Obesity-related Health Complications Research Articles

DNA damage, obesity and obesity-related health complications: what are new data telling us?

Obesity is associated with increased DNA damage, which may in turn contribute to the development of obesity-related complications. DNA damage can also affect adipocyte biology, resulting in increased adiposity. Carefully managed weight loss programs can reverse this process. This article surveys new data that support these contentions. Whole exome sequencing analyses have identified rare variants linked to high BMI and adiposity. Two of the identified genes are linked to DNA damage and DNA repair, suggesting that DNA damage itself may play a role in the cause of obesity. It has also been recognized that obesity increases DNA damage in breast tissue of carriers of BRCA mutations and rates of tumour formation in BRCA1+ mice, indicating effect of obesity on cancer development in high-risk populations. In addition, obesity promotes cancer cell chemoresistance by decreasing fatty acid oxidation involved in cellular DNA damage response, leading to apoptotic cellular death. Obesity is also associated with a reduced capacity of oocytes to repair sperm DNA damage, leading to lower in-vitro fertilization rates in women with obesity. DNA damage and cellular responses to DNA damage can be both the result and the cause of obesity and can strongly influence the development and treatment of obesity-associated diseases.

Yogurt Supplementation Attenuates Insulin Resistance in Obese Mice by Reducing Metabolic Endotoxemia and Inflammation

BackgroundInflammation is an underlying mechanism for the development of obesity-related health complications. Yogurt consumption inhibits obesity-associated inflammation, but the tissue-specific mechanisms have not been adequately described. ObjectivesWe aimed to determine the tissue-specific responses by which yogurt supplementation inhibits inflammation. MethodsC57BL/6 male mice (5 wk old) were fed a Teklad Global 14% Protein Rodent Maintenance diet as a control or a high-fat diet (60% calories from fat) to induce obesity for 11 wk, followed by feeding a Western diet (WD; 43% carbohydrate and 42% fat) or WD supplemented with 5.6% lyophilized yogurt powder for 3 wk to test for the impact of yogurt supplementation. Markers of metabolic endotoxemia and inflammation were assessed in plasma and tissues. Cecal and fecal microbiota were profiled by 16S rRNA sequencing. ResultsIn obese mice, relative to the WD control group, yogurt supplementation attenuated HOMA-IR by 57% (P = 0.020), plasma TNF-α by 31% (P < 0.05) and colonic IFN-γ by 46% (P = 0.0034), which were accompanied by a 40% reduction in plasma LPS binding protein (LBP) (P = 0.0019) and 45% less colonic Lbp expression (P = 0.037), as well as alteration in the beta diversity of cecal microbiota (P = 0.0090) and relative abundance of certain cecal microbes (e.g., Lachnospiraceae Dorea longicatena with P = 0.049). There were no differences in the LBP, Lbp, and Cd14 levels in the liver and small intestine between obese mice with and without yogurt supplementation (P > 0.05). ConclusionsYogurt consumption inhibits obesity-induced inflammation in mice by modulating colonic endotoxin detoxification, changing the gut microbiota, and improving glucose metabolism. This work helps to establish the underlying mechanisms by which yogurt consumption affects markers of metabolic and immune health.

A Self-Guided Lifestyle Intervention for Young Men: Findings from the ACTIVATE Randomized Pilot Trial.

Young men are at high risk for developing obesity-related health complications, yet are markedly underrepresented in lifestyle interventions. This pilot study examined the feasibility and preliminary efficacy of a lifestyle intervention (self-guided + health risk messaging) targeting young men. 35 young men (Age = 29.3 ± 4.27; BMI = 30.8 ± 4.26; 34% racial/ethnic minority) were randomly assigned to the intervention or delayed treatment control. The intervention (ACTIVATE) included 1 virtual group session, digital tools (wireless scale, self-monitoring app), access to self-paced content via a secure website, and 12 weekly texts to reinforce health risk messaging. Fasted objective weight was assessed remotely at baseline and 12-weeks. Perceived risk was assessed via survey at baseline, 2-week, and 12-week. T-tests were used to compare weight outcomes between arms. Linear regressions examined the association between percent weight change and perceived risk change. Recruitment was successful as evidenced by 109% of target enrollment achieved in a 2-month period. Retention was 86% at 12 weeks, with no differences by arm (p = 0.17). Participants in the intervention arm experienced modest weight loss at 12 weeks, whereas slight gains were observed in the control arm (-1.6% ± 2.5 vs. +0.31% ± 2.8, p = 0.04). Change in perceived risk was not associated with change in percent weight (p > 0.05). A self-guided lifestyle intervention showed initial promise for weight management among young men, but these findings are limited by small sample size. More research is needed to bolster weight loss outcomes while retaining the scalable self-guided approach. NCT04267263 (https://www.clinicaltrials.gov/ct2/show/NCT04267263).

