Influence of the Trp64Arg polymorphism in the beta 3 adrenoreceptor gene on insulin resistance, adipocytokine response, and weight loss secondary to lifestyle modification in obese patients

2007 ◽  
Vol 18 (8) ◽  
pp. 587-592 ◽  
Author(s):  
D.A. de Luis ◽  
M. Gonzalez Sagrado ◽  
R. Aller ◽  
O. Izaola ◽  
R. Conde
Keyword(s):  
Insulin Resistance ◽  
Weight Loss ◽  
Lifestyle Modification ◽  
Obese Patients ◽  
Trp64arg Polymorphism

Obesity Therapy: How and Why?

2020 ◽  
Vol 27 (2) ◽  
pp. 174-186 ◽  
Author(s):  
Sara Paccosi ◽  
Barbara Cresci ◽  
Laura Pala ◽  
Carlo Maria Rotella ◽  
Astrid Parenti
Keyword(s):  
Weight Loss ◽  
Lifestyle Modification ◽  
Herbal Medicines ◽  
The Internet ◽  
Obese Patients ◽  
Self Medication ◽  
Pharmacological Management ◽  
Regulatory Standards ◽  
Meta Analyses ◽  
Obesity Drugs

Background: Obesity represents the second preventable mortality cause worldwide, and is very often associated with type 2 Diabetes Mellitus (T2DM). The first line treatment is lifestyle modification to weight-loss, but for those who fail to achieve the goal or have difficulty in maintaining achieved results, pharmacological treatment is needed. Few drugs are available today, because of their side effects. Objective: We aim to review actual pharmacological management of obese patients, highlighting differences between Food and Drug Administration - and European Medicine Agency-approved molecules, and pointing out self-medications readily obtainable and widely distributed. Methods: Papers on obesity, weight loss, pharmacotherapy, self- medication and diet-aid products were selected using Medline. Research articles, systematic reviews, clinical trials and meta-analyses were screened. Results: Anti-obesity drugs with central mechanisms, such as phentermine and lorcaserin, are available in USA, but not in Europe. Phentermine/topiramate and naltrexone/bupropion combinations are now available, even though the former is still under investigation from EMA. Orlistat, with peripheral mechanisms, represents the only drug approved for weight reduction in adolescents. Liraglutide has been approved at higher dose for obesity. Anti-obesity drugs, readily obtainable from the internet, include crude-drug products and supplements for which there is often a lack of compliance to national regulatory standards. Conclusion: Mechanisms of weight loss drugs include the reduction of energy intake or the increase in energy expenditure and sense of satiety as well as the decrease of hunger or the reduction in calories absorption. Few drugs are approved, and differences exist between USA and Europe. Moreover, herbal medicines and supplements often sold on the internet and widely used by obese patients, present a risk of adverse effects.

Abstract MP009: Changes in Aldosterone are Associated With Changes in Obesity-Related Factors in Normotensive Overweight/Obese Young Adults Undergoing Lifestyle Modification

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Jennifer Cooper ◽  
Linda Fried ◽  
Ping Tepper ◽  
Emma Barinas-Mitchell ◽  
Kim Sutton-Tyrrell
Keyword(s):  
Insulin Resistance ◽  
Blood Pressure ◽  
Weight Loss ◽  
Young Adults ◽  
Lifestyle Modification ◽  
Urinary Sodium ◽  
Dietary Sodium ◽  
Related Factor ◽  
Related Factors ◽  
Aldosterone Antagonists

