Impact of exercise on renal function, oxidative stress, and systemic inflammation among patients with type 2 diabetic nephropathy.

Background: Diabetic nephropathy (DN) is a prevalent microvascular diabetic complication all over the world. Objective: This study was designed to measure oxidative stress, systemic inflammation and kidney function response to exercise training in patients with type 2 diabetic (T2DM) nephropathy. Material and Methods: Eighty obese T2DM patients (50 males and 30 females), their body mass index (BMI) mean was 33.85±3.43 Kg/m2 and the mean of diabetes chronicity was 12.53±2.64 year participated in the present study and enrolled two groups; group I: received aerobic exercise training and group II: received no training intervention. Results: The mean values of creatinine, interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α) and malondialdehyde (MDA) were significantly decreased, while the mean values of interleukin-10 (IL-10), glutathione peroxidase (GPx) and glutathione (GSH) were significantly increased in group (A) after the aerobic exercise training, however the results of the control group were not significant. In addition, there were significant differences between both groups at the end of the study (P<0.05). Conclusion: There is evidence that aerobic exercise training modulated oxidative stress and inflammatory cytokines and improved renal function among patients with diabetic nephropathy.

Aerobic versus resistance exercises on systemic inflammation and sleep parameters in obese subjects with chronic insomnia syndrome.

BACKGROUND: Chronic primary insomnia is a prevalent sleep disorder that is associated with adverse effects on health outcomes. Exercise is often considered a non-pharmacological approach that could have beneficial effects on sleep. OBJECTIVE: The aim of the study was to compare the impact of aerobic and resistance exercise training on quality of sleep and inflammatory markers among subjects with chronic primary insomnia. MATERIAL AND METHODS: Sixty previously sedentary subjects with chronic primary insomnia subjects enrolled in this study, their age ranged from 31-52 years. All participants were randomly assigned to aerobic exercise intervention group (group A, n=35) or resistance exercise intervention group (group B, n=35). Polysomnographic recordings for sleep quality assessment, IL-6, IL-10 and TNF-α were measured before and at the end of the study after six months. RESULTS: There was a significant increase in the total sleep duration, sleep efficiency, sleep onset latency and IL-10 in group(A) and group (B) in addition to significant reduction in awake time after sleep onset, REM latency, IL-6 and TNF-α after 6 months of aerbic and resistance exercise training. However, there were significant differences between both groups at the end of the study. CONCLUSION: Aerobic exercise training is more appropriately than resistance exercise training in modulation of inflammatory and sleep quality among subjects with chronic primary insomnia.

Weight reduction improves immune system and inflammatory cytokines in obese asthmatic patients.

BACKGROUND: Activation of immunological and systemic inflammation markers are common in obesity and asthma. OBJECTIVE: The target of this study was to assess impact of weight reduction on immunological and systemic inflammation markers in obese asthma patients. MATERIAL AND METHODS: Eighty asthmatic patients of both sex; their age and body mass index (BMI) mean were 38.72 ± 7.14 year and 32.65 ± 3.18 Kg/m2 respectively. Exclusion criteria included smokers, infections, vaccinations, cancer, surgery, immune system disorders and medications that may influence immune system function as anti-inflammatory medications, analgesics and anti-depressant. All subjects were randomly enrolled in weight reduction group (group A) or control group (group B). RESULTS: The main findings in the present study indicated that weight reducing program in group (A) was associated with significant reduction in the mean values of IL6, TNF-α, and IL8 in addition to significant increase in the mean values of CD4 and CD8 cell count . However, findings of group (B) showed no significant changes. Moreover, Comparison between both groups at the end of the study revealed significant differences. CONCLUSION: Weight reduction improved immunological and systemic inflammation markers in obese asthma patients.

Aerobic exercise affects sleep, psychological wellbeing and immune system parameters among subjects with chronic primary insomnia.

