Endocrine Abstracts

Background and aims: Obesity is associated with dyslipidemia through insulin resistance and adipokines secretion, and weight loss can improve obese patients’ lipid profile. Here we aimed to assess whether non interventional weight changes are associated with alterations in the lipid profile, particularly the triglycerides (TG) to high density lipoprotein (HDL) cholesterol ratio (TG/HDL) which is an emerging marker for insulin resistance, the metabolic syndrome and an elevated risk for coronary artery disease.

Methods: This is a retrospective analysis of subjects referred to annual medical screening. BMI, low density lipoprotein (LDL)- cholesterol, TG and HDL levels were measured annually. Patients were divided according to the change in BMI between visits: reduction of > 5% (“large reduction”), reduction of 2.5-5% (“moderate reduction”), reduction of <2.5% or elevation of <2.5% (“unchanged”), elevation of 2.5-5% (“moderate increase”) and elevation of > 5% (“large increase”). The primary outcomes were the change in LDL, TG, HDL and TG/HDLbetween visits.

Results : The final analysis included 18,828 subjects. Mean changes in LDL (mg/dl), TG (mg/dl), HDL (mg/dl) and TG/HDL (%) were associated with BMI changes and were -3.89, -11.00, +5.76, -13.20 for “large reduction” BMI group, -0.96, -0.91, +2.99, -1.71 for “moderate reduction” BMI group, +1.30, +5.36, +1.93, +5.26 for “unchanged” BMI group, +2.91, +12.50, +1.30, +13.00 for “moderate increase” BMI group, and +3.91, +17.70, +0.43, +19.70 for “large increase” BMI group, respectively (P >.01). The proportion of patients with > 10% rise in TG/HDL progressively increased with the relative change in BMI (20.6%, 30.2%, 37.5%, 46.2%, and 50.2% for “large reduction”, “moderate reduction”, “unchanged”, “moderate increase”, and “large increase” groups, respectively, P>.01). Compared to the “unchanged” group, the odds ratio for TG/HDL rise of > 10% was 0.43, 0.72, 1.43 and 1.68 for “large reduction”, “moderate reduction”, “moderate increase”, and “large increase” groups, respectively (P>.01). Subgroups analysis by gender, initial TG/HDL and initial BMI revealed that the trends of TG/HDL change by BMI did not change significantly, albeit the association of TG/HDL by BMI was mildly mitigated in females.

Conclusions: Non-interventional weight changes, even modest, are associated with alterations in lipid profile.