Lifestyle Intervention and Adipokine Levels in Subjects at High Risk for Type 2 Diabetes Serum adipokines as biomarkers of beta-cell function in patients with type 1 diabetes: positive association with leptin and resistin and negative association with adiponectin. Effect of exercise on circulating adipokine levels in obese young women. Changes in insulin resistance indicators, IGFs, and adipokines in a year-long trial of aerobic exercise in postmenopausal women Effects of supplementation with curcumin on serum adipokine concentrations: A randomized controlled trial. Influence of Weight Loss, Body Composition, and Lifestyle Behaviors on Plasma Adipokines: A Randomized Weight Loss Trial in Older Men and Women with Symptomatic Knee Osteoarthritis Effects of 90-day hypolipidemic treatment on insulin resistance, adipokines and proinflammatory cytokines in patients with mixed hyperlipidemia and impaired fasting glucose. Blood glucose lowering by means of lifestyle intervention has different effects on adipokines as compared with insulin treatment in subjects with type 2 diabetes Effects of individual and combined dietary weight loss and exercise interventions in postmenopausal women on adiponectin and leptin levels. The effectiveness of yoga to prevent diabetes mellitus type 2 Beneficial effects of a long-term oral L-arginine treatment added to a hypocaloric diet and exercise training program in obese, insulin-resistant type 2 diabetic patients. Exercise-Induced Dose-Response Alterations in Adiponectin and Leptin Levels Are Dependent on Body Fat Changes in Women at Risk for Breast Cancer Exercise effects on adipokines and the IGF axis in men with prostate cancer treated with androgen deprivation: A randomized study. Physical Activity/Exercise and Type 2 Diabetes Effect of a Lifestyle Intervention Program With Energy-Restricted Mediterranean Diet and Exercise on Weight Loss and Cardiovascular Risk Factors: One-Year Results of the PREDIMED-Plus Trial Effects of a Walking Intervention Using Mobile Technology and Interactive Voice Response on Serum Adipokines Among Postmenopausal Women at Increased Breast Cancer Risk Effect of exercise training combined with phytoestrogens on adipokines and C-reactive protein in postmenopausal women: a randomized trial. Lifestyle modification improves risk factors in type 2 diabetes relatives. Adipocytokines and the risk of coronary heart disease in healthy middle aged men: the PRIME Study Impact of Weight Loss on Plasma Leptin and Adiponectin in Overweight-to-Obese Post Menopausal Breast Cancer Survivors A low-glycemic load diet reduces serum C-reactive protein and modestly increases adiponectin in overweight and obese adults. Effects of long-term exercise and diet intervention on plasma adipokine concentrations. Periodontal treatment with topical antibiotics improves glycemic control in association with elevated serum adiponectin in patients with type 2 diabetes mellitus.
OBJECTIVE —We investigated whether circulating adipokine concentrations can be altered by lifestyle intervention according to general recommendations in subjects at risk for diabetes as well as the potential of leptin , adiponectin , and resistin as biomarkers for lifestyle-induced improvements in glucose metabolism and insulin resistance . RESEARCH DESIGN AND METHODS —In the Study on Lifestyle intervention and Impaired glucose tolerance Maastricht , 147 men and women with impaired glucose tolerance ( IGT ) were r and omized to either a combined diet- and -exercise intervention or a control program . At baseline and after 1 year , an oral glucose tolerance test , an exercise test , and anthropometric measurements were performed . After 1 year , complete data of 103 subjects ( 50 intervention and 53 control subjects ) were obtained . RESULTS —Lifestyle intervention reduced plasma leptin concentrations ( −14.2 % ) in IGT subjects but did not alter plasma adiponectin ( −0.3 % ) or resistin ( −6.5 % ) concentrations despite marked improvements in glucose tolerance and insulin resistance . CONCLUSIONS —Changes in leptin concentration were related to improvements in insulin sensitivity independent of changes in body composition BACKGROUND We investigated the adipokines adiponectin , leptin and resistin as serum biomarkers of beta-cell function in patients with type 1 diabetes . METHODS One hundred and eighteen patients with type 1 diabetes ( 20.3 ± 7.5 years ) diagnosed < 5 years underwent st and ardized mixed meal test ( MMTT ) for 2 h.  Systemic concentrations of C-peptide , adiponectin , leptin and resistin obtained during MMTT were measured and compared between patient groups by multiple regression analysis . RESULTS Patients were divided by their adipokine levels in subgroups above or below the median level ( ' high versus low ' ) . High adiponectin levels ( > 10.6 µg/mL ) were associated with lower C-peptide compared to the low adiponectin subgroup ( p < 0.03 ) . Increased leptin or resistin concentrations associated positively with beta-cell function even after adjustment for metabolic confounders ( p < 0.04 ) . The described associations between adipokines and C-peptide concentrations persisted in Spearman correlation tests ( p < 0.05 ) . Serum adipokines fell during MMTT ( p < 0.05 ) . CONCLUSIONS Serum adipokine levels differentially correlate with beta-cell function in type 1 diabetes independent of BMI or metabolic control . Serum adipokines should be investigated as biomarkers of beta-cell function in prospect i ve studies and intervention trials in type 1 diabetes We studied the effect of exercise on circulating adipokine , high sensitivity C-reactive protein ( hs-CRP ) , and metabolic parameters in obese young women . Ninety-six healthy Japanese young female students aged 18 - 23 years were studied . The longitudinal intervention study of a 7-month exercise training program ( 30 - 60 min/day , 60 - 70 % HR-reserve , 200 - 400 kcal , 4 - 5 days/week ) was performed in eight obese female students ( BMI > or = 25 kg/m(2 ) ) . Eight control female students ( mean BMI = 22 kg/m(2 ) ) were included in the follow-up study . Body weight , body mass index ( BMI ) , percentage of body fat ( % Fat ) , body fat mass , lean body mass , health-promoting lifestyle profile-scale ( L-scale ) , VO(2)max ( maximal oxygen uptake ) , hs-CRP , lipids , insulin homeostasis model assessment ( HOMA-R ) , fasting levels for circulating adiponectin , leptin , and TNF-alpha , were measured before and after the exercise program . In obese subjects , body weight , BMI , % Fat , body fat mass , lean body mass , hs-CRP , leptin , and TNF-alpha were significantly higher , and L-scale and adiponectin were lower than those in control subjects . In obese subjects , exercise decreased body weight , BMI , % Fat , body fat mass , lean body mass , hs-CRP , leptin , and TNF-alpha , and increased L-scale , VO(2)max , HDL-cho , and adiponectin . It was concluded that changes in circulating adipokine levels are involved in the improvement of the metabolic state by exercise and may be useful markers for evaluation and prescription of exercise Physical activity is a known modifiable lifestyle means for reducing postmenopausal breast cancer risk , but the biologic mechanisms are not well understood . Metabolic factors may be involved . In this study , we aim ed to determine the effects of exercise on insulin resistance ( IR ) indicators , IGF1 , and adipokines in postmenopausal women . The Alberta Physical Activity and Breast Cancer Prevention Trial was a two-armed r and omized controlled trial in postmenopausal , inactive , cancer-free women . A year-long aerobic exercise intervention of 225 min/week ( n=160 ) was compared with a control group asked to maintain usual activity levels ( n=160 ) . Baseline , 6- and 12-month serum levels of insulin , glucose , IGF1 , IGF-binding protein 3 ( IGFBP3 ) , adiponectin , and leptin were assayed , and after data collection , homeostasis model assessment of IR ( HOMA-IR ) scores were calculated . Intention-to-treat analyses were performed using linear mixed models . The treatment effect ratio ( TER ) of exercisers to controls was calculated . Data were available on 308 ( 96.3 % ) women at 6 months and 310 ( 96.9 % ) women at 12 months . Across the study period , statistically significant reductions in insulin ( TER=0.87 , 95 % confidence interval ( 95 % CI)=0.81–0.93 ) , HOMA-IR ( TER=0.86 , 95 % CI=0.80–0.93 ) , and leptin ( TER=0.82 , 95 % CI=0.78–0.87 ) , and an increase in the adiponectin/leptin ratio ( TER=1.21 , 95 % CI=1.13–1.28 ) were observed in the exercise group compared with the control group . No significant differences were observed for glucose , IGF1 , IGFBP3 , adiponectin or the IGF1/IGFBP3 ratio . Previously inactive postmenopausal women who engaged in a moderate-to-vigorous intensity exercise program experienced changes in insulin , HOMA-IR , leptin , and adiponectin/leptin that might decrease the risk for postmenopausal breast cancer OBJECTIVE Previous experimental studies have suggested curcumin as a safe phytochemical that can improve insulin resistance through effects on adiponectin and leptin . This study aim ed to investigate the effect of curcumin on circulating adiponectin and leptin concentrations in patients with metabolic syndrome . METHODS In this pilot , r and omized , double-blind , placebo-controlled trial , subjects who met the criteria of metabolic syndrome according to the National Cholesterol Education Program Adult Treatment Panel III criteria were r and omly assigned to curcumin ( n = 59 ; 1000 mg/d ) or a placebo ( n = 58 ) for 8 wk . Serum adiponectin and leptin concentrations were determined before and after intervention . The pooled effect size for the impact of curcumin supplementation on serum adiponectin and leptin levels was also estimated using r and om-effects meta analysis . RESULTS Eight-week supplementation with curcumin was associated with a significant increase in serum adiponectin levels ( P < 0.001 ) and a reduction in serum leptin concentrations ( P < 0.001 ) . Serum leptin : adiponectin ratio was also improved by curcumin ( P < 0.001 ) . These beneficial effects of curcumin remained significant after adjustment for changes in serum lipids and glucose concentrations and baseline differences in body mass index and serum levels of glucose and glycated hemoglobin as potential confounders of treatment response . Meta analysis suggested that curcumin supplementation can increase adiponectin levels by 76.78 % ( 95 % CI : 6.14 - 147.42 ; P = 0.0330 ) , and reduce leptin by 26.49 % ( 95 % CI : -70.44 to 17.46 ) , however this latter effect size did not reach statistical significance ( P = 0.238 ) . CONCLUSIONS Curcumin can improve serum levels of adiponectin and leptin in patients with metabolic syndrome . This trial was registered at the UMIN Clinical Trials Registry ( http://www.umin.ac.jp/ctr/ ) under Trial No. UMIN000018339 Objective . To investigate effects of weight loss on adipokines and health measures in obese older adults with symptomatic knee osteoarthritis . Methods . Participants were r and omly assigned to either weight loss ( WL ) ( men : 12 , women : 14 ) or weight stable ( WS ) group ( men : 12 , women : 13 ) .  WL intervention included meal replacements and structured exercise training .  