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October 2017 -
Volume 15, Issue 8

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From the Editor

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Original Contribution/Clinical Investigation

Immunity level to diphtheria in beta thalassemia patients
DOI: 10.5742/MEWFM.2017.93048
[pdf version]
Abdolreza Sotoodeh Jahromi, Karamatollah Rahmanian, Abdolali Sapidkar, Hassan Zabetian, Alireza Yusefi, Farshid Kafilzadeh, Mohammad Kargar, Marzieh Jamalidoust,
Abdolhossein Madani

Genetic Variants of Toll Like Receptor-4 in Patients with Premature Coronary Artery Disease, South of Iran
DOI: 10.5742/MEWFM.2017.93049
[pdf version]
Saeideh Erfanian, Mohammad Shojaei, Fatemeh Mehdizadeh, Abdolreza Sotoodeh Jahromi, Abdolhossein Madani, Mohammad Hojjat-Farsangi

Comparison of postoperative bleeding in patients undergoing coronary artery bypass surgery in two groups taking aspirin and aspirin plus CLS clopidogrel
DOI: 10.5742/MEWFM.2017.93050
[pdf version]
Ali Pooria, Hassan Teimouri, Mostafa Cheraghi, Babak Baharvand Ahmadi, Mehrdad Namdari, Reza Alipoor

Comparison of lower uterine segment thickness among nulliparous pregnant women without uterine scar and pregnant women with previous cesarean section: ultrasound study
DOI: 10.5742/MEWFM.2017.93051
[pdf version]
Taravat Fakheri, Irandokht Alimohammadi, Nazanin Farshchian, Maryam Hematti,
Anisodowleh Nankali, Farahnaz Keshavarzi, Soheil Saeidiborojeni

Effect of Environmental and Behavioral Interventions on Physiological and Behavioral Responses of Premature Neonates Candidates Admitted for Intravenous Catheter Insertion in Neonatal Intensive Care Units
DOI: 10.5742/MEWFM.2017.93052
[pdf version]
Shohreh Taheri, Maryam Marofi, Anahita Masoumpoor, Malihe Nasiri

Effect of 8 weeks Rhythmic aerobic exercise on serum Resistin and body mass index of overweight and obese women
DOI: 10.5742/MEWFM.2017.93053
[pdf version]
Khadijeh Molaei, Ahmad Shahdadi, Reza Delavar

Study of changes in leptin and body mass composition with overweight and obesity following 8 weeks of Aerobic exercise
DOI: 10.5742/MEWFM.2017.93054
[pdf version]
Khadijeh Molaei, Abbas Salehikia

A reassessment of factor structure of the Short Form Health Survey (SF-36): A comparative approach
DOI: 10.5742/MEWFM.2017.93088
[pdf version]
Vida Alizad, Manouchehr Azkhosh, Ali Asgari, Karyn Gonano

Population and Community Studies

Evaluation of seizures in pregnant women in Kerman - Iran
DOI: 10.5742/MEWFM.2017.93056
[pdf version]
Hossein Ali Ebrahimi, Elahe Arabpour, Kaveh Shafeie, Narges Khanjani

Studying the relation of quality work life with socio-economic status and general health among the employees of Tehran University of Medical Sciences (TUMS) in 2015
DOI: 10.5742/MEWFM.2017.93057
[pdf version]
Hossein Dargahi, Samereh Yaghobian, Seyedeh Hoda Mousavi, Majid Shekari Darbandi, Soheil Mokhtari, Mohsen Mohammadi, Seyede Fateme Hosseini

Factors that encourage early marriage and motherhood from the perspective of Iranian adolescent mothers: a qualitative study
DOI: 10.5742/MEWFM.2017.93058
[pdf version]
Maasoumeh Mangeli, Masoud Rayyani, Mohammad Ali Cheraghi, Batool Tirgari

