Abstract P373: Changes in Adipokines with Weight Loss and Regain in a 24-Month Behavioral Weight Loss Study: The SMART Trial

Abstract

Background: Weight regain commonly occurs in many adults who intentionally lose weight. Failure to maintain weight loss can lead to an increased risk for chronic diseases, such as type 2 diabetes and atherosclerosis. A potential mechanism behind the increased risk includes the increased secretion of pro-inflammatory adipokines (TNF-α and IL-6) and the decreased secretion of anti-inflammatory adipokines (adiponectin and IL-10). Objectives: We conducted an ancillary study to a 24-month behavioral weight loss trial. The purpose of the study was to examine the association between weight loss and regain and changes in body fat from baseline to 24 months and changes in TNF-α, IL-6, IL-10, and adiponectin. Methods: The analysis included a subsample of participants (n=67) from the SMART Trial who lost and regained at least 10 lbs during the 24-month trial. All participants received standard behavioral treatment for weight loss in group sessions during the first 18 months beginning with weekly sessions, which decreased in frequency over time. Linear mixed modeling was used to examine the association of percent changes in weight and body fat with percent changes in adipokines. Results: The sample was 81% female and 87% White with a mean (±SD) age of 48.4±7.34 years. At entry into study the mean weight was 96.4±15.6 kg and mean BMI was 34.5±4.35 kg/m 2 . Percent body fat was on average 42.1±6.13%. Mean weight change from baseline to six months was -10.7±5.19% and from baseline to 24 months was -3.34±6.66% while mean change in percent body fat was -8.07±11.6% from baseline to six months and -3.03±9.57% from baseline to 24 months. Weight loss over time was significantly associated with an increase in adiponectin [b(se)=-1.7(0.34), p<.0001] and a decrease in IL-6 [b(se)=1.26(0.49), p=0.01]. A similar pattern of associations was observed for reduction in body fat over time with an increase for adiponectin [b(se)=-0.76(0.19), p<.0001] and a decrease for IL-6 [b(se)=0.68(0.25), p=.006]. There were no significant associations found for either weight loss or change in percent body fat with change in IL-10 [weight: b(se)=0.51(0.54), p=.35; body fat: b(se)=0.43(0.28), p=.12] and TNF-alpha [weight: b(se)=0.35(0.44), p=.43; body fat: b(se)=0.19(0.24), p=.43] over 24-months. Conclusion: Weight loss and reduction in body fat were significantly associated with improvements in two of the adipokines. However, by 24 months, when weight regain occurred, those changes were attenuated. Implementing strategies that support healthy behaviors and sustained weight loss can help prevent a state of chronic systemic inflammation and prevent adverse health outcomes.