BACKGROUND: Chronic primary insomnia is characterized by long-term difficulties in maintaining and initiating sleep, too early waking up, poor mood, fatigue, impaired concentration and poor quality of life. Exercise training is recommended to prevent and alleviate sleep disorders. OBJECTIVE: The aim of the study was to investigate the influence of aerobic exercise training on quality of sleep, psychological wellbeing and immune system among subjects with chronic primary insomnia. MATERIAL AND METHODS: Eighty previously sedentary subjects with chronic primary insomnia subjects enrolled in this study, their age ranged from 35-56 years. All participants were randomly assigned to supervised aerobic exercise intervention group (group A, n=40) or control group (group B, n=40). Polysomnographic recordings for sleep quality assessment, Beck Depression Inventory (BDI), Profile of Mood States(POMS), Rosenberg Self-Esteem Scale (RSES), number of CD3+, CD4+, CD8+ T cells count and CD4/CD8 ratio were measured before and at the end of the study after six months. RESULTS: There was a significant increase in the total sleep duration, sleep efficiency and sleep onset latency in group(A) after six months of aerobic exercise training, while, wake time after sleep onset and rapid eye movement (REM) latency significantly reduced after six months of aerobic training compared with values obtained prior to aerobic exercise training. Also, the mean values of BDI, POMS, CD3 count, CD4 count and CD8 count decreased significantly and the mean value of RSES significantly increased in group (A) after the aerobic exercise training, while the results of the control group were not significant. Moreover, there were significant differences between both groups at the end of the study. CONCLUSION: Exercise training can be considered as a non-pharmacological modalty for modifying sleep quality, psychological wellbeing and immune system among subjects with chronic primary insomnia.

Weight reduction ameliorates inflammatory cytokines, adipocytokines and endothelial dysfunction biomarkers among Saudi patients with type 2 diabetes.

BACKGROUND: Type 2 diabetes mellitus (T2DM) considered as one of the cardiovascular disorders (CVD) principle risk factor as diabetes is associated with abnormal levels of endothelial function, inflammatory and adipocytokines. OBJECTIVE: The aim of this study was to measure the impact of weight reducing on inflammatory cytokines, adipocytokines and endothelial function biomarkers among obese T2DM patients. METHODS: One-hundred T2DM patients enrolled in the present study; the age range was 35-55 year. Participants shared in this study were enrolled in group (A) received diet control and aerobic exercise on treadmill, while, group (B) had no intervention for 3 months. RESULTS: The mean values of body mass index (BMI), tumor necrosis factor -alpha (TNF-α), interleukin-6 (IL-6), leptin, inter-cellular adhesion molecule (ICAM-1), vascular cell adhesion molecule (VCAM-1), E-selectin and plasminogen activator inhibitor-1 activity (PAI-1 activity) were significantly decreased and adiponectin was increased significantly in the training group, however the results of the control group were not significant. Also, there were significant differences between both groups at the end of the study. CONCLUSION: Weight reducing program modulates inflammatory cytokines, adipocytokines and endothelial function biomarkers among obese T2DM patients.

Aerobic exercise modulates cytokine profile and sleep quality in elderly.

BACKGROUND: Sleep disturbance is a major problem for older adults which can be exacerbated by increased inflammation as aging is associated with increased circulating pro-inflammatory and lower anti-inflammatory cytokines. There is a need to develop alternative medicine techniques to help improve sleep quality in the elderly. OBJECTIVE: To investigate the effects of aerobic exercise training on the sleep quality and inflammatory cytokines in elderly subjects. MATERIAL AND METHODS: Forty previously sedentary elderly subjects participated in this study, their age ranged from 61- 67 years. All subjects were randomly assigned to supervised aerobic exercise intervention group (group A, n=25) or control group (group B, n=25). Polysomnographic recordings for sleep quality assessment, interleukin- 6 (IL-6), tumor necrosis factor- alpha (TNF-α) and interleukin-10 (IL-10) were measured before and after 6 months at the end of the study. RESULTS: There was a significant increase in total sleep duration, sleep efficiency and sleep onset latency in group(A) after 6 months of aerobic exercise training, while, wake time after sleep onset and rapid eye movement (REM) latency significantly reduced after 6 months of aerobic training compared with values obtained prior to aerobic exercise training. Also, the mean values of TNF- α and IL-6 decreased significantly and the mean value of IL-10 significantly increased in group (A) after the aerobic exercise training, however the results of the control group were not significant. Moreover, there were significant differences between both groups at the end of the study. CONCLUSION: Exercise training can be considered as a non-pharmacological modality for modifying sleep quality and inflammation among elderly.

Impact of aerobic exercise versus resisted exercise on endothelial activation markers and inflammatory cytokines among elderly.

