title: Skeletal muscle structural lipids improve during weight-maintenance after a very low calorie dietary intervention.
abstract: 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.
authors.affiliation: Dept. of Endocrinology, Copenhagen University Hospital, Hvidovre, Denmark. sbhau@dadlnet.dk
authors.forename: Steen B
authors.initials: SB
authors.lastname: Haugaard
authors.forename: Allan
authors.initials: A
authors.lastname: Vaag
authors.forename: Huiling
authors.initials: H
authors.lastname: Mu
authors.forename: Sten
authors.initials: S
authors.lastname: Madsbad
mesh_terms: 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
chemical_list: D004791:Enzyme Inhibitors; D005227:Fatty Acids; D007783:Lactones; D008055:Lipids; D010743:Phospholipids; D014280:Triglycerides; D004281:Docosahexaenoic Acids; D000077403:Orlistat; D015118:Eicosapentaenoic Acid; D008049:Lipase
references.citation: Diabetes. 2001 Oct;50(10):2337-43
references.pmid: 11574417
references.citation: Diabetes Care. 2007 Jan;30(1):27-32
references.pmid: 17192328
references.citation: Eur J Clin Invest. 2008 Jul;38(7):494-501
references.pmid: 18578691
references.citation: J Appl Physiol (1985). 2001 Feb;90(2):670-7
references.pmid: 11160068
references.citation: J Biol Chem. 1996 Jul 5;271(27):16020-5
references.pmid: 8663162
references.citation: Biochim Biophys Acta. 1994 Aug 4;1213(3):277-88
references.pmid: 7914092
references.citation: Obesity (Silver Spring). 2006 Aug;14(8):1283-93
references.pmid: 16988070
references.citation: Diabetes. 1997 Jun;46(6):983-8
references.pmid: 9166669
references.citation: Diabetes. 1991 Feb;40(2):280-9
references.pmid: 1991575
references.citation: Exp Gerontol. 2000 May;35(3):331-41
references.pmid: 10832054
references.citation: J Nutr. 1993 Mar;123(3):512-9
references.pmid: 8463854
references.citation: Diabetes. 1997 Oct;46(10):1579-85
references.pmid: 9313753
references.citation: Lipids. 2007 May;42(5):427-37
references.pmid: 17476547
references.citation: Int J Obes Relat Metab Disord. 1997 Jul;21(7):574-9
references.pmid: 9226488
references.citation: Diabetes Care. 2004 Jun;27(6):1487-95
references.pmid: 15161807
references.citation: Am J Physiol Endocrinol Metab. 2008 Feb;294(2):E203-13
references.pmid: 18003718
references.citation: Diabetes. 2001 Apr;50(4):817-23
references.pmid: 11289047
references.citation: Diabetes. 2003 Aug;52(8):1881-7
references.pmid: 12882901
references.citation: N Engl J Med. 1993 Jan 28;328(4):238-44
references.pmid: 8418404
references.citation: Clin Endocrinol (Oxf). 2006 Feb;64(2):169-78
references.pmid: 16430716
references.citation: Biochim Biophys Acta. 1982 Sep 9;690(2):157-64
references.pmid: 6751393
references.citation: J Biol Chem. 1957 May;226(1):497-509
references.pmid: 13428781
references.citation: Metabolism. 1997 Dec;46(12):1458-64
references.pmid: 9439543
references.citation: Diabetologia. 1994 Oct;37(10):1044-50
references.pmid: 7851683
references.citation: J Lipid Res. 2006 Feb;47(2):366-74
references.pmid: 16301737
references.citation: Metabolism. 2000 Feb;49(2):220-4
references.pmid: 10690948
references.citation: Biochem Biophys Res Commun. 1981 Nov 16;103(1):219-26
references.pmid: 7032521
references.citation: Biochim Biophys Acta. 2005 Mar 21;1733(1):67-75
references.pmid: 15801047
references.citation: J Clin Invest. 1995 Dec;96(6):2802-8
references.pmid: 8675650
references.citation: Diabetes. 1999 Jan;48(1):112-6
references.pmid: 9892230
references.citation: Am J Clin Nutr. 2002 Dec;76(6):1222-9
references.pmid: 12450886
references.citation: Obesity (Silver Spring). 2007 Jan;15(1):117-25
references.pmid: 17228039
references.citation: J Biol Chem. 1990 Jul 5;265(19):11143-50
references.pmid: 2113530
references.citation: Diabetologia. 1999 Jan;42(1):113-6
references.pmid: 10027589
references.citation: Int J Obes Relat Metab Disord. 1996 Apr;20(4):338-45
references.pmid: 8680461
references.citation: Int J Obes Relat Metab Disord. 1998 Jul;22(7):661-6
references.pmid: 9705026
references.citation: Lancet. 1998 Jul 18;352(9123):167-72
references.pmid: 9683204
references.citation: Diabetes. 1999 May;48(5):1113-9
references.pmid: 10331418