Abstract
BackgroundThe objective was to investigate in a group of obese subjects the course in skeletal muscle phospholipid (SMPL) fatty acids (FA) during a 24-weeks weight maintenance program, which was preceded by a successful very low calorie dietary intervention (VLCD). Special focus was addressed to SMPL omega-3 FA, which is a lipid entity that influences insulin action.MethodsNine obese subjects (BMI = 35.7 ± 1.0 kg/m2), who had completed an 8 weeks VLCD (weight-loss = -9.7 ± 1.6 kg, P < 0.001), had obtained skeletal muscle biopsies (vastus lateralis) before and after a dietician-guided 24-weeks weight-maintenance program (-1.2 ± 1.5 kg, P = ns). SMPL FA composition was determined by gas liquid chromatography. During the preceding VLCD, insulin sensitivity (HOMA-IR) and glycemic control (HbA1c) improved but no change in SMPL omega-3 FA was observed. During the weight-maintenance program five subjects received the pancreas lipase inhibitor Orlistat 120 mg t.i.d. versus placebo.ResultsHOMA-IR and HbA1c stabilized and SMPL total omega-3 FA, docosahexaenoic acid and ratio of n-3/n-6 polyunsaturated FA increased by 24% (P < 0.01), 35% (P < 0.02) and 26% (P < 0.01), respectively, whereas saturated and monounsaturated FA did not change. Plasma total-cholesterol and LDL-cholesterol, which decreased during the VLCD, reverted to pre-VLCD levels (P < 0.01). Orlistat therapy was associated with weight-loss (P < 0.05), trends for better glycemic control (P = 0.15) and greater increase in SMPL docosahexaenoic acid (P = 0.12) but similar reversal of plasma cholesterols compared to placebo.ConclusionThe data are consistent with the notion that greater SMPL omega-3 FA obtained during a weight-maintenance program may play a role for preserving insulin sensitivity and glycemic control being generated during a preceding VLCD.
Highlights
The objective was to investigate in a group of obese subjects the course in skeletal muscle phospholipid (SMPL) fatty acids (FA) during a 24-weeks weight maintenance program, which was preceded by a successful very low calorie dietary intervention (VLCD)
We did not observe any net change in skeletal muscle phospholipid LCPUFAn-3 and especially DHA did not increase during the 8 weeks VLCD [3], which could be due to the longer retroconversion step of peroxisomal -oxidation in DHA formation [15] and rapid turnover of whatever docosahexaenoic acid was present
We report that the subjects during this period stabilized in weight and insulin action concomitant with increased LCPUFAn-3 especially the DHA in their skeletal muscle membrane, which coincided by a deterioration of their lipid profile to preVLCD levels
Summary
The objective was to investigate in a group of obese subjects the course in skeletal muscle phospholipid (SMPL) fatty acids (FA) during a 24-weeks weight maintenance program, which was preceded by a successful very low calorie dietary intervention (VLCD). Lipids in Health and Disease 2009, 8:34 http://www.lipidworld.com/content/8/1/34 insulin action [1,2,3,4] It remains, a challenge to stabilize or further improve the results obtained during a VLCD both in terms of weight loss and the metabolic parameters associated with a reduced risk of co-morbidity as cardiovascular disease and type 2 diabetes [1,4,5]. We have recently reported that during 8 weeks VLCD, in which, as expected, plasma lipid profile and insulin sensitivity improved significantly after weight loss, the phospholipid fatty acid composition of the skeletal muscle cell membrane improved in terms of desaturation [3]. We did not observe any net change in skeletal muscle phospholipid LCPUFAn-3 and especially DHA did not increase during the 8 weeks VLCD [3], which could be due to the longer retroconversion step of peroxisomal -oxidation in DHA formation [15] and rapid turnover of whatever docosahexaenoic acid was present
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