title: Changes in adipose tissue depots and metabolic markers following a 1-year diet and exercise intervention in overweight and obese patients with type 2 diabetes.
abstract: OBJECTIVE
  We aim to characterize the effects on total body fat and distribution of a 1-year intensive lifestyle intervention (ILI) for weight loss in overweight and obese adults with type 2 diabetes and to examine whether changes in adipose tissue (AT) depots were associated with changes in metabolic biomarkers.
  
  
  METHODS
  Participants were 54 females and 38 males (age 57.8 ± 6.7 years [mean ± SD]; BMI 31.7 ± 3.5 kg/m(2)) enrolled in the Look AHEAD (Action for Health in Diabetes) trial randomized to ILI or diabetes support and education (DSE) from whom baseline and 1-year MRI measures of total AT (TAT) and regional (arm, trunk, leg) AT, including subcutaneous AT (SAT), visceral AT (VAT), and intermuscular AT (IMAT), were acquired. We tested whether mean changes in ILI and DSE were equal and, within groups, whether changes were different from zero. Regression models tested whether changes in AT compartments were associated with metabolic variable changes.
  
  
  RESULTS
  Body weight changed -0.52 ± 3.62 kg (P = 0.31) in DSE and -7.24 ± 5.40 kg (P < 0.0001) in ILI. Mean ILI changes were different from DSE (P < 0.001 for TAT, SAT, and IMAT and P < 0.01 for VAT in females). Within ILI, SAT and VAT decreased in males and females (P < 0.0001), but IMAT was unchanged (0.00 ± 0.54 kg; P = 0.99). In DSE, SAT and VAT did not change, but IMAT increased by 0.46 ± 0.55 kg (P < 0.001). Controlling for weight loss, reduction of specific AT depots was associated with improvement in metabolic biomarkers.
  
  
  CONCLUSIONS
  Weight loss of 7-10% from an ILI over 1 year reduced SAT and VAT and prevented an increase in IMAT. Reductions in AT depots were associated with improvements in biomarkers.
authors.affiliation: New York Obesity Nutrition Research Center, St. Luke's-Roosevelt Hospital, New York, NY Institute of Human Nutrition and Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY dg108@columbia.edu.
authors.forename: Dympna
authors.initials: D
authors.lastname: Gallagher
authors.affiliation: New York Obesity Nutrition Research Center, St. Luke's-Roosevelt Hospital, New York, NY Institute of Human Nutrition and Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY.
authors.forename: Stanley
authors.initials: S
authors.lastname: Heshka
authors.affiliation: Obesity/Nutrition Research Center, University of Pittsburgh, Pittsburgh, PA Diabetes and Endocrinology, Merck Research Laboratories, Rahway, NJ.
authors.forename: David E
authors.initials: DE
authors.lastname: Kelley
authors.affiliation: New York Obesity Nutrition Research Center, St. Luke's-Roosevelt Hospital, New York, NY.
authors.forename: John
authors.initials: J
authors.lastname: Thornton
authors.affiliation: Department of Radiology, St. Luke's-Roosevelt Hospital, New York, NY.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Boxt
authors.affiliation: New York Obesity Nutrition Research Center, St. Luke's-Roosevelt Hospital, New York, NY.
authors.forename: F Xavier
authors.initials: FX
authors.lastname: Pi-Sunyer
authors.affiliation: New York Obesity Nutrition Research Center, St. Luke's-Roosevelt Hospital, New York, NY.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Patricio
authors.affiliation: Obesity/Nutrition Research Center, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Juliet
authors.initials: J
authors.lastname: Mancino
authors.affiliation: The Johns Hopkins University School of Medicine, Department of Medicine, Baltimore, MD.
authors.forename: Jeanne M
authors.initials: JM
authors.lastname: Clark
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism / Q000473:pathology*; D050154:Adiposity; D000368:Aged; D001521:Behavior Therapy; D015415:Biomarkers / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000178:diet therapy / Q000628:therapy*; D004035:Diet Therapy; D015444:Exercise; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000178:diet therapy / Q000628:therapy*; D015431:Weight Loss; D061217:Weight Reduction Programs / Q000379:methods*
chemical_list: D015415:Biomarkers