human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective : Adipokines are signaling and mediator proteins secreted from adipose tissue . A novel adipokine , visfatin , was reported as a protein which was mainly expressed in visceral adipose tissue . Controversial results have been shown regarding the changes of adipokines following weight reduction . So we investigated the effects of weight reduction on serum concentrations of adiponectin and visfatin in morbidly obese subjects . Methods : 35 severely obese patients ( 26 females and 9 males ) , aged 15 - 58 years , were studied .  Anthropometric parameters and biochemical parameters  as well as  adiponectin and visfatin were analyzed before and 6 weeks after weight reduction . Results : Anthropometric indices decreased significantly . Blood levels of low-density lipoprotein cholesterol , high-density lipoprotein cholesterol , and triglyceride were reduced significantly . The reduction of visfatin and the elevation of adiponectin were significant as well . However , other parameters like fasting glucose and insulin did not change . Moreover , we could not find any significant correlation between the change of serum visfatin and that of adiponectin . Conclusions : 6-week weight reduction after bariatric surgery result ed in decreased serum visfatin and increased adiponectin levels . However , we can not find any significant correlation between changes of adiponectin , visfatin , BMI , waist circumference , and insulin resistance . Further studies with different design are suggested to clarify these associations BACKGROUND Weight loss , through calorie restriction or increases in energy expenditure via exercise , improves glucose tolerance and insulin action . However , exercise-induced energy expenditure may further improve glucoregulation through mechanisms independent of weight loss . OBJECTIVE The objective was to assess the hypothesis that weight loss through exercise-induced energy expenditure improves glucoregulation and circulating factors involved in insulin action to a greater extent than does similar weight loss through calorie restriction . DESIGN Sedentary men and women aged 50 - 60 y with a body mass index ( kg/m(2 ) ) of 23.5 - 29.9 were r and omly assigned to 1 of 2 weight-loss interventions [ 12 mo of exercise training ( EX group ; n = 18 ) or calorie restriction ( CR group ; n = 18 ) ] or to a healthy lifestyle ( HL ) control group ( n = 10 ) . The insulin sensitivity index and areas under the curve for glucose and insulin were assessed with an oral-glucose-tolerance test . Adiponectin and tumor necrosis factor alpha concentrations were measured in fasting serum . Fat mass was measured by dual-energy X-ray absorptiometry . RESULTS Yearlong energy deficits were not significantly different between the EX and CR groups , as evidence d by body weight and fat mass changes . The insulin sensitivity index increased and the glucose and insulin areas under the curve decreased in the EX and CR groups , remained unchanged in the HL group , and did not differ significantly between the EX and CR groups . Marginally significant increases in adiponectin and decreases in the ratio of tumor necrosis factor alpha to adiponectin occurred in the EX and CR groups but not in the HL group . CONCLUSIONS Weight loss induced by exercise training or calorie restriction improves glucose tolerance and insulin action in nonobese , healthy , middle-aged men and women . However , it does not appear that exercise training-induced  weight loss results in greater improvements than those that result from calorie restriction alone Study ing the links between dietary patterns and obesity is especially relevant for Middle-Eastern population s because of their high prevalence of a particular type of obesity , the so-called Middle-Eastern pattern , and their diets ' unique characteristics . Therefore , we wondered if major dietary patterns are related to the prevalence of general obesity and central adiposity among Iranian women . In this cross-sectional study of 486 women aged 40 - 60 y , usual dietary intakes were evaluated using a FFQ and anthropometric measurements .  