Effects of weight loss on regional fat distribution and insulin sensitivity in obesity
Effects of weight loss on regional fat distribution and insulin sensitivity in obesity. B H Goodpaster , D E Kelley , R R Wing , A Meier and F L Thaete Department of Medicine, University of Pittsburgh, Pennsylvania 15261, USA. Abstract Weight loss (WL) decreases regional depots of adipose tissue and...
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Published in: | Diabetes (New York, N.Y.) Vol. 48; no. 4; pp. 839 - 847 |
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Main Authors: | , , , , |
Format: | Journal Article |
Language: | English |
Published: |
Alexandria, VA
American Diabetes Association
01-04-1999
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Subjects: | |
Online Access: | Get full text |
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Summary: | Effects of weight loss on regional fat distribution and insulin sensitivity in obesity.
B H Goodpaster ,
D E Kelley ,
R R Wing ,
A Meier and
F L Thaete
Department of Medicine, University of Pittsburgh, Pennsylvania 15261, USA.
Abstract
Weight loss (WL) decreases regional depots of adipose tissue and improves insulin sensitivity, two parameters that correlate
before WL. To examine the potential relation of WL-induced change in regional adiposity to improvement in insulin sensitivity,
32 obese sedentary women and men completed a 4-month WL program and had repeat determinations of body composition (dual-energy
X-ray absorptiometry and computed tomography) and insulin sensitivity (euglycemic insulin infusion). There were 15 lean men
and women who served as control subjects. VO2max was unaltered with WL (39.2 +/- 0.8 vs. 39.8 +/- 1.1 ml x fat-free mass [FFM](-1)
x min(-1)). The WL intervention achieved significant decreases in weight (100.2 +/- 2.6 to 85.5 +/- 2.1 kg), BMI (34.3 +/-
0.6 to 29.3 +/- 0.6 kg/m2), total fat mass (FM) (36.9 +/- 1.5 to 26.1 +/- 1.3 kg), percent body fat (37.7 +/- 1.3 to 31.0
+/- 1.5%), and FFM (59.2 +/- 2.3 to 55.8 +/- 2.0 kg). Abdominal subcutaneous and visceral adipose tissue (SAT and VAT) were
reduced (494 +/- 19 to 357 +/- 18 cm2 and 157 +/- 12 to 96 +/- 7 cm2, respectively). Cross-sectional area of low-density muscle
(LDM) at the mid-thigh decreased from 67 +/- 5 to 55 +/- 4 cm2 after WL. Insulin sensitivity improved from 5.9 +/- 0.4 to
7.3 +/- 0.5 mg x FFM(-1) x min(-1) with WL. Rates of insulin-stimulated nonoxidative glucose disposal accounted for the majority
of this improvement (3.00 +/- 0.3 to 4.3 +/- 0.4 mg x FFM(-1) x min(-1)). Serum leptin, triglycerides, cholesterol, and insulin
all decreased after WL (P < 0.01). After WL, insulin sensitivity continued to correlate with generalized and regional adiposity
but, with the exception of the percent decrease in VAT, the magnitude of improvement in insulin sensitivity was not predicted
by the various changes in body composition. These interventional weight loss data underscore the potential importance of visceral
adiposity in relation to insulin resistance and otherwise suggest that above a certain threshold of weight loss, improvement
in insulin sensitivity does not bear a linear relationship to the magnitude of weight loss. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 0012-1797 1939-327X |
DOI: | 10.2337/diabetes.48.4.839 |