Adjustment of Unrealistic Weight Loss Expectations on a Mobile CBT-Based Behavior-Change Program: Prospective One-Armed Study

Background: Moderate weight loss of 5–10% is considered a realistically achievable weight loss goal and is associated with decreased risk of obesity-related health complications. However, individuals tend to expect that they will lose as much as 20–30% of their body weight when they start a behavioral weight loss program. Current research is limited on how these expectations change over time during weight loss and the consequences of adjusting one’s expectations in a more realistic direction, particularly on a CBT-based program. Method: Therefore, this prospective cohort study evaluated whether individuals adjusted their weight loss expectations over time during real-world use of a mobile CBT-based behavior-change program (Noom Weight) and how this adjustment related to weight loss outcomes, as well as how the amount of adjustment depended on program engagement. Participants had recently signed up for Noom Weight and reported their weight, expectations for weight loss, and psychological well-being at baseline and six months. Engagement was automatically recorded by the program. Results: We found that after using Noom Weight for six months, participants’ expectations became more realistic (i.e., significantly decreased) compared to baseline (−5.77, s.e. = 0.57, p &lt; 0.001), and this downward adjustment was associated with greater weight loss (b = 1.80, 95% CI 1.21–2.38, p &lt; 0.001). Higher program engagement, particularly reading articles focused on CBT-based principles, was associated with greater decreases in expectations over time (b = −0.007, t = −2.22, p = 0.03). Conclusions: The results suggest that CBT-based principles may aid in adjusting weight loss expectations to more realistic levels and that such adjustment is associated with positive weight outcomes. Future research should build on these results by evaluating adjustment in weight loss expectations over time, rather than solely expectations at baseline.

EGFR-mediated activation of adipose tissue macrophages promotes obesity and insulin resistance

Obesity and obesity-related health complications are increasing in prevalence. Adipose tissue from obese subjects has low-grade, chronic inflammation, leading to insulin resistance. Adipose tissue macrophages (ATMs) are a source of proinflammatory cytokines that further aggravate adipocyte dysfunction. In response to a high fat diet (HFD), ATM numbers initially increase by proliferation of resident macrophages, but subsequent increases also result from infiltration in response to chemotactic signals from inflamed adipose tissue. To elucidate the underlying mechanisms regulating the increases in ATMs and their proinflammatory phenotype, we investigated the role of activation of ATM epidermal growth factor receptor (EGFR). A high fat diet increased expression of EGFR and its ligand amphiregulin in ATMs. Selective deletion of EGFR in ATMs inhibited both resident ATM proliferation and monocyte infiltration into adipose tissue and decreased obesity and development of insulin resistance. Therefore, ATM EGFR activation plays an important role in adipose tissue dysfunction.

Zooming Toward a Telehealth Solution for Vulnerable Children with Obesity During Coronavirus Disease 2019.

Health inequities exist throughout the life course, resulting in racial/ethnic and socioeconomic disparities in obesity and obesity‐related health complications. Obesity and its comorbidities appear to be linked to coronavirus disease 2019 (COVID‐19) mortality. Approaches to reduce obesity in the time of COVID‐19 closures are urgently needed and should start early in life. In New York City, a telehealth pediatric weight‐management collaborative spanning NewYork‐Presbyterian, Columbia University Vagelos College of Physicians and Surgeons, and Weill Cornell Medicine was developed during COVID‐19 with show rates from 76% to 89%. To stave off the impending exacerbation of health disparities related to obesity risk factors in the aftermath of the COVID‐19 pandemic, effective interventions that can be delivered remotely are urgently needed among vulnerable children with obesity. Challenges in digital technology access, social and linguistic differences, privacy security, and reimbursement must be overcome to realize the full potential of telehealth for pediatric weight management among low‐income and racial/ethnic‐minority children.

Human Gut Microbiome Response to Short-Term Bifidobacterium-Based Probiotic Treatment.

