Menopause: The Journal of The North American Menopause Society

Vol. 19, No. 3, pp. 296/301

DOI: 10.1097/gme.0b013e31822d59a2
* 2012 by The North American Menopause Society

Effects of yoga exercise on serum adiponectin and metabolic

syndrome factors in obese postmenopausal women
Jeong-Ah Lee, PhD,1 Jong-Won Kim, PhD,2 and Do-Yeon Kim, PhD1,2

Abstract
Objective: Regular and continuous yoga exercise is one of the most important nonpharmacological methods
of improving serum lipid concentrations, adipose tissue, and metabolic syndrome factors. The purpose of this
study was to analyze the effects of yoga exercise on serum adiponectin and metabolic syndrome factors in obese
postmenopausal Korean women.
Methods: Sixteen healthy postmenopausal women aged 54.50 T 2.75 years with more than 36% body fat
were randomly assigned to either a yoga exercise group (n = 8) or to a Bno exercise[ control group (n = 8). The
variables of body composition, visceral fat, serum adiponectin, and metabolic syndrome factors were measured in all
the participants before and after the 16-week study.
Results: Body weight, percentage of body fat, lean body mass, body mass index, waist circumference, and
visceral fat area had significantly decreased. High-density lipoprotein cholesterol and adiponectin had significantly
increased, but total cholesterol, triglyceride, low-density lipoprotein cholesterol, blood pressure, insulin, glucose, and
homoeostasis model assessmentYinsulin resistance had significantly decreased. Serum adiponectin concentrations
were significantly correlated with waist circumference, high-density lipoprotein cholesterol, diastolic blood pressure,
and homoeostasis model assessmentYinsulin resistance in the postyoga exercise group.
Conclusions: Our findings indicate that yoga exercise improves adiponectin level, serum lipids, and metabolic
syndrome risk factors in obese postmenopausal women. Consequently, yoga exercise will be effective in preventing
cardiovascular disease caused by obesity in obese postmenopausal Korean women.
Key Words: Exercise Y Adiponectin Y Metabolic syndrome Y Homoeostasis model assessmentYinsulin resistance.

T
he increasing prevalence of obesity is a serious health
problem worldwide because obesity is linked to con-
ditions such as hypertension, cardiovascular diseases,
hyperlipidemia, diabetes, and metabolic disorders.1 Some of
the hypothesized factors contributing to the rapid rise in obe-
sity have been the change in people’s lifestyle such as phys-
ical inactivity, high dietary intake, and sedentary lifestyle. The
prevalence of syndromes with multiple risk factors is greatly
increasing, even in East Asia including Korea.
A number of studies have reported that visceral fat is re-
lated to obesity-linked disorders including insulin resistance,
disorders of glucose and lipid metabolism, and hyperten-
sion.2,3 Recent clinical research demonstrated the adipocyto-
kines such as leptin, adiponectin, resistin, visfatin, and tumor
necrosis factor-> not only are used as an organ for storage of
Received June 16, 2011; revised and accepted July 12, 2011.
From the 1Department of Physical Education, Kyungsung University,
Busan, South Korea; and 2Department of Physical Education, Pusan
National University, Busan, South Korea.
Financial disclosure/conflicts of interest: None reported.
Address correspondence to: Do-Yeon Kim, PhD, San 30, Jang-jeon
dong, Keum-jung gu, Physical Education, Pusan National University,
Busan, South Korea. E-mail: kdy4955@pusan.ac.kr
excess energy but also act as an endocrine organ that produces
and secretes various bioactive substances.3<5
Adiponectin is related to insulin resistance, glucose toler-
ance, endothelial dysfunction, markers of inflammation, obesity,
and several other metabolic perturbations. Several researchers
have reported that adiponectin is a negative risk factor for
myocardial infarction and that it also improves glucose toler-
ance, insulin sensitivity, and insulin resistance.6<9
Based on National Cholesterol Education Program Adult
Treatment Panel data, metabolic syndrome (MS) is charac-
terized by multiple risk factors including visceral obesity,
hypertension, hyperglycemia, dyslipidemia, and prothrombotic
and proinflammatory states, in relation to insulin resistance.10,11
In recent years, the lifestyle and dietary habits of the Korean
people have gradually changed because of overnutrition. MS
has become one of the most widespread health challenges in
Korea, with a prevalence of 32.9% and 31.8% in men and
women, respectively.12,13
Regular physical activity has been reported to be effective
in the prevention and delay of the onset of type 2 diabetes and
in increasing insulin sensitivity and improving metabolism.14
Yoga has become increasingly popular in the world as a
means of exercise and training fitness.15 A number of research
studies have shown that yoga can reduce insulin resistance