Measurements of leptin , adiponectin , soluble leptin receptor , lifestyle behaviors , and body composition were collected at baseline and 6 months . Univariate analysis of covariance was performed on 6 month variables , and Spearman and partial correlations were made between variables . Results . Weight loss was 13.0 % and 6.7 % in WL for men and women , respectively . Women in WL had lower whole body and trunk fat than WS . The leptin : adiponectin ratio was lower for women in WL than WS at 6 months , with no group differences in adipokines for men . Leptin and free leptin index correlated with body fat in both genders at baseline . Interestingly , only women showed reductions in leptin ( P < 0.100 ) and correlations between the percentage change leptin and trunk fat and the percentage changes in free leptin index with total fat and trunk fat . Partial correlations between 6 month adipokines after adjustments for covariates and group/time period show potential multivariate influences . Conclusions . In the presence of an effective weight loss intervention in older obese adults , there are significant relationships between weight and fat loss and leptin in women , but not men , suggesting gender-specific features of adipokine metabolism in this age group OBJECTIVE Concerns regarding worsening insulin sensitivity associated with statin treatment have recently emerged . Therefore the aim of this study was to assess and compare the effects of 90-day monotherapies with fenofibrate and atorvastatin , as well as combined therapy , on fasting plasma glucose , insulin resistance index , adipokines ( leptin , resistin , adiponectin ) and levels of proinflammatory cytokines ( TNF-α , IL-6 ) in patients with impaired fasting glucose ( IFG ) and mixed hyperlipidemia . MATERIAL S AND METHODS 67 patients were r and omly assigned to four treatment arms : monotherapy with atorvastatin , monotherapy with fenofibrate , combined therapy ( fenofibrate and torvastatin ) or therapeutic lifestyle change . The study lasted for 90 days . All participants received counseling regarding proper diet and physical activity . RESULTS Compared to the control subjects , prediabetic patients exhibited elevated plasma levels of leptin , resistin , TNF-α and IL-6 , and a lower plasma level of adiponectin . All therapeutic interventions result ed in significant alterations in the lipid profile . Insulin resistance index ( HOMA-IR ) was reduced after treatment with fenofibrate . The effect of atorvastatin on insulin resistance was comparable to therapeutic lifestyle change alone . Therapy with hypolipidemic drugs caused increases in adiponectin levels and decreases in leptin and resistin . An additive effect of the combined treatment on plasma IL-6 level was also observed . CONCLUSIONS Fenofibrate-based treatment was associated with improved insulin sensitivity . Atorvastatin did not cause a deterioration in insulin sensitivity . Hypolipidemic therapies result ed in significant changes in the proinflammatory cytokine network as well as in adipokine levels . At the end of the study the measured parameters nearly resembled those of the healthy subjects Aims /hypothesisAdipokines may be important in mediating signals from adipocytes to insulin-sensitive tissue and vasculature . We studied the effect of different glucose-lowering therapies on serum levels of plasminogen activator inhibitor-1 ( PAI-1 ) , high-sensitivity C-reactive protein ( hs-CRP ) , TNF-α , leptin , adiponectin and ghrelin in patients with type 2 diabetes . Subjects and methods Twenty-eight patients with poorly controlled type 2 diabetes who were receiving oral hypoglycaemic agents  were allocated to one of the following groups , and treated for 1 year : ( 1 ) lifestyle intervention ( L ) ; ( 2 ) insulin treatment ( I ) ; and ( 3 ) combined treatment ( L+I ) . Results Similar improvements in glycaemic control occurred in all three groups . There was a reduction in body weight of 3.0 kg ( median ) ( 95 % CI −5.9 to −2.0 ) in group L , whereas in groups L+I and I body weight increased by 3.5 kg ( 95 % CI 1.5–4.9 ) and 4.9 kg ( 95 % CI −3.1 to 8.2 ) , respectively . By trend analyses , group L had reduced levels of PAI-1 ( p=0.002 ) , hs-CRP ( p<0.0001 ) and TNF-α ( p=0.006 ) , while no significant changes were observed in the levels of leptin or adiponectin . In group I , the median levels of PAI-1 ( p=0.008 ) , TNF-α ( p=0.058 ) and leptin ( p=0.004 ) increased . In the L+I group there was a reduction in PAI-1 levels ( p=0.014 ) and an increase in levels of leptin ( p<0.001 ) . The differences in changes in the levels of PAI-1 , hs-CRP , TNF-α and leptin between groups were also significant ( all p<0.01 ) . Conclusions /interpretationImprovement of glycaemic control through lifestyle intervention in type 2 diabetes had more beneficial effects on adipokine levels than when the same lowering of HbA1c was achieved with insulin treatment BACKGROUND Excess body weight and a sedentary lifestyle are associated with the development of several diseases , including cardiovascular disease , diabetes and cancer in women . One proposed mechanism linking obesity to chronic diseases is an alteration in adipose-derived adiponectin and leptin levels . We investigated the effects of 12-month reduced calorie , weight loss and exercise interventions on adiponectin and leptin concentrations . METHODS Overweight/obese postmenopausal women ( n = 439 ) were r and omized as follows : ( i ) a reduced calorie , weight-loss diet ( diet ; N = 118 ) , ( ii  ) moderate-to-vigorous intensity aerobic exercise ( exercise ; N = 117 ) , ( iii ) a