Effects of weight loss on insulin sensitivity and arterial stiffness in overweight adults.
ABSTRACT Obesity is characterized by metabolic and vascular abnormalities. We examined the effects of weight loss on insulin sensitivity and arterial stiffness in overweight adults. Twelve (9 females; 3 males) overweight (body mass index, 30.3 +/- 3.7) adults (54.9 +/- 3.9 years) without diabetes or vascular disease were counseled by a registered dietician to lose weight over 6 months. Vascular structure, function, and wall mechanical properties were measured via ultrasound. Intravenous glucose tolerance test, 24-hour blood pressure, body composition (dual-energy x-ray absorptiometry), and lipids were also assessed. There were significant reductions in body mass (86.3 +/- 14.2 vs 79.5 +/- 13.8 kg, P < .0001) and percentage of fat (44.3% +/- 7.0% vs 41.0% +/- 8.5%, P < .01) after weight loss. There were significant improvements in total cholesterol (6.0 +/- 0.9 vs 5.0 +/- 0.8 mmol/L, P < .0001), low-density lipoprotein cholesterol (3.9 +/- 0.7 vs 3.2 +/- 0.6 mmol/L, P < .0001), triglycerides (3.4 +/- 2.3 vs 2.4 +/- 0.9 mmol/L, P < .05), and insulin sensitivity (3.3 +/- 1.7 vs 5.4 +/- 1.6 microU x 10(-4) min(-1) mL(-1), P < .0001) after weight loss. Brachial artery compliance (P < .05) and distensibility (P < .05) curves over the physiologic pressure range improved, whereas endothelial function and intima-media thickness remained unchanged. In overweight adults, 6 months of weight loss resulted in improvements in body composition, insulin sensitivity, lipid profile, and brachial artery compliance and distensibility.
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ABSTRACT: Background: Obesity is a global epidemic disease; lifestyle modification is an approach in the prevention and management of obesity. Objective: We determined the effects of education on modified lifestyle intervention on arterial stiffness, metabolic and inflammatory markers. Methods: Twenty-five generally healthy overweight and obese subjects completed nine months education on modified lifestyle intervention at Hospital Universiti Sains Malaysia, Kota Bharu. Subjects were regularly counselled to increase physical activity and modify their diet during intervention. Arterial stiffness was measured noninvasively using carotid femoral pulse wave velocity (PWV) and pulse wave analysis (PWA). Anthropometric measurements, body fat percentage and visceral fat, central and brachial blood pressures, lipid profile, the inflammatory marker high sensitivity C-reactive protein (hsCRP) and insulin sensitivity were also recorded. Results: After nine months, a significant weight loss of 2.2 kg was observed associated with significant reductions in waist and hip circumference, aortic systolic blood pressure, serum fasting insulin, insulin resistance, and hsCRP levels. Insulin sensitivity was increased, while body fat and visceral fat percentages were marginally reduced (p = 0.058 and p = 0.059). No significant differences were seen in arterial stiffness, fasting plasma glucose and lipid profile. Conclusion: Education on modified lifestyle intervention improved insulin sensitivity and resistance, reduced hsCRP and aortic systolic blood pressure despite the small weight reduction achieved. Obesity is a risk factor for type II diabetes, coronary heart disease (CHD), hypertension, stroke, osteoarthritis, gallbladder disease, sleep apnea, and certain forms of cancer. Obesity is associated with increased arterial stiffness [1, 2] and inflammation [3, 4] as well as altered metabolic profile , all of which predisposes to cardiovascular and metabolic complications. The World Health Organization (WHO) reported that at least 2.8 million people die each year as a result of being overweight or obese. Lifestyle modification is one approach in prevention and management of obesity. Most previous reported studies on lifestyle modification were conducted with regimented dietary and exercise interventions for periods of less than six months [6-9]. In this study, we examined the effects of nine months education on lifestyle modification to reduce weight on waist circumference (WC), hip circumference (HC), body fat and visceral fat percentages, arterial stiffness, metabolic and inflammatory markers. Subjects were regularly counselled on good dietary habits and increasing physical activity for 9 months. Measurements of arterial stiffness, fasting plasma glucose (FPG), fasting insulin levels, insulin sensitivity and resistance, lipid Correspondence to: Prof.Asian Biomedicine. 01/2014; 8(2):185-194.
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ABSTRACT: It has been recognized that reduction of abdominal visceral fat and subcutaneous fat are associated with improvement in insulin-resistance (IR) after weight loss. However, few studies have investigated the correlation of reduction in epicardial adipose tissue (EAT) with improvement of IR index after weight loss in obese non-diabetic men with metabolic syndrome (MetS).Diabetology and Metabolic Syndrome 01/2014; 6(1):115. · 2.50 Impact Factor
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ABSTRACT: Obesity is associated with vascular endothelial dysfunction. Effects of weight loss on endothelial function are however not clear. Therefore, we performed a meta-analysis to quantify effects of weight loss on flow-mediated vasodilation (FMD) of the brachial artery, a measurement of endothelial function. Studies with experimental (RCTs) and quasi-experimental designs published before June 2014 were identified by a systematic search. Changes in FMD were defined as the difference between measurements before and after the study. For RCTs, changes were corrected for those in the no-weight loss control group. Summary estimates of weighted mean differences (WMDs) in FMD and 95% confidence intervals (CIs) were calculated using random-effect meta-analyses. The impact of subject characteristics, type of weight-loss treatment, and dietary composition on changes in FMD was also investigated. Four RCTs involving 265 subjects were included. Weight loss increased FMD vs. control by 3.29% (95% CI: 0.98-5.59%; P = 0.005; mean weight loss: 8.6 kg). A total of 1517 subjects participated in 33 studies with 49 relevant study arms. It was estimated that each 10 kg decrease in body weight increased fasting FMD by 1.11% (95% CI: 0.47-1.76%; P = 0.001). Effects were more pronounced when participants had coexisting obesity-related morbidities. Also, effects may be larger when subjects received low-fat diets or weight-reduction regimens including exercise therapy or weight-loss medication. Weight loss significantly improves fasting FMD in adults, which is a risk marker for cardiovascular disease. Effects may depend on subject characteristics, type of weight-loss treatment, and dietary composition. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.Atherosclerosis 12/2014; 239(1):21-30. · 3.71 Impact Factor