Association between Blood Pressure and Insulin Resistance in Obese Females during Weight Loss and Weight Rebound Phenomenon.

Abstract

The purpose of this study was to investigate the effect of weight loss on blood pressure and its related variables in moderately obese Japanese females, including an investigation of the rebound phenomenon. Study I examined the effects of weight loss on blood pressure in 138 moderately obese, nondiabetic females (BMI 29.3+/-0.3 kg/M2; age, 46.3+/-0.8 years) during a 3-month therapeutic dietary and exercise program. Study II investigated the effect of weight rebound on blood pressure over an additional 21 months of exercise in 48 subjects from Study I subjects. After 3 months, the BMI significantly decreased to 27.9+/-0.3 kg/m2. Abdominal total fat, visceral fat (V), and subcutaneous fat (S) also decreased significantly. In addition, the summation of insulin (sigmaIRI), plasma glucose (sigmaPG) and HOMA during 75 g oral glucose tolerance test also all significantly decreased. Significant decreases in both the SBP and DBP were observed after the 3 month weight reduction program. Multiple regression analysis revealed that the reduction in SBP was significantly and positively associated with the reduction in log sigmaIRI and the reduction in log 24h-urinary norepinephrine excretion at the end of Study I. The DBP showed a significantly positive association with the log sigmaIRI. With regard to the weight rebound phenomenon, Study II showed that the SBP, DBP and sigmaIRI all increased significantly, and a positive correlation was observed between the changes in the SBP and those in the log sigmaIRI. However, no such correlation was observed regarding the abdominal total fat and visceral fat during both periods. These results suggest that weight loss therefore caused the BP to decrease due to both an improvement in hyperinsulinemia and a decrease in the adrenergic activity which may be involved in the urinary catecholamine. As a result, hyperinsulinemia is thus considered to play an important role in the pathogenesis of blood pressure due to obesity not only during weight loss, but also during the weight rebound phenomenon.

Impact of Multiple Risk Factor Clustering on the Elevation of Blood Pressure.

“…In a study by Eriksson et al, the complications of impaired glucose tolerance or diabetes mellitus, hyperinsulinemia, and hypertriglyceridemia were found in 6% of all hypertensives, or twice as frequently as in the normotensive population (12). Itoh et al reported that weight reduction during a 3-month therapeutic dietary and exercise program was significantly and positively associated with BP reduction and improvement of hyperinsulinemia (40). The present study also suggests that the complication of metabolic disturbances increases the risk for BP elevation.…”

Healthy strategies for successful weight loss and weight maintenance: a systematic review

“…Seven studies included female participants only Itoh et al 2001;Kuller et al 2006Kuller et al , 2007Kuller et al , 2012Matsuo et al 2010;Rock et al 2007;Teixeira et al 2010;West et al 2011;Wing et al 2010;Yankura et al 2008). Again, these studies found levels of weight loss and weight maintenance similar to those found in studies with both males and females (5%-10%), with the exception of 1 study ) that found ϳ12% lower weight after the weight-loss phase and ϳ9% lower weight from baseline at the end of the maintenance phase.…”

“…For 7 of these studies, the percentage of weight loss could not be calculated, but a significant absolute weight loss-weight maintenance was reported Itoh et al 2001;Jeffery et al 2009;Kuller et al 2006Kuller et al , 2007Kuller et al , 2012Leermakers et al 1999;Tanumihardjo et al 2009;Wolfson et al 2010;Yankura et al 2008;Yatsuya et al 2011) and thus, these studies were retained. The majority of retained studies (n = 20) reported that participant weight was measured by study staff.…”

“…The lengths of the interventions were found to be variable among studies: 15 weeks ), 18 weeks (McLaughlin et al 2008, 21 weeks (Christiansen et al 2007), 3 months Ditschuneit and Flechtner-Mors 2001;Ditschuneit et al 1999Ditschuneit et al , 2002Flechtner-Mors et al 2000;Foreyt et al 1993;Itoh et al 2001;Morgan et al 2009Morgan et al , 2011Tanumihardjo et al 2009), 4 months Layman et al 2009;Thorpe et al 2008), 6 months (Gold et al 2007;Jeffery et al 2009;Krukowski et al 2008;Kuller et al 2006Kuller et al , 2007Kuller et al , 2012Leermakers et al 1999;Matvienko and Hoehns 2009;Rock et al 2007;Rolls et al 2005;West et al 2011;Wing et al 2010;Wolfson et al 2010;Yankura et al 2008;Yatsuya et al 2011), and 12 months Burke et al 2008;Teixeira et al 2010). These time periods were considered to reflect the weight-loss phase, because the intervention either ended or was reduced considerably.…”

“…Increased fibre Itoh et al 2001;Kuller et al 2006Kuller et al , 2007Kuller et al , 2012Layman et al 2009;Thorpe et al 2008;Yankura et al 2008) was the next most commonly used strategy. The fibre recommendations among successful studies were varied and included 17 g·day −1 , 20 g·day −1 , 17 g·1000 kcal −1 ), and 5-10 g of soluble fibre·day −1 Yankura et al 2008), as well as a general recommendation that fibre be increased .…”