Background: Elevated aldosterone promotes inflammation, insulin resistance, and hypertension. These effects are particularly important in obesity because adipocytes secrete factors that increase aldosterone production. Weight loss is thought to lower aldosterone levels, but little longitudinal data is available. We aimed to determine if, independent of changes in sodium intake, reductions in circulating aldosterone are associated with weight loss and improvements in inflammation, adipokines, insulin resistance, and blood pressure in normotensive overweight and obese young adults undergoing lifestyle modification. Methods: Participants were overweight/obese adults aged 20–45 years (20% male, 15% black) from the Slow Adverse Vascular Effects of excess weight trial, a study evaluating the relationships between weight loss, dietary sodium, and vascular health. Subjects were randomly assigned to a regular or reduced sodium diet, and all received a one-year nutrition and physical activity intervention. For this study, individuals providing valid baseline 24hr urine collections were included (n=281). Linear mixed models were used to evaluate associations between changes in aldosterone and changes in weight, blood pressure, and obesity-related factors. Results: Weight loss was significant at 6 months (∼7%), 12 months (∼6%), and 24 months (∼4%) (p<0.0001 for all). Within-subject decreases in aldosterone were associated with decreases in C-reactive protein, leptin, and homeostasis assessment of insulin resistance (HOMA-IR) and with increases in adiponectin (p<0.01 for all) in models including baseline age, sex, race, intervention arm, time since baseline, and baseline and concurrent changes in BMI, urinary sodium and potassium, and the obesity-related factor of interest. Decreases in aldosterone were associated with weight loss only in the subgroup (n=98) with metabolic syndrome (MetS) at baseline (MetS x percent weight loss p=0.02); a 10% weight reduction in this subgroup was associated with a 9% (95% CI 1–16) reduction in aldosterone. Though no association was detected between changes in aldosterone and mean arterial pressure (MAP), a significant association was found between reductions in MAP and 24hr urinary sodium in those with MetS (MetS x urinary sodium reduction p=0.02). Independent of weight loss, a 30% reduction in urinary sodium was associated with a 0.9 mm Hg (95% CI 0.2–1.6) decrease in MAP in those with MetS. Conclusions: Changes in aldosterone are associated with changes in obesity-related factors in overweight/obese normotensive young adults. In persons with MetS, weight loss and dietary sodium restriction are particularly useful to reduce aldosterone and MAP respectively. Given the adverse effects of excess aldosterone on cardiac and vascular remodeling, future studies should investigate the benefits of aldosterone antagonists in individuals with MetS.

scholarly journals Changes Induced by Physical Activity and Weight Loss in the Morphology of Intermyofibrillar Mitochondria in Obese Men and Women

2006 ◽  
Vol 91 (8) ◽  
pp. 3224-3227 ◽  
Author(s):  
Frederico G. S. Toledo ◽  
Simon Watkins ◽  
David E. Kelley
Keyword(s):  
Physical Activity ◽  
Insulin Resistance ◽  
Skeletal Muscle ◽  
Weight Loss ◽  
Insulin Sensitivity ◽  
Lifestyle Modification ◽  
Vastus Lateralis ◽  
Vastus Lateralis Muscle ◽  
Mitochondrial Content ◽  
The Mean

Abstract Context: In obesity, skeletal muscle insulin resistance may be associated with smaller mitochondria. Objective: Our objective was to examine the effect of a lifestyle-modification intervention on the content and morphology of skeletal muscle mitochondria and its relationship to insulin sensitivity in obese, insulin-resistant subjects. Design: In this prospective interventional study, intermyofibrillar mitochondrial content and size were quantified by transmission electron microscopy with quantitative morphometric analysis of biopsy samples from vastus lateralis muscle. Systemic insulin sensitivity was measured with euglycemic hyperinsulinemic clamps. Setting: The study took place at a university-based clinical research center. Participants: Eleven sedentary, overweight/obese volunteers without diabetes participated in the study. Intervention: Intervention included 16 wk of aerobic training with dietary restriction of 500-1000 kcal/d. Main Outcome Measures: We assessed changes in mitochondrial content and size and changes in insulin sensitivity. Results: The percentage of myofiber volume occupied by mitochondria significantly increased from 3.70 ± 0.31 to 4.87 ± 0.33% after intervention (P = 0.01). The mean individual increase was 42.5 ± 18.1%. There was also a change in the mean cross-sectional mitochondrial area, increasing from a baseline of 0.078 ± 0.007 to 0.091 ± 0.007 μm2 (P &lt; 0.01), a mean increase of 19.2 ± 6.1% per subject. These changes in mitochondrial size and content highly correlated with improvements in insulin resistance (r = 0.68 and 0.72, respectively; P = 0.01). Conclusions: A combined intervention of weight loss and physical activity in previously sedentary obese adults is associated with enlargement of mitochondria and an increase in the mitochondrial content in skeletal muscle. These findings indicate that in obesity with insulin resistance, ultrastructural mitochondrial plasticity is substantially retained and, importantly, that changes in the morphology of mitochondria are associated with improvements in insulin resistance.