296 Menopause, Vol. 19, No. 3, 2012

Copyright © 2012 The North American Menopause Society. Unauthorized reproduction of this article is prohibited.
 YOGA EXERCISE ON ADIPONECTIN AND MS FACTORS
syndromeYrelated risk factors for cardiovascular disease and
may help control physiological variables such as blood pres-
sure, heart rate, body composition, visceral fat, and serum lipids
to improve overall exercise capacity.16<19 However, no pub-
lished review to date has considered the evidence of yoga
exercise’s impact on serum adiponectin and MS. Moreover,
little is known on the role of adiponectin in regards to MS in
the Korean population. Therefore, in this study, we investigated
the effects of yoga exercise on serum adiponectin and MS
factors in obese postmenopausal Korean women.
METHODS
Participants
Sixteen healthy female volunteers aged 54.50 T 2.75 years
with more than 36% body fat (BF) were recruited from the
city of Busan, Korea. Menopause was defined as the absence
of menstruation for at least 1 year. To qualify for the study, all
participants were asymptomatic of any illness or disease and
were free of any acute or chronic injury, as established by
the American College of Sports Medicine participant activity
readiness Par-Q health questionnaire. All women were sed-
entary, defined as having less than 1 hour of regular exercise
per week in the previous year, and were healthy nonsmokers
using no medications. The study was approved by the Insti-
tutional Human Research Committee.
Study design
The nature, purpose, and experimental procedures were
outlined verbally to each participant; afterward, each woman
signed an informed consent form before participating in the
study. The participants were tested in the morning, at the
same time of day, to avoid diurnal variation of temperature.
Participants were instructed not to exercise the day before or
on the day of each test, to refrain from caffeine or alcohol in-
gestion the day before or on the morning of each test, to other-
wise follow their normal diet, and to eat a light meal 2 hours
before coming to the laboratory. Upon their initial visit, exam-
inations including a standardized health questionnaire, anthro-
pometry and body composition, resting blood pressure, and
fasting venous blood sampling for blood chemistry were per-
formed. After their baseline measurements, participants were
randomized to a yoga exercise group (n = 8) or to a Bno exer-
cise[ control group (n = 8) for 16 weeks.
Body composition and anthropometric assessment
Blood pressure readings were performed after at least
10 minutes of rest in the supine position in a quiet environ-
ment. Height was measured to the nearest 0.1 cm with the
participant barefoot. Body weight was measured to the near-
est 0.1 kg with light clothes. Waist circumference (WC) was
measured using a measuring tape in the horizontal plane
immediately above the iliac crest. Hip circumference was
measured in the horizontal plane at the maximal circum-