The Effectiveness of Cognitive-Existential Group Therapy on Reducing Existential Anxiety in the Elderly
DOI: 10.5742/MEWFM.2017.93059
[pdf version]
Somayeh Barekati, Bahman Bahmani, Maede Naghiyaaee, Mahgam Afrasiabi, Roya Marsa

Post-mortem Distribution of Morphine in Cadavers Body Fluids
DOI: 10.5742/MEWFM.2017.93060
[pdf version]
Ramin Elmi, Mitra Akbari, Jaber Gharehdaghi, Ardeshir Sheikhazadi, Saeed Padidar, Shirin Elmi

Application of Social Networks to Support Students' Language Learning Skills in Blended Approach
DOI: 10.5742/MEWFM.2017.93061
[pdf version]
Fatemeh Jafarkhani, Zahra Jamebozorg, Maryam Brahman

The Relationship between Chronic Pain and Obesity: The Mediating Role of Anxiety
DOI: 10.5742/MEWFM.2017.93062
[pdf version]
Leila Shateri, Hamid Shamsipour, Zahra Hoshyari, Elnaz Mousavi, Leila Saleck, Faezeh Ojagh

Implementation status of moral codes among nurses
DOI: 10.5742/MEWFM.2017.93063
[pdf version]
Maryam Ban, Hojat Zareh Houshyari Khah, Marzieh Ghassemi, Sajedeh Mousaviasl, Mohammad Khavasi, Narjes Asadi, Mohammad Amin Harizavi, Saeedeh Elhami

The comparison of quality of life, self-efficacy and resiliency in infertile and fertile women
DOI: 10.5742/MEWFM.2017.93064
[pdf version]
Mahya Shamsi Sani, Mohammadreza Tamannaeifar

Brain MRI Findings in Children (2-4 years old) with Autism

DOI: 10.5742/MEWFM.2017.93055
[pdf version]
Mohammad Hasan Mohammadi, Farah Ashraf Zadeh, Javad Akhondian, Maryam Hojjati,
Mehdi Momennezhad

Reviews

TECTA gene function and hearing: a review

DOI: 10.5742/MEWFM.2017.93065
[pdf version]
Morteza Hashemzadeh-Chaleshtori, Fahimeh Moradi, Raziyeh Karami-Eshkaftaki,
Samira Asgharzade

Mandibular canal & its incisive branch: A CBCT study
DOI: 10.5742/MEWFM.2017.93066
[pdf version]
Sina Haghanifar, Ehsan Moudi, Ali Bijani, Somayyehsadat Lavasani, Ahmadreza Lameh

The role of Astronomy education in daily life
DOI: 10.5742/MEWFM.2017.93067
[pdf version]
Ashrafoalsadat Shekarbaghani

Human brain functional connectivity in resting-state fMRI data across the range of weeks
DOI: 10.5742/MEWFM.2017.93068
[pdf version]
Nasrin Borumandnia, Hamid Alavi Majd, Farid Zayeri, Ahmad Reza Baghestani,
Mohammad Tabatabaee, Fariborz Faegh

International Health Affairs

A brief review of the components of national strategies for suicide prevention suggested by the World Health Organization
DOI: 10.5742/MEWFM.2017.93069
[pdf version]
Mohsen Rezaeian

Education and Training

Evaluating the Process of Recruiting Faculty Members in Universities and Higher Education and Research Institutes Affiliated to Ministry of Health and Medical Education in Iran
DOI: 10.5742/MEWFM.2017.93070
[pdf version]
Abdolreza Gilavand

Comparison of spiritual well-being and social health among the students attending group and individual religious rites
DOI: 10.5742/MEWFM.2017.93071
[pdf version]
Masoud Nikfarjam, Saeid Heidari-Soureshjani, Abolfazl Khoshdel, Parisa Asmand, Forouzan Ganji

A Comparative Study of Motivation for Major Choices between Nursing and Midwifery Students at Bushehr University of Medical Sciences
DOI: 10.5742/MEWFM.2017.93072
[pdf version]
Farzaneh Norouzi, Shahnaz Pouladi, Razieh Bagherzadeh

