Exercise training reduces inflammatory metabolic activity of visceral fat assessed by 18 F‐FDG PET/CT in obese women

Obesity plays pivotal roles in the increased risk of cardiometabolic disease via induction of the inflammatory reaction from macrophages in visceral adipose tissue (VAT), which may elevate the inflammatory activity of VAT. This prospective study aimed to evaluate whether the inflammatory activity of...

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Published inClinical endocrinology (Oxford) Vol. 93; no. 2; pp. 127 - 134
Main Authors Pahk, Kisoo, Kim, Eung Ju, Joung, Chanmin, Seo, Hong Seog, Kim, Sungeun
Format Journal Article
LanguageEnglish
Published England 01.08.2020
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Abstract Obesity plays pivotal roles in the increased risk of cardiometabolic disease via induction of the inflammatory reaction from macrophages in visceral adipose tissue (VAT), which may elevate the inflammatory activity of VAT. This prospective study aimed to evaluate whether the inflammatory activity of VAT existed in association with systemic inflammation, and whether exercise could ameliorate the inflammatory activity of VAT assessed by F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in obese women. A total of 23 obese women who participated in an exercise program were included. Subjects underwent F-FDG PET/CT before the start of the exercise program (baseline) and after the completion of the 3-month exercise program. For the assessment of VAT metabolic activity, the maximum standardized uptake value (SUVmax) and the mean standardized uptake value (SUVmean) were measured. The SUVmax of spleen, bone marrow (BM) and the high-sensitivity C-reactive protein (hsCRP) were used as a surrogate marker for systemic inflammation. Baseline SUVmax of VAT was positively correlated with the SUVmax of spleen, BM and hsCRP, whereas VAT SUVmean was not correlated. Exercise reduced SUVmax of VAT in addition to adiposity, the SUVmax of spleen, BM and hsCRP. However, VAT SUVmean was not significantly changed. Furthermore, the association of SUVmax of VAT, and the SUVmax of spleen, BM and hsCRP was no longer relevant after exercise. In obese women, the SUVmax of VAT assessed by F-FDG PET/CT was associated with systemic inflammation and exercise reduced the SUVmax of VAT and abrogated its association with systemic inflammation.
AbstractList Obesity plays pivotal roles in the increased risk of cardiometabolic disease via induction of the inflammatory reaction from macrophages in visceral adipose tissue (VAT), which may elevate the inflammatory activity of VAT. This prospective study aimed to evaluate whether the inflammatory activity of VAT existed in association with systemic inflammation, and whether exercise could ameliorate the inflammatory activity of VAT assessed by 18 F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in obese women.OBJECTIVESObesity plays pivotal roles in the increased risk of cardiometabolic disease via induction of the inflammatory reaction from macrophages in visceral adipose tissue (VAT), which may elevate the inflammatory activity of VAT. This prospective study aimed to evaluate whether the inflammatory activity of VAT existed in association with systemic inflammation, and whether exercise could ameliorate the inflammatory activity of VAT assessed by 18 F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in obese women.A total of 23 obese women who participated in an exercise program were included. Subjects underwent 18 F-FDG PET/CT before the start of the exercise program (baseline) and after the completion of the 3-month exercise program. For the assessment of VAT metabolic activity, the maximum standardized uptake value (SUVmax) and the mean standardized uptake value (SUVmean) were measured. The SUVmax of spleen, bone marrow (BM) and the high-sensitivity C-reactive protein (hsCRP) were used as a surrogate marker for systemic inflammation.DESIGN AND PATIENTSA total of 23 obese women who participated in an exercise program were included. Subjects underwent 18 F-FDG PET/CT before the start of the exercise program (baseline) and after the completion of the 3-month exercise program. For the assessment of VAT metabolic activity, the maximum standardized uptake value (SUVmax) and the mean standardized uptake value (SUVmean) were measured. The SUVmax of spleen, bone marrow (BM) and the high-sensitivity C-reactive protein (hsCRP) were used as a surrogate marker for systemic inflammation.Baseline SUVmax of VAT was positively correlated with the SUVmax of spleen, BM and hsCRP, whereas VAT SUVmean was not correlated. Exercise reduced SUVmax of VAT in addition to adiposity, the SUVmax of spleen, BM and hsCRP. However, VAT SUVmean was not significantly changed. Furthermore, the association of SUVmax of VAT, and the SUVmax of spleen, BM and hsCRP was no longer relevant after exercise.RESULTSBaseline SUVmax of VAT was positively correlated with the SUVmax of spleen, BM and hsCRP, whereas VAT SUVmean was not correlated. Exercise reduced SUVmax of VAT in addition to adiposity, the SUVmax of spleen, BM and hsCRP. However, VAT SUVmean was not significantly changed. Furthermore, the association of SUVmax of VAT, and the SUVmax of spleen, BM and hsCRP was no longer relevant after exercise.In obese women, the SUVmax of VAT assessed by 18 F-FDG PET/CT was associated with systemic inflammation and exercise reduced the SUVmax of VAT and abrogated its association with systemic inflammation.CONCLUSIONIn obese women, the SUVmax of VAT assessed by 18 F-FDG PET/CT was associated with systemic inflammation and exercise reduced the SUVmax of VAT and abrogated its association with systemic inflammation.
