Effects of diet and physical activity-induced weight loss on insulin resistance in severely obese patients
M. Tancic Gajic1,2, S. Vujovic1,2, M. Ivovic1,2, M. Vukcevic3,2, L. Marina1,2, Z. Arizanovic1,2 & D. Micic1,2
Author affiliations
1Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia, Belgrade; 2Faculty of Medicine, University of Belgrade, Serbia, Belgrade, Serbia; 3Clinical Hospital Center Bezanijska Kosa, Belgrade, Serbia.
Introduction: Insulin resistance is quite common among obese individuals. Lifestyle interventions like diet interventions and regular physical activity are still important and safe first-line therapy.
The aim of this study was to assess the effects of diet and physical activity-induced weight loss on insulin resistance in extremely obese patients.
Methods: Forty-four patients (mean age 41.05±10.23 years) were consecutively recruited at Clinic of Endocrinology. They were on three weeks therapeutic fasting or semi-fasting diet in hospital conditions. At the beginning anthropometric measurements were performed. Subjects underwent an oral glucose tolerance test (OGTT) and insulin resistance/sensitivity was evaluated by the homeostasis model assessment (HOMA) and the oral glucose insulin sensitivity (OGIS). At home, patients underwent low calorie diet and dosed physical activity. After body weight reduction for at least 15%, all mentioned assessments were repeated. Statistics: Wilcoxon Signed Rank Test.
Results: None of the patients had significant adverse effects. The mean weight loss was 27 kg or 17% of the initial weight (149.48±25.52 kg vs 123.89±20.68 kg (P<0.01). This was followed by a decrease of body mass index (49.44±10.70 kg/m2 vs 41.41±5.90 kg/m2, P<0.01), waist circumference (140.90±17.17 vs 122.55±12.96 cm, P<0.01), glucose (4.71±0.80 vs 4.13±0.68 mmol/l, P<0.01), insulin (24.95±20.84 vs 16.80±10.06 mU/l, P<0.05), HOMA (5.56±4.55 vs 3.10±2.20, P<0.05) and OGIS (428.54±72.46 vs 490.92±80.56, P<0.01).
Conclusion: Based on aforementioned results, it can be concluded that 17% weight loss of initial weight in severely obese subjects, significantly increases insulin sensitivity and so substantially improve the pro-atherosclerotic milieu associated with obesity.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This work was supported, however funding details unavailable.