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Lipid profiles can predict glycemic control in patients with obesity
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Distinct lipid profiles can help identify insulin resistance in patients with obesity, resulting in better glycemic control and overall long-term weight loss, according to data from a randomized trial.
“Lipid changes during an 8-week [low-calorie diet] allowed us to predict insulin-resistant patients after 6 months of weight maintenance,” Armand Valsesia, PhD, of the Nestle Institute of Health Sciences in Lausanne, Switzerland, and colleagues wrote. “The determination of the lipid composition during a [low-calorie diet] enables the identification of nonresponders and may help clinicians manage metabolic outcomes with further intervention, thereby improving the long-term outcome and preventing type 2 diabetes.”
The multicenter, randomized controlled study included nondiabetic participants with obesity from eight European countries (n = 383) who spent 8 weeks on a diet of 800 to 1,000 kcal per day. Valsesia and colleagues obtained lipid profiles on each participant at baseline, after 8 weeks and again after 6 months of weight maintenance.
After the maintenance period, the researchers reported, lipid signatures identified two groups of patients who were similar at baseline, but had different capacities for weight loss and glycemic control. One group, identified as “responders,” saw significant glycemic improvement (HOMA-insulin resistance mean change: -0.92; 95% CI, -1.17 to -0.67). The other group, described as “nonresponders,” did not show improvement in glycemic control (HOMA-insulin resistance mean change: -0.26; 95% CI, -0.64 to 0.13). The two groups showed significant differences in leptin gene expression and in biopsies of adipose tissue, the researchers wrote.
“The results challenge current practices of assessing total lipids (cholesterol and triglycerides) rather than investigating lipid composition. Mechanistic studies are needed to elucidate the physiological and molecular differences between the two patient groups,” Valsesia and colleagues wrote. “These findings may open new avenues in clinical research to study mechanisms of insulin resistance in the prevention or delay of type 2 diabetes in obese patients, thereby providing new tools to clinicians to better monitor patients in weight-loss interventions.” – by Andy Polhamus
Disclosure: Valsesia is employed by the Nestle Institute of Health Sciences. Please see the full study for a complete list of all other authors’ relevant financial disclosures.
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