ference of the hips or buttocks region, whichever is larger
Copyright © 2012 The North American Menopause Society. Unauthorized reproduction of this article is prohibited.
(above the gluteal fold).20 Body mass index (BMI) was calcu-
lated as weight in kilograms divided by the square of height
in meters.20 Body composition (including overall BF mass,
lean body mass, and visceral fat area [VFA]) was analyzed
at the beginning and end of each phase using the bioelec-
trical impedance analysis method (Inbody 720; Biospace,
Seoul, Korea) following the procedures recommended by the
American College of Sports Medicine.21
Blood sampling
The venous blood samples were collected following a
12-hour overnight fast to measure serum glucose, total cho-
lesterol (TC), triglycerides (TG), high-density (HDL-C) and
low-density (LDL-C) lipoprotein cholesterol, insulin, and
adiponectin. Glucose concentrations in fasting serum, TC,
TG, HDL-C, and LDL-C were measured using a Toshiba
TBA 200FR NEO analyzer (Diamond Diagnostics Inc.,
Holliston, MA). Fasting insulin concentrations were mea-
sured using an insulin kit (Coat-A-Count Insulin; DPC, Los
Angeles, CA) and gamma counter (COBRA 5010 Quantum;
Packard, Meriden, CT). The index of insulin resistance was
assessed using the homoeostasis model assessmentYinsulin
resistance (HOMA-IR), where HOMA-IR = [fasting insulin
(in KU/mL)  fasting glucose (in mmol/L)]/22.5.22 The adi-
ponectin plasma level was determined using a Cobas Integra
800 analyzer (Diamond Diagnostics Inc., Holliston, MA).
Yoga exercise program
Yoga (the coordination and integration of breath with
movement) was taught and practiced three times a week for
60 minutes per session on nonconsecutive days by the yoga
exercise group for 16 weeks. The yoga exercise program
offers the greatest health benefits by enabling each partici-
pant to develop their flexibility, strength, lung capacity, and
balance while lowering their risk of heart disease. All ses-
sions emphasized the proper use of aligned postures and
breathing techniques and maintaining the body through the
use of large muscle movements, asymmetrical movements,
and restorative relaxation.
Statistical analysis
All data are presented as mean T SD, and all statistical
analyses were completed using the Statistical Package for
Social Sciences (SPSS) version 18.0 for Windows (SPSS
Inc., Chicago, IL). All statistical tests used an > level set
at P G 0.05. This intervention trial was designed to com-
pare pre-exercise and postexercise intervention variables.
Changes from baseline to the end of the intervention were
determined using a paired t test and an independent t test.
In multiple linear regression analysis, WC, TG, HDL-C, dia-
stolic blood pressure (DBP), glucose, and HOMA-IR were
assessed as the independent variables, and serum adiponectin
change was assessed as the dependent variable in the yoga
exercise program group. A power analysis was conducted
Menopause, Vol. 19, No. 3, 2012 297
 LEE ET AL

