Cardiometabolic health, visceral fat and circulating irisin levels: results from a real-world weight loss study
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ORIGINAL ARTICLE
Cardiometabolic health, visceral fat and circulating irisin levels: results from a real‑world weight loss study T. Miazgowski1 · A. Kaczmarkiewicz2 · B. Miazgowski2 · J. Kopeć3 Received: 12 August 2020 / Accepted: 31 August 2020 © The Author(s) 2020
Abstract Background The aim of this pragmatic intervention study was to investigate changes in cardiometabolic outcomes, irisin plasma concentration, and body composition during a 4-month intervention in unselected obese individuals. Materials and methods In 111 obese women aged 36.73 ± 7.2 years, we measured changes in weight, lipid profiles, glucose, insulin, Homeostatic Model Assessment-Insulin Resistance Index (HOMA-IR), uric acid, aminotransferases, and irisin. Body composition including lean mass (LM) and total (TF), gynoid (GF), android (AF), and visceral fat (VF) was assessed using densitometry. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ). The participants received tailored written advice targeting lifestyle according to current guidelines. At follow-up, patients rated their adherence in the self-administered questionnaire. Results Mean weight loss in the whole group was 3.12 kg (− 3.3%); 26% of the women achieved the desired target of weight loss (> 5% of the initial weight), whereas weight decreased moderately in 50% and increased in 14%. In 86 women with weight loss, there were significant changes in HOMA-IR (− 13.8%), insulin (− 11.2%), alanine aminotransferase (− 8.0%), VF (− 7.0%), AF (− 5.4%), TF (− 4.7%), GF (− 2.8%) and LM (− 1.5%), whereas irisin and HDL-C levels and the mean IPAQ score did not change. Conclusions In this real-world evidence study, a successful weight loss achieved only 26% of patients, with overall much better adherence to diet restriction than to exercise. However, even mild to moderate weight loss resulted in significant improvements in cardiometabolic health. Weight loss was associated with a modest LM decrease but did not influence plasma irisin. Keywords Cardiometabolic health · Weight loss · Irisin · Real-world study
Introduction It has been well-documented that weight loss in obese individuals lowers cardiometabolic risks, reduces the prevalence and burden of obesity-related comorbidities, and improves overall health. These beneficial changes are driven mainly by changes in body composition: reduction of fat mass and * T. Miazgowski [email protected] 1
Department of Propedeutics of Internal Diseases and Arterial Hypertension, Pomeranian Medical University in Szczecin, ul. Unii Lubelskiej 1, 71‑252 Szczecin, Poland
2
Pomeranian Medical University in Szczecin, Szczecin, Poland
3
Division of Epidemiology, Biostatistics and Public Health Practice, University of British Columbia, Vancouver, BC, Canada
its redistribution. Current guidelines define the desired target as at least 5% weight reduction within the first 6 months of intervention [1, 2]. However, the guidelines are based mainly on data from reference studies performed in selected
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