Gut microbiota is believed to play a crucial role in modulating obesity in humans, and probiotics affecting gut microbiota can alleviate some of the obesity-related health complications. The study was aimed to investigate changes in the composition of the gut microbiome in obese humans due to short-term (2weeks) treatment of obese patients with a probiotic preparation containing Bifidobacterium longum. Faecal microbiome diversity was studied using the 16S amplicon sequencing by Illumina MiSeq. Bioinformatic analysis showed distribution across 14 phyla (with Firmicutes and Bacteroidetes dominating), 21 class, 125 genera and 973 OTUs. The probiotic treatment decreased relative abundance of Bacteroidetes (Prevotellaceae and Bacteroidaceae), while increasing that of Actinobacteria (Bifidobacteriaceae and Coriobacteriaceae), and Firmicutes (Negativicutes: Veillonellaceae and Clostridia: Peptostreptococcaceae). The probiotic treatment decreased total blood sugar and increased patients' assessment of their physical and mental health. Thus even the short-term Bifidobacterium-based probiotic treatment brought significant compositional changes in the 16S rRNA gene diversity in faecal bacterial assemblages by increasing beneficial and decreasing pathogenic or opportunistic bacteria; the related shifts in life quality assessment necessitate further research into the causal relationships involved.

Reference standards for body fat measures using GE dual energy x-ray absorptiometry in Caucasian adults.

BackgroundDual energy x-ray absorptiometry (DXA) is an established technique for the measurement of body composition. Reference values for these variables, particularly those related to fat mass, are necessary for interpretation and accurate classification of those at risk for obesity-related health complications and in need of lifestyle modifications (diet, physical activity, etc.). Currently, there are no reference values available for GE-Healthcare DXA systems and it is known that whole-body and regional fat mass measures differ by DXA manufacturer.ObjectiveTo develop reference values by age and sex for DXA-derived fat mass measurements with GE-Healthcare systems.MethodsA de-identified sample of 3,327 participants (2,076 women, 1,251 men) was obtained from Ball State University’s Clinical Exercise Physiology Laboratory and University of Wisconsin-Milwaukee’s Physical Activity & Health Research Laboratory. All scans were completed using a GE Lunar Prodigy or iDXA and data reported included percent body fat (%BF), fat mass index (FMI), and ratios of android-to-gynoid (A/G), trunk/limb, and trunk/leg fat measurements. Percentiles were calculated and a factorial ANOVA was used to determine differences in the mean values for each variable between age and sex.ResultsNormative reference values for fat mass variables from DXA measurements obtained from GE-Healthcare DXA systems are presented as percentiles for both women and men in 10-year age groups. Women had higher (p<0.01) mean %BF and FMI than men, whereas men had higher (p<0.01) mean ratios of A/G, trunk/limb, and trunk/leg fat measurements than women.ConclusionThese reference values provide clinicians and researchers with a resource for interpretation of DXA-derived fat mass measurements specific to use with GE-Healthcare DXA systems.

Do Maternal Caregiver Perceptions of Childhood Obesity Risk Factors and Obesity Complications Predict Support for Prevention Initiatives Among African Americans?

Objectives African American maternal caregiver support for prevention of childhood obesity may be a factor in implementing, monitoring, and sustaining children's positive health behaviors. However, little is known about how perceptions of childhood obesity risk factors and health complications influence caregivers' support of childhood obesity prevention strategies. The objective of this study was to determine if childhood obesity risk factors and health complications were associated with maternal caregivers' support for prevention initiatives. Methods A convenience sample of maternal caregivers (N = 129, ages 22-65years) completed the childhood obesity perceptions (COP) survey. A linear regression was conducted to determine whether perceptions about childhood obesity risk factors and subsequent health complications influenced caregivers' support for prevention strategies. Results Caregivers' perceptions of childhood obesity risk factors were moderate (M = 3.4; SD = 0.64), as were their perceptions of obesity-related health complications (M = 3.3; SD = 0.75); however, they perceived a high level of support for prevention strategies (M = 4.2; SD = 0.74). In the regression model, only health complications were significantly associated with caregiver support (β = 0.348; p < 0.004). Conclusions Childhood obesity prevention efforts should emphasize health complications by providing education and strategies that promote self-efficacy and outcome expectations among maternal caregivers.

Molecular genetics of human obesity: A comprehensive review

Obesity and its related health complications is a major problem worldwide. Hypothalamus and their signalling molecules play a critical role in the intervening and coordination with energy balance and homeostasis. Genetic factors play a crucial role in determining an individual's predisposition to the weight gain and being obese. In the past few years, several genetic variants were identified as monogenic forms of human obesity having success over common polygenic forms. In the context of molecular genetics, genome-wide association studies (GWAS) approach and their findings signified a number of genetic variants predisposing to obesity. However, the last couple of years, it has also been noticed that alterations in the environmental and epigenetic factors are one of the key causes of obesity. Hence, this review might be helpful in the current scenario of molecular genetics of human obesity, obesity-related health complications (ORHC), and energy homeostasis. Future work based on the clinical discoveries may play a role in the molecular dissection of genetic approaches to find more obesity-susceptible gene loci.

