Statin withdrawal and health-related quality of life in a primary cardiovascular prevention cohort.

PURPOSE: While some work has been done on Health-Related Quality of Life (HRQoL) in statin users, none has focused specifically on statin-associated muscle symptoms (SAMS) sufferers. The objective was to assess self-reported HRQoL, before and after statin withdrawal, in patients reporting SAMS. We hypothesized that the presence of SAMS associated with decreased self-reported physical and mental well-being. METHODS: Patients (50 men/28 women [M/W], aged 49 ± 9 years [Mean ± SD]) in primary cardiovascular prevention were recruited into three cohorts: statin users with (SAMS, 29 M/18W) or without symptoms (No SAMS, 10 M/5W) and controls (11 M/5W). The Short Form 36 Health Survey (SF-36) was used to assess HRQoL. All variables were measured before and after 2 months of statin withdrawal, and repeated measures analyses were used to verify withdrawal and group effects as well as their interaction. RESULTS: SF-36 physical and mental component scores (respectively, PCS and MCS) were lower in the SAMS group compared with other groups (both p < 0.01). Statin withdrawal led to an increase in LDL cholesterol for statin users (+69.0%, p < 0.01) and an improvement in well-being in the SAMS group, other groups showing no change. A time x category interaction (p = 0.02) was seen for PCS and post hoc analyses showed that statin withdrawal improved PCS and MCS (respectively, +12.5% [ES 0.77] and +5.1% [ES 0.27], both p < 0.05) in the SAMS group. CONCLUSION: Patients self-reporting SAMS showed improved HRQoL following drug withdrawal, but this was mirrored by a rise in LDL cholesterol. These findings should be considered by clinicians in the evaluation and follow-up of treatment with statins.

Gene expression in a rarely studied intraabdominal adipose depot, the round ligament, in severely obese women: A pilot study.

Gene expression (qPCR) was compared in round ligament (RL), omental (OME) and mesenteric (MES) ATs from 48 severely obese women (BMI, 54±11 kg/m(2); 38±9 yrs). The mRNA levels of enzymes of lipid metabolism (LPL, HSL, and PDE-3B), cortisol production (11ßHSD-1), adipogenesis (PPAR-γ1/2), thrombosis and inflammation (PAI-1, IL-6, TNF-α and adiponectin) were determined. AT-LPL mRNA was highest in RL. The highest PDE-3B and lowest PAI-1 mRNA levels were observed in RL and MES. The lowest IL-6 and TNF-α and the highest adiponectin and PPAR-g1/2 mRNA levels were found in RL AT. 11ßHSD-1 was highest in RL and OME. A higher lipogenic and adipogenic, and lower pro-inflammatory and pro-thrombotic profiles of the RL suggest a lesser deleterious impact on obesity-related complications.

Gene expression of different adipose tissues of severely obese women with or without a dysmetabolic profile

Despite well-established variations in the health risks posed by visceral vs. subcutaneous abdominal (SCABD) fat depots, surprisingly little is known on the differences within a given adipose tissue (AT) among severely obese patients displaying varying metabolic dysfunction. We thus compared, by quantitative PCR, the expression profile of a number of genes in the SCABD, omental (OME), and mesenteric (MES) depots of severely obese women with (DYS; n = 25) or without (NDYS; n = 23) a dysmetabolic profile. Fasting insulinemia and HOmeostasis Model Assessment-insulin resistance (HOMA-IR) were higher and plasma adiponectin level lower in DYS women (p < 0.05). Among enzymes involved in fatty acid metabolism and local cortisol production, phosphodiesterase-3B expression was lower in SCABD and MES fat, while 11Beta-hydroxysteroid dehydrogenase type 1 mRNA levels were higher in visceral depots of DYS women (p < 0.05). Regarding vascular homeostasis and inflammation, plasminogen activator inhibitor-1 and interleukin-6 mRNA levels were higher in OME fat, while adiponectin expression was lower in SCABD and OME ATs of DYS women (p < 0.05). Finally, HOMA-IR was positively associated with SCABD AT IL6 mRNA, only in DYS women (r = 0.47; p < 0.05). In conclusion, although metabolic and secretory characteristics of all depots vary with subjects’ metabolic profile, we find little evidence for a protective role of SCABD AT and no evidence for a further deleterious role of MES fat in DYS vs. NDYS severely obese women. Regional variation in the overall gene expression revealed that OME and MES fat were more closely related to each other in DYS women, while SCABD and MES depots showed greater resemblance in NDYS women

