Associations of leptin, insulin resistance and thyroid function with long-term weight loss in dieting obese men.
OBJECTIVE
The aim of the present study was to identify predictors of weight loss in obese men participating in a 2-year behaviour modification programme.


METHODS
Longitudinal, clinical intervention study of a behaviour modifying weight loss program.


METHODS
University Hospital, Stockholm, Sweden.


METHODS
Forty-four obese men (age, 42.7 +/- 1.1 years: BMI, 37.1 +/- 0.6 kg m(-2), mean +/- SEM) followed for 2 years.


METHODS
Behaviour modification weight loss programme.


METHODS
Associations between plasma leptin and thyroid function tests, insulin resistance by homeostatic model assessment (HOMA), dietary recall and anthropometrically determined body composition.


RESULTS
At baseline, there were significant correlations between plasma leptin and body mass index (BMI), fat-free mass (FFM) and insulin resistance. Median weight loss over 2 years was 4.9 kg (range, -27.2 to +11.9). Baseline serum leptin concentrations adjusted for BMI (leptin/BMI ratio) were significantly correlated with 2-year weight change (r = 0.34, P = 0.04). A subset of seven of the 44 men gained weight over the 2 years. These 'gainers' differed significantly in initial leptin/BMI ratio (0.62 +/- 0.07) compared with the 37 'losers' (0.42 +/- 0.03, P < 0.05). In a multiple regression model, baseline leptin, insulin and age predicted 22% of the variance in weight change with no additional significant contribution from BMI, FFM, waist:hip ratio, thyroid function tests or energy intake. There was a strong correlation between the change in leptin concentrations and the change in insulin resistance from baseline to 2-year follow-up (r = 0.54; P < 0.001).


CONCLUSIONS
Baseline plasma leptin concentrations predicted long-term weight loss. Inappropriate leptin secretion or disposal, corrected for BMI, was associated with failure to maintain weight loss in obese men in a behaviour modification weight loss programme.
Näslund
E
E
Division of Surgery, Danderyd Hospital, Sweden. erik.naslund@kir.ds.sll.se
Andersson
I
I
Degerblad
M
M
Kogner
P
P
Kral
J G
JG
Rössner
S
S
Hellström
P M
PM
D000328:Adult; D000367:Age Factors; D001521:Behavior Therapy; D001823:Body Composition; D015992:Body Mass Index; D004038:Diet, Reducing; D004734:Energy Metabolism; D006801:Humans; D007333:Insulin Resistance; D020738:Leptin / Q000097:blood*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy* / Q000378:metabolism*; D011237:Predictive Value of Tests; D012044:Regression Analysis; D012189:Retrospective Studies; D013960:Thyroid Function Tests; D013972:Thyrotropin / Q000097:blood*; D013974:Thyroxine / Q000097:blood*; D014284:Triiodothyronine / Q000097:blood*; D015431:Weight Loss
D020738:Leptin; D014284:Triiodothyronine; D013972:Thyrotropin; D013974:Thyroxine