TABLE 1. Descriptive characteristics of the study participants

Age, y Height, cm Weight, kg % Body fat
Yoga (n = 8) 54.75 T 2.76 154.96 T 4.33 60.36 T 4.66 36.14 T 3.10
Control (n = 8) 54.25 T 2.91 156.28 T 2.10 61.25 T 4.27 36.65 T 1.85

using a sample size for each group of eight, obtaining an
estimated power of 0.81 for a paired-sample t test.
RESULTS
Participant characteristics and body composition
A complete description of demographic characteristics of
the study participants can be found in Table 1. The variables
of body composition, serum lipids, MS factors, and energy
metabolism were measured in all women before the start of
the training program and at the end of the 16-week yoga
exercise program. The yoga exercise group and control group
at baseline were similar in body weight, percentage of BF
(% BF), lean body mass, BMI, WC, and VFA. However, after
the yoga exercise program, the yoga group had significantly
lower body weight, % BF, BMI, WC, and VFA (P G 0.05)
than did the control group; however, lean body mass did not
change. Data are summarized in Table 2.
Adiponectin and MS factors
Table 3 shows that baseline values between groups were
comparable for adiponectin, lipid profiles, resting systolic
and diastolic blood pressure, insulin, and HOMA-IR. The
yoga exercise group had significantly higher adiponectin
(P G 0.001) and lower TC, systolic blood pressure (SBP),
DBP, glucose, and HOMA-IR than did the control group
after the training program (P G 0.05). No significant differ-
ences in TG, HDL-C, LDL-C, and insulin levels were found
between the yoga exercise group and control group after the
training program.
In a multiple linear regression analysis (Table 4), serum
adiponectin concentrations were significantly correlated with
WC, HDL-C, DBP, and HOMA-IR in the postyoga exer-
cise group. It was observed that WC, DBP, and HOMA-IR
were significantly decreased with exercise, highlighting an im-
provement in adiponectin and increased HDL-C. However,
triglyceride and glucose were not correlated with adiponectin.
In the control group, adiponectin was significantly and pos-
itively correlated with HDL-C only (results not shown).
DISCUSSION
Regular and continuous yoga exercise is one of the most
important nonpharmacological methods of improving serum
lipid concentrations, adipose tissue, and MS factors because
it significantly improves and controls body weight, % BF,
blood pressure, insulin resistance, blood glucose, and lipid
profiles.19,23 Our study results support the idea that yoga
exercise can reduce adipose tissue and is effective in reducing
MS factors.
The results of the present study indicated that yoga train-
ing was more effective than nonyoga training in control-
ling MS factors in obese postmenopausal women after the
16-week exercise program. In the present study, we found
that the yoga exercise program induced a decrease in body
weight, % BF, BMI, WC, and VFA. Indeed, yoga training
provided continuous improvement in serum adiponectin,
MS factors, insulin, and HOMA-IR. In particular, we found
that the yoga exercise group had significantly higher adipo-
nectin and lower blood pressure and HOMA-IR compared
with the control group; however, no significant differences in
TG, HDL-C, LDL-C, and insulin levels were found between
the yoga exercise group and control group.
Many researchers have noted that the practice of yoga
and yoga-based programs may have a positive influence on
body composition and blood lipid profiles.18,23<27 The current
study’s data are in agreement with previous studies18,19,27,28
in showing significantly decreased body composition. Con-
sistent with our current findings, the study by Kristal et al29
and Bera and Rajapurkar30 showed that some of the fat

TABLE 2. Changes in body composition and VFA after 16-week yoga exercise
Control (n = 8) Yoga exercise (n = 8)

Before After Before After

Weight, kg 61.25 T 4.27 62.88 T 4.58a 60.36 T 4.66 58.06 T 4.31b,c
% BF 36.65 T 1.85 37.45 T 2.71 36.14 T 3.10 33.83 T 3.25a,c
LBM, kg 38.75 T 3.62 39.39 T 4.31 38.56 T 3.34 38.45 T 3.87
2 b
BMI, kg/m 25.19 T 1.71 26.01 T 1.61 25.13 T 1.63 24.24 T 1.43a,c
d
WC, cm 86.00 T 1.69 86.44 T 1.95 86.38 T 1.51 85.13 T 1.36a,c
VFA, m2 102.13 T 9.52 107.38 T 9.83a 103.05 T 10.23 97.50 T 7.73a,c
Values are presented as mean T SD.
% BF, percentage of body fat; LBM, lean body mass; BMI, body mass index; WC, waist circumference; VFA, visceral fat area.
a
P G 0.01 compared with before.
b
P G 0.001 compared with before.
c
P G 0.05 compared with control.
d
P G 0.05 compared with before.

298 Menopause, Vol. 19, No. 3, 2012 * 2012 The North American Menopause Society

Copyright © 2012 The North American Menopause Society. Unauthorized reproduction of this article is prohibited.
 YOGA EXERCISE ON ADIPONECTIN AND MS FACTORS

TABLE 3. Changes in adiponectin, metabolic syndrome factors, and energy metabolism

Control (n = 8) Yoga exercise (n = 8)

