The Effect of Weight Loss on Various Metabolic Parameters in Patients with Systemic Lupus Erythematosus

Abstract

Insulin resistance and components of metabolic syndrome are commonly observed in patients with systemic lupus erythematosus (SLE). While weight loss has been shown to decrease markers of insulin resistance (IR) and other metabolic parameters in other clinical populations, it is currently unknown if SLE patients will also demonstrate a similar change following a behavioral weight loss intervention. PURPOSE: To determine the effect of a behavioral weight loss intervention on markers of insulin resistance and waist circumference in overweight/obese SLE patients during a 16-week pilot study. METHODS: 15 SLE female subjects (BMI: 30.8±3.7 kg/m2; Age: 39.7±10.4 yrs) participated in a 16-week weight loss intervention. Subjects were prescribed a reduced calorie diet (1200-1500 kcal/d) and progressively increased physical activity (300 min/wk at 16 weeks). RESULTS: A variety of measures were assessed at baseline and 16 weeks on 9 completers. The majority (88%) were insulin resistant by HOMA-IR at baseline (mean HOMA-IR: 2.82±1.03). Mean % weight loss was 9.8±2.8 and mean self reported physical activity was 190±59.4 min/wk. Significant decreases in weight loss were seen at week 16 (p=.000). No significant decreases were observed for the following metabolic parameters (fasting glucose, insulin, and HOMA-IR). However, changes in fasting insulin were significantly correlated with changes in weight (r=.583, p=0.05). CONCLUSION: A short-term lifestyle intervention resulted in significant reduction in weight and waist circumference in SLE patients. Even though no significant changes were seen in insulin resistance or several other metabolic parameters, the changes in fasting insulin were significantly correlated with changes in weight. The association between weight loss and decrease in fasting insulin warrants further investigation, as insulin resistance is common in this population. Moreover, the longer term effects of weight loss and physical activity with a representative sample should be examined.