Effects of Identical Weight Loss on Body Composition and Features of Insulin Resistance in Obese Women With High and Low Liver Fat Content

• Published in: Diabetes (New York, N.Y.) Vol. 52; no. 3; pp. 701 - 707
• Main Authors: TIIKKAINEN, Mirja, BERGHOLM, Robert, VEHKAVAARA, Satu, RISSANEN, Aila, HÄKKINEN, Anna-Maija, TAMMINEN, Marjo, TERAMO, Kari, YKI-JÄRVINEN, Hannele
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01-03-2003
• Subjects: Abdomen; Adipose Tissue; Adult; Alanine Transaminase - blood; Analysis; Biological and medical sciences; Blood Pressure; Body Composition; Body Constitution; Body Mass Index; Cholesterol, HDL - blood; Cholesterol, LDL - blood; Diabetes; Diabetes mellitus; Diabetes research; Diet; Fatty acids; Female; Fundamental and applied biological sciences. Psychology; gamma-Glutamyltransferase - blood; Gestational diabetes; Glucose; Glycated Hemoglobin A - analysis; Health aspects; Humans; Insulin - blood; Insulin Resistance; Liver; Liver - enzymology; Liver - physiopathology; Magnetic resonance imaging; Metabolism; Middle Aged; Obesity; Obesity - physiopathology; Overweight persons; Physiological aspects; Spectrum analysis; Weight control; Weight Loss; Women; Women's health; Womens health; Finland
• ISSN: 0012-1797; 1939-327X
• DOI: 10.2337/diabetes.52.3.701

Effects of Identical Weight Loss on Body Composition and Features of Insulin Resistance in Obese Women With High and Low Liver
Fat Content
Mirja Tiikkainen 1 ,
Robert Bergholm 1 ,
Satu Vehkavaara 1 ,
Aila Rissanen 2 ,
Anna-Maija Häkkinen 3 ,
Marjo Tamminen 1 ,
Kari Teramo 4 and
Hannele Yki-Järvinen 1
1 Department of Medicine, Division of Diabetes, University of Helsinki, Helsinki, Finland
2 Department of Obesity Research Unit, University of Helsinki, Helsinki, Finland
3 Department of Oncology, University of Helsinki, Helsinki, Finland
4 Department of Obstetrics and Gynecology, University of Helsinki, Helsinki, Finland
Abstract
Our objective was to determine how 8% weight loss influences subcutaneous, intra-abdominal, and liver fat (LFAT), as well
as features of insulin resistance, in obese women with high versus low LFAT. A total of 23 women with previous gestational
diabetes were divided into groups of high (9.4 ± 1.4%) and low (3.3 ± 0.4%) LFAT based on their median LFAT (5%) measured
with proton spectroscopy. Both groups were similar with respect to age, BMI, and intra-abdominal and subcutaneous fat. Before
weight loss, women with high LFAT had higher fasting serum insulin and triglyceride concentrations than women with low LFAT.
At baseline, LFAT correlated with the percent of fat ( r = 0.44, P < 0.05) and saturated fat ( r = 0.45, P < 0.05) of total caloric intake but not intra-abdominal or subcutaneous fat or fasting serum free fatty acids. Weight loss
was similar between the groups (high LFAT −7.4 ± 0.2 vs. low LFAT −7.7 ± 0.3 kg). LFAT decreased from 9.4 ± 1.4 to 4.8 ± 0.7%
( P < 0.001) in women with high LFAT and from 3.3 ± 0.4 to 2.0 ± 0.2% ( P < 0.001) in women with low LFAT. The absolute decrease in LFAT was significantly higher in women with high than low LFAT
(−4.6 ± 1.0 vs. −1.3 ± 0.3%, P < 0.005). The decrease in LFAT was closely correlated with baseline LFAT ( r = −0.85, P < 0.001) but not with changes in the volumes of intra-abdominal or subcutaneous fat depots, which decreased similarly in
both groups. LFAT appears to be related to the amount of fat in the diet rather than the size of endogenous fat depots in
obese women. Women with initially high LFAT lost more LFAT by similar weight loss than those with low LFAT, although both
groups lost similar amounts of subcutaneous and intra-abdominal fat. These data suggest that LFAT is regulated by factors
other than intra-abdominal and subcutaneous fat. Therefore, LFAT does not appear to simply reflect the size of endogenous
fat stores.
Footnotes
Address correspondence and reprint requests to Hannele Yki-Järvinen, MD, Department of Medicine, University of Helsinki, PO
Box 340, FIN-00029 HUCH, Helsinki, Finland. E-mail: ykijarvi{at}helsinki.fi .
Received for publication 19 August 2002 and accepted in revised form 9 December 2002.
ALT, alanine aminotransferase; FFA, free fatty acid; IMCL, intramyocellular lipid; LFAT, liver fat; MRI, magnetic resonance
imaging.
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