BACKGROUND: Aging is the major risk factor for the development of cardiovascular diseases as aging increases plasma levels of pro-inflammatory mediators and endothelial dysfunction. Physical exercise is a potential strategy for improving the endothelial dysfunction and chronic inflammation that accompanies aging. However, there is a need to differentiate between aerobic and resistance exercise training regarding endothelial activation markers and systemic inflammation among elderly population. OBJECTIVE: The aim of this study was to compare the impact of six months of aerobic versus resisted exercise training on inflammatory cytokines and endothelial activation markers among elderly. MATERIAL AND METHODS: Eighty previously sedentary elderly subjects participated in this study, their age ranged from 61-66 years. All subjects were randomly assigned to supervised aerobic exercise intervention group (group A, n=40) or resistance exercise group (group B, n=40). RESULTS: The mean value of interleukin-10 (IL-10) was significantly increased, where the mean value of inter-cellular adhesion molecule (ICAM-1), vascular cell adhesion molecule (VCAM-1), E-selectin, tumor necrosis factor alpha (TNF-α) and interleukin-6 (IL-6) were significantly decreased in group (A) and group (B). In addition, there were significant differences in the mean levels of the investigated parameters between group (A) and group (B) at the end of the study. CONCLUSION: The current study provides evidence that aerobic exercise is more appropriate in modulate entering altered endothelial activation and inflammatory markers than resisted exercise among elderly population.

Impact of aerobic versus resisted exercise training on systemic inflammation biomarkers and quality of Life among obese post-menopausal women.

BACKGROUND: Although post-menopausal obesity is an important public national health problem in Saudi Arabia, to date no study has evaluated the effects of weight reduction on biochemical & clinical parameters and quality of Life for obese Saudi post-menopausal women. OBJECTIVE: The aim of this study was examine the effects of aerobic versus resisted exercise training effects upon systemic inflammation biomarkers and quality of life for obese post-menopausal Saudi women. MATERIAL AND METHODS: One hundred Saudi post-menopausal obese women participated in this study, their age ranged from 50-58 years and their body mass index (BMI) ranged from 30-35 kg/m2. All participants were divided into two equal groups: The first group received aerobic exercise training on treadmill where, the second group received resisted exercise training. Health-related quality of life (SF-36 HRQL), tumor necrosis factor- alpha(TNF-α), Interleukin-2(IL-2), Interleukin-4 (IL-4), Interleukin-6 (IL-6) and C-reactive protein (CRP) were measured before and after 3 months at the end of the study. RESULTS: The mean values of SF-36 HRQL subscale scores were significantly increased, while the mean value of TNF-α, Il-2, IL-4, IL-6, CRP and BMI were significantly decreased in both groups after treatments. There were significant differences between mean levels of the investigated parameters in group (A) and group (B) after treatment with more changes in patients received aerobic exercise training. CONCLUSION: The current study provides evidence that aerobic exercise is more appropriate than resisted exercise training in modulating inflammatory cytokines and quality of life among obese post-menopausal women.

Impact of aerobic exercises on selected inflammatory markers and immune system response among patients with sickle cell anemia in asymptomatic steady state.

BACKGROUND & OBJECTIVE: Sickle cell anemia (SCA) is well recognized as a chronic inflammatory disease. Despite progress in therapy, SCA remains a cause of significant morbidity and mortality. The relationship between exercise and immune function has been of great interest to the scientific community and the lay public. The aim of this study was to measure the impact of aerobic exercise training on the immunologic parameters and inflammatory cytokines of patients with sickle cell anemia (SCA) in asymptomatic steady state. MATERIAL AND METHODS: Sixty asymptomatic sickle cell anemia patients were involved in this study, their age ranged from 25- 40 years and were assigned to two sub-groups; group (A) received aerobic exercise training for 12 weeks, however group (B) received no training intervention for 12 weeks. Parameters of CD3, CD4 and CD8 were quantified, Leukocyte, differential counts, IL-6 and TNF-α were measured before and after 12 weeks, at the end of the study. RESULTS: The mean values of CD3, CD4 and CD8, leukocyte, monocytes counts, IL-6 and TNF-α were significantly decreased in group (A), while group (B) showed non-significant changes in these parameters. Also; there were significant differences between mean levels of the investigated parameters in group (A) and group (B) after treatment. CONCLUSION: The current study provides evidence that aerobic exercise training improves inflammatory markers and immune system in patients with sickle cell anemia (SCA) in asymptomatic steady state.

Inflammatory cytokines and immune system modulation by aerobic versus resisted exercise training for elderly.