Gene expression of different adipose tissues of severely obese women with or without a dysmetabolic profile.

Despite well-established variations in the health risks posed by visceral vs. subcutaneous abdominal (SCABD) fat depots, surprisingly little is known on the differences within a given adipose tissue (AT) among severely obese patients displaying varying metabolic dysfunction. We thus compared, by quantitative PCR, the expression profile of a number of genes in the SCABD, omental (OME), and mesenteric (MES) depots of severely obese women with (DYS; n = 25) or without (NDYS; n = 23) a dysmetabolic profile. Fasting insulinemia and HOmeostasis Model Assessment-insulin resistance (HOMA-IR) were higher and plasma adiponectin level lower in DYS women (p < 0.05). Among enzymes involved in fatty acid metabolism and local cortisol production, phosphodiesterase-3B expression was lower in SCABD and MES fat, while 11ß-hydroxysteroid dehydrogenase type 1 mRNA levels were higher in visceral depots of DYS women (p < 0.05). Regarding vascular homeostasis and inflammation, plasminogen activator inhibitor-1 and interleukin-6 mRNA levels were higher in OME fat, while adiponectin expression was lower in SCABD and OME ATs of DYS women (p < 0.05). Finally, HOMA-IR was positively associated with SCABD AT IL6 mRNA, only in DYS women (r = 0.47; p < 0.05). In conclusion, although metabolic and secretory characteristics of all depots vary with subjects' metabolic profile, we find little evidence for a protective role of SCABD AT and no evidence for a further deleterious role of MES fat in DYS vs. NDYS severely obese women. Regional variation in the overall gene expression revealed that OME and MES fat were more closely related to each other in DYS women, while SCABD and MES depots showed greater resemblance in NDYS women.

Is practice rate rather than exercise intensity more important in health benefits of moderately obese postmenopausal women?

OBJECTIVE: The aim of this study was to evaluate the impact of brisk walking on physical fitness, body composition and fasting lipid-lipoprotein profile of women 50-65 years-old, once adherence or exercise intensity is considered. METHODS: A sample of 159 healthy, sedentary, obese postmenopausal women (body mass index [BMI]=29-35 kg/m2) was subjected to 3 sessions/week of 45 min-walking, at 60% of heart rate reserve (HRR), during 16 weeks. Body composition, physical fitness and fasting lipid-lipoprotein profile were assessed before and after the intervention. RESULTS: Among the three tertiles of adherence to exercise sessions (<71%, 71-87%,>87%) women displaying the greatest one were characterized by the highest reduction in body weight (-1.9±2.7 kg) (mean±SD), fat mass (-2.0±2.3 kg) and waist girth (-4.4±3.4 cm) and the best improvement in physical fitness (7.3±3.5 mL O2/kg/min), (P<0.0001). A comparable analysis based on tertiles of walking intensity (<56%, 56-63%,>63% HRR) did not show between-group differences in body composition or physical fitness. Also, the fasting lipid-lipoprotein profile was improved by a reduction of cholesterol, LDL cholesterol, and triglyceride levels and by an increase in HDL cholesterol, irrespective of the participants' adherence (0.05

Weight loss and regain in obese individuals: a link with adipose tissue metabolism indices?

