The effects of exercise on C-reactive protein, insulin, leptin and some cardiometabolic risk factors in Egyptian children with or without metabolic syndrome

Nashwa Nabil Kamal, Merhan Mamdouh Ragy, Nashwa Nabil Kamal, Merhan Mamdouh Ragy

Abstract

Background: The prevalence and magnitude of obesity in the children and the adolescents have increased dramatically in the developing countries over the last 20-30 years. The prevalence of metabolic syndrome (MS) in children is increasing.

Aim: This study aimed to investigate the changes of C-reactive protein (CRP), leptin, insulin, and blood lipids before and after the exercise therapy in normal and obese children (with or without metabolic syndrome).

Methods: The study covered 49 normal children (control), 32 obese children without metabolic syndrome and 12 obese children with metabolic syndrome. We examined the influence of exercise (3 times/week) for 12 weeks on the levels of serum CRP, leptin, insulin, homeostatic model assessment insulin resistance (HOMA-IR), triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) in all groups.

Results: There were significant correlations between HOMA-IR and the individual components of the metabolic syndrome. After 12 weeks of exercise, both of the obese children groups, with and without metabolic syndrome, showed reduced body weight, body mass index (BMI), and CRP level, and increased HDL-C level. The percentage of metabolic syndrome decreased from 12.9% before the exercise training to 7.5% after training. Also, there was a significant reduction in BMI (from 47.3 to 32.6%), in systolic blood pressure (from 18.3 to 15.1%) and in HDL-C level (from 18.3 to 9.7%).

Conclusion: Overweight children have multiple risk factors associated with the metabolic syndrome. 12-week exercise may have a positive effect on reducing risk factors for the metabolic syndrome.

Figures

Figure 1
Figure 1
Variables in metabolic syndrome components before and after exercise intervention in all exercisers (n = 93).