Leptin Receptor Lys656Asn Polymorphism Is Associated with Decreased Leptin Response and Weight Loss Secondary to a Lifestyle Modification in Obese Patients

2006 ◽  
Vol 37 (7) ◽  
pp. 854-859 ◽  
Author(s):  
Daniel de Luis Roman ◽  
Rocio Aller de la Fuente ◽  
Manuel Gonzalez Sagrado ◽  
Olatz Izaola ◽  
Rosa Conde Vicente
Keyword(s):  
Weight Loss ◽  
Leptin Receptor ◽  
Lifestyle Modification ◽  
Obese Patients

HDL-sphingomyelin reduction after weight loss by an energy-restricted diet is associated with the improvement of lipid profile, blood pressure, and decrease of insulin resistance in overweight/obese patients

2016 ◽  
Vol 454 ◽  
pp. 77-81 ◽  
Author(s):  
Miriam Martínez-Ramírez ◽  
Magdalena Madero ◽  
Gilberto Vargas-Alarcón ◽  
Jesús Vargas-Barrón ◽  
José Manuel Fragoso ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Blood Pressure ◽  
Weight Loss ◽  
Lipid Profile ◽  
Obese Patients ◽  
Restricted Diet

scholarly journals Tumor Necrosis Factor-α in Sera of Obese Patients: Fall with Weight Loss

1998 ◽  
Vol 83 (8) ◽  
pp. 2907-2910 ◽  
Author(s):  
Paresh Dandona ◽  
Ruth Weinstock ◽  
Kuldip Thusu ◽  
Ehad Abdel-Rahman ◽  
Ahmad Aljada ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Body Mass Index ◽  
Weight Loss ◽  
Insulin Release ◽  
Tumor Necrosis ◽  
Tumor Necrosis Factor Α ◽  
Area Under The Curve ◽  
Obese Patients ◽  
Factor Α ◽  
Necrosis Factor

abstract In view of the recent demonstration that obesity in animals and humans is associated with an increase in tumor necrosis factor-α (TNFα) expression, that this expression falls with weight loss, and that TNFα may specifically inhibit insulin action, the possibility that TNFα may be a mediator of insulin resistance has been raised. We have undertaken this study to investigate whether serum TNFα concentrations are elevated in obese subjects, whether they fall after weight loss, and whether this fall parallels the fall in insulin release after glucose challenge. Obese patients (age range: 25–54, weight mean ± sd: 96.4 ± 13.8 kg, body mass index: 35.7 ± 5.6 kg/m2) were started on a diet program. The mean weight fell to 84.5 ± 11.3 (P &lt; 0.0001) and body mass index to 31.3 ± 4.9 (P &lt; 0.0001). Plasma TNFα concentrations were markedly elevated in the obese (3.45 ± 0.16 pg/mL), when compared with controls (0.72 ± 0.28 pg/mL), and fell significantly (2.63 ± 1.40 pg/mL) after weight loss (P &lt; 0.02). The magnitude of insulin release after glucose (75 g) challenge (area under the curve) also fell significantly (P &lt; 0.01) after weight loss. The magnitude of weight loss and fall in TNFα were related to basal body weight (r = 0.57, P &lt; 0.001) and basal TNFα (r = 0.55, P &lt; 0.001) concentrations, respectively, but not to each other or to the glucose-induced insulin release (area under the curve). We conclude that obesity is associated with increased plasma TNFα concentrations, which fall with weight loss. Because circulating TNFα may mediate insulin resistance in the obese, a fall in TNFα concentrations may contribute to the restoration of insulin resistance after weight loss, Thus, TNFα may be an important circulating cytokine, which may provide a potentially reversible mechanism for mediating insulin resistance.

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