This study was performed to examine whether changes in subcutaneous adipose tissue (SCAT) metabolism indices after weight loss were related to the magnitude of weight regain. Nine men and ten premenopausal women whose body mass index ranged from 30 to 42 kg/m(2), 35-48 years old, were studied before and after a 15-week weight loss program, as well as at a 17-22-month follow-up period. Although body composition was evaluated at all study periods, abdominal and femoral SCAT-lipoprotein lipase (LPL) and hormone-sensitive lipase (HSL) activities, and Alpha2- and Beta-adrenoceptors (ARs) were measured before and after weight loss, exclusively. Although the SCAT-LPL activity did not change after weight loss in men, it tended to decrease in the femoral depot of women (p = 0.06). SCAT-HSL activity remained unchanged after weight reduction in men, while the post-weight loss lipase activity tended to be higher in both regions of women (p = 0.06). Although the post-weight loss number of β-ARs was higher irrespective of the fat depot (0.001 < p < 0.05), the number of Alpha2-ARs was increased in the femoral (p < 0.05), but not in the abdominal SCAT (p = 0.08) after weight reduction, in men. Neither the Alpha2- nor the Beta-AR density changed after weight reduction, in women. Abdominal SCAT-LPL activity after weight reduction was negatively related to weight regain indices, in women (-0.65 < Rhô < -0.75; 0.01 < p < 0.05). Both the post-weight loss abdominal SCAT Alpha 2-AR density and the Alpha 2-/Beta-AR balance were positively associated with weight regain indices, in men (0.69 < Rhô < 0.88; 0.01 < p < 0.05). These results suggest that selected SCAT metabolism indices could predict failure to weight loss maintenance, in both genders

Weight loss and regain in obese individuals: a link with adipose tissue metabolism indices?

This study was performed to examine whether changes in subcutaneous adipose tissue (SCAT) metabolism indices after weight loss were related to the magnitude of weight regain. Nine men and ten premenopausal women whose body mass index ranged from 30 to 42 kg/m(2), 35-48 years old, were studied before and after a 15-week weight loss program, as well as at a 17-22-month follow-up period. Although body composition was evaluated at all study periods, abdominal and femoral SCAT-lipoprotein lipase (LPL) and hormone-sensitive lipase (HSL) activities, and α2- and ß-adrenoceptors (ARs) were measured before and after weight loss, exclusively. Although the SCAT-LPL activity did not change after weight loss in men, it tended to decrease in the femoral depot of women (p = 0.06). SCAT-HSL activity remained unchanged after weight reduction in men, while the post-weight loss lipase activity tended to be higher in both regions of women (p = 0.06). Although the post-weight loss number of ß-ARs was higher irrespective of the fat depot (0.001 < p < 0.05), the number of α2-ARs was increased in the femoral (p < 0.05), but not in the abdominal SCAT (p = 0.08) after weight reduction, in men. Neither the α2- nor the ß-AR density changed after weight reduction, in women. Abdominal SCAT-LPL activity after weight reduction was negatively related to weight regain indices, in women (-0.65 < Rhô < -0.75; 0.01 < p < 0.05). Both the post-weight loss abdominal SCAT α2-AR density and the α2-/ß-AR balance were positively associated with weight regain indices, in men (0.69 < Rhô < 0.88; 0.01 < p < 0.05). These results suggest that selected SCAT metabolism indices could predict failure to weight loss maintenance, in both genders.

Pro-inflammatory phospholipid arachidonic acid/eicosapentaenoic acid ratio of dysmetabolic severely obese women.

