BENEFICIAL EFFECT ON AVERAGE LIPID-LEVELS FROM ENERGY RESTRICTION ANDFAT LOSS IN OBESE INDIVIDUALS WITH OR WITHOUT TYPE-2 DIABETES

OBJECTIVE - The risk of cardiovascular disease in type 2 diabetes is g reater than is accounted for by conventional risk factors. We investig ated whether energy restriction or modest fat loss improved the lipid profile in obese subjects with and without type 2 diabetes. The relati onship of site of adipose tissue loss to lipid changes was also examin ed. RESEARCH DESIGN AND METHODS - Lipid levels were measured in 18 sub jects with normal glucose tolerance (NGT) (n = 9, BMI = 31.5 +/- 0.8 [ SEM] kg/m(2)) or type 2 diabetes (n = 9, BMI = 31.8 +/- 0.7) before an d on the 4th (d4) and 28th (d28) days of a hypocaloric formula diet. B ody composition was assessed with dual energy X-ray absorptiometry on d0 and d28. RESULTS - Mean daily energy intake during the diet was 1,1 00 +/- 60 kcal (33% protein, 38% carbohydrate, and 29% fat). Mean weig ht loss was 6.2 +/- 0.4 kg. Initial lipid profiles were similar in sub jects with or without diabetes, and diabetes did not affect the respon ses. Dietary intervention resulted in early (d4) and late (d28) change s. Energy restriction (d4) reduced VLDL cholesterol and total triglyce ride (TG) concentrations and increased LDL particle size. With fat los s (d28), there were falls in total LDL cholesterol (free and esterifie d components), LDL TG, and LDL apolipoprotein B (apoB) concentrations. Reduction in central abdominal fat (but not other body fat) was corre lated with a less atherogenic lipid profile: Delta abdominal fat versu s Delta LDI free cholesterol, r = 0.65, P = 0.006 and versus Delta apo B, r = 0.64, P = 0.008. CONCLUSIONS - Even in obese subjects with an a verage lipid profile, modest weight loss reduces atherogenicity, indep endently of type 2 diabetes, and abdominal fat loss is specifically re lated to such improvements.