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Thu, Nov-13-03, 19:12
http://www.medscape.com/viewarticle/464329
Blood Test May Predict Rebound Weight Gain
Charlene Laino
Nov. 12, 2003 (Orlando) - Plasma levels of norepinephrine,
insulin, and leptin can help to predict which patients
will rebound after a successful weight loss program, a new
study suggests.
Patients with hypertension also appear to be at risk of
rebound weight gain, said Kazuko Masuo, MD, PhD, from the
Department of Geriatrics at Osaka University Graduate School
of Medicine in Suita City, Japan. She reported the results
here Sunday at the American Heart Association (AHA)
Scientific Sessions.
"The idea that a simple blood test can identify those that
will yo-yo - before they even start their diet - is a new
concept," said Robert H. Eckel, MD, chair of the AHA's
Nutrition, Physical Activity and Metabolism Council and
professor of medicine at the University of Colorado Health
Sciences Center in Denver. "Identification of these people
will help us to help them long-term."
About two thirds of American adults are overweight or obese,
according to the most recent government statistics. But it's
not for lack of trying: Experts estimate that up to two thirds
of women and half of men are on a diet at any given time.
"Part of the problem is that so many of these people are
repeat dieters," said Dr. Eckel, who moderated a discussion of
the new findings. Studies suggest that as many as two in three
dieters are back on the merry-go-round within a year, he said.
It is important to note, Dr. Masuo said, that the rebound rate
is high even if dieters adhere to their weight loss regimens.
In the study, the researchers followed 52 obese young men with
normal blood pressure and 61 obese men with hypertension who
were on a low-calorie diet. As part of their weight loss
regimen, all the participants exercised for an hour each day.
At baseline, mean body mass index (BMI) of patients was 27.9
kg/m2 in the obese normotensive group and 28.1 kg/m2 in the
obese hypertensive group. Blood pressure was an average of
131/83 mm Hg in the obese normotensive group and 171/106 mm Hg
in the obese hypertensive group.
At six months, about two thirds of the men in both groups had
successfully lost at least 10% of their body weight.
But by two years later, only 51% of the successful dieters
with high blood pressure had kept the weight off compared with
70% of those with normal blood pressure, Dr. Masuo reported.
When both groups of patients were analyzed together, those who
rebounded tended to have higher blood pressure at baseline:
146/99 mm Hg compared with
136/89 mm Hg for those who did not rebound (P < .05),
the study showed. Rebound was defined as more than a
10% increase in BMI at 24 months compared with BMI
at six months.
Baseline plasma norepinephrine levels were 302 pg/mL in the
patients who rebounded compared with 240 pg/mL in those who
did not (P < .05), the study showed.
Those who rebounded - regardless of blood pressure - also
tended to have higher levels of plasma insulin at the
beginning of the study: 10.8 ľU/mL
vs. 7.1 ľU/mL for the successful long-term dieters (P < .05).
Also, baseline plasma leptin levels were 19.5 ng/mL in the
group that rebounded compared with 28.2 ng/mL in those who did
not (P < .01), Dr. Masuo said.
The results suggest that sympathetic overactivity and insulin
resistance contribute to rebound after weight loss, she said.
"If we could find how to improve the sympathetic nervous
sensitivity of [receptors that mediate thermogenesis and
weight loss during sympathetic activity], this would be
beneficial in obesity and obesity-related hypertension," Dr.
Masuo said.
AHA 2003 Scientific Sessions: Abstract 3049. Presented
Nov. 9, 2003.
Reviewed by Gary D. Vogin, MD
Blood Test May Predict Rebound Weight Gain
Charlene Laino
Nov. 12, 2003 (Orlando) - Plasma levels of norepinephrine,
insulin, and leptin can help to predict which patients
will rebound after a successful weight loss program, a new
study suggests.
Patients with hypertension also appear to be at risk of
rebound weight gain, said Kazuko Masuo, MD, PhD, from the
Department of Geriatrics at Osaka University Graduate School
of Medicine in Suita City, Japan. She reported the results
here Sunday at the American Heart Association (AHA)
Scientific Sessions.
"The idea that a simple blood test can identify those that
will yo-yo - before they even start their diet - is a new
concept," said Robert H. Eckel, MD, chair of the AHA's
Nutrition, Physical Activity and Metabolism Council and
professor of medicine at the University of Colorado Health
Sciences Center in Denver. "Identification of these people
will help us to help them long-term."
About two thirds of American adults are overweight or obese,
according to the most recent government statistics. But it's
not for lack of trying: Experts estimate that up to two thirds
of women and half of men are on a diet at any given time.
"Part of the problem is that so many of these people are
repeat dieters," said Dr. Eckel, who moderated a discussion of
the new findings. Studies suggest that as many as two in three
dieters are back on the merry-go-round within a year, he said.
It is important to note, Dr. Masuo said, that the rebound rate
is high even if dieters adhere to their weight loss regimens.
In the study, the researchers followed 52 obese young men with
normal blood pressure and 61 obese men with hypertension who
were on a low-calorie diet. As part of their weight loss
regimen, all the participants exercised for an hour each day.
At baseline, mean body mass index (BMI) of patients was 27.9
kg/m2 in the obese normotensive group and 28.1 kg/m2 in the
obese hypertensive group. Blood pressure was an average of
131/83 mm Hg in the obese normotensive group and 171/106 mm Hg
in the obese hypertensive group.
At six months, about two thirds of the men in both groups had
successfully lost at least 10% of their body weight.
But by two years later, only 51% of the successful dieters
with high blood pressure had kept the weight off compared with
70% of those with normal blood pressure, Dr. Masuo reported.
When both groups of patients were analyzed together, those who
rebounded tended to have higher blood pressure at baseline:
146/99 mm Hg compared with
136/89 mm Hg for those who did not rebound (P < .05),
the study showed. Rebound was defined as more than a
10% increase in BMI at 24 months compared with BMI
at six months.
Baseline plasma norepinephrine levels were 302 pg/mL in the
patients who rebounded compared with 240 pg/mL in those who
did not (P < .05), the study showed.
Those who rebounded - regardless of blood pressure - also
tended to have higher levels of plasma insulin at the
beginning of the study: 10.8 ľU/mL
vs. 7.1 ľU/mL for the successful long-term dieters (P < .05).
Also, baseline plasma leptin levels were 19.5 ng/mL in the
group that rebounded compared with 28.2 ng/mL in those who did
not (P < .01), Dr. Masuo said.
The results suggest that sympathetic overactivity and insulin
resistance contribute to rebound after weight loss, she said.
"If we could find how to improve the sympathetic nervous
sensitivity of [receptors that mediate thermogenesis and
weight loss during sympathetic activity], this would be
beneficial in obesity and obesity-related hypertension," Dr.
Masuo said.
AHA 2003 Scientific Sessions: Abstract 3049. Presented
Nov. 9, 2003.
Reviewed by Gary D. Vogin, MD