BACKGROUND: Fatty acids (FAs) and adipokines such as adiponectin or interleukin-6 (IL-6) are known to modulate inflammation and the development of metabolic syndrome. Whether FA composition assessed in plasma triacylglycerols (TAGs), phospholipids (PLs) and non-esterified fatty acids (NEFAs) and adipose tissue (AT) PLs differed between dysmetabolic and non-dysmetabolic severely obese women remains to be established. Whether the plasma and/or AT arachidonic acid (AA)/eicosapentaenoic acid (EPA) ratio in the PL sub-fraction may be associated with adipokine AT gene expression needs to be examined. METHODS: FA composition was measured in plasma lipid classes and in the TAG and PL sub-fractions of subcutaneous abdominal and omental ATs of severely obese women paired for age and adiposity but showing a dysmetabolic profile (n = 13) or not (n = 14). FA profile was assessed by gas chromatography. Plasma and AT mRNA concentrations of adiponectin and IL-6 were measured by ELISA and real-time polymerase chain reaction, respectively. RESULTS: Plasma adiponectin and FA concentrations in the NEFA sub-fraction were, respectively, lower and higher in dysmetabolic than in non-dysmetabolic women (p < 0.05). Despite similar FA levels in the PL sub-fraction, the AA/EPA ratio was higher in plasma and ATs (p < 0.005), because of an EPA decrease in plasma and subcutaneous abdominal fat vs. an AA increase in the omental depot. The AA/EPA ratio was negatively associated with adiponectin concentrations in plasma and subcutaneous abdominal AT (0.01 < p < 0.05). CONCLUSIONS: Metabolic dysfunction is associated with a pro-inflammatory phospholipid AA/EPA ratio in plasma and ATs, and an altered adiponectin secretion that could contribute to developing metabolic syndrome.

Short-term impact of a 4-week intensive cardiac rehabilitation program on quality of life and anxiety-depression.

INTRODUCTION: Cardiac rehabilitation programs are well recognized as being essential to the comprehensive care of patients with cardiovascular disease and chronic heart failure. These programs aim at reducing cardiovascular risks, promoting healthy lifestyle behaviours and compliance as well as limiting disability and increasing quality of life (QoL) of cardiac patients. PURPOSE: To evaluate the impact of a 4-week cardiac rehabilitation program on physical parameters and several aspects of the QoL of cardiac patients. METHODS: A cohort of 101 cardiac patients (men: 70%) mean age 65±12 years (mean±SD) participated in a cardiac rehabilitation program. Before and after the 4-week cardiac rehabilitation program, the study recorded and assessed the patients' physical parameters such as weight, body mass index (BMI), waist circumference and effort tolerance as well as QoL using different questionnaires: SF-36 Health Survey (SF-36), Hospital Anxiety and Depression Scale (HAD) and the Pittsburgh Sleep Quality Index (PSQI). RESULTS: The patients' physical parameters (BMI and waist circumference) decreased by 3%, while effort tolerance increased by 25% (P<0.0001). Furthermore, for all patients, the PSQI, HAD and physical and mental SF-36 scores improved significantly (P<0.0001). The different SF-36 subscales' scores did also increase after the program (P<0.0001). CONCLUSION: Despite a modest weight loss and reduction in waist circumference, a 4-week cardiac rehabilitation program (short-term) seems to be sufficient for improving patients' physical state and mental well-being.

High lipolytic activity and dyslipidemia in a spontaneous hypertensive/NIH corpulent (SHR/N-cp) rat: a genetic model of obesity and type 2 diabetes mellitus.

In order to better understand the link between obesity and type 2 diabetes, lipolysis and its adrenergic regulation was investigated in various adipose depots of obese adult females SHR/N-cp rats. Serum insulin, glucose, free fatty acids (FFA), triglycerides (TG) and glycerol were measured. Adipocytes were isolated from subcutaneous (SC), parametrial (PM) and retroperitoneal (RP) fat pads. Total cell number and size, basal lipolysis or stimulated by norepinephrine (NE) and BRL 37344 were measured in each depot. Obese rats were hyperinsulinemic and hyperglycemic, suggesting high insulin resistance. They presented a marked dyslipidemia, attested by increased serum FFA and TG levels. High serum glycerol levels also suggest a strong lipolytic rate. Obese rats showed an excessive development of all fat pads although a more pronounced effect was observed in the SC one. The cellularity of this depot was increased 8 fold when compared to lean rats, but these fat cells were only 1.5 to 2-fold larger. SC adipocytes showed a marked increase in their basal lipolytic activity but a lack of change in responsiveness to NE or BRL 37344. The association between high basal lipolysis and increased cellularity yields to a marked adipose cell lipolytic rate, especially from the SC region. SHR/N-cp rats were characterized by a hyperplasic type of obesity with an excessive development of the SC depot. The dyslipidemia, attested by an altered serum lipid profile could be attributed to excessive lipolysis that contributes to increased FFA levels, and to early development of insulin resistance through a lipotoxicity effect.