Before After Before After

Adiponectin, Kg/mL 6.25 T 1.08 5.73 T 0.82a 6.18 T 1.31 7.63 T 0.98b,c
TC, mg/dL 205.86 T 16.07 215.25 T 13.69b 210.50 T 23.21 195.13 T 16.99b,d
TG, mg/dL 112.50 T 22.66 121.50 T 25.72b 108.50 T 23.70 104.00 T 21.75a
HDL-C, mg/dL 48.63 T 10.43 46.25 T 8.97a 46.75 T 10.76 50.25 T 10.63b
LDL-C, mg/dL 156.25 T 25.06 167.13 T 21.54a 158.38 T 24.35 149.75 T 23.30e
SBP, mm Hg 131.13 T 3.68 133.75 T 3.15a 133.75 T 5.01 125.50 T 4.75c,e
b
DBP, mm Hg 87.13 T 2.90 89.00 T 3.21 86.00 T 6.46 78.25 T 4.71b,c
Insulin, KU/mL 7.93 T 1.20 8.26 T 1.21b 8.01 T 1.06 7.75 T 1.08b
Glucose, mmol/L 100.63 T 10.84 106.38 T 10.73e 101.25 T 8.58 94.75 T 10.21b,f
HOMA-IR 2.16 T 0.17 2.25 T 0.09a 2.14 T 0.18 2.06 T 0.13d,e
Values are presented as mean T SD.
TC, total cholesterol; TG, triglyceride; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; SBP, systolic blood pressure;
DBP, diastolic blood pressure; HOMA-IR, homeostasis model assessmentYinsulin resistance index.
a
P G 0.05 compared with before.
b
P G 0.01 compared with before.
c
P G 0.001 compared with control.
d
P G 0.01 compared with control.
e
P G 0.001 compared with before.
f
P G 0.05 compared with control.

folds, waist, umbilical and hip circumferences were reduced
significantly after yoga training. However, some groups of
researchers have reported no change in body weight.31,32 In
the present study, yoga exercise significantly decreased body
weight, % BF, BMI, WC, VFA, TC, TG, LDL-C, blood pres-
sure, insulin, glucose, and HOMA-IR. In a study by Bijlani
et al,26 yoga exercise significantly decreased fasting blood
glucose, serum TC, TG, LDL-C, and very lowYdensity lip-
oprotein cholesterol and increased HDL-C. This finding
regarding blood lipid profiles are similar to the findings of
Gordon et al,33 who demonstrated significant positive changes
in serum TC and concentrations of fasting blood glucose and
decreased serum TG, concentrations of LDL-C, and very low-
density lipoprotein cholesterol. The results of this study and
previous studies indicate the positive influence of yoga exercise
on body composition and lipid profiles and suggest that such
would be beneficial for obese postmenopausal Korean women.
The results of this investigation revealed a significant
improvement in both SBP and DBP compared with baseline
values. Previous studies have reported that yoga exercise
reduced resting SBP and DBP from 3.9% to 13.9% and
5.8% to 15.8%, respectively.34,35 Similar data were observed
with neither a change in SBP nor a change in DBP.25 These
changes occurred in the absence of changes in glucose toler-
ance, body weight, VFA, lipid profiles, and energy metabo-
lism, suggesting that yoga exercise directly acts to lower
blood pressure in obese postmenopausal women.
Adiponectin is known to be an anti-inflammatory adipokine
secreted solely by adipocytes,36 and adiponectin levels sig-
nificantly correlated with variables of MS such as dyslipid-
emia. In addition, excess visceral fat is associated with MS
factors such as insulin and HOMA-IR, and the VFA is in-
versely correlated with adiponectin.37 In the present study, we
found a positive correlation between visceral fat and insulin
and HOMA-IR changes after the yoga exercise program. We
also observed that the yoga exercise group had significantly
higher adiponectin and reduced body weight, LDL-C, and
insulin resistance by the end of the yoga exercises. The con-
centration of adiponectin increased during the yoga exercise
program, with a significant negative correlation being ob-
served between adiponectin and WC. Adiponectin also showed
a significant positive correlation with HDL-C and significant
negative correlations with DBP and HOMA-IR. To identify
the factors affecting adiponectin, WC, TG, HDL-C, DBP, glu-
cose, and HOMA-IR, the data were examined using a multi-
ple regression analysis. We observed that serum adiponectin