Elucidating the roles of stearoyl-CoA desaturase 1 in adipocyte fatty acid metabolism and cellular function

Worldwide obesity rates have risen to epidemic proportions, with over 600 million obese individuals across the globe. These individuals are prone to obesity-related health complications, including type 2 diabetes, hypertension, cancer, and cardiovascular disease. Obesity also coincides with the expansion of adipose tissue, which has an important role storing excess calories in the form of triacylglycerol (TAG) within adipocyte lipid droplets. The predominant fatty acids (FAs), comprising adipocyte TAGs, are monounsaturated FAs, which are produced by stearoyl-CoA desaturase 1 (SCD1). Specifically, SCD1 converts saturated FAs palmitate (PA) and stearate (SA) into palmitoleate and oleate, respectively. Interestingly, whole-body SCD1-deficiency is associated with reduced lipogenesis and adiposity. This places SCD1 as a potential target for obesity therapies; however, our understanding of the mechanisms linking SCD1 with changes in adipocyte function remains unclear. This thesis provides important new insights into how SCD1 impacts adipocyte FA metabolism and cellular function. Using a specific SCD1 inhibitor, changes in lipid metabolism, global gene expression, inflammation, cellular stress, and basal insulin signaling were assessed in 3T3-L1 adipocytes. Results demonstrated that SCD1 inhibition caused a reduction in TAGs and phospholipids, which coincided with the downregulation of genes associated with the biosynthesis of these lipid fractions. Cellular diacylglycerols were increased with SCD1 inhibition and insulin signaling was partially impaired. In contrast, markers of cellular stress were unaltered. Furthermore, the FA composition of each lipid fraction was dramatically modified, with SCD1-inhibited adipocytes specifically upregulating the elongation of PA to SA. Stable isotope tracer experiments revealed that this elongation was occurring via elongase 6. Additionally, reduced SCD1 activity in adipocytes exacerbated the effects of exogenous SA on markers of inflammation. Taken together, SCD1 activity has many indirect influences on adipocyte metabolism in addition to its role in FA desaturation. Importantly, SCD1 facilitates the storage of FAs in TAGs and the ability of adipocytes to handle exogenous FAs. SCD1 also prevents saturated FA and DAG accumulation, and preserves insulin signaling in adipocytes. Ultimately this thesis highlights the importance of SCD1 in the maintenance of adipocyte cellular function, and emphasizes the wide-ranging impact of SCD1 on adipocyte FA metabolism.

Obesity, Where Is It Driving Us?

Obesity is recognized as an important issue that has an impact on several areas of our daily lives, such as driving. In the literature there exists an association between obesity and motor vehicle crashes. The goal of this article is to promote insightful reflection and discussion around this emerging topic. Searches were conducted on Pubmed. Search terms were “obesity” and “driving.” The literature was sorted into a summary of the general ideas and is presented for discussion. Relevant issues discussed include anthromechanical issues and car design, seat belt usage, and obesity-related health complications (ocular pathologies, diabetic complications, and obstructive sleep apnoea/hypopnea). Finally, though limited prevention strategies exist for these issues in the literature, some strategies are presented for consideration. With such a complex issue, there is no simple solution. Education is the first step, and with a comprehensive understanding of the risks, actions can be taken to prevent these issues.

Maternal obesity: Implications for pregnancy outcome and long-term risks–a link to maternal nutrition

As obesity becomes a worldwide epidemic, its prevalence during reproductive age is also increased. Alarming reports state that two-thirds of adults in the USA are overweight or obese, with half of them in the latter category, and the rate of obese pregnant women is estimated at 18–38%. These women are of major concern to women's health providers because they encounter numerous pregnancy-related complications. Obesity-related reproductive health complications range from infertility to a wide spectrum of diseases such as hypertensive disorders, coagulopathies, gestational diabetes mellitus, respiratory complications, and fetal complications such as large-for-gestational-age infants, congenital malformations, stillbirth, and shoulder dystocia. Recent reports suggest that obesity during pregnancy can be a risk factor for developing obesity, diabetes, and cardiovascular diseases in the newborn later in life. This review will address the implication of obesity on pregnancy and child health, and explore recent literature on obesity during pregnancy.