combination of a reduced calorie , weight-loss diet and moderate-to-vigorous intensity aerobic exercise ( diet + exercise ; N = 117 ) , and ( iv ) control ( N = 87 ) . The reduced calorie diet had a 10 % weight-loss goal . The exercise intervention consisted of 45 min of moderate-to-vigorous aerobic activity 5 days per week . Adiponectin and leptin levels were measured at baseline and after 12 months of intervention using a radioimmunoassay . RESULTS Adiponectin increased by 9.5 % in the diet group and 6.6 % in the diet + exercise group ( both P ≤ 0.0001 vs. control ) . Compared with controls , leptin decreased with all interventions ( diet + exercise , -40.1 % , P < 0.0001 ; diet , -27.1 % , P < 0.0001 ; exercise , -12.7 % , P = 0.005 ) . The results were not influenced by the baseline body mass index ( BMI ) . The degree of weight loss was inversely associated with concentrations of adiponectin  ( diet , P-trend = 0.0002 ; diet + exercise , P-trend = 0.0005 ) and directly associated with leptin ( diet , P-trend < 0.0001 ; diet + exercise , P-trend < 0.0001 ) . CONCLUSION Weight loss through diet or diet + exercise  increased adiponectin concentrations . Leptin concentrations decreased in all of the intervention groups , but the greatest reduction occurred with diet + exercise . Weight loss and exercise exerted some beneficial effects on chronic diseases via effects on adiponectin and leptin Background : Type 2 diabetes mellitus ( T2DM ) is becoming a leading problem worldwide . Emerging reports reveal alarming evidence of increasing prevalence of T2DM that has reached p and emic levels . Despite the significant incidence , there are limited reliable data re sources and comprehensive systematic review and meta- analysis on the effects of yoga on people who are a prediabetic or high risk for developing T2DM . Objective : The objective of this protocol is to conduct a full-scale systematic review and meta-analyses on the effects of yoga on people who are prediabetes or high risk of developing T2DM . Methods : The articles enrolled in the study will be retrieved from the online data bases between 2002 and the date the search es are executed . The search es will be repeated just before the final analyses and further relevant studies for inclusion . We will conduct a bibliographic search in data bases : Medline / PubMed , Scopus , Cochrane Library , EBSCO , and IndMED using keywords including prediabetes state , high risk for diabetes , metabolic syndrome , and yoga . A defined search strategy will be implemented along with selection criteria to obtain full-text articles of relevant studies . This study protocol was prepared according to the Preferred Reporting Items for Systematic Review s and Meta- Analysis for Protocol s 2015 guidelines . There will be no language restrictions . Ethics and dissemination : The proposed study will be based on published studies and publicly available anonymized data without directly involving human participants and therefore requires neither formal human ethical review nor approval by a human research ethics committee . We published an outline of the protocol in the International Prospect i ve Register of Systematic Review s ( PROSPERO ) in 2018 . We plan to disseminate the findings of this systematic review and meta- analysis through publication in a peer- review ed journal and presentation at relevant conference proceedings . In addition , we believe the results of the systematic review will have implication s for policy and practice . We will prepare policymaker summary using a vali date d format , disseminate through social media and email discussion groups . Review registration number : PROSPERO registration number CRD Because chronic L-arginine supplementation improves insulin sensitivity and endothelial function in nonobese type 2 diabetic patients , the aim of this study was to evaluate the effects of a long-term oral L-arginine therapy on adipose fat mass ( FM ) and muscle free-fat mass ( FFM ) distribution , daily glucose levels , insulin sensitivity , endothelial function , oxidative stress , and adipokine release in obese type 2 diabetic patients with insulin resistance who were treated with a combined period of hypocaloric diet and exercise training .  Thirty-three type 2 diabetic patients participated in a hypocaloric diet plus an exercise training program for 21 days . Furthermore , they were divided into two groups in r and omized order : the first group was also treated with L-arginine ( 8.3 g/day ) , and the second group was treated with placebo . Although in the placebo group body weight , waist circumference , daily glucose profiles , fructosamine , insulin , and homeostasis model assessment index significantly decreased , L-arginine supplementation further decreased FM ( P < 0.05 ) and waist circumference ( P < 0.0001 ) , preserving FFM ( P < 0.03 ) , and improved mean daily glucose profiles ( P < 0.0001 ) and fructosamine ( P < 0.03 ) . Moreover , change in area under the curve of cGMP ( second messenger of nitric oxide ; P < 0.001 ) , superoxide dismutase ( index of antioxidant capacity ; P < 0.01 ) , and adiponectin levels ( P < 0.02 ) increased , whereas basal endothelin-1 levels ( P < 0.01 ) and leptin-to-adiponectin ratio ( P < 0.05 ) decreased in the L-arginine group . Long-term oral L-arginine treatment result ed in an additive effect compared with a diet and exercise training program alone on glucose metabolism and insulin sensitivity . Furthermore , it improved endothelial function , oxidative stress , and adipokine release in obese type 2 diabetic patients with insulin resistance Background : Dysregulation