TABLE 4. Regression analysis of adiponectin and metabolic syndrome factors in the after-yoga exercise group
Independent variables B SE A t F R2
Constant 66.484 5.749 11.565
WC, cm j0.680 0.053 j0.945 j12.775a
TG, mg/dL 0.013 0.002 0.290 7.133
HDL-C, mg/dL 0.117 0.006 1.275 19.714a 196.480 0.999
DBP, mm Hg 0.184 0.008 0.890 22.198a
Glucose, mmol/L j0.069 0.010 j0.718 j6.583
HOMA-IR j7.825 0.508 j1.044 j15.418a
WC, waist circumference; TG, triglyceride; HDL-C, high-density lipoprotein cholesterol; DBP, diastolic blood pressure; HOMA-IR, homeostasis model
assessmentYinsulin resistance index.
a
P G 0.05.

Menopause, Vol. 19, No. 3, 2012 299

Copyright © 2012 The North American Menopause Society. Unauthorized reproduction of this article is prohibited.
 LEE ET AL
was significantly correlated with WC, HDL-C, DBP, and
HOMA-IR in the postyoga exercise group. This strong relation
between MS factors and adiponectin was explained mostly by
increased VFAs. However, TG and glucose were not associated
with adiponectin concentrations in obese postmenopausal
women. These findings are in agreement with a previous study
on yoga exercise training that reported positive changes in MS
factors and energy metabolism.38 Therefore, the present study
demonstrates that a decreased concentration of adiponectin is
significantly associated with MS risk factors. Similar to our
results, Kim et al39 have reported that adiponectin levels were
inversely correlated with insulin, HOMA-IR, TG, blood pres-
sure, adipose tissue area, and BMI, whereas HDL-C was pos-
itively correlated (P G 0.05). This study also found that visceral
adipose tissue area, SBP, and HDL-C level were independent
variables of serum adiponcetin concentrations. The current
study’s data are in agreement with previous studies38<40 show-
ing significantly decreased body weight, TG, insulin, blood
pressure, and HOMA-IR. Our findings support the notion that
yoga exercise can be used to lower and manage body compo-
sition, lipid profiles, and energy metabolism in obese post-
menopausal women.
CONCLUSIONS
The findings of the study demonstrate the effects of
yoga exercise on serum adiponectin and MS factors in obese
postmenopausal women. Regular and continuous yoga exer-
cise was effective in improving body composition, visceral
fat, serum lipids, and energy metabolism. Consequently, yoga
exercise may be effective in preventing cardiovascular dis-
ease caused by obesity in premenopausal and postmenopausal
obese women. These findings emphasized that yoga exercise
may be necessary to improve adiponectin level, serum lipids,
and MS risk factors in obese postmenopausal Korean women.
On the basis of the results of this study, the following rec-
ommendations are made for further studies: additional studies
are needed to confirm the results of this study and to compare
the effects of yoga exercise on these variables in obese and
nonobese men and women by age or exercise type; they are
also needed to develop effective yoga exercise programs for
different age groups or body types.
REFERENCES
1. Reilly JJ, Methven E, McDowell ZC, et al. Health consequences of
obesity. Arch Dis Child 2003;88:748-752.
2. Fujioka S, Matsuzawa Y, Tokunaga K, Tarui S. Contribution of intra-
abdominal fat accumulation to the impairment of glucose and lipid
metabolism. Metabolism 1987;36:54-59.
3. Matsuzawa Y, Fujioka S, Tokunaga K, Tarui S. A novel classifica-
tion: visceral fat obesity and subcutaneous fat obesity. In: Berry VEM,
Blondheim SH, Shafrir E, eds. Recent Advances in Obesity Research.
London, England: John Libbey & Co. Ltd., 1987:92-96.
4. Ahima RS, Osei SY. Adipokines in obesity. Front Horm Res 2008;36:
182-197.
5. Funahashi T, Matsuzawa Y. Metabolic syndrome: clinical concept and
molecular basis. Ann Med 2007;39:482-494.
6. Hotta K, Funahashi T, Bodkin NL, et al. Circulating concentrations
of the adipocyte protein, adiponectin, are decreased in parallel with
300 Menopause, Vol. 19, No. 3, 2012
Copyright © 2012 The North American Menopause Society. Unauthorized reproduction of this article is prohibited.
reduced insulin sensitivity during the progression to type-2 diabetes in
rhesus monkeys. Diabetes 2001;50:1126-1133.