Invited Commentary: Childhood and Adolescent Obesity: Psychological and Behavioral Issues in Weight Loss Treatment

The prevalence of childhood and adolescent obesity has tripled in the past three decades. This increase has been accompanied by a dramatic rise in obesity-related health complications among American youth. Thus, many obese youth are now experiencing illnesses that will threaten their life expectancy in the absence of significant weight loss. Despite these concerns, a relatively modest body of research has focused on the treatment of adolescent obesity. Results from trials investigating the efficacy of behavioral and pharmacological treatments, like studies of these interventions with adults, suggest that individuals typically lose 5-10% of their initial weight. Unfortunately, weight regain is common. Given the increase in the number of obese adolescents, coupled with the modest results from more conservative treatment approaches, it is not surprising that bariatric surgery for adolescents who suffer from extreme obesity has grown in popularity. The weight losses after surgery are impressive and many adolescents, like adults, experience significant improvements in their physical and mental health postoperatively. However, only a small fraction of adolescents and adults who are heavy enough for bariatric surgery present for surgical treatment. Among those who undergo surgery, a significant minority appear to struggle with a number of behavioral and psychosocial issues that threaten their lifelong success. With all of this in mind, the current obesity problem in the United States and other Westernized countries likely will present a significant challenge to both current and future medical and mental health professionals who work with adolescents and young adults.

A review of web‐based weight loss interventions in adults

Unprecedented obesity rates are changing the burden of disease worldwide and obesity-related health complications are increasing healthcare costs. In response, researchers, clinicians and public health practitioners are seeking new and effective tools such as the Internet to effect weight loss. This review highlights peer-reviewed literature on randomized controlled trials that examine Internet-delivered weight loss and maintenance programmes. The scope of this review is broader than previous reviews, including more males and non-Caucasian participants. The reviewed studies show intervention results ranging from no weight loss to an average loss of 7.6 kg. It is difficult to draw a definitive conclusion on the potential impact of Internet-based weight loss as study methods are highly variable between papers, low adherence was recorded and not all studies include a control group. As the demand for low-cost, efficacious interventions that yield statistically significant and/or clinically relevant results grows, more rigorous, population-specific research is needed to determine if Internet-delivered interventions may slow or reverse with weight gain and obesity and the associated health consequences.

Continuing Professional Development: Managing obesity and weight gain in mental health service users

This article introduces the growing problem of obesity in mental health services users. It examines factors such as prevalence and potential causes before exploring obesity-related health complications. The mental health practitioner role in screening, assessing, giving health education and promotion advice in relation to diet and physical activity will be explored alongside self assessment to test the reader’s knowledge

Inhibitory effect of IL-8 on insulin action in human adipocytes via MAP kinase pathway

BackgroundVarious cytokines and other compounds are produced in human adipose tissue and might have functions in the adipose tissue. They might be involved in complications associated with obesity and diabetes. Recently, interleukin-8 (IL-8) has been shown to be produced and released from human adipose tissue and/or adipocytes, suggesting IL-8 involvement in some obesity-related health complications. Therefore, we found it of interest to investigate whether IL-8 is involved in the insulin action in human adipocytes.MethodsThe IL-8 levels in the medium were measured using ELISA. The IL-8 mRNA expression was analyzed using Northern blot analysis. The phosphorylation of Akt was analyzed using Western blot analysis. Furthermore, we examined the effect of IL-8 on the phosphorylation of Akt induced by insulin.ResultsThe level of IL-8 in the medium and the IL-8 mRNA expression after stimulation with either TNF-α, IL-1β, or CRP was significantly enhanced in human adipocytes. It is particularly interesting that IL-8 per se also enhanced IL-8 mRNA expression. The IL-8 induced-IL-8 mRNA expression was inhibited by PD98059 (a MEK inhibitor) or SB203580 (a p38 MAPK inhibitor). The IL-8 inhibited insulin-induced Akt phosphorylation. The inhibitory effect of IL-8 was eliminated by either PD 98059 or SB203580.ConclusionThese data suggest that IL-8 is a main adipocytokine producing insulin resistance via the inhibition of insulin-induced Akt phosphorylation in adipocytes. The attenuation of IL-8 action might be a target for prevention of diabetes and its complications.

