Skeletal muscle structural lipids improve during weight-maintenance after a very low calorie dietary intervention.
BACKGROUND
The objective was to investigate in a group of obese subjects the course in skeletal muscle phospholipid (SMPL) fatty acids (FA) during a 24-weeks weight maintenance program, which was preceded by a successful very low calorie dietary intervention (VLCD). Special focus was addressed to SMPL omega-3 FA, which is a lipid entity that influences insulin action.


METHODS
Nine obese subjects (BMI = 35.7 +/- 1.0 kg/m(2)), who had completed an 8 weeks VLCD (weight-loss = -9.7 +/- 1.6 kg, P < 0.001), had obtained skeletal muscle biopsies (vastus lateralis) before and after a dietician-guided 24-weeks weight-maintenance program (-1.2 +/- 1.5 kg, P = ns). SMPL FA composition was determined by gas liquid chromatography. During the preceding VLCD, insulin sensitivity (HOMA-IR) and glycemic control (HbA1c) improved but no change in SMPL omega-3 FA was observed. During the weight-maintenance program five subjects received the pancreas lipase inhibitor Orlistat 120 mg t.i.d. versus placebo.


RESULTS
HOMA-IR and HbA1c stabilized and SMPL total omega-3 FA, docosahexaenoic acid and ratio of n-3/n-6 polyunsaturated FA increased by 24% (P < 0.01), 35% (P < 0.02) and 26% (P < 0.01), respectively, whereas saturated and monounsaturated FA did not change. Plasma total-cholesterol and LDL-cholesterol, which decreased during the VLCD, reverted to pre-VLCD levels (P < 0.01). Orlistat therapy was associated with weight-loss (P < 0.05), trends for better glycemic control (P = 0.15) and greater increase in SMPL docosahexaenoic acid (P = 0.12) but similar reversal of plasma cholesterols compared to placebo.


CONCLUSIONS
The data are consistent with the notion that greater SMPL omega-3 FA obtained during a weight-maintenance program may play a role for preserving insulin sensitivity and glycemic control being generated during a preceding VLCD.
Haugaard
Steen B
SB
Dept. of Endocrinology, Copenhagen University Hospital, Hvidovre, Denmark. sbhau@dadlnet.dk
Vaag
Allan
A
Mu
Huiling
H
Madsbad
Sten
S
D015992:Body Mass Index; D031204:Caloric Restriction; D004038:Diet, Reducing / Q000379:methods*; D004281:Docosahexaenoic Acids / Q000032:analysis; D004311:Double-Blind Method; D015118:Eicosapentaenoic Acid / Q000032:analysis; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D005227:Fatty Acids / Q000032:analysis*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007333:Insulin Resistance; D007783:Lactones / Q000627:therapeutic use; D008049:Lipase / Q000037:antagonists & inhibitors; D008055:Lipids / Q000097:blood; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000737:chemistry*; D009765:Obesity / Q000178:diet therapy* / Q000378:metabolism; D000077403:Orlistat; D010743:Phospholipids / Q000032:analysis*; D010865:Pilot Projects; D014280:Triglycerides / Q000032:analysis
D004791:Enzyme Inhibitors; D005227:Fatty Acids; D007783:Lactones; D008055:Lipids; D010743:Phospholipids; D014280:Triglycerides; D004281:Docosahexaenoic Acids; D000077403:Orlistat; D015118:Eicosapentaenoic Acid; D008049:Lipase
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