title: Insulin sensitivity deteriorates after short-term lifestyle intervention in the insulin sensitive phenotype of obesity.
abstract: OBJECTIVE
  To investigate the effects of a 3-month lifestyle intervention on insulin sensitivity and its related cardiometabolic factors in obese patients.
  
  
  METHODS
  Anthropometry, body composition, oral glucose tolerance test, lipids, alanine aminotransferase, insulin sensitivity (insulinogenic index (ISI), homeostasis model assessment, β-cell performance (disposition index)) were evaluated in 263 obese women and 93 obese men before and after 3 months of hypocaloric low fat/high protein diet associated with physical activity 30 min/day.
  
  
  RESULTS
  Patients were divided into 3 groups according to the intervention-induced ISI changes: group 1 (decrease), group 2 (stability) and group 3 (increase). Insulin sensitivity and the disposition index were significantly higher before the intervention in group 1 than in group 3. BMI, waist circumference, and fat mass significantly decreased in groups 1 and 3 in both sexes. β-cell performance decreased in group 1 and increased in group 3. Metabolic variables improved in group 3, whereas glucose levels increased in women of group 1. The post-intervention insulin sensitivity was lower in group 1 than in group 3.
  
  
  CONCLUSIONS
  Lifestyle intervention induces changes in insulin sensitivity and metabolic factors that depend on the pre-intervention degree of insulin sensitivity. Weight loss leads to metabolic benefits in insulin-resistant, obese patients, whereas it may paradoxically worsen the metabolic conditions in the insulin-sensitive phenotype of obesity.
authors.affiliation: Department of Medical Sciences and Rehabilitation, Istituto Auxologico Italiano, Via Ariosto 13, Milan, Italy.
authors.forename: Luisa
authors.initials: L
authors.lastname: Gilardini
authors.forename: Luciana
authors.initials: L
authors.lastname: Vallone
authors.forename: Raffaella
authors.initials: R
authors.lastname: Cottafava
authors.forename: Gabriella
authors.initials: G
authors.lastname: Redaelli
authors.forename: Marina
authors.initials: M
authors.lastname: Croci
authors.forename: Antonio
authors.initials: A
authors.lastname: Conti
authors.forename: Lucia
authors.initials: L
authors.lastname: Pasqualinotto
authors.forename: Cecilia
authors.initials: C
authors.lastname: Invitti
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D001823:Body Composition; D015992:Body Mass Index; D031204:Caloric Restriction; D018752:Diet, Fat-Restricted; D004038:Diet, Reducing; D004044:Dietary Proteins / Q000008:administration & dosage; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006266:Health Education; D006801:Humans; D007333:Insulin Resistance; D050417:Insulin-Secreting Cells / Q000502:physiology; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000378:metabolism* / Q000628:therapy; D010641:Phenotype; D012737:Sex Factors; D055105:Waist Circumference; D015431:Weight Loss / Q000502:physiology*; D061217:Weight Reduction Programs
chemical_list: D001786:Blood Glucose; D004044:Dietary Proteins