Sharma Piyush, Yadav Raj Kumar, Khadgawat Rajesh, Dada Rima
Integral Health and Wellness Clinic, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India.
Department of Endocrinology, Metabolism and Diabetes, All India Institute of Medical Sciences, New Delhi, India.
Front Med (Lausanne). 2022 Aug 8;9:898293. doi: 10.3389/fmed.2022.898293. eCollection 2022.
Obesity is one of the major global problems in today's world, both in children, and the adult age group. Current evidence suggests obesity alters the expression of various genes related to oxidative stress, inflammation, and aging. In recent times complementary therapy like yoga-based lifestyle intervention (YBLI) is used as an adjunct therapy to modern medicine. This study examines the efficacy of 12 weeks of yoga-based lifestyle intervention with standard care (SC) on the expression of genes related to oxidative stress, inflammation, and aging in obese adults.
This was a two-arm parallel randomized control trial implemented at Integral Health Clinic (IHC), an outpatient facility that regularly conducted YBLI programs for the prevention of lifestyle diseases like obesity and diabetes in the Department of Physiology, All India Institute of Medical Sciences (AIIMS), New Delhi. Blood samples at baseline and weeks 2,4, and 12 were collected from 72 adults (male = 21; female = 51) of age 20-45 years with a body-mass index (BMI) of 25-35 kg/m who were randomized to receive either a 12-week SC ( = 36) or YBLI ( = 36). SC included recommendations for the management of obesity as per Indian guidelines including a low-calorie individualized diet and physical activity. (physical postures), (breathing exercises), and meditation were all part of the YBLI. Primary outcomes were relative fold change in the expression of genes associated with oxidative stress [Nuclear factor-kappa B (NF-Kappa B)], inflammation [Tumor necrosis factor-α (TNFα), interleukin-6 (IL-6)], and aging [human telomerase reverse transcriptase (TERT)] in peripheral blood mononuclear cells between the two groups at week-12.
There were no significant changes in fold change of TERT, IL-6, and NF-kappa B between the groups at week 12. The relative fold change of TERT was significantly greater in the YBLI group ( = <0.0001) vs the SC group at 2 weeks. The relative fold change of TNF α was significantly lower at week 12 in YBLI though the change was not continuous and reliable. Within both groups, TERT expression was significantly increased at week 2 though the change was greater in the YBLI group ( < 0.0001). TNF α gene expression was significantly lower at weeks 2 and 4, compared to baseline level, in the SC group but it increased at week 12.
The results while did not confirm our hypothesis, are important to share with the scientific society, to be able to improve prospective study designs and find optimal time/intervention/biological marker settings for this highly important scientific field. The results are suggestive of a positive impact of YBLI and SC on the fold change of aging-related TERT gene in obesity, though the benefit was not evident till week 12. However, the results should be evaluated with caution and in light of other published studies. To better understand the positive effects of YBLI on oxidative stress, inflammation, and aging-related gene expression in obesity, larger studies are recommended.
肥胖是当今世界主要的全球性问题之一,在儿童和成年人中均存在。目前的证据表明,肥胖会改变与氧化应激、炎症和衰老相关的各种基因的表达。近年来,诸如基于瑜伽的生活方式干预(YBLI)等补充疗法被用作现代医学的辅助疗法。本研究考察了为期12周的基于瑜伽的生活方式干预联合标准护理(SC)对肥胖成年人氧化应激、炎症和衰老相关基因表达的影响。
这是一项双臂平行随机对照试验,在全印度医学科学研究所(AIIMS)新德里分校生理学系的综合健康诊所(IHC)开展,该门诊机构定期开展YBLI项目以预防肥胖和糖尿病等生活方式疾病。从72名年龄在20 - 45岁、体重指数(BMI)为25 - 35 kg/m²的成年人(男性 = 21;女性 = 51)中采集基线以及第2、4和12周的血样,这些受试者被随机分为接受为期12周的SC组(n = 36)或YBLI组(n = 36)。SC包括根据印度指南对肥胖管理的建议,包括低热量个体化饮食和体育活动。体式、呼吸练习和冥想均为YBLI的组成部分。主要结局是两组在第12周时外周血单核细胞中与氧化应激相关基因[核因子-κB(NF-κB)]、炎症相关基因[肿瘤坏死因子-α(TNFα)、白细胞介素-6(IL-6)]和衰老相关基因[人端粒酶逆转录酶(TERT)]表达的相对倍数变化。
第12周时,两组间TERT、IL-6和NF-κB的倍数变化无显著差异。第2周时,YBLI组TERT的相对倍数变化显著高于SC组(P = <0.0001)。第12周时,YBLI组TNFα的相对倍数变化显著较低,尽管该变化不连续且不可靠。两组内,第2周时TERT表达均显著增加,尽管YBLI组变化更大(P < 0.0001)。与基线水平相比,SC组在第2周和第4周时TNFα基因表达显著降低,但在第12周时升高。
尽管结果未证实我们的假设,但与科学界分享这些结果很重要,以便能够改进前瞻性研究设计,并为这一极其重要的科学领域找到最佳时间/干预/生物标志物设置。结果提示YBLI和SC对肥胖中与衰老相关的TERT基因倍数变化有积极影响,尽管直到第12周益处才明显。然而,应谨慎评估这些结果,并参考其他已发表的研究。为了更好地理解YBLI对肥胖中氧化应激、炎症和衰老相关基因表达的积极作用,建议开展更大规模的研究。