An interdisciplinary therapy for lifestyle change is effective in improving psychological and inflammatory parameters in women with grade I obesity

SOUZA, ADRIANA P. DE; CARVALHO, LORENZA OLIVEIRA T.; PEDROSO, AMANDA PAULA; MORAES, AMANDA DE SANTOS; CIPULLO, MARCOS ALBERTO TADDEO; DÂMASO, ANA RAIMUNDA; TELLES, MÔNICA M.; OYAMA, LILA M.; TASHIMA, ALEXANDRE K.; CARANTI, DANIELLE A.; RIBEIRO, ELIANE B.

doi:10.1590/0001-3765202320230365

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HEALTH SCIENCES • An. Acad. Bras. Ciênc. 95 (suppl 2) • 2023 • https://doi.org/10.1590/0001-3765202320230365 linkcopy

An interdisciplinary therapy for lifestyle change is effective in improving psychological and inflammatory parameters in women with grade I obesity

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Obesity and depression, disorders associated with inflammation, have high incidences in women. Understanding the derangements present in the initial phase of obesity may point to factors that could help avoiding disease aggravation. The present study aimed at investigating the effects of a 6-months interdisciplinary therapy for weight loss in women with grade I obesity. Before and after the therapy, 37 middle-aged women donated blood and responded to questionnaires for depression and anxiety symptoms. Inflammatory parameters were evaluated in serum and a preliminary screening of the plasma proteome was performed. The therapy decreased anthropometric, psychological scores, and serum levels of inflammatory parameters. Depression and anxiety scores correlated positively with some inflammatory parameters. The proteomic analysis showed changes in proteins related to cholesterol metabolism and inflammatory response. Interdisciplinary therapy improves anthropometric and inflammatory statuses and ameliorating psychological symptoms. The decrease of MCP-1 levels after interdisciplinary therapy has not been reported so far, at the best of our knowledge. The present demonstration of positive associations of inflammatory markers and psychological scores indicate that these mediators may be useful to monitor psychological status in obesity. The present proteome data, although preliminary, pointed to plasma alterations indicative of improvement of inflammation after interdisciplinary therapy.

Key words
Anxiety; depression; inflammation; obesity; proteome

	Baseline	Confidence interval	Post-IT	Confidence interval	p-value
Body composition
BM (Kg)	88.35 ± 1.90	84.3 – 92.4	85.19 ± 2.02	80.9 – 89.5	<0.01 ^a
BMI (Kg/m2)	33.8 (30.1 - 34.5)	32.0 – 33.9	32.3 (28.9 – 33.5)	30.9 – 32.6	<0.01 ^b
FFM (Kg)	50.21 ± 0.96	48.1 – 52.3	49.13 ± 1.02	46.9 – 51.3	<0.01 ^a
FFM (%)	56.89 ± 0.44	56.0 – 57.8	57.75 ± 0.47	56.7 – 58.8	<0.01 ^a
BF (Kg)	38.14 ± 1.06	35.9 – 40.4	36.06 ± 1.12	33.7 – 38.4	<0.01 ^a
BF (%)	43.11 ± 0.44	42.2 – 44.0	42.25 ± 0.47	41.2 – 43.3	<0.01 ^a
Food intake
Total intake (Kcal)	1802.11 ± 129.44	1524.5 – 2079.7	1606.12 ± 87.85	1417.7 – 1794.5	0.04 ^a
Carbohydrates (g)	240.22 ± 15.95	206.0 – 274.4	216.21 ± 12.72	188.9 – 243.5	0.11^a
Proteins (g)	76.77 ± 6.95	61.9 – 91.7	71.58 ± 5.09	60.7 – 82.5	0.47^a
Lipids (g)	59.35 ± 6.42	45.6 – 73.1	50.55 ± 3,47	43.1 – 58.8	0.08^a
SFA (g)	15.94 ± 2.72	10.1 – 21.8	10.86 ± 1.43	7.8 – 13.9	0.04 ^a
MUFAs (g)	10.53 (4.31 – 24.33)	8.7 – 16.8	10.07 (2.52 – 17.13)	7.8 – 12.4	0.14^b
PUFA (g)	6.94 ± 0.94	4.9 – 9.0	7.34 ± 0.95	5.3 – 9.4	0.72^a
Fibers (g)	11.64 ± 1.19	9.1 – 14.2	9.93 ± 1.01	7.8 – 12.1	0.12^a

Inflammatory markers
	Baseline	Confidence interval	Post-therapy	Confidence interval	p-value
Leptin (ng/mL)	21.32 (13.50 - 61.24)	19.2 – 36.4	14.18 (8.53 - 49.08)	13.9 – 27.8	<0.01 ^b
Adiponectin (ug/mL)	6.99 (2.40 - 34.93)	4.6 – 14.9	4.63 (2.39 - 17.92)	4.8 – 11.0	0.26^b
Leptin / Adiponectin	3.00 (0.53 - 25.51)	1.8 – 8.8	3.13 (0.54 - 10.90)	2.3 – 6.2	0.46^b
ICAM-1 (ng/mL)	99.78 ± 9.56	79.3 – 120.3	62.13 ± 5.85	49.6 – 74.7	<0.01 ^a
VCAM-1 (ng/mL)	727.00 ± 83.85	547.2 – 906.8	391.58 ± 38.72	308.5 – 474.3	<0.01 ^a
MCP-1 (pg/mL)	280.00 (201.00 – 499.00)	272.8 – 368.6	247.00 (94.08 – 474.00)	213.1 – 315.9	<0.01 ^b
PAI-1 (ng/mL)	88.35 ± 7.49	72.3 – 104.4	50.93 ± 6.32	37.4 – 64.5	<0.01 ^a

Psychological test
	Baseline	Confidence interval	Post-therapy	Confidence interval	p-value
BDI	16.13 ± 2.14	11.5 – 20.7	8.00 ± 1.23	5.4 – 10.6	<0.01 ^a
BAI	7 (0 - 35)	5.6 – 16.9	5 (0 - 23)	3.0 – 10.3	0.02 ^b

UniProt ID	Gene name	Protein	Metabolic process	Fold-change	p-Value*
Down-regulation by IT
P02647	APOA1	Apolipoprotein A-I	Cholesterol metabolic process	0.74	0.05
P06727	APOA4	Apolipoprotein A-IV	Cholesterol metabolic process Innate immune response in mucosa	0.80	0.05
P02765	AHSG	Alpha-2-HS-glycoprotein	Acute-phase response Neutrophil degranulation Platelet degranulation	0.63	0.02
P04217	A1BG	Alpha-1B-glycoprotein	Neutrophil degranulation Platelet degranulation	0.78	0.03
P01871	IGHM	Immunoglobulin heavy constant mu	Innate Immune response	0.61	<0.01
O75882	ATRN	Attractin	Inflammatory response	Not detected at post-therapy¹
Up-regulation by IT
P00450	CP	Ceruloplasmin	Cellular iron ion homeostasis	1.64	<0.01
P02768	ALB	Serum albumin	Cellular response to starvation. Lipoprotein metabolic process	1.36	<0.01
P01611	IGKV1D-12	Immunoglobulin kappa variable 1D-12	Regulation of complement activation Immune response	Not detected at baseline²

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[tfnI] ^aPaired Student “t” test (Mean ± Standard Error); ^bWilcoxon test (Median (Minimum - Maximum))

Abbreviations: BM = body mass; BMI = body mass index; FFM = fat free mass; BF = body fat; SFA = saturated fatty acids; MUFA = monounsaturated fatty acids; PUFA = polyunsaturated fatty acids. N = 15.