of adipokines , such as adiponectin and leptin , is associated with a variety of chronic diseases , including cancer . Physical activity protects against breast cancer and one of the mechanisms which may underlie this association is exercise-induced changes in adipokine levels . The WISER Sister Trial was a three-armed r and omized controlled trial in premenopausal women ( n = 137 ) with an elevated risk for breast cancer . Methods : A 5-menstrual-cycle-long dosed aerobic exercise intervention compared low-dose exercise ( 150 min/wk ; n = 44 ) or high-dose exercise ( 300 min/wk ; n = 48 ) with a control group asked to maintain usual activity levels ( n = 45 ) . Exercise intensity progressed to and was maintained at 70 % to 80 % of age predicted heart rate max . Body composition and adipokine levels were measured at baseline and follow-up . Results : We observed significant linear trends for increased fitness capacity ( Δ% : −2.0 % control , 10.1 % low dose , 13.1 % high dose ) , decreased fat tissue-to-total tissue mass ( Δ% : 0.7 % control , −2.9 % low dose , −3.7 % high dose ) , increased body fat adjusted adiponectin ( Δ% : −0.6 % control , 0.6 % low dose , 0.9 % high dose ) , and decreased body fat adjusted leptin ( Δ% : 0.7 % control , −8.2 % low dose , −10.2 % high dose ) . Conclusions : In this r and omized clinical trial of premenopausal women at risk for breast cancer , we demonstrate a dose – response effect of exercise on adiponectin and leptin and that dose response is dependent on changes in body fat . Impact : Improved adipokine levels , achieved by aerobic exercise training-induced decreases in body fat , may decrease breast cancer risk for high-risk premenopausal women . Cancer Epidemiol Biomarkers Prev ; 25(8 ) ; 1195–200 . © 2016 AACR BACKGROUND And rogen deprivation therapy ( ADT ) has significant deleterious effects on body composition that may be accompanied by unfavourable changes in adipokine levels . While exercise has been shown to improve a number of side effects associated with ADT for prostate cancer , no studies have assessed the effect of exercise on adiponectin and leptin levels , which have been shown to alter the mitogenic environment . METHODS Twenty-six men with prostate cancer treated with ADT were r and omized to home-based aerobic exercise training or resistance exercise training for 24 weeks . Adiponectin , leptin , insulin-like growth factor 1 ( IGF-1 ) , insulin-like growth factor binding protein 3 ( IGFBP-3 ) were analyzed by ELISA ( enzyme-linked immunosorbent assay ) , in addition to physical activity volume , peak aerobic capacity , and anthropometric measurements , at baseline , 3 months and 6 months . RESULTS Resistance exercise significantly reduced IGF-1 after 3 months ( p = 0.019 ) ; however , this change was not maintained at 6 months . At 6 months , IGFBP-3 was significantly increased compared to baseline for the resistance training group ( p = 0.044 ) . In an exploratory analysis of all exercisers , favourable changes in body composition and aerobic fitness were correlated with favourable levels of leptin , and favourable leptin : adiponectin and IGF-1:IGFBP-3 ratios at 3 and 6 months . CONCLUSIONS Home-based exercise is correlated with positive changes in adipokine levels and the IGF-axis that may be related to healthy changes in physical fitness and body composition . While the improvements of adipokine markers appear to be more apparent with resistance training compared to aerobic exercise , these findings must be considered cautiously and require replication from larger r and omized controlled trials to clarify the role of exercise on adipokines and IGF-axis proteins for men with prostate cancer For decades , exercise has been considered a cornerstone of diabetes management , along with diet and medication . However , high- quality evidence on the importance of exercise and fitness in diabetes was lacking until recent years . The present document summarizes the most clinical ly relevant recent advances related to people with type 2 diabetes and the recommendations that follow from these . Our recently published technical review on physical activity/exercise and type 2 diabetes ( 1 ) includes greater detail on individual studies , on prevention of diabetes , and on the physiology of exercise . The present statement focuses on type 2 diabetes . Issues primarily germane to type 1 diabetes will be covered in a subsequent technical review and ADA Statement . The levels of evidence used are defined by the ADA in ref . 2 . Two r and omized trials each found that lifestyle interventions including ∼150 min/week of physical activity and  diet-induced weight loss of 5–7 % reduced the risk of progression from impaired glucose tolerance ( IGT ) to type 2 diabetes by 58 % ( 3,4 ) . A cluster-r and omized trial found that diet alone , exercise alone , and combined diet and exercise were equally effective in reducting the progression from IGT to diabetes ( 5 ) . Therefore , there is firm and consistent evidence that programs of increased physical activity  and modest weight loss reduce the incidence of type 2 diabetes in individuals with IGT . Boule et al. ( 6 ) undertook a systematic review and meta- analysis on the effects of structured exercise interventions in clinical trials of ≥8 weeks duration on HbA1c ( A1C ) and body mass in people with type 2 diabetes . Postintervention A1C was significantly lower in exercise than control groups ( 7.65 vs. 8.31 % , weighted mean difference −0.66 % ; P < 0.001 ) . In contrast , postintervention body weight did not differ between the exercise and control groups . Meta-regression