Abstract
BackgroundThe aim of this pragmatic intervention study was to investigate changes in cardiometabolic outcomes, irisin plasma concentration, and body composition during a 4-month intervention in unselected obese individuals.Materials and methodsIn 111 obese women aged 36.73 ± 7.2 years, we measured changes in weight, lipid profiles, glucose, insulin, Homeostatic Model Assessment-Insulin Resistance Index (HOMA-IR), uric acid, aminotransferases, and irisin. Body composition including lean mass (LM) and total (TF), gynoid (GF), android (AF), and visceral fat (VF) was assessed using densitometry. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ). The participants received tailored written advice targeting lifestyle according to current guidelines. At follow-up, patients rated their adherence in the self-administered questionnaire.ResultsMean weight loss in the whole group was 3.12 kg (− 3.3%); 26% of the women achieved the desired target of weight loss (> 5% of the initial weight), whereas weight decreased moderately in 50% and increased in 14%. In 86 women with weight loss, there were significant changes in HOMA-IR (− 13.8%), insulin (− 11.2%), alanine aminotransferase (− 8.0%), VF (− 7.0%), AF (− 5.4%), TF (− 4.7%), GF (− 2.8%) and LM (− 1.5%), whereas irisin and HDL-C levels and the mean IPAQ score did not change.ConclusionsIn this real-world evidence study, a successful weight loss achieved only 26% of patients, with overall much better adherence to diet restriction than to exercise. However, even mild to moderate weight loss resulted in significant improvements in cardiometabolic health. Weight loss was associated with a modest LM decrease but did not influence plasma irisin.
Highlights
It has been well-documented that weight loss in obese individuals lowers cardiometabolic risks, reduces the prevalence and burden of obesity-related comorbidities, and improves overall health
Irisin―an exercise-induced myokine produced by proteolytic cleavage of fibronectin type III domain-containing protein 5 (FNDC5)―is involved in the regulation of energy metabolism by activating thermogenesis [5]
Among the body composition parameters, we focused on visceral fat ―a key contributor to unfavorable changes in glucose and lipid metabolism, as well as lean mass, whose reduction has been suggested to be a detrimental effect of weight loss programs [17, 18]
Summary
It has been well-documented that weight loss in obese individuals lowers cardiometabolic risks, reduces the prevalence and burden of obesity-related comorbidities, and improves overall health. Some but not all reports suggested a possible role of irisin in the modulation of glucose [9, 10] and lipid metabolism [11, 12] as well as its correlation with weight, surrogate measures of adiposity such as BMI and waist circumference (both negative [14] and positive [15]), and level of physical activity [16]. Based on these suggestions we hypothesized that in obese individuals, life style improvement and weight reduction might influence plasma levels of this myokine. Among the body composition parameters, we focused on visceral fat ―a key contributor to unfavorable changes in glucose and lipid metabolism, as well as lean mass, whose reduction has been suggested to be a detrimental effect of weight loss programs [17, 18]
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