Obesity plays pivotal roles in the increased risk of cardiometabolic disease via induction of the inflammatory reaction from macrophages in visceral adipose tissue (VAT), which may elevate the inflammatory activity of VAT. This prospective study aimed to evaluate whether the inflammatory activity of VAT existed in association with systemic inflammation, and whether exercise could ameliorate the inflammatory activity of VAT assessed by F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in obese women. A total of 23 obese women who participated in an exercise program were included. Subjects underwent F-FDG PET/CT before the start of the exercise program (baseline) and after the completion of the 3-month exercise program. For the assessment of VAT metabolic activity, the maximum standardized uptake value (SUVmax) and the mean standardized uptake value (SUVmean) were measured. The SUVmax of spleen, bone marrow (BM) and the high-sensitivity C-reactive protein (hsCRP) were used as a surrogate marker for systemic inflammation. Baseline SUVmax of VAT was positively correlated with the SUVmax of spleen, BM and hsCRP, whereas VAT SUVmean was not correlated. Exercise reduced SUVmax of VAT in addition to adiposity, the SUVmax of spleen, BM and hsCRP. However, VAT SUVmean was not significantly changed. Furthermore, the association of SUVmax of VAT, and the SUVmax of spleen, BM and hsCRP was no longer relevant after exercise. In obese women, the SUVmax of VAT assessed by F-FDG PET/CT was associated with systemic inflammation and exercise reduced the SUVmax of VAT and abrogated its association with systemic inflammation.
Author Seo, Hong Seog
Kim, Sungeun
Joung, Chanmin
Pahk, Kisoo
Kim, Eung Ju
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Cites_doi 10.1016/j.jcmg.2014.10.009
10.1172/JCI29069
10.1016/S0140-6736(10)62037-5
10.1074/jbc.M113.522037
10.1016/S0140-6736(12)61766-8
10.1152/ajpendo.00284.2006
10.1038/oby.2007.178
10.1161/CIRCULATIONAHA.117.029617
10.1111/obr.12406
10.1371/journal.pone.0148776
10.1016/j.jacc.2015.06.1328
10.1016/j.acra.2017.04.010
10.1371/journal.pone.0056415
10.2337/db12-1146
10.1146/annurev-immunol-032713-120236
10.3803/EnM.2014.29.4.405
10.1002/oby.20957
10.1016/j.jcmg.2010.07.002
10.1016/j.jcmg.2010.06.004
10.1111/cen.13604
10.1038/nrcardio.2014.80
10.1161/CIRCRESAHA.114.302699
10.1038/nature05488
10.1172/JCI57132
10.1161/CIRCIMAGING.113.001093
10.3945/ajcn.2008.26546
10.1038/nri3041
10.1161/ATVBAHA.107.159228
10.1097/MD.0000000000000725
10.1152/physrev.00033.2011
10.1161/CIRCULATIONAHA.107.185649
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Keywords exercise
positron emission tomography