Clinical Research and Methods

Barriers to the management of ventilator-associated pneumonia: A qualitative study of critical care nurses' experiences
DOI: 10.5742/MEWFM.2017.93073
[pdf version]
Fereshteh Rashnou, Tahereh Toulabi, Shirin Hasanvand, Mohammad Javad Tarrahi

Clinical Risk Index for Neonates II score for the prediction of mortality risk in premature neonates with very low birth weight
DOI: 10.5742/MEWFM.2017.93074
[pdf version]
Azadeh Jafrasteh, Parastoo Baharvand, Fatemeh Karami

Effect of pre-colporrhaphic physiotherapy on the outcomes of women with pelvic organ prolapse
DOI: 10.5742/MEWFM.2017.93075
[pdf version]
Mahnaz Yavangi, Tahereh Mahmoodvand, Saeid Heidari-Soureshjani

The effect of Hypertonic Dextrose injection on the control of pains associated with knee osteoarthritis
DOI: 10.5742/MEWFM.2017.93076
[pdf version]
Mahshid Ghasemi, Faranak Behnaz, Mohammadreza Minator Sajjadi, Reza Zandi,
Masoud Hashemi

Evaluation of Psycho-Social Factors Influential on Emotional Divorce among Attendants to Social Emergency Services
DOI: 10.5742/MEWFM.2017.93077
[pdf version]
Farangis Soltanian

Models and Systems of Health Care

Organizational Justice and Trust Perceptions: A Comparison of Nurses in public and private hospitals
DOI: 10.5742/MEWFM.2017.93078
[pdf version]
Mahboobeh Rajabi, Zahra Esmaeli Abdar, Leila Agoush

Case series and Case reports

Evaluation of Blood Levels of Leptin Hormone Before and After the Treatment with Metformin
DOI: 10.5742/MEWFM.2017.93079
[pdf version]
Elham Jafarpour

Etiology, Epidemiologic Characteristics and Clinical Pattern of Children with Febrile Convulsion Admitted to Hospitals of Germi and Parsabad towns in 2016
DOI: 10.5742/MEWFM.2017.93080
[pdf version]
Mehri SeyedJavadi, Roghayeh Naseri, Shohreh Moshfeghi, Irandokht Allahyari, Vahid Izadi, Raheleh Mohammadi,

Faculty development

The comparison of the effect of two different teaching methods of role-playing and video feedback on learning Cardiopulmonary Resuscitation (CPR)
DOI: 10.5742/MEWFM.2017.93081
[pdf version]
Yasamin Hacham Bachari, Leila Fahkarzadeh, Abdol Ali Shariati

Office based family medicine

Effectiveness of Group Counseling With Acceptance and Commitment Therapy Approach on Couples' Marital Adjustment
DOI: 10.5742/MEWFM.2017.93082
[pdf version]
Arash Ziapour, Fatmeh Mahmoodi, Fatemeh Dehghan, Seyed Mehdi Hoseini Mehdi Abadi,
Edris Azami, Mohsen Rezaei


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October 2017 - Volume 15, Issue 8

Study of changes in leptin and body mass composition with overweight and obesity following 8 weeks of Aerobic exercise


Khadijeh Molaei
(1)
Abbas Salehikia
(2)

(1) Master in Sport Physiology, Faculty of Physical Education and Sport Sciences, Sistan Baluchestan University (pardis) of Zahedan, Zahedan, Iran(2) Assistant Professor in sport physiology, faculty of Physical Education and sport Sciences, Sistan Baluchestan University of Zahedan, Zahedan, Iran

Correspondence:
Khadijeh Molaei
Master in Sport Physiology,
Faculty of Physical Education and Sport Sciences,
Sistan Baluchestan University (pardis) of Zahedan,
Zahedan, Iran

Email:
molaeikhadijeh@gmail.com

Abstract


Introduction: Obesity causes diseases such as coronary artery disease, mellitus diabetes, hypertension, cancer and stroke. The purpose of this study is to investigate changes in leptin and body mass composition in women with overweight and obesity after 8 weeks of aerobic exercise.