By the use of factor analysis , we extracted 3 major dietary patterns : healthy dietary pattern , western dietary pattern , and Iranian dietary pattern . Individuals in the upper category of the healthy pattern score were less likely to be generally ( OR = 0.28 ; 95 % CI = 0.14 - 0.53 ) and central ly obese ( OR = 0.30 ; 95 % CI = 0.16 - 0.55 ) , whereas those in the upper quintile of western pattern had greater odds ( for general obesity : 2.73 ; 95 % CI = 1.46 - 5.08 and for central obesity : 5.74 ; 95 % CI = 2.99 - 10.99 ) . Controlling for potential confounders attenuated the associations , but even after adjusting for energy intake , the associations were significant for both general and central obesity . Although the Iranian dietary pattern and general obesity were not significantly associated , subjects in the highest quintile had greater odds of being central ly obese , either before ( OR = 2.15 ; 95 % CI = 1.18 - 3.90 ) or after ( OR = 2.08 ; 95 % CI = 1.09 - 3.65 ) control for confounders . This study indicates significant associations among  major dietary patterns , general obesity , and central adiposity in a Middle-Eastern country . Further prospect i ve investigations are required to confirm such associations BACKGROUND Although the typical diet of the Mediterranean region has received much recognition over the past several years for its association with substantial health benefits , it remains unknown whether its favorable effects are mediated through changes in adiponectin concentrations . OBJECTIVE The objective was to determine whether adherence to a Mediterranean-type diet is associated with higher plasma adiponectin concentrations . DESIGN This study was a prospect i ve and cross-sectional evaluation of plasma adiponectin concentrations and dietary data from 987 diabetic women from the Nurses ' Health Study who had no history of cardiovascular disease at the time blood was drawn in 1990 . RESULTS Women who scored highest on a 9-point scale that measures adherence to a Mediterranean-type dietary pattern tended to be older , were less likely to be current smokers , had lower body mass indexes and waist circumferences , and had higher total energy intakes , physical activities , and plasma adiponectin concentrations than did women with the lowest scores . Median plasma adiponectin concentrations were 23 % higher in women who most closely followed a Mediterranean-type diet than in low adherers after adjustment for age and energy intake ( P < 0.01 ) . Body composition , lifestyle , and medical history explained some , but not all , of the observed association between diet and adiponectin concentrations because high adherers tended to have greater adiponectin concentrations than did moderate or low adherers , even after adjustment for these variables . CONCLUSIONS Our data suggest that , of the several components of the Mediterranean dietary pattern score , alcohol , nuts , and whole grains show the strongest association with adiponectin concentrations . Close adherence to a Mediterranean-type diet is associated with higher adiponectin concentrations Among the factors influencing weight loss and maintenance , psychobehavioral , nutritional , metabolic , hormonal and hereditary predictors play an important role . Psychobehavioral factors influence adherence to lifestyle changes and thus weight loss maintenance . The outcome of short-term weight reduction treatment is mainly affected by changes in energy and nutrient intake and physical activity and thus the impact of hormones can possibly be obscured . In order to reveal hormonal determinants of weight loss , a 4-week in-patient comprehensive weight reduction program was introduced in which food intake and physical activity were under the strict control . Women ( n = 67 , BMI : 32.4+/-4.4 kg ; age : 48.7+/-12.2 years ) who exhibited stable weight on a 7 MJ/day diet during the first week of weight management were given a hypocaloric diet yielding daily energy deficit 2.5 MJ over the subsequent 3-week period . This treatment result ed in a mean weight loss of 3.80+/-1.64 kg . Correlation analysis revealed that baseline concentrations of several hormones were significantly associated either with a higher ( free triiodothyronine , C-peptide , growth hormone , pancreatic polypeptide ) or with a lower ( insulin-like growth factor-I , cortisol , adiponectin , neuropeptide Y ) reduction of anthropometric parameters in response to weight management . In a backward stepwise regression model age , initial BMI together with baseline levels of growth hormone , peptide YY , neuropetide Y and C-reactive protein predicted 49.8 % of the variability in weight loss . Psychobehavioral factors ( items of the Eating Inventory , Beck Depression score ) did not contribute