BACKGROUND: Aging is characterized with immunosenescence associated with a hyper-inflammatory state, characterized by elevated circulating levels of pro-inflammatory mediators. Physical exercise is a potential strategy for improving the immune system dysfunction and chronic inflammation that accompanies aging. However, there is a need to differentiate between aerobic and resistance exercise training regarding human immune system and systemic inflammation among the elderly Saudi population. OBJECTIVE: The aim of this study was to compare the impact of 6 months of aerobic versus resisted exercise training on inflammatory cytokines and immune system response among elderly. MATERIAL AND METHODS: Sixty previously sedentary elderly subjects participated in this study, their age ranged from 61-66 years. All Subjects were randomly assigned to supervised aerobic exercise intervention group (group A, n=40) or resistance exercise group (group B, n=40). Number of CD3+,CD4+,CD8+ T cells count and CD4/CD8 ratio were quantified, IL-6, TNF-α and IL10 were measured before and after 6 months, at the end of the study. RESULTS: The mean values of CD3+, CD4+ and CD8+ T cells count and IL-10 were significantly increased, whereas the mean values of CD4/CD8 ratio, IL-6 and TNF-α were significantly decreased in group (A) and group (B). Also; there were significant differences between mean levels of the investigated parameters in group (A) and group (B) after treatment. CONCLUSION: The current study provides evidence that aerobic exercise is more appropriate in modulating the immune system and inflammatory markers among the elderly population.

Impact of weight reduction on selected immune system response among Hepatitis C virus Saudi patients.

BACKGROUND: Recently, about 2.35% of the world populations are estimated to be chronically infected with hepatitis C virus (HCV). Previous cohort studies indicated that obesity increases risk of hepatic steatosis and fibrosis in non-diabetic patients with chronic hepatitis C infection due to diminished response to anti-viral therapy and as a result obesity is considered as an important factor in the progression of chronic HCV. However, there is a strong association between BMI and the human immune system among HCV patients. OBJECTIVE: This study aimed to examine effects of weight reduction program on selected immune parameters among HCV Saudi patients. MATERIAL AND METHODS: One-hundred obese Saudi patients with chronic HCV infection participated in this study, their age ranged from 50-58 years and their body mass index (BMI) ranged from 30-35 kg/m2. All Subjects were included in two groups: The first group received weight reduction program in the form of treadmill aerobic exercises in addition to diet control whereas, the second group received no therapeutic intervention. Parameters of CD3, CD4 and CD8 were quantified; Leukocyte, differential counts and BMI were measured before and after 3 months, at the end of the study. RESULTS: The mean values of BMI, white blood cells, total neutrophil count, monocytes, CD3, CD4 and CD8 were significantly decreased in the training group as a result of weight loss program; however the results of the control group were not significant. Also, there were significant differences between both groups at the end of the study. CONCLUSION: Weight loss modulates immune system parameters of patients with HCV.

Impact of weight reduction on insulin resistance, adhesive molecules and adipokines dysregulation among obese type 2 diabetic patients.

BACKGROUND: Type 2 diabetes mellitus is usually related to vascular problems and is associated with impairment in endothelial function characterized by impaired endothelial-dependent vasodilation and increased platelet adhesion. There is limitation in clinical studies that have addressed the beneficial effects of weight reduction in modulating biomarkers of endothelial dysfunction and adipokines dysregulation for obesity associated with type 2 diabetes mellitus. OBJECTIVE: This study was designed to detect the effects of weight loss on insulin resistance, adhesive molecules and adipokines dysregulation in obese type 2 diabetic patients. METHODS: Eighty obese patients with type 2 diabetes mellitus, their age ranged from 35-55 years and their body mass index ranged from 31-37 kg/m2 were equally assigned into 2 groups: the weight reduction group received aerobic exercises in addition to diet regimen, where the control group received medical treatment only for 12 weeks. RESULTS: There was a 24.04%, 19.33%, 22.78% ,12.28%, 9.35%, 22.53% & 10.12 % reduction in mean values of Homeostasis Model Assessment-Insulin Resistance Index (HOMA-IR), Leptin, Adiponectin, Resistin, intercellular cell adhesion molecule -1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1) and E-selectin & body mass index (BMI) respectively in addition to 26.20% & 24.58% increase in the mean values of adiponectin & the quantitative insulin-sensitivity check index (QUICKI) respectively in group (A) at the end of the study. The mean values of leptin, resistin, insulin, HOMA-IR, ICAM-1, VCAM-1, E-selectin & BMI were significantly decreased in addition to significant increase in the mean values of adiponectin & QUICKI in group (A) those that received aerobic exercise training in addition to diet regimen. While the results of group (B) those that received no treatment intervention were not significant. In addition, there were significant differences between mean levels of the investigated parameters in group (A) and group (B) after treatment (P<0.05). CONCLUSION: Within the limit of this study, 10% reduction in body mass index modulates insulin resistance, adhesive molecules and adipokines dysregulation among obese type 2 diabetic patients.

