Effect of weight loss on adipokine levels in obese patients.
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Background: Adipose tissue functions as an endocrine organ by releasing adipokines which have important roles in the regulation of inflammation and insulin sensitivity. Although there is evidence of improvements in the circulating levels of adipokines with weight loss, few studies relate such changes to specific diets. We investigated the effect of weight loss achieved by two different diets on circulating adipokine levels in obese individuals. Methods: 120 obese patients (BMI ≥ 35 kg/m2) underwent a screening period of 3-months on a low fat, reduced-calorie diet. Patients failing to achieve a 5% weight loss using this approach were randomly allocated to either a low carbohydrate/high protein diet (LCHP) (n=17) or a commercial very-low-calorie diet (LighterLife – LL) (n=14) for a period of 9-months. Results: A significant weight loss (Kg) only maintained for LL at 9-months (-32.3 ± 22.7, p < 0.0001) but not LCHP. Changes in adiponectin (ng/ml) (15.8 ± 17.1 vs -0.8 ± 6.2, p = 0.003) and leptin (ng/ml) (-17.6 ± 24.3 vs -3.0 ± 9.2, p = 0.049) at 9-months were significantly greater for LL than for LCHP which may reflect greater weight loss and decrease in fat mass. Changes in TNF-α, IL-6 and PAI-1 did not differ significantly between the dietary interventions at 9-months. Conclusions: A significant weight loss of 23.8% of baseline weight was observed using a very-low-calorie diet and resulted in significant improvements in circulating levels of leptin, PAI-1 and adiponectin, which are likely to be due to the weight loss and not the macronutrient intake. (ISRCTN: ISRCTN09760867)