Long-term Yoga May Reduce Inflammation in Metabolic Syndrome

22 Feb, 2018

Three hours of yoga a week for a year improved serum levels of adipokines — proteins secreted by fat cells, which are involved in inflammation — in patients with high-normal blood pressure and metabolic syndrome in a new study.

These findings, by Rashmi Supriya, PhD, from the Hong Kong Polytechnic University, China, and colleagues, were published online February 7 in the Scandinavian Journal of Medicine and Science in Sports.

The researchers previously showed that a year of yoga classes whittled the waistline and lowered blood pressure in this cohort of patients with prehypertension and metabolic syndrome. The latter is defined as having three of the following: abdominal obesity, high blood pressure, high blood glucose level, high serum triglyceride level, or low HDL cholesterol level.

The current research "demonstrates that 1-year yoga training induces a favorable modulation of circulatory adipokines," Supriya and colleagues report.

Moreover, it suggests that "yoga exercise might serve as an effective lifestyle intervention to reduce chronic inflammation by downregulating the proinflammatory adipokines and upregulating the anti-inflammatory adipokines in individuals with high-normal blood pressure and metabolic syndrome."

In addition, determining serum levels of a panel of adipokines "might be useful for monitoring the beneficial outcomes of prolonged yoga exercise interventions."

Downward Dog and Other Poses, Regulated Breathing

The researchers note that metabolic syndrome is a serious public health concern, owing to its intimate link to the pathogenesis of diabetes mellitus, stroke, and cardiovascular diseases.

They explain that visceral fat secretes higher amounts of inflammatory cytokines, such as plasminogen activator inhibitor-1 (PAI-1), visfatin, and chemerin, whereas subcutaneous fat secretes the proinflammatory hormone leptin and the anti-inflammatory hormone adiponectin.

Yoga reduces levels of inflammatory adipokines and has been associated with decreased stress, anxiety, depression, waist circumference, and blood pressure and with improved quality of life.

Supriya and colleagues therefore hypothesized that "yoga training would induce a favorable modulation of the adipokine profile by reducing the circulatory abundance of proinflammatory adipokines and increasing anti-inflammatory adipokines in adults with [metabolic syndrome] and high-normal blood pressure."

They analyzed blood samples from 97 participants from their previous study of patients in China. Participants were aged 30 to 80 years and had metabolic syndrome and high-normal blood pressure (systolic blood pressure ≥130 mm Hg or diastolic blood pressure ≥85 mm Hg).

The participants had been randomly assigned to a control group (45 patients) or a yoga group (52 patients). Those in the control group did not receive any intervention.

Those in the yoga group attended small classes with about 10 participants. The classes were conducted by a certified yoga instructor, lasted 1 hour, and were held three times a week for 1 year. They consisted of a 10-minute warm-up, 40 minutes of selected yoga poses (from among 36 possibilities), and 10 minutes of a breathing and relaxation exercise.

At baseline, there were no significant differences between the groups, including the amount of physical activity normally undertaken. The mean age of the participants was 58 years, and the mean blood pressure was 141/90 mm Hg.

For participants in both groups, baseline levels of adiponectin, PAI-1, visfatin, chemerin, and leptin were similar.

After 1 year, the mean waist circumference was reduced by 4% in the yoga group and 2% in the control group.

From baseline to 1 year, the mean values of the inflammatory adipokines leptin, PAI-1, and chemerin decreased by 27%, 7%, and 14%, respectively, in the yoga group and increased by 9%, 14%, and 21%, respectively, in the control group.

The mean value of the anti-inflammatory adiponectin increased by 20% in the yoga group and decreased by 16% in the control group.

"These novel results support the beneficial complementary role of yoga exercise in the management of [metabolic syndrome] by illustrating the favorable modulating effects of yoga training on blood adipokines," Supriya and colleagues state.

The mechanism to explain the link between yoga and improved inflammatory biomarkers remains to be discovered.

"These findings help to reveal the response of adipokines to long-term yoga exercise, which underpins the importance of regular exercise to human health," said senior author Parco Siu, PhD, from the University of Hong Kong, in a statement.

The study was funded by grants from the Hong Kong Research Grants Council Hong Kong PhD Fellowship Scheme; the Hong Kong Polytechnic University Research Fund; and the University of Hong Kong Seed Fund for Basic Research. The authors have disclosed no relevant financial relationships.

Scand J Med Sci Sports. Published online February 7, 2018. Abstract