Effects of visceral adipose tissue reduction on CVD risk factors independent of weight loss: The Look AHEAD study

ABSTRACT

Objectives: To determine if the reduction of visceral adipose tissue (VAT) volume by lifestyle intervention improved risk factors for cardiovascular disease (CVD) independent of weight loss amount. Design: Ancillary study of randomized-controlled trial. Setting: Data analysis using multivariable regression models. Participants: Participants of the Look AHEAD (Action for HEAlth in Diabetes) Fatty Liver Ancillary Study. Main outcome measures: Correlations between changes in VAT and in CVD risk factors, while adjusting for weight loss and treatment (intensive lifestyle intervention [ILI] vs. diabetes support and education [DSE]). Results: Of 100 participants analyzed, 52% were women, and 36% were black, with a mean age of 61.1 years. In the DSE group, mean weight and VAT changed by 0.1 % (p=0.90) and 4.3% (p=0.39), respectively. In the ILI group, mean weight and VAT decreased by 8.0% (p<0.001) and 7.7% (p=0.01), respectively. Across both groups, mean weight decreased by 3.6% (p<0.001), and mean VAT decreased by 1.2% (p=0.22); the decrease in VAT was correlated with the increase in HDL-cholesterol (HDL-C; R=−0.37; p=0.03). There were no correlations between changes in VAT and blood pressure, triglycerides, LDL-C, glucose, or HbA1c. After adjusting for age, race, gender, baseline metabolic values, fitness, and treatment group, changes in HDL-C were not associated with changes in VAT, while weight changes were independently associated with decrease in glucose, HbA1c, and increase in HDL-C. Conclusions: VAT reduction was not correlated with improvements of CVD risk factors in a sample of overweight and obese adults with type 2 diabetes after adjusting for weight loss.

KEYWORDS:

• Cardiovascular disease
• visceral adipose tissue
• VAT
• weight loss

Acknowledgments

Anawin Sanguankeo analyzed and interpreted data, performed statistical analysis, wrote the manuscript, and reviewed/edited the manuscript. Mariana Lazo and Sikarin Upala analyzed and interpreted data and reviewed/edited the manuscript. Frederick L. Brancati, Susanne Bonekamp, Henry J. Pownall, and Ashok Balasubramanyam reviewed/edited the manuscript. Jeanne M. Clark provided the study concept and design, interpreted data, and reviewed/edited the manuscript.

Funding

The study was supported by the National Institutes of Health and the National Institute of Diabetes and Digestive and Kidney Diseases (grants R01-DK-060427 and U01-DK-57149, respectively), The Johns Hopkins University School of Medicine General Clinical Research Center (grant M01-RR-00052), and the Department of Veterans Affairs.

Declaration of interest

The authors declare that there are not conflict of interest. All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.

Additional information

Funding

The study was supported by the National Institutes of Health and the National Institute of Diabetes and Digestive and Kidney Diseases (grants R01-DK-060427 and U01-DK-57149, respectively), The Johns Hopkins University School of Medicine General Clinical Research Center (grant M01-RR-00052), and the Department of Veterans Affairs.