Alta actividad lipolítica y dislipidemia en la rata SHR/N-cp: módulo genético de obesidad y diabetes mellitus tipo 2 / High lipolytic activity and dyslipidemia in a Spontaneous Hypertensive/NIH Corpulent (SHR/N-cp) rat: a genetic model of obesity and type 2 diabetes mellitus

In order to better understand the link between obesity and type 2 diabetes, lipolysisand its adrenergic regulation was investigated in various adipose depots of obeseadult females SHR/N-cp rats. Serum insulin, glucose, free fatty acids (FFA), triglycerides(TG) and glycerol were measured. Adipocytes were isolated from subcutaneous(SC), parametrial (PM) and retroperitoneal (RP) fat pads. Total cell numberand size, basal lipolysis or stimulated by norepinephrine (NE) and BRL 37344 weremeasured in each depot. Obese rats were hyperinsulinemic and hyperglycemic, suggestinghigh insulin resistance. They presented a marked dyslipidemia, attested byincreased serum FFA and TG levels. High serum glycerol levels also suggest a stronglipolytic rate. Obese rats showed an excessive development of all fat pads although amore pronounced effect was observed in the SC one. The cellularity of this depot wasincreased 8 fold when compared to lean rats, but these fat cells were only 1.5 to2-fold larger. SC adipocytes showed a marked increase in their basal lipolytic activitybut a lack of change in responsiveness to NE or BRL 37344. The associationbetween high basal lipolysis and increased cellularity yields to a marked adipose celllipolytic rate, especially from the SC region. SHR/N-cp rats were characterized bya hyperplasic type of obesity with an excessive development of the SC depot. Thedyslipidemia, attested by an altered serum lipid profile could be attributed to excessivelipolysis that contributes to increased FFA levels, and to early development ofinsulin resistance through a lipotoxicity effect(AU)

Regulation of lypolysis in white adipose tissues of lean and obese Zucker rats

Obese Zucker rat is often used as a model of genetic obesity to understand themechanism of the development of obesity. In the present work, in order to betterunderstand the regulation of lipolysis in the Zucker rat, the lipolytic activities ofadipocytes isolated from different adipose depots of lean and obese Zucker rats, inthe basal state or after catecholamine stimulation have been measured. The obeseZucker rat presents hyperinsulinemia without hyperglycemia and with elevated plasmafree fatty acids, suggesting a dyslipidemia. Morphological studies of three adiposedeposits show a marked hypertrophic and hyperplastic type of obesity, much pronouncedin the subcutaneous depot. In the current study we show that the basallipolytic rate is higher in adipocytes from each deposit of obese rats (when results arecorrected for cell surface area). This finding, associated with the increase of alldeposits, could contribute to the elevated plasma FFA observed. Investigation of theresponsiveness of dibutyril cAMP (DBcAMP) points out that the defect in the NEresponsiveness is essentially located at post-receptor level. Nevertheless, a receptordefect could not be excluded as suggested by a decrease of the Beta-ARs observed in alldeposits. Our study points out that the lipolytic resistance to catecholamines in adiposetissue of obese Zucker rats appears to counteract the increase in the lipolyticrate, in order to moderate the increase in plasma FFA levels that may contribute tothe hyperinsulinemia observed, characteristic of an insulino-resistant state (AU)

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Regulation of lypolysis in white adipose tissues of lean and obese Zucker rats.