Method: T
he research method is semi-experimental. 34 women with overweight and obesity (40 ± 10 years, 25 BMI) volunteered and were randomly divided into experimental (17) and control (n = 17) groups. The training group started an 8-week training session with three sessions per week (51 minutes for each session) with 66% maximum heart rate in the first week and gradually reached 86% of the maximum heart rate with the progression of the training program. Each training session included warming up; the main part of the exercise included the implementation of low impact and high impact aerobic movements, in the standing position and back to the original sitting position. The control group was asked to maintain their normal life during the study period. Blood samples were taken in two phases: one was taken 48 hours before the tests and the other was taken 48 hours after the last aerobic training session. Serum leptin concentrationwas calculated using ELISA method using special kit. Shapiro-Wilk test was used to determine the consistency and normality of the information about the subjects in the research groups. For analyzing the data and considering the intra-group differences, the paired t-test was used and covariance test was used at the significance level of P0.05 to investigate the inter-group differences between the groups. SPSS 21 was used to perform statistical calculations.

Results:
Data analysis showed that 8-weekly sport exercises had a significant effect on BMI (P = 0.001), body weight (P = 0.000), and leptin (P = 0.001).
Conclusion: Aerobic exercise can lead to weight loss and leptin. This exercise can be used as a non-invasive way to treat obesity and prevent its complications.


Key words:
Leptin, Body Mass Index, Aerobic exercise, overweight


INTRODUCTION

The global spread of obesity is seen in all age groups, so that about 250 million people who are about 7% of the world’s current population are obese and two to three times of this amount are overweight (1). According to the World Health Organization reports, the number of obese and overweight people will increase by about 1.5 billion in 2015 (2). The prevalence of abdominal obesity in Brazil, France and the United States is reported to be 39.2%, 33.3% and more than 50 % respectively (3.1). Studies in different cities of Iran indicate a high prevalence of abdominal obesity in the population, so that the prevalence of abdominal obesity in these cities is as below: Tehran (over 76%), Rafsanjan (54.7%), Isfahan (84.6%), Arak (66.8%), Najaf Abad (82.2%) and Mazandaran province (82.2%) (4-6). Published statistics by the Institute for Endocrine Sciences and Metabolism of Shahid Beheshti University of Medical Sciences and Health Services showed that the prevalence of abdominal obesity increased from from 67.1% to 83.1% in the years 2002- 2009 (7).

The discovery of leptin hormone in 1995 has led to advances in obesity research. Leptin that is produced by the ob-gene is a protein hormone that is composed of 129 amino acids with a molecular weight of 16 kDa (8-9). This hormone is mainly secreted from adipose tissue and plays an important role in regulating body weight and energy homeostasis in the body. Leptin is actually an alert mechanism for regulating body fat. The higher adipose tissue contains more leptin and the lower adipose tissue secretes less leptin (8).

Laboratory studies are under way to better understand the function of leptin. Part of this research is the study of the effects of exercise on leptin levels. Several studies have shown that low-fat diet and physical exercise lower blood levels of leptin (9) and since regular body exercises play a crucial role in losing weight and body fat, if leptin levels are affected by exercise, it can explain how exercise affects obesity. Also, those who exercise regularly achieve better weight stability and metabolic fitness (1). Individuals who perform a particular exercise receive better results in reducing bodily mass than those who do not follow specific exercise (11). Leptin is associated with increased energy intake, reduced appetite and increased body temperature (12). In addition, leptin density significantly correlates with body mass index (BMI) and body fat percentage (12).

