Beneficial effect on average lipid levels from energy restriction and fat loss in obese individuals with or without type 2 diabetes.
OBJECTIVE
The risk of cardiovascular disease in type 2 diabetes is greater than is accounted for by conventional risk factors. We investigated whether energy restriction or modest fat loss improved the lipid profile in obese subjects with and without type 2 diabetes. The relationship of site of adipose tissue loss to lipid changes was also examined.


METHODS
Lipid levels were measured in 18 subjects with normal glucose tolerance (NGT) (n = 9, BMI = 31.5 +/- 0.8 [SEM] kg/m2) or type 2 diabetes (n = 9, BMI = 31.8 +/- 0.7) before and on the 4th (d4) and 28th (d28) days of a hypocaloric formula diet. Body composition was assessed with dual energy X-ray absorptiometry on d0 and d28.


RESULTS
Mean daily energy intake during the diet was 1,100 +/- 60 kcal (33% protein, 38% carbohydrate, and 29% fat). Mean weight loss was 6.2 +/- 0.4 kg. Initial lipid profiles were similar in subjects with or without diabetes, and diabetes did not affect the responses. Dietary intervention resulted in early (d4) and late (d28) changes. Energy restriction (d4) reduced VLDL cholesterol and total triglyceride (TG) concentrations and increased LDL particle size. LDL TG, and LDL apolipoprotein B (apoB) concentrations. Reduction in central abdominal fat (but not other body fat) was correlated with a less atherogenic lipid profile: delta abdominal fat versus delta LDL free cholesterol, r = 0.65, P = 0.006 and versus delta apoB, r = 0.64, P = 0.008.


CONCLUSIONS
Even in obese subjects with an average lipid profile, modest weight loss reduces atherogenicity, independently of type 2 diabetes, and abdominal fat loss is specifically related to such improvements.
Markovic
T P
TP
Garvan Institute of Medical Research, St. Vincent's Hospital, Sydney, Australia. t.markovic@garvan.unsw.edu.au
Campbell
L V
LV
Balasubramanian
S
S
Jenkins
A B
AB
Fleury
A C
AC
Simons
L A
LA
Chisholm
D J
DJ
D000273:Adipose Tissue / Q000378:metabolism; D000328:Adult; D000886:Anthropometry; D001823:Body Composition / Q000502:physiology; D003920:Diabetes Mellitus / Q000178:diet therapy / Q000378:metabolism / Q000503:physiopathology*; D003924:Diabetes Mellitus, Type 2 / Q000178:diet therapy / Q000378:metabolism / Q000503:physiopathology*; D018752:Diet, Fat-Restricted; D002149:Energy Intake / Q000502:physiology; D005260:Female; D006801:Humans; D050356:Lipid Metabolism; D008055:Lipids / Q000737:chemistry; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000188:drug therapy / Q000378:metabolism / Q000503:physiopathology*; D012016:Reference Values; D015431:Weight Loss / Q000502:physiology*
D008055:Lipids