1.
Effect of weight loss on the cardiovascular risk profile of obese patients with psoriasis.
Jensen, P, Zachariae, C, Christensen, R, Geiker, NR, Schaadt, BK, Stender, S, Astrup, A, Hansen, PR, Skov, L
Acta dermato-venereologica. 2014;94(6):691-4
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Plain language summary
Psoriasis is a chronic inflammatory skin disease. It is characterised by a systemic immunological response which is mainly elicited by activated T-helper (Th)1 and Th17 lymphocytes. Like psoriasis, atherosclerosis is characterised by Th1-driven inflammation both systemically and locally in arterial walls and atherosclerotic plaques. The aim of this study was to examine the effect of weight reduction on traditional cardiovascular risk factors and on endothelial function. This study is a prospective randomised trial. The participants were randomised to either low-energy diet (n=30) providing 800–1,000 kcal/day for 8 weeks followed by 8 weeks of reduced food intake reaching 1,200 kcal/day or normal healthy foods (n=30) for 16 weeks. Results indicate that after 16 weeks, obese patients with psoriasis following the low-energy diet lost significantly more weight compared to controls encouraged to eat normal healthy foods. This resulted in significant reductions of several endpoints associated with increased cardiovascular risk. Authors conclude that certain components of the cardiovascular risk profile of obese patients with psoriasis can be effectively reduced by weight reduction.
Abstract
Psoriasis is associated with obesity and other cardiovascular risk factors including endothelial dysfunction. We aimed to investigate the effects of weight loss on the cardiovascular risk profile of obese patients with psoriasis. A randomised controlled study was conducted in which we measured the microvascular endothelial function with peripheral arterial tonometry (PAT), selected plasma markers of endothelial function, and traditional cardiovascular risk factors in 60 obese patients with psoriasis. The participants were randomised to either low-energy diet (n = 30) providing 800-1,000 kcal/day for 8 weeks followed by 8 weeks of reduced food intake reaching 1,200 kcal/day or normal healthy foods (n = 30) for 16 weeks. The intervention group lost significantly more weight than controls, which resulted in significant reductions of diastolic blood pressure, resting heart rate, total cholesterol, VLDL cholesterol, triglyceride, plasma glucose, glycated haemoglobin, and tissue plasminogen activator inhibitor. Microvascular endothelial function assessed by PAT remained unchanged. We conclude that certain components of the cardiovascular risk profile of obese patients with psoriasis can be significantly improved by weight reduction.
2.
Metabolic syndrome, circulating RBP4, testosterone, and SHBG predict weight regain at 6 months after weight loss in men.
Wang, P, Menheere, PP, Astrup, A, Andersen, MR, van Baak, MA, Larsen, TM, Jebb, S, Kafatos, A, Pfeiffer, AF, Martinez, JA, et al
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.