to weight change induced by a well-controlled short-term weight reduction program Weight loss intervention is the principal non-pharmacological method for prevention and treatment of type 2 diabetes . However , little is known whether it influences insulin sensitivity directly or via its anti-inflammatory effect . The aim of this study was to assess the independent role of changes in inflammation status and weight loss on insulin sensitivity in this population .Overweight and obese nondiabetic participants without co-morbidities underwent a one-year weight loss intervention focused on caloric restriction and behavioral support . Markers of inflammation , body composition , anthropometric para-meters , and insulin sensitivity were recorded at baseline , 6 , and 12 months . Insulin sensitivity was assessed with frequently sample d intravenous glucose tolerance test and Minimal Model . Twenty-eight participants ( F : 15 , M : 13 , age 39±5 years , BMI 33.2±4.6 kg/m(2 ) ) completed the study , achieving 9.4±6.9 % weight loss , which was predominantly fat mass ( 7.7±5.6 kg , p<0.0001 ) . Dietary intervention result ed in significant decrease in leptin , leptin-to-adiponectin ratio , hs-CRP , and IL-6 ( all p<0.02 ) , and improvement in HOMA-IR and Insulin Sensitivity Index ( SI ) ( both p<0.001 ) . In response to weight loss IL-1β , IL-2 , leptin , and resistin were significantly associated with insulin , sensitivity , whereas sICAM-1 had only marginal additive effect . Moderate weight loss in otherwise healthy overweight and obese individuals result ed in an improvement in insulin sensitivity and in the overall inflammation state ; the latter played only a minimal independent role in modulating insulin sensitivity Calorie restriction ( CR ) and alternate-day fasting ( ADF ) beneficially affect several aspects of adipose tissue physiology , but direct comparisons between regimens have yet to be performed . The present study evaluated the effects of ADF versus CR on body fat distribution and circulating adiponectin levels and examined the kinetic mechanisms that underlie changes in fat distribution . Thirty female C57BL/6J mice were r and omized to one of five groups for 4 weeks : ( a ) CR-25 % ( 25 % energy restriction daily ) , ( b ) ADF-75 % ( 75 % restriction on fast day ) , ( c ) ADF-85 % ( 85 % restriction on fast day ) , ( d ) ADF-100 % ( 100 % restriction on fast day ) and ( e ) control ( ad libitum fed ) .  Body weights of the CR mice were lower than that of the ADF and control groups posttreatment . After 4 weeks of diet , the proportion of visceral fat decreased ( P<.001 ) and the proportion of subcutaneous fat increased ( P<.001 ) similarly in ADF and CR animals . Adiponectin increased ( P<.05 ) by 62 - 86 % in the ADF groups and by 69 % in the CR group . Triglyceride ( TG ) synthesis and de novo lipogenesis were augmented ( P<.05 ) in the subcutaneous fat pad of ADF and CR animals , relative to control . No differences in net lipolysis were observed , result ing in greater TG accumulation in the subcutaneous fat pad , with a shift in the ratio of TG between depots . These findings indicate that ADF ( both modified and true ) produces similar beneficial modulations in body fat distribution and adiponectin levels as daily CR This study examined the independent and combined effects of diet and exercise on adipocytokine and inflammatory cytokines in postmenopausal women with type 2 diabetes . Using a r and omized , controlled design , 33 women ( age , 50 - 70 years ) were assigned to diet alone ( D ) , exercise alone ( EX ) , or diet + exercise ( D + E ) for 14 weeks . Before and after the interventions , blood sample s for adipocytokines and inflammatory markers were drawn , a meal test was performed , and abdominal fat distribution was measured by magnetic resonance imaging ( MRI ) . Body weight decreased approximately 4.5 + /- 0.6 kg ( P < .05 ) after the D and D + E interventions , whereas only small changes in body weight were found with the exercise-alone intervention . Plasma C-reactive protein levels were decreased by approximately 15 % with all 3 interventions , whereas leptin levels were reduced with the D and D + E intervention ( D : pre = 48.7 + /- 6.0 , post = 38.9 + /- 5.0 ng/mL ; D + E : pre = 38.5 + /- 6.0 , post = 22.9 + /- 5.0 ng/mL ; P < .05 ) with no differences between groups . There was 
    Output:
    
agent
Weight loss diet beneficially affects blood adiponectin concentrations .
