Cardiometabolic effect of weight loss in metabolically healthy obese subjects

Introduction: Peripheral adiposity is associated with better metabolic health and higher plasma adiponectin (ADPN) levels. Since ADPN is secreted mainly by adipose tissue (AT), it is intriguing that higher visceral adipose tissue (VAT) is associated with lower ADPN levels and poor metabolic health. Hypothesis: We hypothesized that various AT depots differ in their ability to secrete ADPN. Methods: Paired AT samples (VAT and subcutaneous adipose tissue (SAT)) were collected from 19 subjects (10 women, 15 obese) undergoing elective abdominal surgery. The samples were cultured and the supernatant was collected after 24 hours. ADPN levels released into the supernatant from VAT and SAT were measured using multiplex methods. Subjects were defined as obese or non-obese (NO) based on BMI > or ≤ 30kg/m2 respectively. Obese subjects were further classified as metabolically unhealthy obese (MUO) or metabolically healthy obese (MHO) based on presence or absence of type 2 diabetes mellitus, hypertension, or cardiovascular disease at the time of surgery. Results: Mean ADPN secretion levels from SAT and VAT were similar in NO subjects (17.3 ± 3.4 vs. 9.8 ± 13.0 ng/mL/mg, p=0.5) whereas the mean ADPN secretion was lower from VAT among obese subjects (15.9 ± 0.8 vs. 4.5 ± 0.2 ng/mL/mg, p=0.0002). ADPN secretion decreased from VAT (r=-0.16) and increased from SAT (r=0.33) with increased BMI (Fig.1). When MHO and MUO were compared, ADPN secretion from VAT in MHO was reduced only slightly (16.1 ± 8.2 vs. 4.0 ± 2.0 ng/mL/mg, p=0.07) whereas ADPN secretion was significantly reduced in MUO (15.9 ± 5.3 vs. 4.7 ± 4.6 ng/mL/mg, p=0.003). Conclusions: Reduced ADPN secretion from VAT in subjects with increasing BMI may explain lower circulating ADPN levels in obese individuals. Higher ADPN production from SAT and the relatively preserved secretion of ADPN from VAT may explain metabolic health in some obese individuals. Futures studies will help identify factors that control ADPN secretion from AT.

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Reply to the letter to the editor: Lifestyle interventions on weight loss among metabolically healthy obese women

Clinical Nutrition ◽

10.1016/j.clnu.2020.07.017 ◽

2020 ◽

Vol 39 (9) ◽

pp. 2933-2934

Author(s):

M. Palau-Rodríguez ◽

M. Garcia-Aloy ◽

M. Rosa Bernal-Lopez ◽

R. Gómez-Huelgas ◽

F.J. Tinahones ◽

...

Keyword(s):

Weight Loss ◽

Lifestyle Interventions ◽

Obese Women ◽

Metabolically Healthy Obese ◽

Letter To The Editor ◽

Healthy Obese ◽

Metabolically Healthy

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Impact of Intensive Lifestyle Modification on Levels of Adipokines and Inflammatory Biomarkers in Metabolically Healthy Obese Women

Mediators of Inflammation ◽

10.1155/2019/4165260 ◽

2019 ◽

Vol 2019 ◽

pp. 1-9 ◽

Cited By ~ 5

Author(s):

Ricardo Gomez-Huelgas ◽

Josefina Ruiz-Nava ◽

Sonia Santamaria-Fernandez ◽

Antonio Vargas-Candela ◽

Ana Victoria Alarcon-Martin ◽

...

Keyword(s):

Weight Loss ◽

Lifestyle Modification ◽

Inflammatory Biomarkers ◽

Inflammatory Biomarker ◽

Metabolically Healthy Obese ◽

Group 3 ◽

Healthy Obese ◽

Metabolically Healthy ◽

Group 2 ◽

Group 1

Background. For the metabolically healthy obese (MHO) subjects, it is unclear whether weight loss provides cardiometabolic benefits. Our objective was to evaluate whether changes in adipokine and inflammatory biomarker levels were related to lifestyle modification (with Mediterranean diet and physical exercise program). Methods. 115 women (35-55 years) with BMI of 30-40 kg/m2 and ≤1 metabolic syndrome criteria were included. After a 2-year intervention, participants were classified by percent weight loss: Group 1, <5%; Group 2, ≥5%-<10%; and Group 3, ≥10%. Anthropometric data, inflammatory biomarker (IL-6, TNFa, and hsCRP) and adipokine levels (adiponectin and resistin), and lifestyle program adherence at baseline and 2 years were analyzed. Results. The final sample comprised 67 women. 23 (38.3%) lost <5%, 22 (36.7%) lost ≥5%-<10%, and 22 (36.7%) lost ≥10% of baseline weight. After 2 years, in Group 1, adiponectin, hsCRP, IL-6, and TNFa decreased (-1.2 ng/ml, p=0.003; -2.1 mg/l, p=0.003; -2.4 pg/ml, p<0.001; and -2.4 pg/ml, p=0.001, respectively) and resistin increased (+2.4 ng/ml, p<0.001). In Group 2, hsCRP and IL-6 decreased (-2.0 mg/l, p=0.009 and -2.6 pg/ml, p=0.001) but TNFa increased (+0.2 pg/ml, p=0.02). In Group 3, resistin increased (+3.5 ng/ml, p<0.001) but hsCRP, IL-6, and TNFa decreased (-2.0 mg/l, p=0.009; -2.5 pg/ml, p<0.001; and -4.1 pg/ml, p<0.001). Adiponectin, hsCRP, and physical exercise correlated significantly to subjects’ dietary adherence. Conclusion. Weight loss reduces inflammatory biomarkers in the MHO but induces a deterioration in the adipokine profile, which does not improve with diet and exercise intervention. These findings allow us to clarify mechanisms behind inflammation and metabolic disorder genesis so as to prevent development of obesity-associated comorbidities.

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