Limited studies have been conducted on leptin and have reported different outcomes. Azizi (2011) examined 8 weeks of running on a treadmill with an intensity of 65-85% maximum heart rate and reported that the leptin level significantly decreased in the training group but this decrease was not significant in comparison with the control group (13). Also, Akbarpour (2013) showed that 12 weeks of aerobic training on obese men with cardiovascular disease resulted in a significant decrease in leptin in the experimental group compared to the control group (14). Hejazi et al. (2014) investigated the effects of leptin changes after 12 weeks of aerobic training, which was performed 3 days a week and with an intensity of 75-65% of the heart rate in obese middle-aged women. They reported that exercise significantly decreased leptin (15). While Weltman et al. (2000) noted that a high intensity exercise session does not change the amount of leptin in the blood (16).

This contradiction in research results can be influenced by various factors such as the amount of fat and its distribution, inflammatory conditions, hormones and other factors, including the type and intensity of exercise. Therefore, more research is needed for understanding the mechanisms that control the synthesis and release of leptin and in clarifying the role of leptin better. Thus, according to little research done on the effect of long-term exercise on serum leptin levels and also given the importance of examining this new adipokin in obese people and the increasing interest of women in aerobic exercise, the aim of this study is to evaluate the effect of 8 weeks of aerobic exercise on resting levels of leptin and lipid profiles in overweight and obese women.

MATERIALS AND METHODS

After distributing recall papers, among women, 34 overweight and obese women were selected voluntarily and available from Zahedan on the basis of entry and exit criteria. The criteria for entering the study were: having overweight and obesity of BMI 25 and a minimum age of 30 years and a maximum age of 50 years. Also, the criteria for leaving the research were: 1- Cardiovascular disease, severe hypertension, type 1 diabetes mellitus, thyroid-related diseases, 2- drug use, 3- smoking and alcohol consumption 4. Non-participation in any regular exercise during past 6 months. Samples should not have any particular diet at the time of the research. Due to the experimental nature of research and observance of ethical issues, at first, the consent form of participation in the research and the medical records questionnaire were completed by the subjects. Then subjects were randomly divided into two groups of training (17 people) and control (17 people). The training group participated in an 8-week training program and three sessions per week, while the control group was asked to maintain their normal life during the study period.

Aerobic exercise program included 8 weeks aerobic training, 3 sessions per week and 51 minutes each session which started with 66% of maximum heart rate in the first week and gradually increased to 86% of the heart rate with the progression of the exercise program. Each training session consisted of warming up (stretching and running slowly for 11 minutes), the main part of the exercise included performing low impact and high-impact aerobic exercises (41 minutes) in standing position and returning to the initial state in sitting position (11 minutes). It should be noted that the control group did not attend any regular exercise at any time during the course of the research. The maximum heart rate of the participants in the exercise group was calculated using the Pollard pulse rate. The exercise protocol was carried out in a covered sports hall with proper ventilation and it was the same for all 8 weeks in terms of temperature and operating hours.

Blood samples were taken in two stages; one was taken 48 hours before the tests, and the other was taken 48 hours after the last aerobic exercise session in order to eliminate the effect of the exercise, in the laboratory between 5:00 and 8:00 am in a fasting state. Serum vaspin concentration and lipid profile was measured by ELISA method and by using a special kit of Human LEPTIN of EASTBIOPHARM Company according to the manufacturer’s instructions.

Shapiro-Wilk’s test was used to determine the consistency and normality of the information about the subjects of the research groups. In order to analyze the data, paired t-test was used to examine the intra-group differences and to examine the inter-group differences between research groups; covariance test was used at a significant level of P0.05. SPSS 21 was used to perform statistical calculations.

FINDINGS


As shown in Table 1, subjects prior to the implementation of the research protocol did not have a significant difference in terms of age, weight, and composition of the body. Data analysis showed that 8-weekly exercise had a significant effect on BMI (P = 0.001), body weight (P = 0/000), and leptin (P = 0.001).