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective : Adipokines are signaling and mediator proteins secreted from adipose tissue . A novel adipokine , visfatin , was reported as a protein which was mainly expressed in visceral adipose tissue . Controversial results have been shown regarding the changes of adipokines following weight reduction . So we investigated the effects of weight reduction on serum concentrations of adiponectin and visfatin in morbidly obese subjects . Methods : 35 severely obese patients ( 26 females and 9 males ) , aged 15 - 58 years , were studied .  Anthropometric parameters and biochemical parameters  as well as  adiponectin and visfatin were analyzed before and 6 weeks after weight reduction . Results : Anthropometric indices decreased significantly . Blood levels of low-density lipoprotein cholesterol , high-density lipoprotein cholesterol , and triglyceride were reduced significantly . The reduction of visfatin and the elevation of adiponectin were significant as well . However , other parameters like fasting glucose and insulin did not change . Moreover , we could not find any significant correlation between the change of serum visfatin and that of adiponectin . Conclusions : 6-week weight reduction after bariatric surgery result ed in decreased serum visfatin and increased adiponectin levels . However , we can not find any significant correlation between changes of adiponectin , visfatin , BMI , waist circumference , and insulin resistance . Further studies with different design are suggested to clarify these associations BACKGROUND Weight loss , through calorie restriction or increases in energy expenditure via exercise , improves glucose tolerance and insulin action . However , exercise-induced energy expenditure may further improve glucoregulation through mechanisms independent of weight loss . OBJECTIVE The objective was to assess the hypothesis that weight loss through exercise-induced energy expenditure improves glucoregulation and circulating factors involved in insulin action to a greater extent than does similar weight loss through calorie restriction . DESIGN Sedentary men and women aged 50 - 60 y with a body mass index ( kg/m(2 ) ) of 23.5 - 29.9 were r and omly assigned to 1 of 2 weight-loss interventions [ 12 mo of exercise training ( EX group ; n = 18 ) or calorie restriction ( CR group ; n = 18 ) ] or to a healthy lifestyle ( HL ) control group ( n = 10 ) . The insulin sensitivity index and areas under the curve for glucose and insulin were assessed with an oral-glucose-tolerance test . Adiponectin and tumor necrosis factor alpha concentrations were measured in fasting serum . Fat mass was measured by dual-energy X-ray absorptiometry . RESULTS Yearlong energy deficits were not significantly different between the EX and CR groups , as evidence d by body weight and fat mass changes . The insulin sensitivity index increased and the glucose and insulin areas under the curve decreased in the EX and CR groups , remained unchanged in the HL group , and did not differ significantly between the EX and CR groups . Marginally significant increases in adiponectin and decreases in the ratio of tumor necrosis factor alpha to adiponectin occurred in the EX and CR groups but not in the HL group . CONCLUSIONS Weight loss induced by exercise training or calorie restriction improves glucose tolerance and insulin action in nonobese , healthy , middle-aged men and women . However , it does not appear that exercise training-induced  weight loss results in greater improvements than those that result from calorie restriction alone Study ing the links between dietary patterns and obesity is especially relevant for Middle-Eastern population s because of their high prevalence of a particular type of obesity , the so-called Middle-Eastern pattern , and their diets ' unique characteristics . Therefore , we wondered if major dietary patterns are related to the prevalence of general obesity and central adiposity among Iranian women . In this cross-sectional study of 486 women aged 40 - 60 y , usual dietary intakes were evaluated using a FFQ and anthropometric measurements .  