{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T02:50:59Z","timestamp":1792205459506,"version":"4.4.0"},"reference-count":37,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2022,6,9]],"date-time":"2022-06-09T00:00:00Z","timestamp":1654732800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background and aims<\/jats:title>\n<jats:p>Obesity is linked to elevated levels of inflammatory serum markers such as C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor alpha (TNFa). Adiponectin and resistin are adipokines related to obesity. It has been described that adipose tissue presents a high production and secretion of these diverse pro-inflammatory molecules, which may have local effects on the physiology of fat cells as well as systemic effects on other organs. Our aim was to evaluate the impact that lifestyle modifications, by following a Mediterranean Diet (MedDiet) program and physical activity (PA) training, would have on inflammatory biomarkers and adipokine profile in a Metabolically Healthy Obese (MHO) elderly population from Malaga (Andalusia, Spain).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Subjetcs and methods<\/jats:title>\n<jats:p>Subjects aged \u226565 years (65 to 87 years old) with obesity (BMI \u226530 kg\/m<jats:sup>2<\/jats:sup>) were included in this study if they met \u22641 of the following criteria: systolic blood pressure \u2265130 mmHg and\/or diastolic blood pressure \u2265 85 mmHg; triglycerides \u2265150 mg\/dL; HDL-C &lt;40mg\/dL in men and &lt;50mg\/dL women; and fasting blood glucose \u2265100mg\/dL. Selected subjects underwent a personalized intensive lifestyle modification. Anthropometric measurements, PA, MedDiet adherence, analytical parameters, and inflammatory biomarkers were analyzed after 12 months of intervention.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>166 MHO elderly subjects, 40 (24.1%) male and 126 (75.9%) female (p &lt; 0.0001), aged 71.7\u00b15.2 years old (65 to 87 years old) were included in the study. After 12 months of intervention, only the waist circumference was significantly reduced in all the population (-2.5 cm, p&lt;0.0001), although weight and BMI were maintained. MedDiet adherence increased significantly (p&lt;0.001), but all intensity levels of PA decreased significantly (p&lt;0.001). Concerning inflammatory biomarkers, only TNFa serum increased their levels after the intervention (p&lt;0.001). Regarding the adipokine profile, adiponectin concentrations experienced a significant increment (p&lt;0.001); besides, resistin concentrations decreased significantly (p&lt;0.001). In this sense, only TNFa, adiponectin, and resistin correlated with PA. Adiponectin also correlates with insulin, triglycerides and HDL-c in baseline conditions and after 12 months of intervention; CRP, IL-6, TNFa, adiponectin, and resistin concentrations correlated with anthropometric parameters and some intensities of PA. In addition, adiponectin levels correlates with insulin, triglycerides and HDL-c. In baseline conditions, resistin levels correlated positively with TNFa (p = 0.01) and CRP (p&lt;0.0001) levels. TNFa and IL-6 correlated positively with CRP (p = 0.03 and p&lt;0.0001, respectively). After 12 months of intervention, only IL-6 correlated positively with CRP (p = 0.006). In addition, adipokines levels correlated positively during the process of lifestyle modification. However, during this process, only IL-6 correlated positively with itself (p&lt;0.0001) and with CRP (p = 0.03).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Healthy aging is a multifactorial biological process in which lifestyle is essential. The presence of obesity in elderly metabolically healthy population is not a problem necessarily. Elderly MHO population who eat a MedDiet and practice regularly PA are capable to modulate their production of inflammatory cytokines (CRP, IL-6, TNFa) and adipokines profile (adiponectin, resistin), preventing other metabolic disorders.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0265362","type":"journal-article","created":{"date-parts":[[2022,6,9]],"date-time":"2022-06-09T17:46:59Z","timestamp":1654796819000},"page":"e0265362","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":41,"title":["Metabolically healthy obesity: Inflammatory biomarkers and adipokines in elderly population"],"prefix":"10.1371","volume":"17","author":[{"given":"Lidia","family":"Cobos-Palacios","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Isabel","family":"Ruiz-Moreno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Vilches-Perez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Vargas-Candela","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00f3nica","family":"Mu\u00f1oz-\u00dabeda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7546-7965","authenticated-orcid":true,"given":"Javier","family":"Ben\u00edtez Porres","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Navarro-Sanz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Dolores","family":"Lopez-Carmona","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3722-5492","authenticated-orcid":true,"given":"Jaime","family":"Sanz-Canovas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis M.","family":"Perez-Belmonte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Jos\u00e9","family":"Mancebo-Sevilla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Gomez-Huelgas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0238-0890","authenticated-orcid":true,"given":"Mar\u00eda Rosa","family":"Bernal-Lopez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,6,9]]},"reference":[{"issue":"1","key":"pone.0265362.ref001","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1007\/s001090100202","article-title":"Searching for genes underlying normal variation in human adiposity","volume":"79","author":"AG Comuzzie","year":"2001","journal-title":"J Mol Med (Berl)"},{"issue":"5","key":"pone.0265362.ref002","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.2337\/diacare.27.5.1047","article-title":"Global prevalence of diabetes: estimates for the year 2000 and projections for 2030","volume":"27","author":"S Wild","year":"2004","journal-title":"Diabetes Care"},{"issue":"7","key":"pone.0265362.ref003","doi-asserted-by":"crossref","first-page":"1793","DOI":"10.1172\/JCI29069","article-title":"Inflammation and insulin resistance","volume":"116","author":"SE Shoelson","year":"2006","journal-title":"J Clin Invest"},{"issue":"9","key":"pone.0265362.ref004","doi-asserted-by":"crossref","first-page":"1347","DOI":"10.1038\/sj.ijo.0803259","article-title":"Circulating levels of MCP-1 and IL-8 are elevated in human obese subjects and associated with obesity-related parameters","volume":"30","author":"CS Kim","year":"2006","journal-title":"Int J Obes (Lond)"},{"issue":"5091","key":"pone.0265362.ref005","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1126\/science.7678183","article-title":"Adipose expression of tumor necrosis factor-alpha: direct role in obesity-linked insulin resistance","volume":"259","author":"GS Hotamisligil","year":"1993","journal-title":"Science"},{"issue":"3","key":"pone.0265362.ref006","doi-asserted-by":"crossref","first-page":"333","DOI":"10.2174\/1566524053766022","article-title":"Insulin resistance in type 2 diabetes\u2014role of the adipokines","volume":"5","author":"P. 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