title: Weight loss larger than 10% is needed for general improvement of levels of circulating adiponectin and markers of inflammation in obese subjects: a 3-year weight loss study.
abstract: OBJECTIVE
  To investigate the effects of: I) short- (8 weeks), II) long-term (3 years) weight loss, and III) the degree of weight loss on circulating levels of adiponectin, high sensitive-C reactive protein (hs-CRP), and fibrinogen in obese subjects. Moreover, to evaluate the effect of the lipase inhibitor, orlistat, on these parameters.
  
  
  METHODS
  Weight loss induced in 93 obese subjects (mean weight: 108.9+/-15.8 kg) through 8-week very-low-energy diet (VLED, 800 kcal/day) followed by randomization to orlistat or placebo together with lifestyle intervention for further 3 years. Adiponectin and hs-CRP were measured at baseline, after 8 weeks of VLED and 6, 12, and 36 months after the VLED by flowmetric xMAP technology (Luminex Multi-Analyte Profiling System, Luminex Corp., Austin, TX, USA). Fibrinogen was measured in a coagulation assay.
  
  
  RESULTS
  Weight loss after VLED treatment was 14.3+/-4.5 kg and after 3 years 7.7+/-8.7 kg. Orlistat-treated subjects regained 3.9 kg less than placebo-treated from the end of the VLED to 3 years (P=0.01). No differences were detected between the two groups regarding changes in adiponectin, hs-CRP, or fibrinogen. Accordingly, the groups were combined for further analyses. Serum adiponectin increased by 22% (P<0.05) after the VLED but returned to baseline after 3 years. Both short- and long-term weight losses needed to be in excess of 10% (approximately 12 kg) in order to increase adiponectin levels significantly. Weight loss was associated with a significant decrease in hs-CRP. Fibrinogen decreased by 12% (P<0.05) after 3 years.
  
  
  CONCLUSIONS
  In obese subjects, weight loss was associated with an increase in serum adiponectin and a decrease in hs-CRP and plasma fibrinogen. Long-term weight loss (3 years) must exceed 10% to induce a combined significant improvement in these inflammatory markers.
authors.affiliation: Department of Endocrinology and Metabolism C, Aarhus University Hospital, Aarhus Sygehus, Tage Hansensgade 2, DK-8000 Aarhus C, Denmark.
authors.forename: Erik L
authors.initials: EL
authors.lastname: Madsen
authors.forename: Aila
authors.initials: A
authors.lastname: Rissanen
authors.forename: Jens M
authors.initials: JM
authors.lastname: Bruun
authors.forename: Kristin
authors.initials: K
authors.lastname: Skogstrand
authors.forename: Serena
authors.initials: S
authors.lastname: Tonstad
authors.forename: David M
authors.initials: DM
authors.lastname: Hougaard
authors.forename: Bjørn
authors.initials: B
authors.lastname: Richelsen
mesh_terms: D050153:Abdominal Fat; D052242:Adiponectin / Q000097:blood*; D000328:Adult; D000368:Aged; D019440:Anti-Obesity Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D004038:Diet, Reducing; D004311:Double-Blind Method; D002149:Energy Intake; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D006801:Humans; D007783:Lactones / Q000627:therapeutic use*; D008049:Lipase / Q000037:antagonists & inhibitors; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000188:drug therapy / Q000628:therapy*; D000077403:Orlistat; D012307:Risk Factors; D012537:Scandinavian and Nordic Countries; D013997:Time Factors; D015431:Weight Loss
chemical_list: D052242:Adiponectin; D019440:Anti-Obesity Agents; D015415:Biomarkers; D004791:Enzyme Inhibitors; D007783:Lactones; D005340:Fibrinogen; D002097:C-Reactive Protein; D000077403:Orlistat; D008049:Lipase