By the use of factor analysis , we extracted 3 major dietary patterns : healthy dietary pattern , western dietary pattern , and Iranian dietary pattern . Individuals in the upper category of the healthy pattern score were less likely to be generally ( OR = 0.28 ; 95 % CI = 0.14 - 0.53 ) and central ly obese ( OR = 0.30 ; 95 % CI = 0.16 - 0.55 ) , whereas those in the upper quintile of western pattern had greater odds ( for general obesity : 2.73 ; 95 % CI = 1.46 - 5.08 and for central obesity : 5.74 ; 95 % CI = 2.99 - 10.99 ) . Controlling for potential confounders attenuated the associations , but even after adjusting for energy intake , the associations were significant for both general and central obesity . Although the Iranian dietary pattern and general obesity were not significantly associated , subjects in the highest quintile had greater odds of being central ly obese , either before ( OR = 2.15 ; 95 % CI = 1.18 - 3.90 ) or after ( OR = 2.08 ; 95 % CI = 1.09 - 3.65 ) control for confounders . This study indicates significant associations among  major dietary patterns , general obesity , and central adiposity in a Middle-Eastern country . Further prospect i ve investigations are required to confirm such associations BACKGROUND Although the typical diet of the Mediterranean region has received much recognition over the past several years for its association with substantial health benefits , it remains unknown whether its favorable effects are mediated through changes in adiponectin concentrations . OBJECTIVE The objective was to determine whether adherence to a Mediterranean-type diet is associated with higher plasma adiponectin concentrations . DESIGN This study was a prospect i ve and cross-sectional evaluation of plasma adiponectin concentrations and dietary data from 987 diabetic women from the Nurses ' Health Study who had no history of cardiovascular disease at the time blood was drawn in 1990 . RESULTS Women who scored highest on a 9-point scale that measures adherence to a Mediterranean-type dietary pattern tended to be older , were less likely to be current smokers , had lower body mass indexes and waist circumferences , and had higher total energy intakes , physical activities , and plasma adiponectin concentrations than did women with the lowest scores . Median plasma adiponectin concentrations were 23 % higher in women who most closely followed a Mediterranean-type diet than in low adherers after adjustment for age and energy intake ( P < 0.01 ) . Body composition , lifestyle , and medical history explained some , but not all , of the observed association between diet and adiponectin concentrations because high adherers tended to have greater adiponectin concentrations than did moderate or low adherers , even after adjustment for these variables . CONCLUSIONS Our data suggest that , of the several components of the Mediterranean dietary pattern score , alcohol , nuts , and whole grains show the strongest association with adiponectin concentrations . Close adherence to a Mediterranean-type diet is associated with higher adiponectin concentrations Among the factors influencing weight loss and maintenance , psychobehavioral , nutritional , metabolic , hormonal and hereditary predictors play an important role . Psychobehavioral factors influence adherence to lifestyle changes and thus weight loss maintenance . The outcome of short-term weight reduction treatment is mainly affected by changes in energy and nutrient intake and physical activity and thus the impact of hormones can possibly be obscured . In order to reveal hormonal determinants of weight loss , a 4-week in-patient comprehensive weight reduction program was introduced in which food intake and physical activity were under the strict control . Women ( n = 67 , BMI : 32.4+/-4.4 kg ; age : 48.7+/-12.2 years ) who exhibited stable weight on a 7 MJ/day diet during the first week of weight management were given a hypocaloric diet yielding daily energy deficit 2.5 MJ over the subsequent 3-week period . This treatment result ed in a mean weight loss of 3.80+/-1.64 kg . Correlation analysis revealed that baseline concentrations of several hormones were significantly associated either with a higher ( free triiodothyronine , C-peptide , growth hormone , pancreatic polypeptide ) or with a lower ( insulin-like growth factor-I , cortisol , adiponectin , neuropeptide Y ) reduction of anthropometric parameters in response to weight management . In a backward stepwise regression model age , initial BMI together with baseline levels of growth hormone , peptide YY , neuropetide Y and C-reactive protein predicted 49.8 % of the variability in weight loss . Psychobehavioral factors ( items of the Eating