References

    1. Alberti KG, Zimmet P, Shaw J. The metabolic syndrome–a new worldwide definition. Lancet. 2005;366(9491):1059–1062. doi: 10.1016/S0140-6736(05)67402-8.
    1. Singh R, Bhansali A, Sialy R, Aggarwal A. Prevalence of metabolic syndrome in adolescents from a north Indian population. Diabet Med. 2007;24(2):195–199. doi: 10.1111/j.1464-5491.2007.02066.x.
    1. Fu J-F, Liang L, Zou C-C, Hong F, Wang C-L, Wang X-M. Prevalence of the metabolic syndrome in Zhejiang Chinese obese children and adolescents and the effect of metformine combined with lifestyle intervention. Int J Obes. 2007;31:15–22. doi: 10.1038/sj.ijo.0803453.
    1. Yoshinaga M, Tanaka S, Shimago A, Sameshima K, Nishi J, Nomura Y, Kawano Y, Hashiguchi J, Ichiki T, Shimizu S. Metabolic syndrome in overweight and obese Japanese children. Obes Res. 2005;0(7):1135–1140. 0(4): 627–633.
    1. Zimmet P, Alberti G, Kaufman F. The metabolic syndrome in children and adolescents. Lancet. 2007;369:2059–2061. doi: 10.1016/S0140-6736(07)60958-1.
    1. Ford E. Prevalence of the metabolic syndrome defined by the International Diabetes Federation among adults in the U.S. Diabetes Care. 2005;28(11):2745–2749. doi: 10.2337/diacare.28.11.2745.
    1. Pearson TA, Mensah GA, Alexander RW, Anderson JL, Cannon RO III, Criqui M, Fadl YY, Fortmann SP, Hong Y, Myers GL, Rifai N, Smith SC, Taubert K, Tracy RP, Vinicor F. Markers of inflammation and cardiovascular disease: application to clinical and public health practice: a statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation. 2003;107:499–511. doi: 10.1161/01.CIR.0000052939.59093.45.
    1. Ridker PM, Rifai N, Rose L, Buring JE, Cook NR. Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events. N Engl J Med. 2002;347:1557–1565. doi: 10.1056/NEJMoa021993.
    1. Juonala M, Viikari J, Ronnemaa T, Taittonen L, Marniemi J. Childhood C-reactive protein in predicting CRP and carotid intima thickness in adulthood: the Cardiovascular Risk in Young Finns Study. Arterioscler. Thromb. Vasc Biol. 2006;26:1883–1888. doi: 10.1161/01.ATV.0000228818.11968.7a.
    1. Webber J. Energy balance in obesity. Proc Nutr Soc. 2003;62:539–543. doi: 10.1079/PNS2003256.
    1. Moran O, Phillip M. Leptin: obesity, diabetes and other peripheral effects—a review. Pediatric Diabetes. 2003;4(2):101–109. doi: 10.1034/j.1399-5448.2003.00017.x.
    1. Barness LA. Obesity in children. Fetal Pediatr. 2007;26:75–85. doi: 10.1080/15513810701448755.
    1. Lambert M, Paradis G, O’Loughlin J, Delvin EE, Hanley JA, Levy E. Insulin resistance syndrome in a representative sample of children and adolescents from Quebec, Canada. Int J Obes Relat Metab Disord. 2004;28:833–841. doi: 10.1038/sj.ijo.0802694.
    1. De Ferranti SD, Gauvreau K, Ludwig DS, Neufeld EJ, Newburger JW, Rifai N. Prevalence of the metabolic syndrome in American adolescents: findings from the Third National Health and Nutrition Examination Survey. Circulation. 2004;110:2494–2497. doi: 10.1161/01.CIR.0000145117.40114.C7.
    1. Cook S, Weitzman M, Auinger P, Nguyen M, Dietz WH. Prevalence of a metabolic syndrome phenotype in adolescents: findings from the third National Health and Nutrition Examination Survey, 1988–1994. Arch. 2003;157:821–827. doi: 10.1001/archpedi.157.8.821.
    1. Karacabey K, Saygin O, Ozmerdivenli R, Simsek E, Bulut S, Karacabey K, Saygin O. The effects of exercise on the immune system and stress hormones in sportswomen. Neuro Endocrinol. 2005;26:361–366.
    1. Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge clin. Chem. 1972;18:499–502.
    1. d’Annunzio G, Vanelli M, Meschi F, Pistorio A, Caso M, Pongiglione C. The SIEDP Study Group Valori normali di HOMA-IR in bambinie adolescenti: studio multicentrico italiano Quad. Pediatr. 2004;3:44.
    1. Steinberger J, Daniels SR, Eckel RH, Hayman L, Lustig RH. Progress and challenges in metabolic syndrome in children and adolescents: a scientific statement from the American Heart Association Atherosclerosis, Hypertension, and Obesity in the Young Committee of the Council on Cardiovascular Disease in the Young; Council on Cardiovascular Nursing; and Council on Nutrition, Physical Activity, and Metabolism. Circulation. 2009;119:628–647. doi: 10.1161/CIRCULATIONAHA.108.191394.
    1. Hiura M, Kikuchi T, Nagasaki K, Uchiyama M. Elevation of serum C- reactive protein levels is associated with obesity in boys. Hypertens Res. 2003;26(7):541–546. doi: 10.1291/hypres.26.541.
    1. Thomas NE, Baker JS, Graham MR, Cooper SM, Davies B. C-reactive protein in schoolchildren and its relation to adiposity, physical activity, aerobic fitness and habitual diet. Br. 2008;42(5):357–360. doi: 10.1136/bjsm.2007.043604.
