Effects of lifestyle modification on adipocytokine levels in obese patients.

Objective: Adipose tissue is considered an active secretory organ of adipocytokines. The principal aim of our study was to examine the changes in adipocytokines levels after weigth reduction in obese patients.

Materials And Methods: A population of 126 obese (body mass index > 30) non-diabetic outpatients was analyzed in a prospective way. Before and after three months of a lifestyle modification program, an indirect calorimetry, a tetrapolar electrical bioimpedance, blood pressure, a serial assessment of nutritional intake with 3 days written food records and a series of biochemical analyses were performed. The lifestyle modification program consisted of a daily hypocaloric diet (1520 kcal: 52% of carbohydrates, 25% of lipids and 23% of proteins). The exercise program consisted of an aerobic exercise for at least 3 times per week (60 minutes each).

Results: The mean age was 45.6 +/- 16.9 years and the mean BMI 34.5 +/- 5.2, with 33 males (26.2%) and 93 females (73.8%). A total of 88 patients completed the follow up during 3 months, with a percentage of weight loss of 3.1%. Seventy two patients lost weight after treatment (responders) with an average age of 45.4 +/- 16.8 years and a percentage of weight loss of 4.2%. Sixteen patients did not respond (no-responders), with an increase in weight (88.9 +/- 10.5 vs 88.7 +/- 10.9 kg: p < 0.05) and BMI (34.7 +/- 5.4 vs 35.5 +/- 5.5 kg: p < 0.05). The average age (45.9 +/- 15.9 years) of this group was similar than that of responders. In responders (weight loss), BMI, weight, fat mass, glucose, total cholesterol, LDL cholesterol and systolic blood pressure decreased and VO2 increased. After treatment, no statistical differences were detected in energy intake: carbohydrate, fat, and protein. Exercise improved after treatment in responder group. Only serum leptin levels had a significant decrease in responder group (12%). After treatment, no responder group has similar values of all adipokines, including leptin (81.3 +/- 70.6 vs. 76.1 +/- 43 ng/ml).

Conclusion: Three months of lifestyle modification significantly improved anthropometric and cardiovascular risk factors, regardless of their minimal decrease in energy intake and the weight loss. Additional studies will be need to clarify the contribution of lifestyle modification in changes of serum adipocytokine levels.