7. Maeda N, Shimomura I, Kishida K, et al. Diet-induced insulin resis-
tance in mice lacking adiponectin/ACRP30. Nat Med 2002;8:731-737.
8. Pischon T, Girman CJ, Hotamisligil GS, Rifai N, Hu FB, Rimm EB.
Plasma adiponectin levels and risk of myocardial infarction in men.
JAMA 2004;291:1730-1737.
9. Stefan N, Vozarova B, Funahashi T, et al. Plasma adiponectin con-
centration is associated with skeletal muscle insulin receptor tyrosine
phosphorylation, and low plasma concentration precedes a decrease in
whole-body insulin sensitivity in humans. Diabetes 2002;51:1884-1888.
10. Lepor NE, Vogel RE. Summary of the third report of the National Cho-
lesterol Education Program Adult Treatment Panel III. Rev Cardiovasc
Med 2001;2:160-165.
11. Talbert RL. Role of the National Cholesterol Education Program Adult
treatment panel III guidelines in managing dyslipidemia. Am J Health
Syst Pharm 2003;60:S3-S8.
12. Ministry of Health and Welfare (MOHW). Korea National Health and
Nutrition Examination Survey Report (KNHANES III)VHealth Exami-
nation 2005.
13. Park MY, Lee KS. Nutrition and Welfare for the Elderly. Paju, South
Korea: Kwangmoonkag Publishers, 2006.
14. Derouich M, Boutayeb A. The effect of physical exercise on the
dynamics of glucose and insulin. J Biochem 2002;35:911-917.
15. Raub JA. Psychophysiologic effects of hatha yoga on musculoskeletal
and cardiopulmonary function. A literature review. J Altern Complement
Med 2002;8:797-812.
16. Harinath K, Malhotra AS, Pal K, et al. Effects of hatha yoga and
Omkar meditation on cardiorespiratory performance, psychologic profile,
and melatonin secretion. J Altern Complement Med 2004;10:261-268.
17. Innes KE, Bourguignon C, Taylor AG. Risk indices associated with
the insulin resistance syndrome, cardiovascular disease, and possible
protection with yoga: a systematic review. J Am Board Fam Pract
2005;18:491-519.
18. Kim DY, Lee JA, Yang JH. Effects of hatha yoga exercise on body
composition, serum lipids, and health-related fitness of obese middle-
aged women. Korean J Life Sci 2011;21:521-528.
19. Lee JA, Kim DY. Effects of hatha yoga exercise on serum leptin and
metabolic syndrome factors in menopause obese middle-aged women.
Korean J Life Sci 2010;20:1100-1106.
20. Heyward VH, Wagner DR. Applied Body Composition Assessment.
2nd ed. Champaign, IL: Human Kinetic Publishers, 2004.
21. American College of Sports Medicine. ACSM’s Guidelines for Exercise
Testing and Prescription. 7th ed. Philadelphia, PA: Lippinocott Williams
& Wilkins, 2006.
22. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF,
Turner RC. Homeostasis model assessment: insulin resistance and A-cell
function from fasting plasma glucose and insulin concentrations in man.
Diabetologia 1985;28:412-419.
23. Sivasankaran S, Pollard-Quintner S, Sachdeva R, et al. The effect of
a six-week program of yoga and meditation on brachial artery reactivity:
do psychosocial interventions affect vascular tone? Clin Cardiol
2006;29:393-398.
24. Ahn YD. Effect of participation in hata yoga and gate ball and weight-
training on none mineral density in postmenopausal women. Korean J
Phys Ed 2002;41:459-466.
25. Bhaskaracharyulu C, Sitarama Raju P, Girija Kumari D, et al. Bio-
chemical parameters in normal volunteers before and after yogic prac-
tices. Indian J Med Res 1982;76:144-148.
26. Bijlani RL, Vempati RP, Yadav RK, et al. A brief but comprehensive
lifestyle education program based on yoga reduces risk factors for car-
diovascular disease and diabetes mellitus. J Altern Complement Med
2005;11:267-274.
27. Khare K, Jain D. Effect of yoga on plasma glucose and serum fructos-
amine level in NIDDM. Yoga Mimamsa 1999;33:1-9.
28. Manchanda S, Narang R, Reddy K, et al. Retardation of coronary ath-
erosclerosis with yoga lifestyle intervention. J Assoc Physicians India
2000;48:687-694.
29. Kristal AR, Littman AJ, Benitez D, White E. Yoga practice is associated
with attenuated weight gain in healthy, middle-aged men and women.
Altern Ther Health Med 2005;11:28-33.
30. Bera TK, Rajapurkar MV. Body composition, cardiovascular endurance
and anaerobic power of yogic practitioner. Indian J Physiol Pharmacol
1993;37:225-228.
* 2012 The North American Menopause Society
 YOGA EXERCISE ON ADIPONECTIN AND MS FACTORS