Impact of weight loss on oxidative stress and inflammatory cytokines in obese type 2 diabetic patients.

BACKGROUND: Type 2 diabetes mellitus is associated with abnormal markers of inflammatory cytokines and oxidative stress markers. Although, these abnormalities could be modulated with weight reduction; there is limitation in clinical studies that have addressed the beneficial effects of weight reduction in modulating biomarkers of inflammatory cytokines and oxidative stress for obesity associated with type 2 diabetes mellitus. OBJECTIVE: This study was designed to detect the effects of weight loss on the inflammatory cytokines, oxidative stress markers in obese type 2 diabetic patients. MATERIAL AND METHODS: Eighty obese patients with type 2 diabetes mellitus, their age ranged from 35-57 years and their body mass index ranged from 31-35 kg/m2 were equally assigned into 2 groups: the weight reduction group received aerobic exercises, diet regimen, where as the control group received medical treatment only for 12 weeks. RESULTS: The mean values of body mass index (BMI), tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), C-reactive protein (sCRP), conjugated dienes (CD) and malondialdehyde (MDA) were significantly decreased, while the mean values of glutathione peroxidase (GPx), superoxide dismutase (SOD) and glutathione (GSH) were significantly increased in patients of group (A), while changes were not significant in group (B). Also, there were significant differences between mean levels of the investigated parameters in group (A) and group (B) at the end of the study. CONCLUSION: Weight loss ameliorates inflammatory cytokines and oxidative stress markers in obese type 2 diabetic patients.

Treadmill walking exercise modulates bone mineral status and inflammatory cytokines in obese asthmatic patients with long term intake of corticosteroids.

BACKGROUND: Obesity and asthma are an important public health problem in Saudi Arabia. An increasing body of data supports the hypothesis that obesity is a risk factor for asthma. Asthma appears to be associated with low bone mineral density (BMD) due to long-term use of corticosteroids. Studies recently showed that weight bearing exercise training can increase mineral bone density, reduce weight and improve metabolic control. OBJECTIVE: The present study aimed to measure the effects of treadmill walking exercises on bone mineral status and inflammatory cytokines in obese asthmatic patients treated with long term intake of corticosteroids. METHODS: Eighty obese asthmatic patients of both sexes, their age ranged from 41 to 53 years. Subjects were divided into two equal groups: training group (group A) received aerobic exercise training on treadmill for six months in addition to the medical treatment where, the control group (group B) received only the medical treatment. RESULTS: The results of this study indicated a significant increase in BMD of the lumbar spine & the radius, serum calcium and high density lipoprotein cholesterol (HDL-c) & significant reduction in parathyroid hormone, leptin, tumor necrosis factor- alpha(TNF-α), interleukin-2 (IL-2), interleukin-4 (IL-4), interleukin-6 (IL-6), low density lipoprotein cholesterol (LDL-c), triglycerides (TG) and body mass index (BMI) in group (A), while these changes were not significant in group (B).Also; there was a significant difference between both groups at the end of the study. CONCLUSION: Treadmill walking exercise training is an effective treatment policy to improve bone mineral status and modulates inflammatory cytokines and blood lipids profile in obese asthmatic patients with long term intake of corticosteroids.

Plasma inflammatory biomarkers response to aerobic versus resisted exercise training for chronic obstructive pulmonary disease patients.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a main risk for morbidity, associated with alterations in systemic inflammation. Recent studies proved that morbidity and mortality of COPD is related to systemic inflammation as it contributes to the pathogenesis of atherosclerosis and cardiovascular disease. However, increase of inflammatory cytokines adversely affects quality of life, alteration in ventilatory and skeletal muscles functions. Moreover, exercise training has many beneficial effects in correction of the adverse effects of COPD. OBJECTIVE: This study aimed to compare the response of inflammatory cytokines of COPD to aerobic versus resisted exercises. MATERIALS AND METHODS: One hundred COPD diseased patients participated in this study and were randomly included in two groups; the first group received aerobic exercise, whereas the second group received resisted exercise training for 12 weeks. RESULTS: The mean values of TNF-α, Il-2, IL-4, IL-6 and CRP were significantly decreased in both groups. Also; there was a significant difference between both groups at the end of the study with more reduction in patients who received aerobic exercise training. CONCLUSION: Aerobic exercise is more appropriate than resisted exercise training in modulating inflammatory cytokines level in patients with chronic obstructive pulmonary disease.