    1. Warnberg J, Nova E, Romeo J, Moreno LA, Sjostrom M, Marcos A. Lifestyle-related determinants of inflammation in adolescence. Br J Nutr. 2007;98(1):S116–S120. doi: 10.1017/S0007114507691909.
    1. Weisberg SP, McCann D, Desai M, Rosenbaum M, Leibel RL, Ferrante AW. Obesity is associated with macrophage accumulation in adipose tissue. J Clin Invest. 2003;112:1796–1808.
    1. Cruz ML, Weigensberg MJ, Huang TTK, Ball G, Shaibi GQ, Goran MI. The metabolic syndrome in overweight Hispanic youth and the role of insulin sensitivity. J Clin Endocrinol Metab. 2004;89:108–113. doi: 10.1210/jc.2003-031188.
    1. Weiss F, Dziura J, Burgert T, Tamborlane WV, Taksali SE, Yeckel CW. Obesity and the metabolic syndrome in children and adolescents. N Engl J Med. 2004;350:2362–2374. doi: 10.1056/NEJMoa031049.
    1. Nassis GP, Papantakou K, Skenderi K, Triandafillopoulou M, Kavouras SA, Yannakoulia M. Aerobic exercise training improves insulin sensitivity without changes in BW, body fat, adiponectin, and inflammatory markers in overweight and obese girls. Metabolism. 2005;54:1472–1479. doi: 10.1016/j.metabol.2005.05.013.
    1. Park TG, Hong HR, Lee J, Kang HS. Lifestyle plus exercise intervention improves metabolic syndrome markers without change in adiponectin in obese girls. Ann Nutr Metab. 2007;51:197–203. doi: 10.1159/000104137.
    1. Youngren JF, Keen S, Kulp JL, Tanner CJ, Houmard JA, Goldfine ID. Enhanced muscle insulin receptor autophosphorylation with short-term aerobic exercise training. Am J Physiol Endocrinol Metab. 2001;280:528–533.
    1. Goran MI, Bergman RN, Avila Q, Watkins M, Ball GD, Shaibi GQ, Weigensberg MJ, Cruz ML. Impaired glucose tolerance and reduced beta-cell function in overweight Latino children with a positive family history for type 2 diabetes. J Clin Endocrinol Metab. 2004;89:207–212. doi: 10.1210/jc.2003-031402.
    1. Jensen J, Lai YC. Regulation of muscle glycogen synthase phosphorylation and kinetic properties by insulin, exercise, adrenaline and role in insulin resistance. Arch Physiol Biochem. 2009;115:13–21. doi: 10.1080/13813450902778171.
    1. Esposito K, Pontillo A, Di Palo C, Giugliano G, Masella M, Marfella R, Giugliano D. Effect of weight loss and lifestyle changes on vascular inflammatory markers in obese women: a randomized trial. JAMA. 2003;289:1799–1804. doi: 10.1001/jama.289.14.1799.
    1. Kasapis C, Thompson P. The effects of physical activity on serum C-reactive protein and inflammatory markers: a systematic review. J Am Coll Cardiol. 2005;45(10):1563–1569. doi: 10.1016/j.jacc.2004.12.077.
    1. Couillard C, Despres JP, Lamarche B, Bergeron J, Gagnon J, Leon AS. Effects of endurance exercisetraining on plasma HDL cholesterol levels depend on levels of triglycerides: evidence from men of the Health, Risk Factors, Exercise Training and Genetics (HERITAGE) Family Study. Arterioscler Thromb Vasc Biol. 2001;21:1226–1232. doi: 10.1161/hq0701.092137.
    1. Jiang XC, Moulin P, Quinet E, Goldberg IJ, Yacoub LK, Agellon LB, Compton D, Schitzer-Polokoff R, Tall AR. Mammalian adipose tissue and muscle are major sources of lipid transfer protein mRNA. J Biol Chem. 1991;266:4631–4639.
    1. Tall A. Exercise to reduce cardiovascular risk: how much is enough? N. 2002;347:1522–1523. doi: 10.1056/NEJMe020117.
    1. Aroonparkmongkol S, Wacharasindhu S, Srivuthana S. Serum levels of leptin in obese Thai children. Chula Med. 2005;49:693–699.
    1. Chaichanwatanakul K, Weerakulwattana P, Nunloi S. Leptin level in Thai children and adolescents: relation to body mass index and sexes. Siriraj Med. J. 2006;58(1):006–008.
    1. Nishimura R, Sano H, Matsudaira T, Myashita Y, Morimoto A, Shirasawa T, Takahashi E, Kawaquchi T, Tajima N. Childhood obesity and its relation to serum adiponectin and leptin: A report from a population-based study. Diabetes Res Clin. 2007;76:245–250. doi: 10.1016/j.diabres.2006.09.023.
    1. Unal M, Unal DO, Baltaci AK, Mogulkoc R, Kayserilioglu A. Investigation of serum leptin levels in professional male football players and healthy sedentary males. Neuro Endocrinology Letters. 2005;26:148–151.
    1. Woo KS, Chook P, Yu CW, Sung RY, Qiao M, Leung SS, Lam CW, Metreweli C. Overweight in children is associated with arterial endothelial dysfunction and intima-media thickening. Int. 2004;28:852–857. doi: 10.1038/sj.ijo.0802539.
    1. Roberts CK, Vaziri ND, Barnard RJ. Effect of diet and exercise intervention on blood pressure, insulin, oxidative stress, and nitric oxide availability. Circulation. 2002;106:2530–2532. doi: 10.1161/01.CIR.0000040584.91836.0D.

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