Obese Zucker rat is often used as a model of genetic obesity to understand the mechanism of the development of obesity. In the present work, in order to better understand the regulation of lipolysis in the Zucker rat, the lipolytic activities of adipocytes isolated from different adipose depots of lean and obese Zucker rats, in the basal state or after catecholamine stimulation have been measured. The obese Zucker rat presents hyperinsulinemia without hyperglycemia and with elevated plasma free fatty acids, suggesting a dyslipidemia. Morphological studies of three adipose deposits show a marked hypertrophic and hyperplastic type of obesity, much pronounced in the subcutaneous depot. In the current study we show that the basal lipolytic rate is higher in adipocytes from each deposit of obese rats (when results are corrected for cell surface area). This finding, associated with the increase of all deposits, could contribute to the elevated plasma FFA observed. Investigation of the responsiveness of dibutyril cAMP (DBcAMP) points out that the defect in the NE responsiveness is essentially located at post-receptor level. Nevertheless, a receptor defect could not be excluded as suggested by a decrease of the beta-ARs observed in all deposits. Our study points out that the lipolytic resistance to catecholamines in adipose tissue of obese Zucker rats appears to counteract the increase in the lipolytic rate, in order to moderate the increase in plasma FFA levels that may contribute to the hyperinsulinemia observed, characteristic of an insulino-resistant state.

Effects of jump training on passive mechanical stress and stiffness in rabbit skeletal muscle: role of collagen.

AIMS: This study evaluated the effect of a 15-week jump training period on mechanical parameters and collagen concentration of different muscle types in rabbits, at 50, 90 and 140 days of age. METHODS: Trained (T) animals were made to jump over obstacles in order to get food and water. The height of the obstacle was increased according to the animal's age. Control (C) animals were sedentary. Mechanical parameters (force, stress, stiffness) and collagen concentration were measured in Extensor Digitorum Longus (EDL), Rectus Femoris (RF), Semimembranosus Proprius (SMP) and Psoas Major (PSOAS). RESULTS: Both EDL and RF collagen concentrations and passive mechanical parameters increased between 50 and 140 days of age (P<0.001), whereas SMP and PSOAS collagen concentrations decreased (P<0.001). Soluble collagen concentration decreased similarly with age in all muscles and groups. Exercise training at 140 days induced a significant increase in force (EDL 20.4% and RF 15.3%, 0.01

Chronic effects of dehydroepiandrosterone on rat adipose tissue metabolism.

The goal of the present study was to examine cellular mechanisms that regulate adipose cell metabolism in ovariectomized (OVX) and intact rats that were subjected to long-term (27 weeks) treatment with dehydroepiandrosterone (DHEA). Forty-eight 16-month-old female rats were divided into 4 groups of 9 to 11 animals (intact, intact-DHEA, OVX, OVX-DHEA). Adipose tissue lipoprotein lipase (LPL), hormone-sensitive lipase (HSL), and cyclic adenosine monophosphate (cAMP)-dependent phosphodiesterase (cAMP-PDE) activities were determined, and alpha2-, beta1/beta2-, and beta3-adrenoceptors (ARs) were quantified. DHEA did not affect body weight, fat, or muscle mass in intact rats. The similar retroperitoneal fat pad weight of intact-DHEA rats compared to intact animals was in agreement with the lack of difference in the enzyme activities and AR densities. The increased body weight of OVX rat was paralleled by a greater retroperitoneal adipose tissue mass (P <.01), which was in turn associated with a marked rise in LPL activity (P <.005) and a slight decrease in HSL activity (P <.05) compared to intact animals. OVX-DHEA rats, compared to untreated OVX animals, had a smaller retroperitoneal fat depot, which correlated with a decrease in LPL activity (P <.005) and moderate increase in both HSL activity and beta3-AR density (P <.05). DHEA-treatment lowered fasting insulin and triglyceride levels in both intact and OVX rats (P <.05). Plasma testosterone, androsterone, androstenedione, and androstenediol levels were also significantly increased in both intact-DHEA and OVX-DHEA rats compared to untreated animals (P <.0001). These findings suggest that the antiobesity action of DHEA may be related in part to changes in lipase activities and in beta3-AR density, and that it is dependent on the ovarian status of the animal.