Biochemical parameters response to weight loss in patients with non-alcoholic steatohepatitis.

BACKGROUND: Non-alcoholic steatohepatitis (NASH) is a chronic liver disease that is capable of progressing to end-stage liver disease, but generally has a benign course. Non-alcoholic steatohepatitis (NASH) is a growing public health problem with no approved therapy. NASH projected to be the leading cause of liver transplantation in the United States by 2020. Obesity, non-insulin-dependent diabetes mellitus and hyperlipidaemia are the most common associations of the disease. Global prevalence of NASH is 10-24% amongst general population but increases to 25-75% in obese diabetic individuals. OBJECTIVE: There is an urgent need for efficient therapeutic options as there is still no approved medication. The aim of this study was to detect changes in biochemical parameters including insulin resistance, cytokines, blood lipid profile and liver enzymes following weight loss in patients with non-alcoholic steatohepatitis. MATERIALS AND METHODS: One hundred obese patients with NASH, their age between 35-50 years, body mass index (BMI) from 30 to 35 Kg/m(2) were included in the study in two subgroups; the first group (A) received moderate aerobic exercise training in addition to diet regimen , where the second group (B) received no treatment intervention. RESULTS: The mean values of leptin, TNF-α, IL6, IL8, Alanine Aminotransferase (ALT), Aspartate Aminotransferase (AST), Homeostasis Model Assessment-Insulin Resistance- index (HOMA-IR), Total Cholesterol (TC), Low Density Lipoprotein Cholesterol (LDL-c) , Triglycerides (TG) and BMI were significantly decreased in group (A), where the mean value of Adiponectin and High Density Lipoprotein Cholesterol (HDL-c) were significantly increased, while there were no significant changes in group (B). Also, there was a significant difference between both groups at the end of the study. CONCLUSION: Weight loss modulates insulin resistance, adiponectin, leptin, inflammatory cytokine levels and markers of hepatic function in patients with nonalcoholic steatohepatitis.

Aerobic exercise improves quality of life, psychological well-being and systemic inflammation in subjects with Alzheimer's disease.

BACKGROUND: Alzheimer's disease has a destructive drawbacks on the patient and his/her entire family as this disease badly af fects the behavior, cognition and abilities to do activities of daily living (ADL). The physical and mental benefits of exercise are widely known but seldom available to persons suffering from Alzheimer's disease. OBJECTIVE: The aim of this study was to measure quality of life, systemic inflammation and psychological well-being response to aerobic exercises in Alzheimer's. METHODS: Forty Alzheimer elderly subjects were enrolled in two groups; the first group received treadmill aerobic exercise, while the second group was considered as a control group and received no training intervention for two months. Assessment of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), Rosenberg Self-Esteem Scale (RSES),Beck Depression Inventory (BDI), Profile of Mood States(POMS) and SF-36 health quality of life (SF-36 HRQL) were taken before and at the end of the study. RESULTS: There was a 25.2%, 19.4%, 23.5%, 21.3%, 17.7% , 11.7%, 12.5% and 10.1 % reduction in mean values of TNF-α, IL-6, BDI, POMS, health transition SF-36 subscale, bodily pain SF-36 subscale, role functioning: emotional SF-36 subscale and mental health SF-36 subscale respectively in addition to 15.7%, 13.1%, 12.6%, 11.1%, 13.2% and 11.2 % increase in mean values of RSES, physical functioning SF-36 subscale, role functioning:physical SF-36 subscale, general health SF-36 subscale, Vitality SF-36 subscale and Social functioning SF-36 subscale respectively in group (A) received aerobic exercise training, so that there was a significant reduction in the mean values of TNF-α, IL-6, BDI & POMS and increase in the mean values of SF-36 HRQL subscale scores, RSES in group (A) as a result of aerobic exercise training, while the results of group (B) who received no training intervention were not significant. Also, there were significant differences between mean levels of the investigated parameters in group (A) and group (B) at the end of the study (P<0.05). CONCLUSION: Treadmill walking exercise training is an effective treatment policy to improve quality of life, systemic inflammation and psychological wellbeing in Alzheimer's.

