Effects of Different Doses of Exercise on Inflammation Markers Among Adolescents With Overweight/Obesity: HEPAFIT Study

Abstract

Propose Obesity-related metabolic risk factors in adolescents with overweight/obesity may be associated with systemic low-grade inflammation, and therefore we investigated whether a 6-month exercise training altered markers of inflammation. Methods Secondary analyses of a randomized controlled exercise-based intervention trial (September 2017 to December 2018). Adolescents aged 11 to 17 years (Tanner stage II to V), 70% girls, with a body mass index (BMI) z-score at or above the 85 th percentile, and/or with excess of adiposity (body fat >30%). The participants were randomly assigned to the following 4 groups for 6 months: (1) standard physical education lessons, as a control (CTRL); (2) high-intensity physical education class (HIPE); (3) low-to-moderate intensity physical education class (LIPE); (4) a combined group (PLUS group). Inflammatory markers and immune molecules including chemokines, cytokines, and growth factors (n=65 biomarkers) were determined by cytokine antibody array. Results Of the 120 randomly assigned participants, 95 were included in the analysis. Considering these 22 proteins, the LIPE group shows statistical significance in 9 proteins with logfold-change (logFC) and p<0.05 was found in BLC, Eotaxin, FGF-6, GCP-2, I-309, IGFBP-4, MCP-4, NAP-2, and PARC), followed by the PLUS group in 9 proteins (BLC, EGF, Eotaxin, FGF-6, MCP-4, NAP-2, Osteopontin, PARC, and RANTES), the HIPE group in 7-proteins (FGF-4, FGF-7, GCP-2, IGF-1, IGFBP-1, IGFBP-4, and MIP-1 delta), the CTRL group in 6 proteins (FGF-4, IP-10, Leptin, MCP-1, MIG, and MIP-1 delta). However, sub-analysis performed to detect differentially expressed proteins at baseline and post-intervention, with significance at an adjusted p value ≤ 0.05 and absolute (logFC) ≥ 1.0, shown three down-regulated proteins in the LIPE group (BLC (logFC)= 1.27, Eotaxin (logFC)= 1.18 and MCP-4 (logFC)= 1.14), and four proteins in the HIPE group (BLC (logFC)= 1.45, FGF-6 (logFC)= 1.20, MCP-4 (logFC)= 1.50, and PARC ​(logFC)= 1.33), supporting that the changes that we observed in the exercise groups were not time-related changes but occurred in response to exercise. Conclusions Implementing a 6-month physical exercise program in overweight/obese adolescents, based on LIPE and PLUS groups, significantly change several circulating inflammatory levels. Interventions involving supervised physical exercise may reduce the associated effects of systemic low-grade inflammation, thus preventing the development of obesity-related metabolic diseases in adolescents with overweight/obesity.

Effects of different types of exercise intensity on improving health-related physical fitness in children and adolescents: a systematic review

“…We first imported the documents into the document management software Endnote, and after removing duplicate documents and screening titles and Ramirez-Velez etal. 30 1…”

“…Each exercise lasts 60 min, with walking and running at different intensities crossed Tadiotto et al 28 HIIT reduces BMI-z, waist-to-height ratio, and improves physical fitness 52 adolescents (11)(12)(13)(14)(15)(16) Ramirez-Velez etal. 30 Based on the LIPE and groups, several levels of circulating inflammation can be significantly altered 95 adolescents (M = 13.5 ± 1.6 years) Randomly assigned School-based exercise programs. 3 times a week for 6 months Cao et al 31 HIIT was highly effective in improving cardiopulmonary function fitness compared to MICT and had a similar effect in improving body composition in obese boys.…”

The Related Metabolic Diseases and Treatments of Obesity

“…A clinical study (NCT02753231) shows that a low-to-moderate intensity physical education class (LIPE), or its combination with a high-intensity physical education class, significantly regulates the expression of inflammatory or immune regulatory markers, including C-X-C motif chemokine ligand 13 (CXCL13, or BLC), C-C motif chemokine ligand 5 (CCL5), CCL11, CCL13, CCL18, and FGF6 [ 74 ]. A mouse study also shows that exercise reduces the expression of TNF-α and macrophage marker F4/80 in adipose tissues in HFD-fed mice, but it increases the expression of the M2 macrophage marker CD163, indicating phenotypic switching from M1 to M2 macrophages in adipose tissues [ 75 ].…”

Resistance exercise training augments the immunomodulatory adaptations to aerobic high‐intensity interval training

“…In addition to these single comparisons of uni – and multi‐modal aerobic and RE protocols, a systematic review revealed that aerobic exercise (AE) is more likely than other types to induce a negative impact on the TLR4 pathway (Cavalcante et al, 2017). In addition, a cytokine antibody array (more than 60 biomarkers) study comparing the effects of four different exercise modalities on inflammation revealed that combined exercise (multi‐modal) is more likely to reduce chronic systemic low‐grade inflammation during obesity (Ramírez‐Vélez et al, 2022).…”