Inventory , Beck Depression score ) did not contribute to weight change induced by a well-controlled short-term weight reduction program Weight loss intervention is the principal non-pharmacological method for prevention and treatment of type 2 diabetes . However , little is known whether it influences insulin sensitivity directly or via its anti-inflammatory effect . The aim of this study was to assess the independent role of changes in inflammation status and weight loss on insulin sensitivity in this population .Overweight and obese nondiabetic participants without co-morbidities underwent a one-year weight loss intervention focused on caloric restriction and behavioral support . Markers of inflammation , body composition , anthropometric para-meters , and insulin sensitivity were recorded at baseline , 6 , and 12 months . Insulin sensitivity was assessed with frequently sample d intravenous glucose tolerance test and Minimal Model . Twenty-eight participants ( F : 15 , M : 13 , age 39±5 years , BMI 33.2±4.6 kg/m(2 ) ) completed the study , achieving 9.4±6.9 % weight loss , which was predominantly fat mass ( 7.7±5.6 kg , p<0.0001 ) . Dietary intervention result ed in significant decrease in leptin , leptin-to-adiponectin ratio , hs-CRP , and IL-6 ( all p<0.02 ) , and improvement in HOMA-IR and Insulin Sensitivity Index ( SI ) ( both p<0.001 ) . In response to weight loss IL-1β , IL-2 , leptin , and resistin were significantly associated with insulin , sensitivity , whereas sICAM-1 had only marginal additive effect . Moderate weight loss in otherwise healthy overweight and obese individuals result ed in an improvement in insulin sensitivity and in the overall inflammation state ; the latter played only a minimal independent role in modulating insulin sensitivity Calorie restriction ( CR ) and alternate-day fasting ( ADF ) beneficially affect several aspects of adipose tissue physiology , but direct comparisons between regimens have yet to be performed . The present study evaluated the effects of ADF versus CR on body fat distribution and circulating adiponectin levels and examined the kinetic mechanisms that underlie changes in fat distribution . Thirty female C57BL/6J mice were r and omized to one of five groups for 4 weeks : ( a ) CR-25 % ( 25 % energy restriction daily ) , ( b ) ADF-75 % ( 75 % restriction on fast day ) , ( c ) ADF-85 % ( 85 % restriction on fast day ) , ( d ) ADF-100 % ( 100 % restriction on fast day ) and ( e ) control ( ad libitum fed ) .  Body weights of the CR mice were lower than that of the ADF and control groups posttreatment . After 4 weeks of diet , the proportion of visceral fat decreased ( P<.001 ) and the proportion of subcutaneous fat increased ( P<.001 ) similarly in ADF and CR animals . Adiponectin increased ( P<.05 ) by 62 - 86 % in the ADF groups and by 69 % in the CR group . Triglyceride ( TG ) synthesis and de novo lipogenesis were augmented ( P<.05 ) in the subcutaneous fat pad of ADF and CR animals , relative to control . No differences in net lipolysis were observed , result ing in greater TG accumulation in the subcutaneous fat pad , with a shift in the ratio of TG between depots . These findings indicate that ADF ( both modified and true ) produces similar beneficial modulations in body fat distribution and adiponectin levels as daily CR This study examined the independent and combined effects of diet and exercise on adipocytokine and inflammatory cytokines in postmenopausal women with type 2 diabetes . Using a r and omized , controlled design , 33 women ( age , 50 - 70 years ) were assigned to diet alone ( D ) , exercise alone ( EX ) , or diet + exercise ( D + E ) for 14 weeks . Before and after the interventions , blood sample s for adipocytokines and inflammatory markers were drawn , a meal test was performed , and abdominal fat distribution was measured by magnetic resonance imaging ( MRI ) . Body weight decreased approximately 4.5 + /- 0.6 kg ( P < .05 ) after the D and D + E interventions , whereas only small changes in body weight were found with the exercise-alone intervention . Plasma C-reactive protein levels were decreased by approximately 15 % with all 3 interventions , whereas leptin levels were reduced with the D and D + E intervention ( D : pre = 48.7 + /- 6.0 , post = 38.9 + /- 5.0 ng/mL ; D + E : pre = 38.5 + /- 6.0 , post = 22.9 + /- 5.0 ng/mL ; P < .05 ) with no differences between groups . There was 
    Output:
    