Reduction of visceral adipose tissue during weight loss.

OBJECTIVE: The aims of the present study were to retrospectively: (1) compare how weight loss affects the reduction of adipose tissue from three different sites between men and women; and (2) to verify whether gender differences in the reduction of adipose tissue are influenced by changes in fat mass (FM) and initial levels of fat in different compartments. DESIGN: Double-blind randomized treatment with fenfluramine once daily coupled to a non-macronutrient specific energy restriction. SUBJECTS: Seventeen obese men (age 43.9+/-1.5 and body mass index (BMI) 34.3+/-0.7) and 17 obese women (age 41.2+/-1.2 and BMI 35.7+/-0.6). INTERVENTIONS: Subjects were given fenfluramine (60 mg) or placebo once daily and were also subjected to a non-macronurient specific energy restriction of -2.9 MJ/day (-700 kcal/day) for 15 weeks. RESULTS: Body weight, FM, fat-free mass (FFM), waist circumference, BMI, as well as visceral (VAT), subcutaneous abdominal (SAT) and thigh (TAT) adipose tissue were all significantly reduced. Men lost significantly more VAT (-41.6%) than SAT (-22.5%), or than TAT (-20.5%) while no site difference in fat loss was observed in women when changes were calculated as a percentage of initial levels. Men lost about twice as much fat from the VAT compartment than did women (P<0.05), even after having considered changes in FM as a potential covariate. In absolute values, TAT was reduced to a lesser extent in men than in women. However, when initial levels of respective fat depots were also taken into account, gender differences in VAT and TAT loss were no longer statistically significant. CONCLUSION: These results suggest that gender differences in VAT reduction during weight loss are independent of changes in FM. However, once initial levels of VAT are also taken into account, gender differences in the reduction of this tissue during weight loss are no longer apparent.

Increase in plasma pollutant levels in response to weight loss is associated with the reduction of fasting insulin levels in men but not in women.

Environmental pollutants can act as endocrine modulators. In this study, we examined whether weight loss-induced changes in plasma organochlorine compounds (OC) were associated with those in plasma insulin levels. Fasting insulin and the area under the curve (AUC) of insulin after a 75-g oral glucose load, plasma levels of 1 commercial polychlorinated biphenyl (PCB) mixture (Aroclor 1260), 1 PCB congener (PCB 153), and 3 pesticides (2,2'-bis(4-chlorophenyl)-1,1-dichloroethylene (p,p'-DDE), beta-hexachlorocyclohexane (beta-HCH), and hexachlorobenzene (HCB)) were measured before and after a 15-week weight loss program induced by a caloric restriction in a sample of obese men and women. Both genders showed a similar reduction in body weight (approximately 11 kg) in response to treatment, although men lost significantly more fat mass than women (mean +/- SD 9.4 +/- 4.1 v 5.9 +/- 5 kg, respectively, P <.05). Fasting insulin and AUC of insulin significantly decreased in men and women after the treatment. In response to weight loss, a significant increase in OC was observed in both genders, and this effect was more pronounced in men. The greater the increase in plasma OC levels, the greater the reduction in fasting insulin was in response to weight loss in men (-.49 < r < -.59, P <.05), but not in women (-.22 < r <.01, not significant [NS]). In both genders, no relationship was observed between changes in plasma OC levels and changes in AUC of insulin (-.41 < r < -.08, NS). In men, relationships between changes in plasma HCB, Aroclor 1260, and PCB-153 concentrations and those in fasting insulin levels in response to weight loss remained significantly correlated after correction for fat mass loss (-.46 < partial r < -.51, P values ranging from.05 to.07). These results suggest that weight loss-induced increase in plasma pollutant levels tends to be independently associated with the reduction of fasting insulin levels in men, but not in women. Further studies are needed to verify whether these findings are causally related.

