Section of Metabolic Genetics, Novo Nordisk Foundation Center for Basic Metabolic Research.
Danish Diabetes Academy, Odense, Demark.
Am J Clin Nutr. 2018 Nov 1;108(5):913-921. doi: 10.1093/ajcn/nqy187.
Body fat distribution is a marker of metabolic health independent of body size. Visceral fat accumulation has been suggested to result from a decreased expandability of the subcutaneous fat depots. Furthermore, the visceral fat may be easier to mobilize than the peripheral fat. We examined whether differences in abdominal obesity at baseline influenced prospective body-weight changes.
In this study we examined whether body-fat distribution at baseline was associated with long-term and short-term weight changes.
We included 3 observational studies (ntotal = 7271) with mean follow-up times of 5-9 y and two 8-10-wk weight loss intervention studies (ntotal = 1091). We examined the association between baseline waist circumference and weight changes in a substitution regression model, where body weight, height, and fat-free mass were fixed so that a difference in waist circumference would reflect a difference in body fat distribution alone. The results were summarized in meta-analyses.
In the observational studies, we found no associations between baseline waist circumference and subsequent weight change in men (β: 0.03 kg; 95% CI: -0.01, 0.08 kg; P = 0.19), but a negligible inverse association in women (β: -0.05 kg; 95% CI: -0.08, -0.01 kg; P = 0.01). There was no association between baseline waist circumference and weight loss in the intervention studies (men: β: -0.05 kg; 95% CI: -0.13, 0.03 kg; P = 0.25; women: β: -0.00 kg; 95% CI: -0.03, 0.03 kg; P = 0.84). However, in all studies, the SDs of the weight change residuals were greater, the greater the waist circumference at baseline. This trend was statistically significant in women in most studies as well as in men in 1 of the studies.
With narrow CIs in 3 observational studies and 2 weight loss interventions, we did not find any clinically or epidemiologically relevant association between baseline abdominal obesity and weight change. However, the present study suggests that a greater baseline abdominal obesity is a marker for greater weight fluctuations. The CCHS trial was registered at www.clinicaltrials.gov as NCT02993172. The Health2006 trial was registered at www.clinicaltrials.gov as NCT00316667. The ORG study was conducted before trial registration was required. The NUGENOB trial was registered at www.isrctn.com as ISRCTN25867281. The DiOGenes trial was registered atwww.clinicaltrials.gov as NCT00390637.
体脂分布是代谢健康的标志物，与体型无关。内脏脂肪的积累被认为是由于皮下脂肪储存的扩张能力下降所致。此外，内脏脂肪可能比外周脂肪更容易动员。我们研究了基线时腹部肥胖的差异是否会影响前瞻性体重变化。
本研究旨在探讨基线时体脂分布是否与长期和短期体重变化有关。
我们纳入了 3 项观察性研究（共 7271 人），平均随访时间为 5-9 年，以及 2 项 8-10 周的体重减轻干预研究（共 1091 人）。我们在替代回归模型中检查了基线腰围与体重变化之间的关系，其中体重、身高和去脂体重是固定的，因此腰围的差异仅反映体脂分布的差异。结果在荟萃分析中进行了总结。
在观察性研究中，我们未发现男性基线腰围与随后体重变化之间存在关联（β：0.03kg；95%CI：-0.01，0.08kg；P=0.19），但女性存在可忽略的负相关（β：-0.05kg；95%CI：-0.08，-0.01kg；P=0.01）。干预研究中基线腰围与体重减轻之间也没有关联（男性：β：-0.05kg；95%CI：-0.13，0.03kg；P=0.25；女性：β：-0.00kg；95%CI：-0.03，0.03kg；P=0.84）。然而，在所有研究中，体重变化残差的标准差越大，基线腰围越大。在大多数研究中，这种趋势在女性中具有统计学意义，在 1 项研究中在男性中也具有统计学意义。
在 3 项观察性研究和 2 项体重减轻干预研究中，我们没有发现基线腹部肥胖与体重变化之间存在任何临床或流行病学相关的关联。然而，本研究表明，较大的基线腹部肥胖是体重波动较大的标志。CCHS 试验在 www.clinicaltrials.gov 上注册为 NCT02993172。Health2006 试验在 www.clinicaltrials.gov 上注册为 NCT00316667。ORG 研究在试验注册之前进行。NUGENOB 试验在 www.isrctn.com 上注册为 ISRCTN25867281。DiOGenes 试验在 www.clinicaltrials.gov 上注册为 NCT00390637。