confirmed that the beneficial effect of exercise on A1C OBJECTIVE The long-term impact of intentional weight loss on cardiovascular events remains unknown . We describe 12-month changes in body weight and cardiovascular risk factors in PREvención con DIeta MEDiterránea (PREDIMED)-Plus , a trial design ed to evaluate the long-term effectiveness of an intensive weight loss lifestyle intervention on primary cardiovascular prevention . RESEARCH DESIGN AND METHODS Overweight/obese adults with metabolic syndrome aged 55–75 years ( n = 626 ) were r and omized to an intensive weight loss lifestyle intervention based on an energy-restricted Mediterranean diet , physical activity promotion , and behavioral support ( IG ) or a control group ( CG ) . The primary and secondary outcomes were changes in weight and cardiovascular risk markers , respectively . RESULTS Diet and physical activity changes were in the expected direction , with significant improvements in IG versus CG . After 12 months , IG participants lost an average of 3.2 kg vs. 0.7 kg in the CG ( P < 0.001 ) , a mean difference of −2.5 kg ( 95 % CI −3.1 to −1.9 ) . Weight loss ≥5 % occurred in 33.7 % of IG participants compared with 11.9 % in the CG ( P < 0.001 ) . Compared with the CG , cardiovascular risk factors , including waist circumference , fasting glucose , triglycerides , and HDL cholesterol , significantly improved in IG participants ( P < 0.002 ) . Reductions in insulin resistance , HbA1c , and circulating levels of leptin , interleukin-18 , and MCP-1 were greater in IG than CG participants ( P < 0.05 ) . IG participants with prediabetes/diabetes significantly improved glycemic control and insulin sensitivity , along with triglycerides and HDL cholesterol levels compared with their CG counterparts . CONCLUSIONS PREDIMED-Plus intensive lifestyle intervention for 12 months was effective in decreasing adiposity and improving cardiovascular risk factors in overweight/obese older adults with metabolic syndrome , as well as in individuals with or at risk for diabetes Practical methods to reduce the risk of obesity-related breast cancer among high-risk subgroups are lacking . Few studies have investigated the effects of exercise on circulating adipokines , which have been shown to be associated with obesity and breast cancer . The aim of this study was to examine the effects of a walking intervention on serum adiponectin , leptin , and the adiponectin-to-leptin ratio ( A/L ) .  Seventy-one overweight and obese postmenopausal women at increased risk of developing breast cancer were stratified by BMI ( 25–30 kg/m2 or > 30 kg/m2 ) and r and omized to a 12-week , two-arm walking intervention administered through interactive voice response ( IVR ) and mobile devices . The intervention arms were IVR + coach and IVR + no-coach condition . Pre – post changes in serum adiponectin , leptin , and the A/L ratio were examined using mixed regression models , with ratio estimates ( and 95 % confidence intervals [ CI ] ) corresponding to postintervention adipokine concentrations relative to preintervention concentrations . While postintervention effects included statistically significant improvements in anthropometric measures , the observed decreases in adiponectin and leptin ( ratio = 0.86 , 95 % CI 0.74–1.01 , and ratio = 0.94 , 95 % CI 0.87–1.01 , respectively ) and increase in A/L ratio = 1.09 , 95 % CI 0.94–1.26 ) were not significant . Thus , these findings do not support significant effects of the walking intervention on circulating adipokines among overweight and obese postmenopausal women . Additional studies are essential to determine the most effective and practical lifestyle interventions that can promote beneficial modification of serum adipokine concentrations , which may prove useful for obesity-related breast cancer prevention Phytoestrogens and training could be effective to reduce cardiovascular and type 2 diabetes mellitus risk factors in postmenopausal women . Nevertheless , the impact of their combination on adipokines and systemic inflammation was never investigated . The objective was to verify if 6 months of mixed training combined with phytoestrogens could have an additional effect on adipokine levels and systemic inflammation in obese postmenopausal women . Fifty-two obese women aged between 50 and 70 years were r and omly assigned to ( 1 ) exercise with placebo ( EX + PL ; n = 25 ) or ( 2 ) exercise with phytoestrogens ( EX + PHY ; n = 27 ) . Body weight , waist circumference , fat mass , and lean body mass ( dual-energy x-ray absorptiometry ) were assessed . Fasting plasma glucose and insulin , adiponectin , leptin , and C-reactive protein ( CRP ) levels were obtained after a 12-hour overnight fast . Total energy intake was measured with a 3-day dietary record . All measurements were performed before and after the 6-month intervention . Although energy intake remained unchanged , body composition was improved in all women ( all Ps < .02 ) . Plasma CRP and leptin levels decreased in both groups similarly ( all Ps < .03 ) , whereas plasma adiponectin and insulin did not change with exercise combined with placebo or phytoestrogens . Correlation analyses showed that homeostasis model assessment of insulin resistance ( r = -0.58 , P = .02 ) and fasting insulin levels ( r = -0.42 , P = .02 ) at baseline were both correlated with changes in leptin levels . Baseline fasting glucose ( r = -0.36 , P = .03 ) and adiponectin ( r = 0.45 , P = .005 ) levels were associated with changes in CRP concentrations . Although mixed exercise program combined with phytoestrogens does not seem to provide any additional