title: Dietary intervention induces flow of changes within biomarkers of lipids, inflammation, liver enzymes, and glycemic control.
abstract: OBJECTIVE
  To determine how changes in lipids, liver enzymes, and inflammatory and glycemia markers intercorrelate during prolonged dietary intervention in obese participants with or without type 2 diabetes (T2D).
  
  
  METHODS
  We examined the dynamics and intercorrelations among changes in biomarkers during the 2-y Dietary Intervention Randomized Controlled Trial (DIRECT) in 322 participants (including 46 with T2D; 52 y of age, body mass index 31 kg/m(2)) throughout rapid weight loss (0-6 mo) and weight-maintenance/regain (7-24 mo) phases.
  
  
  RESULTS
  The 2-y increase of high-density lipoprotein cholesterol was greater in participants with T2D (+9.41 versus+6.57 mg/dL, P < 0.05), although they tended to have smaller waist circumferences (-2.1 versus -4.0 cm, P = 0.08). In models adjusted for age, sex, and weight loss, the 2-year decrease of triacylglycerols was associated with increases of low-density and high-density lipoprotein cholesterol. An increase of apolipoprotein A1 was associated with a decrease in high-sensitive C-reactive protein (P < 0.05 for all comparisons). Exclusively in participants with T2D, the 2-year decrease in triacylglycerols was further correlated with decreases in apolipoprotein B100 and liver enzymes, and a decrease in fasting glucose correlated with decreases in low-density lipoprotein cholesterol, apolipoprotein B100, and alanine aminotransferase (P < 0.05 for all comparisons). In the entire group, multivariate models adjusted for age, sex, intervention group, and 6-mo weight loss identified decreased high-sensitive C-reactive protein at 6 mo as an exclusive predictor of a greater decrease in triacylglycerols (β = 0.154, P = 0.008) and a greater increase in high-density lipoprotein cholesterol (β = -0.452, P = 0.005) during the subsequent 18 mo.
  
  
  CONCLUSIONS
  Long-term dietary intervention induces a flow of changes within biomarkers and the cross-talk is likely to be stronger in T2D. A decrease in systemic inflammation during the weight-loss phase may predict greater long-term improvement in lipids (www.ClinicalTrials.gov, identifier NCT00160108).
authors.affiliation: S. Daniel Abraham Center for Health and Nutrition, Departments of Epidemiology and Biochemistry, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel. golanra@bgu.ac.il
authors.forename: Rachel
authors.initials: R
authors.lastname: Golan
authors.forename: Amir
authors.initials: A
authors.lastname: Tirosh
authors.forename: Dan
authors.initials: D
authors.lastname: Schwarzfuchs
authors.forename: Ilana
authors.initials: I
authors.lastname: Harman-Boehm
authors.forename: Joachim
authors.initials: J
authors.lastname: Thiery
authors.forename: Georg Martin
authors.initials: GM
authors.lastname: Fiedler
authors.forename: Matthias
authors.initials: M
authors.lastname: Blüher
authors.forename: Michael
authors.initials: M
authors.lastname: Stumvoll
authors.forename: Iris
authors.initials: I
authors.lastname: Shai
mesh_terms: D000410:Alanine Transaminase / Q000097:blood; D016632:Apolipoprotein A-I / Q000097:blood; D053299:Apolipoprotein B-100 / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D002097:C-Reactive Protein / Q000378:metabolism; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000178:diet therapy*; D004038:Diet, Reducing; D005215:Fasting; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000178:diet therapy* / Q000209:etiology; D008055:Lipids / Q000097:blood*; D008099:Liver / Q000201:enzymology*; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D015999:Multivariate Analysis; D009765:Obesity / Q000097:blood / Q000150:complications / Q000178:diet therapy*; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference; D015431:Weight Loss / Q000502:physiology*
chemical_list: D016632:Apolipoprotein A-I; D053299:Apolipoprotein B-100; D015415:Biomarkers; D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D008055:Lipids; D014280:Triglycerides; D002097:C-Reactive Protein; D000410:Alanine Transaminase