31. Jain S, Talukdar B. Role of yoga in control of hyperglycemia in
middle aged patients of non-insulin dependent diabetes mellitus. Indian
J Clin Biochem 1995;10:62-65.
32. Jain S, Uppal A, Bhatnagar S, Talukdar B. A study of response pattern
of non-insulin dependent diabetes mellitus. Diabetes Res Clin Pract
1993;19:69-74.
33. Gordon LA, Morrison EY, McGrowder DA, et al. Effect of exercise
therapy on lipid profile and oxidative stress indicators in patients with
type 2 diabetes. BMC Complement Altern Med 2008;13:8-21.
34. Koertge J, Weidner G, Elliott-Eller M, et al. Improvement in medical
risk factors and quality of life in women and men with coronary artery
disease in the Multicenter Lifestyle Demonstration Project. Am J Cardiol
2003;91:1316-1322.
35. Singh S, Malhotra V, Singh KP, Madhu SV, Tandon OP. Role of
yoga in modifying certain cardiovascular functions in type 2 diabetic
patients. J Assoc Physicians India 2004;52:203-206.
36. Graham TE, Yang Q, Bluher M, et al. Retinol-binding protein 4 and
insulin resistance in lean, obese, and diabetic subjects. N Engl J Med
2006;354:2552-2563.
37. Okamoto Y, Kihara S, Funahashi J, Matsuzawa Y, Libby P. Adipo-
nectin: a key adipocytokine in metabolic syndrome. Clin Sci 2006;116:
1784-1792.
38. Kim KB, Lee JA. Effects of hatha yoga exercise on serum adiponectin
and metabolic syndrome factors in obese middle-aged women. Korean J
Phys Ed 2007;46:389-397.
39. Kim SJ, Park KG, Kim HK, et al. Serum adiponectin concentra-
tion according to visceral fat amount and its relationship of metabolic
risk factors in premenopausal obese women. Korean J Med 2004;66:
259-263.
40. Park SS, Choi KM, Kwon SB, et al. Relationship between serum adipo-
nectin and development of the metabolic syndrome. Korean Endocrinol
Metab 2004;19:492-500.

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