effect , mixed training improves systemic inflammation and leptin concentrations in obese postmenopausal women AIMS To investigate the short-term ( 16 weeks ) effect of lifestyle intervention on insulin sensitivity , anthropometric and metabolic variables in non-diabetic first-degree relatives of type 2 diabetic patients ( FDR ) . METHODS Seventy-seven ( 49 male , 28 female ) FDR were allocated to one of three groups , diet ( D-group ; n = 25 ) , diet and exercise ( DE-group ; n = 30 ) or control group ( C-group ; n = 22 ) . Lifestyle counselling was based on current nutrition recommendations , including increased intake of fatty fish and low glycaemic index foods . Group counselling was given on two occasions with follow-up through telephone interviews every 10 days . Assessment s included insulin sensitivity index ( Si ) , anthropometry , lipid parameters , circulating leptin and adiponectin levels . RESULTS The D-group reduced total cholesterol ( -0.31 mmol/l , P = 0.024 ) , LDL cholesterol ( -0.22 mmol/l , P = 0.021 ) and apolipoprotein B ( -9.5 mg/dl , P = 0.009 ) levels , whereas the DE-group decreased body weight ( -2.1 % , P = 0.030 ) and waist circumference ( -3.0 cm , P < 0.001 ) versus controls . A 13 % reduction in fasting insulin was observed in the DE-group , but no significant improvement in Si in D-group or DE-group was observed . A subgroup , adherent to diet and who increased exercise , significantly improved Si and lipid profile . CONCLUSIONS The improved metabolic risk profile in FDR suggests that lifestyle changes can be effective in individuals at high risk to develop type 2 diabetes and cardiovascular disease Background : Adipokines play an important role in glucose , lipid and lipoprotein metabolisms , as well as in coagulation and inflammatory processes . So far , studies have evaluated the association of individual adipokines with future coronary heart disease ( CHD ) event and provided mixed results . Objectives : We sought to investigate the association of a set of adipocytokines , including total adiponectin , adipsin , resistin , leptin and plasminogen activator inihibitor-1 ( PAI-1 ) , with future CHD events in apparently healthy men . Methods : We built a nested case – control study within the PRIME Study , a multicenter prospect i ve cohort of 9779 healthy European middle-aged men .  Total adiponectin , adipsin , resistin , leptin and PAI-1  were measured in the baseline plasma sample of 617 men who developed a first CHD event ( coronary death , myocardial infa rct ion , stable or unstable angina ) during 10 years of follow-up and in 1215 study -matched controls , by multiplex assays using commercial kits . HRs for CHD were estimated by conditional logistic regression analysis . Results : Median concentrations of total adiponectin , adipsin and resistin were similar in cases and in controls , whereas those of leptin and PAI-1 were higher in cases than in controls , 6.30 vs 5.40 ng ml−1 , and 10.09 vs 8.48 IU ml−1 , respectively . The risk of future CHD event increased with increasing quintiles of baseline leptin and PAI-1 concentrations only in unadjusted analysis ( P-value for trend < 0.003 and < 0.0001 , respectively ) . However , these associations were no longer significant after adjustment for usual CHD risk factors including hypertension , diabetes , smoking , total cholesterol , triglycerides and HDL cholesterol . Conversely , baseline CRP and IL-6 levels remained associated with CHD risk in multivariate analysis . Conclusions : In apparently healthy men  , circulating total adiponectin , adipsin , resistin , leptin and PAI-1 were not independent predictors of future CHD event Women who are obese at the time of breast cancer diagnosis have higher overall mortality than normal weight women and some evidence implicates adiponectin and leptin as contributing to prognostic disadvantage . While intentional weight loss is thought to improve prognosis , its impact on these adipokines is unclear . This study compared the pattern of change in plasma leptin and adiponectin in overweight-to-obese post-menopausal breast cancer survivors during  weight loss .  Given the controversies about what dietary pattern is most appropriate for breast cancer control and regulation of adipokine metabolism , the effect of a low fat versus a low carbohydrate pattern was evaluated using a non-r and omized , controlled study design .  Anthropometric data and fasted plasma were obtained monthly during the six-month weight loss intervention . While leptin was associated with fat mass , adiponectin was not , and the lack of correlation between leptin and adiponectin concentrations throughout weight loss implies independent mechanisms of regulation . The temporal pattern of change in leptin but not adiponectin was affected by magnitude of weight loss . Dietary pattern was without effect on either adipokine . Mechanisms not directly related to dietary pattern , weight loss , or fat mass appear to play dominant roles in the regulation of circulating levels of these adipokines Low-glycemic load ( GL ) diets improve insulin resistance and glucose homeostasis in individuals with diabetes . Less is known about whether low-GL diets , independent of weight loss , improve the health profile for persons without diabetes or other preexisting conditions . We conducted a r and omized , cross-over feeding study testing low- compared to High-GL diets on biomarkers of inflammation and adiposity in healthy adults . Eighty participants ( n = 40 with BMI 18.5 - 24.9 kg/m² ; n = 40 with BMI 28.0 - 40.0 kg/m² ) completed two 28-d feeding periods in r and om order where one period