[Impact of weight loss on adipocytokines, C-reactive protein and insulin sensitivity in hypertensive women with central obesity].
OBJECTIVE
To assess the impact of weight reduction on serum adipocytokines, C-reactive protein (CRP), and insulin sensitivity in hypertensive female patients with central obesity.


METHODS
This study was performed using the database and stored serum samples of female patients who had participated in an intervention study focused on weight loss. Thirty hypertensive women aged 18 to 65, body mass index (BMI) > 27 kg/m2, and central obesity were selected. They were randomly assigned to receive either a low-calorie diet plus orlistat 120 mg three times daily or a low-calorie diet alone for 16 weeks. Patients who experienced weight loss greater than 5% (n = 24) were assessed for blood pressure, anthropometric parameters, visceral fat, insulin resistance (HOMA-R - homeostasis model assessment of insulin resistance) and sensitivity (ISI - Insulin Sensitivity Index) indices, plus serum lipids, adipocytokines (adiponectin, leptin, IL-6, and TNF-alpha) and CRP levels.


RESULTS
After BMI had been reduced by approximately 5% in both groups, visceral fat, fasting glucose, triglycerides, and TNF-alpha decreased. Only the orlistat group, which was more insulin resistant at baseline, showed a significant reduction in blood glucose after oral glucose load, in addition to increased insulin sensitivity.


CONCLUSIONS
This study's findings indicate that a weight loss greater than 5% is associated with improved inflammatory status and decreased insulin resistance, regardless of changes in adiponectin and TNF-a levels. The greatest improvements in insulin sensitivity experienced by the orlistat-treated patients could not be attributed to the use of this drug because of the higher number of insulin-resistant subjects in this group.
Borges
Rodolfo Leão
RL
Universidade Federal de São Paulo, UNIFESP/Universidade de Brasília - UnB - São Paulo, SP/Brasília, DF - Brazil. endorodolfo@uol.com.br
Ribeiro-Filho
Fernando Flexa
FF
Carvalho
Kenia Mara Baiocchi
KM
Zanella
Maria Teresa
MT
D054392:Adipokines / Q000097:blood*; D052242:Adiponectin / Q000097:blood; D000293:Adolescent; D000328:Adult; D000368:Aged; D019440:Anti-Obesity Agents / Q000627:therapeutic use; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism*; D016009:Chi-Square Distribution; D004038:Diet, Reducing; D005260:Female; D006801:Humans; D006973:Hypertension / Q000378:metabolism*; D007333:Insulin Resistance / Q000502:physiology*; D007783:Lactones / Q000627:therapeutic use; D008055:Lipids / Q000097:blood; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy* / Q000188:drug therapy / Q000378:metabolism; D000077403:Orlistat; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D049629:Waist-Hip Ratio; D015431:Weight Loss / Q000187:drug effects / Q000502:physiology*
D054392:Adipokines; D052242:Adiponectin; D019440:Anti-Obesity Agents; D001786:Blood Glucose; D007783:Lactones; D008055:Lipids; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein; D000077403:Orlistat