Increase in plasma pollutant levels in response to weight loss in humans is related to in vitro subcutaneous adipocyte basal lipolysis.

OBJECTIVE: To examine whether weight loss-induced changes in in vitro basal lipolysis of subcutaneous abdominal and femoral fat cells were related to those in plasma organochlorine levels. DESIGN: A 15 week weight loss program induced by a moderate caloric restriction. SUBJECTS: Seventeen men and 20 women (age 36-50 y, body fat 25-50%). MEASUREMENTS: In vitro basal lipolysis of subcutaneous abdominal and femoral adipocytes and plasma levels of five polychlorinated biphenyl congeners (Aroclor 1260, PCBs 118, 138, 153 and 180) and three chlorinated pesticides (dichlorodiphenyl dichloroethene (p,p'-DDE), beta-hexachlorocyclohexane (beta-HCH) and hexachlorobenzene (HCB)) were measured before and after the weight reducing program. RESULTS: Both genders showed a similar reduction in body weight (approximately 11 kg) in response to treatment, although men lost significantly more fat mass than women (mean+/-s.d., 9.4+/-4.1 vs 5.9+/-5 kg, respectively, P<0.05). Mean basal fat cell lipolysis did not vary before and after weight reduction, regardless of depots and genders. In response to weight loss, significant increases of all organochlorines investigated were observed in men, whereas only p,p'-DDE, Aroclor 1260, PCBs 153 and 180 significantly rose in women. In men, higher the increase in basal lipolysis of subcutaneous abdominal or femoral adipocytes, greater the rise in plasma levels of most pollutants (HCB, Aroclor 1260, PCBs 118, 138 and 153) was in response to weight loss (0.51

Difference in leptin response to a high-fat meal between lean and obese men.

The aim of this study was to compare the leptin responses to a high-fat meal in lean and obese men, and to investigate whether the net leptin response (area under the incremental curve) after the meal was related to the thermic effect of food (TEF). Blood samples were collected after an overnight fast and every 2 h for 8 h after a high-fat breakfast (60 g of fat/m(2) body surface area) in 12 lean and 12 obese men for determination of glucose, insulin and leptin. The TEF was calculated as postprandial energy expenditure minus fasting energy expenditure, as measured by indirect calorimetry. Fasting plasma glucose levels were similar in lean and obese men, and increased in the same way after the meal. Fasting and postprandial plasma insulin concentrations were significantly greater in obese than in lean men (P<0.01 and P<0.05 respectively). Accordingly, obese men showed a significantly higher net insulin response than lean subjects (P<0.001). Fasting plasma leptin levels were greater in obese than in lean men (P<0.001). After the meal, plasma leptin increased significantly in lean men, whereas it decreased in obese men (group by time interaction, P<0.01). The net response of leptin was greater in lean than in obese men, but this did not reach statistical significance (P=0.07). Moreover, the TEF was similar in the two groups. No significant relationship was observed between either the net insulin response or the net leptin response after the high-fat meal and the TEF of lean subjects (-0.05

Effect of a six month gemfibrozil treatment and dietary recommendations on the metabolic risk profile of visceral obese men.

OBJECTIVE: The aim of the present study was to investigate the effects of a 6 month gemfibrozil treatment. SUBJECTS: A sample of 64 visceral obese men (age 46+/-6 y; body mass index 31+/-3 kg/m(2); waist circumference 104+/-7 cm; mean+/-s.d.) who received dietary recommendations. METHODS: Subjects were randomly assigned to receive a placebo (n=32) or gemfibrozil (1200 mg/day) (n=32). RESULTS: In both placebo and gemfibrozil treated groups, significant reductions were noted in body weight, fat mass, waist circumference and visceral adipose tissue area measured by computed tomography (0.0001