SUSTAINED IMPROVEMENT IN BLOOD-LIPIDS, COAGULATION, AND FIBRINOLYSIS AFTER MAJOR WEIGHT-LOSS IN OBESE SUBJECTS

Objective: To study whether major weight loss causes sustained improve ment in blood lipids and haemostatic profile in obese subjects, and to compare the influence of two different slimming and maintenance regim ens. Design: Two-stranded randomized intervention study. Setting: Univ ersity Department. Subjects: Thirty-six out of 43 obese patients recru ited from out-patient waiting list completed the study. Interventions: Weight loss was achieved by very low energy formula diet (2 MJ/d for 8 weeks, n = 18), or low-energy conventional diet (5 MJ/d for 17 weeks , n = 18), both combined with anorectic compound. Participants were re -randomized to consume low fat diet ad libitum (n = 16), or energy-res tricted diet (n = 20) for weight maintenance during 24 weeks. Main out come measures: Plasma lipids, fibrinogen, factor VII coagulant activit y (FVIIc), and plasminogen activator inhibitor type 1 (PAI-1) antigen. Results: Weight loss averaged 13.6 kg (95% CI: 12.3-14.9 kg). After 2 4 weeks' weight maintenance, plasma total cholesterol was 9% lower, hi gh density lipoprotein cholesterol 5% higher, triglycerides 30% lower, FVIIc 12% lower, fibrinogen 6% lower, and PAI-1 antigen 34% lower tha n at baseline tall changes highly significant). There were no signific ant differences between slimming or maintenance regimens. Conclusions: Major weight loss is associated with sustained and marked improvement s in blood lipids and hemostatic profile, irrespective of the tested s limming and maintenance regimens. Sponsorship: 2 Nycomed DAK A/S, Rosk ilde, Demark, and the Danish Medical Research Council.