Treating Child Obesity and Associated Medical Conditions

With American children on course to grow into the most obese generation of adults in history, Sonia Caprio argues that it is critical to develop more effective strategies for preventing childhood obesity and treating serious obesity-related health complications. She notes that although pediatricians are concerned about the obesity problem, most are ineffective in addressing it. Treatment should begin, Caprio explains, with a thorough medical exam, an assessment of nutrition and physical activity, an appraisal of the degree of obesity and associated health complications, a family history, and full information about current medications. Caprio also summarizes the current use of medications and surgery in treating child obesity and argues, that for severe forms of obesity, the future lies in developing new and more effective drugs. Caprio explains that today's most effective obesity treatment programs have been carried out in academic centers through an approach that combines a dietary component, behavioral modification, physical activity, and parental involvement. Such programs, however, have yet to be translated to primary pediatric care centers. Successfully treating obesity, she argues, will require a major shift in pediatric care that builds on the findings of these academic centers regarding structured intervention programs. To ensure that pediatricians are well trained in implementing such programs, the American Medical Association is working with federal agencies, medical specialty societies, and public health organizations to teach doctors how to prevent and manage obesity in both children and adults. Such training should be a part of undergraduate and graduate medical education and of continuing medical education programs. Caprio also addresses the problem of reimbursement for obesity treatment. Despite the health risks of obesity, patients get little support from health insurers, thus putting long-term weight-management programs beyond the reach of most. Caprio argues that obesity should be recognized as a disease and receive coverage for its treatment just as other diseases do.

Monocyte Chemoattractant Protein-1 Release Is Higher in Visceral than Subcutaneous Human Adipose Tissue (AT): Implication of Macrophages Resident in the AT

Human adipose tissue (AT) produces several adipokines including monocyte chemoattractant protein (MCP)-1, involved in the pathogenesis of atherosclerosis. Human AT cultures, isolated adipocytes, and stromal-vascular cells were used to investigate the relationship among AT-resident macrophages, MCP-1, and adiposity and the regulation of MCP-1. mRNA levels of specific macrophage markers (CD68 and CD14) are correlated with adiposity in sc AT and visceral AT (P < 0.05). MCP-1 production is higher in stromal-vascular cells vs. adipocytes (P < 0.01) and correlates with macrophage markers in both AT compartments (P < 0.05). MCP-1 release is higher in obese subjects (P < 0.05) and in VAT (P < 0.01), but after adjusting for AT-resident macrophages, the differences disappear. MCP-1 is stimulated by IL-1beta, TNF-alpha, IL-8, IL-4, and IL-6 + IL-6-soluble receptor and is decreased by dexamethasone, IL-10, metformin, and thiazolidinediones. MCP-1 is correlated with specific macrophage markers, adiposity, and AT localization, but the relationship seems to be related to the number of AT-resident macrophages. Despite this, MCP-1 may be involved in obesity-related health complications, and the decrease of MCP-1 by metformin and thiazolidinediones suggests that these antidiabetic compounds have antiinflammatory properties improving the low-grade inflammatory state observed in obesity.

Monocyte chemoattractant protein-1 is produced in isolated adipocytes, associated with adiposity and reduced after weight loss in morbid obese subjects

Obesity is associated with insulin resistance and premature atherosclerosis. The human adipose tissue produce several adipokines including monocyte chemoattractant protein (MCP)-1, associated with cardiovascular disease and found to be involved in the pathogenesis of atherosclerosis in vitro. (1) To compare mRNA levels of MCP-1, leptin and a macrophage-specific marker (CD68) in isolated adipocytes vs stromal-vascular (SV) cells, (2) to compare mRNA levels of MCP-1 in human adipose tissue to circulating MCP-1 and adiposity (eg BMI: kg/m2) and (3) investigate the effect of weight loss in obese subjects on circulating MCP-1 and leptin. (1) MCP-1 and CD68 mRNA levels in isolated adipocytes vs SV cells were 17% (P<0.01) and approximately 2% (P<0.001), respectively. Leptin mRNA levels in SV cells were approximately 1% of that in isolated adipocytes (P<0.01). (2) MCP-1 mRNA levels correlated with circulating MCP-1 (P<0.05) and BMI (P<0.05). (3) A 12% weight loss (P<0.001) was associated with a 25% decrease in insulin levels (P<0.01). Circulating MCP-1 and leptin decreased by 20% (P<0.001) and by 24% (P<0.001), respectively. The findings demonstrate that MCP-1 is produced in isolated human adipocytes. In addition, the findings suggest that MCP-1 may be involved in obesity-related health complications and support the hypothesis that weight loss is beneficial by improving the low-grade inflammation observed in obesity.