Relationship Between Changes in Fat and Lean Depots Following Weight Loss and Changes in Cardiovascular Disease Risk Markers

Abstract

BackgroundGluteofemoral fat mass has been associated with improved cardiovascular disease risk factors. It is not clear if loss of this protective fat during weight loss partially negates the effect of loss of visceral fat. The aim of this study was to examine regional fat loss in a large weight‐loss cohort from one center and to determine if fat loss in the leg and total lean tissue loss is harmful.Methods and ResultsWe combined the data from 7 of our previously published 3‐month weight‐loss studies and examined the relationship between regional fat and lean tissue loss and changes in cardiovascular disease risk factors in 399 participants. At baseline, leg fat was positively associated with high‐density lipoprotein cholesterol in women and inversely with fasting triglyceride level in both sexes. Abdominal lean tissue was also related to systolic blood pressure in men. Changes in regional fat and lean tissue were positively associated with changes in glucose, insulin, total cholesterol, triglycerides, low‐density lipoprotein cholesterol and systolic and diastolic blood pressure (r=0.11–0.22, P<0.05) with leg fat and arm lean tissue dominating in multivariate regression. After adjustment for total weight or total fat change, these relationships disappeared except for a positive relationship between arm and lean leg mass loss and changes in triglycerides and systolic blood pressure.ConclusionsLoss of leg fat and leg lean tissue was directly associated with beneficial changes in cardiovascular disease risk markers. Loss of lean tissue may not have an adverse effect on cardiovascular disease risk, and measures to retain lean tissue during weight loss may not be necessary.

Comparative Efficacy and Safety of Glucagon-like Peptide-1 Receptor Agonists in Children and Adolescents with Obesity or Overweight: A Systematic Review and Network Meta-Analysis

“…In this study, we did not observe a significant effect of GLP-1 RAs on reducing SBP and DBP among children and adolescents with obesity or overweight. An excess of fat tissue regardless of age and sex has been associated with increased blood pressure [40]; therefore, reductions in fat tissue may result in improvements in blood pressure and lipid profiles [41]. In this NMA, the effect of exenatide on total fat tissue reduction and blood pressure reduction was not significant [28,29].…”

Impact of baseline adipose tissue characteristics on change in adipose tissue volume during a low calorie diet in people with obesity—results from the LION study

“…Thus, comparisons to studies using waist and hip circumferences are difficult. Previous weight-loss studies found larger changes in abdominal AT than in lower body AT (hip, leg, or gluteofemoral) [23,[54][55][56]. A study including an overfeeding/underfeeding protocol found that the upper body AT returned to pre-weight-gain levels more rapidly than lower body AT during underfeeding [57].…”

Visceral fat reduction is positively associated with blood pressure reduction in overweight or obese males but not females: an observational study

“…Another study mentions that both volume and quality of visceral and subcutaneous fat to metabolic risk including hypertension [34]. Other findings may not show the association of visceral fat and hypertension like in a 3-month weight-loss intervention study showed significant reduction in lean leg mass, instead of visceral fat, was positively associated with systolic blood pressure [35]. Another study concluded that waist circumference had an advantage over visceral fat thickness as an obesity index to identify components of metabolic syndrome that included hypertension [36].…”