113M Gannagé-Yared , C Yaghi , B Habre , . (2008) Osteoprotegerin in relation to body weight, lipid parameters, insulin sensitivity, adipocytokines, and C-reactive protein in obese and non-obese young individuals: results from both cross-sectional and interventional study. Eur J Endocrinol 158, 353359.

114JI Botella-Carretero , F Alvarez-Blasco , MA Martinez-Garcia , . (2007) The decrease in serum IL-18 levels after bariatric surgery in morbidly obese women is a time-dependent event. Obes Surg 17, 11991208.

115EL Madsen , A Rissanen , JM Bruun , . (2008) Weight loss larger than 10 % is needed for general improvement of levels of circulating adiponectin and markers of inflammation in obese subjects: a 3-year weight loss study. Eur J Endocrinol 158, 179187.

116DL Magro , B Geloneze , R Delfini , . (2008) Long-term weight regain after gastric bypass: a 5-year prospective study. Obes Surg 18, 648651.

117ME Lean , TS Han & CE Morrison (1995) Waist circumference as a measure for indicating need for weight management. BMJ 311, 158161.

118TS Han , EM van Leer , JC Seidell , . (1995) Waist circumference action levels in the identification of cardiovascular risk factors: prevalence study in a random sample. BMJ 311, 14011405.

120I Lemieux , A Pascot , D Prud'homme , . (2001) Elevated C-reactive protein: another component of the atherothrombotic profile of abdominal obesity. Arterioscler Thromb Vasc Biol 21, 961967.

121TB Chaston & JB Dixon (2008) Factors associated with percent change in visceral versus subcutaneous abdominal fat during weight loss: findings from a systematic review. Int J Obes (Lond) 32, 619628.

122PM Clifton (2003) Diet and C-reactive protein. Curr Atheroscler Rep 5, 431436.

123MA Albert , RJ Glynn & PM Ridker (2003) Plasma concentration of C-reactive protein and the calculated Framingham Coronary Heart Disease Risk Score. Circulation 108, 161165.

124B Thorand , J Baumert , A Döring , . (2006) Sex differences in the relation of body composition to markers of inflammation. Atherosclerosis 184, 216224.

125PM Ridker , CH Hennekens , N Rifai , . (1999) Hormone replacement therapy and increased plasma concentration of C-reactive protein. Circulation 100, 713716.

126AD Pradhan , JE Manson , JE Rossouw , . (2002) Inflammatory biomarkers, hormone replacement therapy, and incident coronary heart disease: prospective analysis from the Women's Health Initiative observational study. JAMA 288, 980987.

132UG Kyle , Y Schutz , YM Dupertuis , . (2003) Body composition interpretation: contributions of the fat-free mass index and the body fat mass index. Nutrition 19, 597604.

134LK Forsythe , MBE Livingstone , MS Barnes , . (2008) C-reactive protein and body composition in a representative sample of young adults. Proc Nutr Soc (In the Press).

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