All ETDs from UAB

Advisory Committee Chair

Barbara Gower

Advisory Committee Members

Marcas Bamman

Douglas Heimburger

Gary Hunter

Bradley Newcomer

Robert Oster

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) School of Health Professions


Chronic diseases such as type 2 Diabetes Mellitis (T2DM) and cardiovascular disease (CVD) are accompanied by chronic low-grade systemic inflammation and are related to obesity and ethnicity. For instance, African-Americans (AA) have increased risk for developing T2DM and are more likely to be overweight relative to Caucasians (C). However, C have more intra-abdominal adipose tissue (IAAT) and have higher risk for CVD than AA. The influence that ethnicity has on disease risk is obscured by ethnic differences in fat distribution and sensitivity to insulin. Ethnic differences in markers of inflammation (MOI) have not been investigated. It is also unclear if the decreases in MOI seen with weight loss are mediated by fat mass losses in different fat depots, which may differ among the ethnicities. The current study aimed to determine if, independent of fat distribution, there are ethnic differences in MOI. Furthermore, this study was designed to determine the effect of weight loss, with and without exercise interventions, on MOI in AA and C women. 213 overweight, but otherwise healthy women were recruited for a weight loss protocol, with or without exercise. Subjects were randomized into intervention groups: diet only, diet + aerobic training, or diet + resistance training. Body fat distribution was determined ii by dual-energy x-ray absorptiometry and computed tomography; insulin sensitivity by frequently sampled intravenous glucose tolerance test; and MOI by ELISA. The hypotheses of this study were that C women would have higher MOI than AA. However, after adjusting for IAAT, there would be no ethnic difference in MOI. Furthermore, independent of weight loss modality, MOI would be lower after weight loss and would specifically reflect the amount of fat lost. At baseline, plasma concentrations of TNF-α and its receptors were higher in C than AA. However, after adjusting for IAAT, the ethnic difference in TNF-α was attenuated to borderline significance (P=0.054). Among all women combined, all MOI decreased significantly with weight loss. When comparisons were conducted by ethnicity, all MOI decreased with weight loss among C, but only CRP decreased in AA. Overall, weight loss yielded favorable improvements in inflammation regardless of weight loss mechanism.



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