Metabolic syndrome, circulating RBP4, testosterone, and SHBG predict weight regain at 6 months after weight loss in men.

Obesity (Silver Spring, Md.). 2013;21(10):1997-2006
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Metabolic syndrome (MetS) is a cluster of conditions including increased blood pressure, high blood sugar, excess body fat around the waist and abnormal cholesterol or triglyceride levels, leading to an increased risk of heart disease and type 2 diabetes. Weight loss helps to reduce MetS in the obese, but most people who lose weight regain it again, possibly due to changes in hormones and cell signalling proteins produced by fat cells, known as adipokines. The aim of this study was to examine the changes in sex hormones and adipokines and their role as predictors of weight regain in men. The study consisted of a weight-loss phase of 8 weeks on a low-calorie diet, followed by a follow-up phase of 6 months on one of four diets differing in protein content and glycaemic index. From each diet group, the researchers selected 6 men who had regained weight and 6 who had continued to lose weight during the follow-up period, and compared metabolic and hormonal markers between them. The researchers found that men who had MetS at the start of the study were nearly 3 times more likely to regain weight after the initial weight loss. A tendency to regain weight was correlated with high levels of retinol-binding protein, and low levels of both sex hormone binding globulin (SHBG) and testosterone. Among the hormones and proteins tested, SHBG showed the strongest correlation with obesity and MetS. The authors concluded that the hormones and proteins studied may play roles in the link between MetS and weight regain.

Abstract

OBJECTIVE Weight loss helps reduce the symptoms of the metabolic syndrome (MetS) in the obese, but weight regain after active weight loss is common. The changes and predictive role of circulating adipokines and sex hormones for weight regain in men during dietary intervention, and also the effect of basal MetS status on weight regain, were investigated. DESIGN AND METHODS Twenty-four men who continued to lose weight (WL) and 24 men who regained weight (WR) during the 6-month follow-up period after weight loss were selected from the Diogenes Study. Their circulating concentrations of leptin, adiponectin, retinol-binding protein 4 (RBP4), luteinizing hormone, prolactin, progesterone, total and free testosterone, and sex hormone-binding globulin (SHBG) were measured at baseline, after 8-week low-calorie diet-induced active weight loss, and after a subsequent 26-week ad libitum weight maintenance diet, and analyzed together with anthropometrical and physiological parameters. RESULTS Overweight and obese men with MetS at baseline had higher risk to regain weight (odds ratio = 2.8, P = 0.015). High baseline RBP4, low total testosterone, and low SHBG are predictors of weight loss regain (different between WR and WL with P = 0.001, 0.038, and 0.044, respectively). CONCLUSIONS These variables may play roles in the link between MetS and weight loss regain.

Lifestyle medicine

Fundamental Clinical Imbalances : Hormonal ; Immune and inflammation
Patient Centred Factors : Mediators/Metabolic syndrome
Environmental Inputs : Diet
Personal Lifestyle Factors : Nutrition
Functional Laboratory Testing : Blood
Bioactive Substances : Adipokines ; Metabolic syndrome ; Weight regain

Methodological quality

Allocation concealment : Not applicable

Metadata

Nutrition Evidence keywords : Adipokines ; Metabolic syndrome ; Weight regain