Exercise alleviates depression related systemic inflammation in chronic obstructive pulmonary disease patients.

BACKGROUND: Depression is a highly prevalent co-morbidity in Chronic Obstructive Pulmonary Disease (COPD) which was shown to be associated with a worse course of disease, including reduced quality of life and increased symptoms burden, healthcare use, and even mortality. It has been speculated that systemic inflammation may play a role in the presence of depression. Currently, physical activity is an important lifestyle factor that has the potential to modify inflammatory cytokines and depression, however our understanding of how to use exercise effectively in COPD patients to alleviate depression related systemic inflammation is incomplete and has prompted our interest to identify the type and intensities of effective exercise. OBJECTIVE: The aim of this study was to measure the changes in depression related systemic inflammation of aerobic exercise training in COPD patients in Jeddah area. MATERIAL AND METHODS: Eighty patients with moderate severity of COPD participated in this study and were divided into two groups; the first group received aerobic exercise, whereas the second group received no exercise training for 12 weeks. RESULTS: The mean values of tumor necrosis factor-alpha (TNF-α), interleukin-4 (IL-4), interleukin-6 (IL-6), C-reactive protein (CRP) and Beck Depression Inventory (BDI) scores were significantly decreased in in group (A) after treatments, but the changes in group (B) were not significant .Also, there were significant differences between mean levels of the investigated parameters in group (A) and group (B) at the end of the study. CONCLUSION: Aerobic exercise is an effective treatment policy to improve depression related to systemic inflammation in patients with chronic obstructive pulmonary disease.

Non-alcoholic fatty liver disease: The diagnosis and management.

Non-alcoholic fatty liver disease (NAFLD) is now the most frequent chronic liver disease that occurs across all age groups and is recognized to occur in 14%-30% of the general population, representing a serious and growing clinical problem due to the growing prevalence of obesity and overweight. Histologically, it resembles alcoholic liver injury but occurs in patients who deny significant alcohol consumption. NAFLD encompasses a spectrum of conditions, ranging from benign hepatocellular steatosis to inflammatory nonalcoholic steatohepatitis, fibrosis, and cirrhosis. The majority of hepatocellular lipids are stored as triglycerides, but other lipid metabolites, such as free fatty acids, cholesterol, and phospholipids, may also be present and play a role in disease progression. NAFLD is associated with obesity and insulin resistance and is considered the hepatic manifestation of the metabolic syndrome, a combination of medical conditions including type 2 diabetes mellitus, hypertension, hyperlipidemia, and visceral adiposity. Confirmation of the diagnosis of NAFLD can usually be achieved by imaging studies; however, staging the disease requires a liver biopsy. Current treatment relies on weight loss and exercise, although various insulin-sensitizing agents, antioxidants and medications appear promising. The aim of this review is to highlight the current information regarding epidemiology, diagnosis, and management of NAFLD as well as new information about pathogenesis, diagnosis and management of this disease.

Bone metabolism and hand grip strength response to aerobic versus resistance exercise training in non-insulin dependent diabetic patients.

BACKGROUND: Diabetes mellitus has been shown in many studies to be associated with reduced bone mass and an increased risk of fracture. Currently, our understanding of how to use exercise effectively in diabetic patients in prevention of osteoporosis is incomplete and has prompted our interest to identify the type of effective osteogenic exercise. OBJECTIVE: The aim of this study was to compare the changes in handgrip strength and bone metabolism after 6 months between aerobic and resistance exercise training in non-insulin dependent diabetic patients in Jeddah area. MATERIALS AND METHODS: One hundred non-insulin dependent diabetic male patients participated in this study and were divided into two equal groups; the first group (A) received aerobic exercise training, where the second group (B) received resistance exercise training. The program consisted of three sessions per week for six months. RESULTS: The mean values of serum calcium and Hand grip strength were significantly increased, while the mean values of parathyroid hormone were significantly decreased in both groups .Also, there were significant differences between mean levels of the investigated parameters in group (A) and group (B) after treatment. CONCLUSION: Aerobic exercise training on treadmill is appropriate to improve markers of bone metabolism and hand grip strength in non-insulin dependent diabetic patients.