Abstract
Background/Objectives:
We assessed the effect of weight loss-associated changes in detailed body composition on plasma insulin levels and homeostatic model assessment (HOMA) index to calculate the magnitude of reduction in different adipose tissue depots required to improve insulin sensitivity.
SubjectS/Methods:
A total of 50 subjects aged 20–69 years were studied. The participants were compiled from low-calorie diet interventions and bariatric surgery and differed in their baseline body mass index (BMI; range 21.6–54.4 kg/m2) and degree of weight losses (range −3.3 to −56.9 kg). Detailed body composition and liver fat were measured using whole-body magnetic resonance imaging (MRI). Insulin resistance was assessed by HOMA.
Results:
Mean body weight decreased by −16.0±13.6 kg. Significant changes were observed in total adipose tissue (TATMRI, range −0.5 to −36.0 kg), total subcutaneous adipose tissue (SATMRI), visceral adipose tissue (VATMRI), skeletal muscle, liver fat, plasma insulin levels and HOMA. Decreases in insulin and HOMA were correlated with reductions in TATMRI, SATMRI, VATMRI (just with HOMA) and liver fat. Losses of 2.9 and 6.5 kg body weight, 2.0 and 5.0 kg TATMRI as well as 1.6 and 6% liver fat were required to decrease plasma insulin levels by 1 μU/ml and HOMAadjusted for baseline HOMA by 1 point. Multiple regression analysis showed that baseline liver fat and changes in liver fat explained 49.7% and 55.1% of the variance in weight loss-associated changes in plasma insulin and HOMA, respectively.
Conclusions:
Decreases of adipose tissues and liver fat are the major determinants of reduction in plasma insulin levels and improvement in HOMA index.
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Acknowledgements
We thank Britta Jux, Klinik fur Radiologische Diagnostik, University Hospital Schleswig Holstein Kiel, for help with MRI scanning. The study was funded by Deutsche Forschungsgemeinschaft (DFG Mü 714/ 8-3) BMBF Kompetenznetz Adipositas, Core domain 'Body composition' (Kö rperzusammensetzung; FKZ 01GI1125).
Author contributions
MP and MJM designed the study; MP did the segmentations and analyzed the data; C-CG was responsible for MRI examinations; PP and WT are surgeons and are responsible for recruitments and treatments of severely obese patients undergoing bariatric surgery; MP and MJM wrote the paper.
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Pourhassan, M., Glüer, CC., Pick, P. et al. Impact of weight loss-associated changes in detailed body composition as assessed by whole-body MRI on plasma insulin levels and homeostatis model assessment index. Eur J Clin Nutr 71, 212–218 (2017). https://doi.org/10.1038/ejcn.2016.189
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DOI: https://doi.org/10.1038/ejcn.2016.189
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