Inflammatory cytokines and immune system response to weight reduction in obese patients with type 2 diabetes mellitus
More details
Hide details
Department of Physical Therapy, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.
Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University
Online publication date: 2017-12-29
Publication date: 2018-01-03
Corresponding author
Shehab M. Abd El-Kader   

Department of Physical Therapy, Faculty of Applied Medical Sciences, King Abdulaziz University, P.O. Box 80324, Jeddah, 21589,Saudi Arabia
Eur J Gen Med 2018;15(1):10-15
Systemic inflammation and activated immune system response are common features in obese patients with non-insulin dependent diabetes mellitus (NIDDM) as obesity-induced NIDDM represents a burden for healthcare systems worldwide. However, there is a strong association between BMI and the human immune system and systemic inflammation among obese patients with NIDDM.

Material and Methods:
Eighty obese patients with NIDDM participated in this study, their age ranged from 41-52 years and their BMI ranged from 31-36 kg/m2. All Subjects were included in two groups: The first group received life style modification in the form of treadmill aerobic exercises in addition to diet control where, the second group received no therapeutic intervention. Parameters of CD4 and CD8 cells count were quantified, IL-6, TNF-α, leptin and body mass index (BMI) were measured before and after 3 months at the end of the study.

The mean values of CD4 and CD8 cells count were significantly increased, where mean values of TNF-α, IL-6, IL-8 and body mass index (BMI) were significantly decreased in group (A). While group (B) showed non-significant changes in these parameters. Also; there were significant differences between mean levels of the investigated parameters in group (A) and group (B) at the end of the study.

Within the limit of this study, life style modification modulates systemic inflammation and immunological parameters among obese patients with NIDDM.

This study aimed to examine effects of weight reducing program on selected immune and systemic inflammation parameters among obese patients with NIDDM.

Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27:1047–53.
Shu CJ, Benoist C, Mathis D. The immune system’s involvement in obesity-driven type 2 diabetes. Semin Immunol. 2012;24(6):436-42.
Donath M, Shoelson S. Type 2 diabetes as an inflammatory disease. Nat Rev Immunol. 2011; 11:98–107.
Chawla A, Nguyen K, Goh Y: Macrophage-mediated inflammation in metabolic disease. Nat Rev Immunol. 2011;11:738–49.
Cruz N, Sousa L, Sousa M, Pietrani N, Fernandes A, Gomes K. The linkage between inflammation and Type 2 diabetes Mellitus. Diabetes Res Clin Pract. 2013; 99(2):85-92.
Marti A, Marcos A, Martinez J. Obesity and immune function relationships. Obes Rev. 2001;2(2):131-40.
Renehan A, Tyson M, Egger M, Heller R, Zwahlen M. Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet. 2008;371:569–78.
Nieman D, Nehlsen-Cannarella S, Henson D, Butterworth D, Fagoaga OR. Immune response to obesity and moderate weight loss. Int J Obes Relat Metab Disord. 1996;20:353-360.
Womack J, Tien PC, Feldman J, Shin JH, Fennie K, Anastos K, Cohen MH, Bacon MC, Minkoff H. Obesity and immune cell counts in women. Metabolism. 2007;56(7):998-1004.
Kintscher U, Hartge M, Hess K, Foryst-Ludwig A, Clemenz M, Wabitsch M, Fischer-Posovszky P, Barth TF, Dragun D, Skurk T, Hauner H, Blüher M, Unger T, Wolf AM, Knippschild U, Hombach V, Marx N. T-lymphocyte infiltration in visceral adipose tissue: a primary event in adipose tissue inflammation and the development of obesity-mediated insulin resistance. Arterioscler Thromb Vasc Biol. 2008;28:1304–10.
Antuna-Puente B, Feve B, Fellahi S, Bastard J. Adipokines: the missing link between insulin resistance and obesity. Diabetes Metab. 2008;34:2–11.
American College of Sports Medicine. Guidelines for graded exercise testing and exercise prescription, Lea & Febiger, Philadelphia. 2005.
World Health Organization. Diet, Nutrition and the Prevention of Chronic Diseases. London, HMSO (Tech. Rep. Ser., no. 797). 1990.
Sciacqua A, Candigliota M, Ceravolo R, Scozzafava A, Sinopoli F, Corsonello A, Sesti G, Perticone F. Weight loss in combination with physical activity improves endothelial dysfunction in human obesity. Diabetes Care. 2003;26:1673-8.
Murakami T, Horigome H, Tanaka K, Nakata Y, Ohkawara K, Katayama Y, Matsui A. Impact of weight reduction on production of platelet-derived microparticles and fibrinolytic parameters in obesity. Thrombosis Research. 2007;119:45-53.
Dandona P, Weinstock R, Thusu K, Abdel-Rahman E, Aljada A, Wadden T. Tumor necrosis factor-α in serum of obese patients: fall with weight loss. J Clin Endocrinol Metab. 1998;83(8):2907-10.
Sandoval D, Davis S: Leptin, Metabolic control and regulation. J. Diabetes Complications. 2003;17(2):108-13.
Loria-Kohen V, Fernández-Fernández C, Bermejo LM, Morencos E, Romero-Moraleda B, Gómez-Candela C. Effect of different exercise modalities plus a hypocaloric diet on inflammation markers in overweight patients: A randomised trial. Clinical Nutrition. 2013;32:511-8.
Balagopal P, George D, Patton N, Yarandi H, Roberts WL, Bayne E, Gidding S. Lifestyle-only intervention attenuates the inflammatory state associated with obesity: a randomized controlled study in adolescents. Journal of Pediatrics. 2005;146(3):342–8.
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,” Journal of the American Medical Association. 2003;289(14):1799–804.
You T, Nicklas B. Chronic inflammation: role of adipose tissue and modulation by weight loss. Curr. Diabetes Rev. 2006;2:29–37.
Nicklas B, You T, Pahor M. Behavioural treatments for chronic systemic inflammation: effects of dietary weight loss and exercise training. CMAJ. 2005;172:1199–209.
Mathur M, Pedersen B. Exercise as a mean to control low-grade inflammation. Mediators Inflamm. 2008:109502.
Timmerman K, Flynn M, Coen P, Markofski M, Pence B. Exercise training-induced lowering of inflammatory (CD14+CD16+) monocytes: a role in the anti-inflammatory influence of exercise? Leukoc Biol. 2008;84:1271–8.
Wang J, Song H, Tang X, Yang Y, Vieira VJ, Niu Y, Ma Y. Effect of exercise training intensity on murine T regulatory cells and vaccination response. Scand J Med Sci Sports. 2012;22(5):643-52.
Wasinski F, Bacurau RF, Moraes MR, Haro AS, Moraes-Vieira PM, Estrela GR, Paredes-Gamero EJ, Barros CC, Almeida SS, Câmara NO, Araujo RC. Exercise and Caloric Restriction Alter the Immune System of Mice Submitted to a High-Fat Diet. Mediators Inflamm. 2013;395672.
Lamas O, Martı´nez J, Marti A. Energy restriction restores the impaired immune response in overweight (cafeteria) rats. Journal of Nutritional Biochemistry. 2004;15:418–25.
Starkie R, Ostrowski S, Jauffred S, Febbraio M, Pedersen B. Exercise and IL-6 infusion inhibit endotoxin induced TNF-alpha production in humans. The FASEB Journal. 2003;17(8):884–6.
Jankord R, Jemiolo B. Influence of physical activity on serumIL-6 and IL-10 levels in healthy older men. Medicine and Science in Sports and Exercise. 2004;36(6): 960–4.
Kasapis C, Thompson P. The effects of physical activity on serum C-reactive protein and inflammatory markers: a systematic review. Journal of the American College of Cardiology. 2005; 45(10):1563–9.
Journals System - logo
Scroll to top