Abstract P171: Magnitude of Long Term Improvements in Cardiometabolic Risk Factors are Influenced by Percent Weight Loss and Baseline Measures
Weight loss is associated with improvements in metabolic and cardiovascular risk factors, including glucose, insulin, C-reactive protein (CRP), and blood lipids. Few studies have evaluated the effect of weight loss on these risk factors long term (> 18 month) or sought to identify factors associated with sustained improvements in these measures. In a sample of 442 overweight/obese women participating in a weight loss trial examining the response to either a commercial weight loss program or minimal diet counseling over 24 months, we sought to identify predictors of metabolic improvement with weight loss. Total cholesterol, LDL-C, HDL-C, triglycerides (TG), insulin, glucose, and CRP were measured at baseline, 12 months, and after the 24-month intervention. We hypothesized that baseline biomarker measures as well as clinically significant weight loss (>10% of baseline weight) would be associated with greater improvements in cardiometabolic risk factors. Further, we hypothesized that demographic characteristics (age, race/ethnicity) would be significantly associated with the changes observed in risk factors. Participants had a mean (SD) age of 44(10) years, a BMI of 33.9(3.4) kg/m2, and body weight of 92.1(10.8) kg at enrollment. At baseline, CRP was elevated (≥3 mg/L) in 50.5% of participants; mean total cholesterol and glucose were within normal ranges (196(36) and 94(11), respectively); and insulin was elevated at 17.8(8.8) μU/mL. At 24 months, significant reductions in body weight, waist circumference, CRP, total cholesterol, and LDL-C were observed (p>0.05), while HDL-C significantly decreased (p>0.001). At 12 months, total cholesterol and LDL-C were reduced and step test performance significantly improved regardless of the amount of weight lost, whereas reductions in CRP, insulin, and TG were observed only in those who lost ≥10% body weight. Change in weight demonstrated a positive predictive value for change in cholesterol, insulin, glucose, and triglycerides. Baseline level of the biomarker showed the greatest predictive value for follow-up measures for insulin, cholesterol, glucose, and triglycerides. Race/ethnicity, waist circumference, step test performance and baseline weight were not associated with biomarker change. In conclusion, our data support and extend the results from shorter term weight loss trials and suggest that the magnitude of weight loss and baseline values of biomarkers are associated with improvements in cardiometabolic risk factors even after 24 months.
- © 2013 by American Heart Association, Inc.