inflammation
visceral fat
obesity
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References e_1_2_7_6_1
e_1_2_7_5_1
e_1_2_7_4_1
e_1_2_7_3_1
e_1_2_7_8_1
e_1_2_7_7_1
e_1_2_7_19_1
e_1_2_7_18_1
e_1_2_7_17_1
e_1_2_7_16_1
e_1_2_7_2_1
e_1_2_7_15_1
e_1_2_7_14_1
e_1_2_7_13_1
e_1_2_7_12_1
e_1_2_7_11_1
e_1_2_7_10_1
e_1_2_7_26_1
e_1_2_7_27_1
e_1_2_7_28_1
e_1_2_7_29_1
e_1_2_7_30_1
e_1_2_7_25_1
e_1_2_7_31_1
e_1_2_7_24_1
e_1_2_7_32_1
e_1_2_7_23_1
e_1_2_7_22_1
e_1_2_7_21_1
e_1_2_7_20_1
Demerath EW (e_1_2_7_9_1) 2008; 88
References_xml – ident: e_1_2_7_30_1
  doi: 10.1016/j.jcmg.2014.10.009
– ident: e_1_2_7_6_1
  doi: 10.1172/JCI29069
– ident: e_1_2_7_2_1
  doi: 10.1016/S0140-6736(10)62037-5
– ident: e_1_2_7_29_1
  doi: 10.1074/jbc.M113.522037
– ident: e_1_2_7_3_1
  doi: 10.1016/S0140-6736(12)61766-8
– ident: e_1_2_7_27_1
  doi: 10.1152/ajpendo.00284.2006
– ident: e_1_2_7_20_1
  doi: 10.1038/oby.2007.178
– ident: e_1_2_7_32_1
  doi: 10.1161/CIRCULATIONAHA.117.029617
– ident: e_1_2_7_17_1
  doi: 10.1111/obr.12406
– ident: e_1_2_7_22_1
  doi: 10.1371/journal.pone.0148776
– ident: e_1_2_7_31_1
  doi: 10.1016/j.jacc.2015.06.1328
– ident: e_1_2_7_26_1
  doi: 10.1016/j.acra.2017.04.010
– ident: e_1_2_7_16_1
  doi: 10.1371/journal.pone.0056415
– ident: e_1_2_7_28_1
  doi: 10.2337/db12-1146
– ident: e_1_2_7_13_1
  doi: 10.1146/annurev-immunol-032713-120236
– ident: e_1_2_7_18_1
  doi: 10.3803/EnM.2014.29.4.405
– ident: e_1_2_7_25_1
  doi: 10.1002/oby.20957
– ident: e_1_2_7_11_1
  doi: 10.1016/j.jcmg.2010.07.002
– ident: e_1_2_7_12_1
  doi: 10.1016/j.jcmg.2010.06.004
– ident: e_1_2_7_23_1
  doi: 10.1111/cen.13604
– ident: e_1_2_7_14_1
  doi: 10.1038/nrcardio.2014.80
– ident: e_1_2_7_8_1
  doi: 10.1161/CIRCRESAHA.114.302699
– ident: e_1_2_7_4_1
  doi: 10.1038/nature05488
– ident: e_1_2_7_7_1
  doi: 10.1172/JCI57132
– ident: e_1_2_7_24_1
  doi: 10.1161/CIRCIMAGING.113.001093
– volume: 88
  start-page: 1263
  year: 2008
  ident: e_1_2_7_9_1
  article-title: Visceral adiposity and its anatomical distribution as predictors of the metabolic syndrome and cardiometabolic risk factor levels
  publication-title: Am J Clin Nutr
  doi: 10.3945/ajcn.2008.26546
– ident: e_1_2_7_15_1
  doi: 10.1038/nri3041
– ident: e_1_2_7_10_1
  doi: 10.1161/ATVBAHA.107.159228
– ident: e_1_2_7_21_1
  doi: 10.1097/MD.0000000000000725
– ident: e_1_2_7_5_1
  doi: 10.1152/physrev.00033.2011
– ident: e_1_2_7_19_1
  doi: 10.1161/CIRCULATIONAHA.107.185649
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Title Exercise training reduces inflammatory metabolic activity of visceral fat assessed by 18 F‐FDG PET/CT in obese women
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