DISCUSSION AND CONCLUSION

The main findings of this study were significant reduction in serum leptin levels, BMI and weight in overweight and obese women. Exercise affects body composition, and carbohydrate and fat metabolism, and considering the effect of exercise activities on serum leptin levels in energy balance and glucose hemostasis is very important (17). In confirmation of the present study findings, some studies that have improved body readiness level and have an effect on body composition, have reduced serum leptin (17). The size of the fat mass, especially the abdominal fat, plays a special role in the level of blood leptin. In obese people, elevation of adipose tissue was associated with increased leptin and increased leptin resistance (18). Of course, in one study, after 60 minutes of aerobic exercise activity for 7 weeks, no significant changes were observed in the level of blood leptin (19). These findings were also observed in some other studies with different intensity and duration of training periods (16). Fataru et al. (2005) stated that 6 months of exercise (3 days a week) would lead to a decrease in blood leptin, with a decrease in subcutaneous fat and body mass index which is consistent with the findings of the present study (18). Gökbel et al. (2009) indicated that leptin concentration significantly decreased in long term aerobic exercise immediately after exercise, 24 and 48 hours after exercise, and in the re-initiation period (20). Oazaki et al. (2010) also investigated the effect of moderate-intensity aerobic exercise (50% maximal oxygen consumption) and diet for 1 week on fat loss and leptin concentrations in non-active obese and non-obese middle-aged women. Based on these findings, leptin concentration and fat mass decreased, but decrease in leptin concentration was not associated with weight loss (21).

However, Bijeh et al. (2009) did not observe significant changes in body weight and body mass index and blood leptin levels by assessing the effect of 6 months of aerobic exercise on leptin level, cortisol, and insulin and serum glucose in middle-aged lean women. The reason for this discrepancy can be that regular physical activity is likely to reduce serum leptin levels if the body mass index is significantly reduced. In short, the decrease in the concentration of leptin after long-term exercises (more than 60 minutes) is assigned to overnight leptin reduction and hormonal changes due to exercise. Extremely long exercises that caused significant energy imbalances, affected periodical and overnight Leptin changes (23). However, the effect of leptin on physical activity and the return period to initial state is still unknown. There are some reasons that can explain the changes in the response of leptin to physical activity (17). Regarding all of these, it is believed that sports activities can play an important role in energy costs due to several factors, including weight loss and also can alter the response of leptin by effecting on hormonal concentrations (insulin, cortisol, growth hormone, catecholamine and testosterone) and metabolites (free fatty acid, lactic acid, and triglycerides)

Type of exercise is one of the factors influencing leptin levels (24). Long-term mild activity that consumes 900 kilocalories of energy, reduces leptin concentrations for more than 2 days after exercise, while high-intensity short-term activity with an energy consumption of approximately 200 kcal has no effect on leptin levels (24). The amount of exercise activity can have a significant effect on the levels of leptin, which is independent of the effects of exercise on the balance of energy (24).

The duration of exercise is one of the important determinants of severity that affects serum leptin levels (25). Studies are focused on leptin and short-term exercise. The severity and duration of activity, the nutritional status of individuals, the hours of blood transfusion, the caloric imbalance, the cyclic rhythm of leptin, etc. are affected by exercise (26). People with higher degrees of obesity are more resistant against leptin and therefore require a greater amount of exercise to affect leptin levels (27).

In summary, it may be said that aerobic exercise may be a suitable treatment for obesity and additionally if diet is used properly, it will have more beneficial effects.

REFERENCES

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21. Okazaki T, Himeno H, Nanri H, Ogata M, Ikeda M. Effects of mild aerobic exercise and a mild hypocaloric diet on plasma leptin in sedentary women. Clin Exp Pharmacol Physiol 1999; 26: 415-20.
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26. Hayase H, Nomura S, Abe T, Isawa T. Relation between fat distribution and several plasma adipocytokines after exercise training in premenopausal and postmenopausal women. J Physiol Anthropol Appl Human Sci. 2002;21:105-13.
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