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Epidemiology and Population Health

Associations between weight change and biomarkers of cardiometabolic risk in South Asians: secondary analyses of the PODOSA trial

Subjects

Abstract

Background/Objectives:

The association of weight changes with cardiometabolic biomarkers in South Asians has been sparsely studied.

Subjects/Methods:

We measured cardiometabolic biomarkers at baseline and after 3 years in the Prevention of Diabetes and Obesity in South Asians Trial. We investigated the effect of a lifestyle intervention on biomarkers in the randomized groups. In addition, treating the population as a single cohort, we estimated the association between change in weight and change in biomarkers.

Results:

Complete data were available at baseline and after 3 years in 151 participants. At 3 years, there was an adjusted mean reduction of 1·44 kg (95% confidence interval (95% CI): 0.18–2.71) in weight and 1.59 cm (95% CI: 0.08–3.09) in waist circumference in the intervention arm as compared with the control arm. There was no clear evidence of difference between the intervention and control arms in change of mean value of any biomarker. As a single cohort, every 1 kg weight reduction during follow-up was associated with a reduction in triglycerides (−1.3%, P=0.048), alanine aminotransferase (−2.5%, P=0.032), gamma-glutamyl transferase (−2.2%, P=0.040), leptin (−6.5%, P<0.0001), insulin (−3.7%, P=0.0005), fasting glucose (−0.8%, P=0.0071), 2-h glucose (−2.3%, P=0.0002) and Homeostatic Model Assessment of insulin resistance (HOMA-IR: −4.5%, P=0.0002). There was no evidence of associations with other lipid measures, tissue plasminogen activator, markers of inflammation or blood pressure.

Conclusions:

We demonstrate that modest weight decrease in SAs is associated with improvements in markers of total and ectopic fat as well as insulin resistance and glycaemia in South Asians at risk of diabetes. Future trials with more intensive weight change are needed to extend these findings.

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Acknowledgements

We have previously thanked and named many individuals who contributed to PODOSA.7 We further acknowledge and thank them. We acknowledge the co-investigators and the trial staff who did not contribute to this paper but did help in many other ways with the study: Professor John Forbes and Dr Joel Smith (University of Edinburgh, health economics), Anu Sharma, Alyson Hutchison and Ruby Bhopal (study dietitians). Mrs Anne Houghton (University of Edinburgh) provided secretarial support. Lynne Cherry and Elaine Butler (University of Glasgow) provided technical assistance. Welcome Trust Clinical Research Facility, Edinburgh provided technical assistance by processing and storing PODOSA DNA samples. PODOSA was supported by the National Prevention Research Initiative (grant number G0501310), a funding consortium comprising the British Heart Foundation; Cancer Research UK; Department of Health; Diabetes UK; Economic and Social Research Council; Medical Research Council; Health and Social Care Research and Development Office for Northern Ireland; Chief Scientist Office, Scottish Government Health Directorate; the Welsh Assembly Government; and World Cancer Research Fund. Additional financial support was provided from NHS Lothian and NHS Greater Glasgow and Clyde R&D, Chief Scientist Office, NHS Health Scotland and NHS National Services Scotland. PW is supported by BHF fellowship FS/12/62/29889. Neither funders nor the trial sponsor influenced the work reported here.

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Correspondence to P Welsh or N Sattar.

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Competing interests

JT received research grants, served as a consultant to and/or a member of advisory boards for, and/or gave lectures organized by AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly, ImpetoMedical, Merck, MSD, Sanofi-Aventis, Novartis, Novo Nordisk and Servier. The remaining authors declare no conflict of interest.

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Supplementary Information accompanies this paper on International Journal of Obesity website

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Welsh, P., Cezard, G., Gill, J. et al. Associations between weight change and biomarkers of cardiometabolic risk in South Asians: secondary analyses of the PODOSA trial. Int J Obes 40, 1005–1011 (2016). https://doi.org/10.1038/ijo.2016.35

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