was a high-GL diet ( mean GL/d = 250 ) and the other a low-GL diet ( mean GL/d = 125 ) . Diets were isocaloric with identical macronutrient content ( as percent energy ) . All food was provided and participants maintained weight and usual physical activity . Height , weight , and DXA were measured at study entry and weight assessed again thrice per week . Blood was drawn from fasting participants at the beginning and end of each feeding period and serum concentrations of high-sensitivity CRP , serum amyloid A , IL-6 , leptin , and adiponectin were measured . Linear mixed models tested the intervention effect on the biomarkers ; models were adjusted for baseline biomarker concentrations , diet sequence , feeding period , age , sex , and body fat mass . Among participants with high-body fat mass ( > 32.0 % for males and > 25.0 % for females ) , the low-GL diet reduced CRP ( P = 0.02 ) and marginally increased adiponectin ( P = 0.06 ) . In conclusion , carbohydrate quality , independent of energy , is important . Dietary patterns emphasizing low-GL foods may improve the inflammatory and adipokine profiles of overweight and obese individuals BACKGROUND In a r and omized , controlled , 2 x 2 factorial trial on the effect of long-term changes in diet and exercise , a significant reduction in body weight and fat mass was observed . Alterations in leptin and plasminogen activator inhibitor-1 concentrations were previously reported from this study . OBJECTIVE We examined the separate and combined effects of a 1-y exercise and diet intervention on several adipokines ; adiponectin , interleukin-6 and -8 , tumor necrosis factor-alpha , monocyte chemoattractant protein-1 , hepatocyte growth factor , nerve growth factor , C-reactive protein , and resistin . DESIGN One hundred eighty-eight men with several risk factors for diabetes and cardiovascular disease were r and omly allocated to 4 groups : diet , exercise , combined diet and exercise , and control . RESULTS Plasma adiponectin concentrations remained unchanged , whereas body mass index and fat mass decreased after dietary changes and an increase in physical activity . In the control group , adiponectin concentrations were reduced . Analyzed according to the factorial design , only diet intervention had a significant ( P = 0.03 ) positive effect on plasma adiponectin relative to control , and this effect was largely explained by changes in fat mass . After adjustment for change in percentage body fat , there were significant positive effects on tumor necrosis factor-alpha in all 3 intervention groups ( P = 0.01 for the diet group , 0.03 for the exercise group , and 0.05 for the combined diet and exercise group ) . Minor changes were observed for the other adipokines . Neither baseline concentrations of nor changes in adiponectin and plasminogen activator inhibitor-1 were significantly correlated to the other adipokines , whereas concentrations of and changes in the other adipokines were significantly correlated . CONCLUSION Diet intervention had a significant positive effect on adiponectin concentrations , which is largely explained by a reduction in fat mass OBJECTIVES Chronic inflammation of periodontitis aggravates glycemic control in type 2 diabetic patients through aggravation of insulin resistance . Increased or decreased release of various inflammatory mediators , such as high sensitivity C-reactive protein ( hs-CRP ) , tumor necrosis factor (TNF)-α , interleukin (IL)-6 and adipokines , such as adiponectin , leptin , and resistin , are presumed to be responsible for developing and progressing insulin resistance . The purpose of this study was to examine the effects of periodontal treatment on glycemic control , serum inflammatory mediators and adipokines in type 2 diabetes patients with periodontitis . METHODS Twenty-one type 2 diabetic patients with periodontitis received periodontal treatment with topical antibiotics ( intervention group ) and 8 patients did not receive periodontal treatment ( control group )  . Periodontal examination , including probing pocket depth ( PPD ) and bleeding on probing ( BOP ) , and blood sampling  were performed at baseline , 2 and 6 months after periodontal treatments . Glycated hemoglobin ( HbA1c ) , hs-CRP , TNF-α , IL-6 , adiponectin , leptin , and resistin were analyzed . RESULTS In the intervention group , improvements of PPD and BOP , decrease in HbA1c and elevation of serum adiponectin were observed , while in the control group , all parameters were not changed . Generalized linear model revealed that changes of serum adiponectin and TNF-α and change of BOP correlated significantly with the reduction of HbA1c at 6 months after periodontal treatments . CONCLUSION The results demonstrated that periodontal treatment improves periodontal status and glycemic control with elevation of serum adiponectin in type 2 diabetic patients . The results suggest that HbA1c is reduced by amelioration of insulin resistance due to elevated serum adiponectin after periodontal treatments
As for physical exercise modalities , aerobic exercise , but not other modalities , increased adiponectin and reduced leptin levels .
In conclusion , physical exercise and , specifically , aerobic exercise , leads to higher adiponectin and lower leptin levels  in prediabetic and diabetic adults .
It is speculated that lifestyle interventions known to improve diabetic metabolic state may exert their effects via adipokines .
The aim of this systematic review and meta- analysis was to evaluate the chronic effects of physical exercise on adiponectin and leptin levels in adult prediabetic and diabetic individuals .