PLoS Genet | A sedentary lifestyle, a poor diet and new technologies that reduce physical activity cause health problems worldwide, as reduced energy expenditure together with increased energy intake lead to weight gain and increased cardiometabolic health risks [1]. Obesity is an important predictor for the development of both type 2 diabetes (T2D) and cardiovascular diseases, which suggests a central role for adipose tissue in the development of these conditions [2]. Adipose tissue is an endocrine organ affecting many metabolic pathways, contributing to total glucose homeostasis [2]. T2D is caused by a complex interplay of genetic and lifestyle factors [3], and a family history of T2D has been associated with reduced physical fitness and an increased risk of the disease [4]–[6]. Individuals with high risk of developing T2D strongly benefit from non-pharmacological interventions, involving diet and exercise [7], [8]. Exercise is important for physical health, including weight maintenance and its beneficial effects on triglycerides, cholesterol and blood pressure, suggestively by activating a complex program of transcriptional changes in target tissues.
Epigenetic mechanisms such as DNA methylation are considered to be important in phenotype transmission and the development of different diseases [9]. The epigenetic pattern is mainly established early in life and thereafter maintained in differentiated cells, but age-dependent alterations still have the potential to modulate gene expression and translate environmental factors into phenotypic traits [10]–[13]. In differentiated mammalian cells, DNA methylation usually occurs in the context of CG dinucleotides (CpGs) and is associated with gene repression [14]. Changes in epigenetic profiles are more common than genetic mutations and may occur in response to environmental, behavioural, psychological and pathological stimuli[15]. Furthermore, genetic variation not associated with a phenotype could nonetheless affect the extent of variability of that phenotype through epigenetic mechanisms, such as DNA methylation. It is not known whether epigenetic modifications contribute to the cause or transmission of T2D between generations. Recent studies in human skeletal muscle and pancreatic islets point towards the involvement of epigenetic modifications in the regulation of genes important for glucose metabolism and the pathogenesis of T2D [11],[12], [16]–[21]. However, there is limited information about the regulation of the epigenome in human adipose tissue [22].
The mechanisms behind the long-lasting effects of regular exercise are not fully understood, and most studies have focused on cellular and molecular changes in skeletal muscle. Recently, a global study of DNA methylation in human skeletal muscle showed changes in the epigenetic pattern in response to long-term exercise [23]. The aims of this study were to: 1) explore genome-wide levels of DNA methylation before and after a six months exercise intervention in adipose tissue from healthy, but previously sedentary men; 2) investigate the differences in adipose tissue DNA methylation between individuals with or without a family history of T2D; 3) relate changes in DNA methylation to adipose tissue mRNA expression and metabolic phenotypes in vitro.
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