Effects of Identical Weight Loss on Body Composition and Features of Insulin Resistance in Obese Women With High and Low Liver Fat Content

  1. Mirja Tiikkainen1,
  2. Robert Bergholm1,
  3. Satu Vehkavaara1,
  4. Aila Rissanen2,
  5. Anna-Maija Häkkinen3,
  6. Marjo Tamminen1,
  7. Kari Teramo4 and
  8. Hannele Yki-Järvinen1
  1. 1Department of Medicine, Division of Diabetes, University of Helsinki, Helsinki, Finland
  2. 2Department of Obesity Research Unit, University of Helsinki, Helsinki, Finland
  3. 3Department of Oncology, University of Helsinki, Helsinki, Finland
  4. 4Department of Obstetrics and Gynecology, University of Helsinki, Helsinki, Finland

    Abstract

    Our objective was to determine how 8% weight loss influences subcutaneous, intra-abdominal, and liver fat (LFAT), as well as features of insulin resistance, in obese women with high versus low LFAT. A total of 23 women with previous gestational diabetes were divided into groups of high (9.4 ± 1.4%) and low (3.3 ± 0.4%) LFAT based on their median LFAT (5%) measured with proton spectroscopy. Both groups were similar with respect to age, BMI, and intra-abdominal and subcutaneous fat. Before weight loss, women with high LFAT had higher fasting serum insulin and triglyceride concentrations than women with low LFAT. At baseline, LFAT correlated with the percent of fat (r = 0.44, P < 0.05) and saturated fat (r = 0.45, P < 0.05) of total caloric intake but not intra-abdominal or subcutaneous fat or fasting serum free fatty acids. Weight loss was similar between the groups (high LFAT −7.4 ± 0.2 vs. low LFAT −7.7 ± 0.3 kg). LFAT decreased from 9.4 ± 1.4 to 4.8 ± 0.7% (P < 0.001) in women with high LFAT and from 3.3 ± 0.4 to 2.0 ± 0.2% (P < 0.001) in women with low LFAT. The absolute decrease in LFAT was significantly higher in women with high than low LFAT (−4.6 ± 1.0 vs. −1.3 ± 0.3%, P < 0.005). The decrease in LFAT was closely correlated with baseline LFAT (r = −0.85, P < 0.001) but not with changes in the volumes of intra-abdominal or subcutaneous fat depots, which decreased similarly in both groups. LFAT appears to be related to the amount of fat in the diet rather than the size of endogenous fat depots in obese women. Women with initially high LFAT lost more LFAT by similar weight loss than those with low LFAT, although both groups lost similar amounts of subcutaneous and intra-abdominal fat. These data suggest that LFAT is regulated by factors other than intra-abdominal and subcutaneous fat. Therefore, LFAT does not appear to simply reflect the size of endogenous fat stores.

    Footnotes

    • Address correspondence and reprint requests to Hannele Yki-Järvinen, MD, Department of Medicine, University of Helsinki, PO Box 340, FIN-00029 HUCH, Helsinki, Finland. E-mail: ykijarvi{at}helsinki.fi.

      Received for publication 19 August 2002 and accepted in revised form 9 December 2002.

      ALT, alanine aminotransferase; FFA, free fatty acid; IMCL, intramyocellular lipid; LFAT, liver fat; MRI, magnetic resonance imaging.

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