Unterschiedliche Effekte einer Gewichtsreduktion bei adipösen Patienten mit und ohne metabolische Störungen [thesis]

Julia Gawron, Universitätsbibliothek Der FU Berlin
2021
In view of the constantly growing prevalence of obesity, it seems sensible to implement individually adapted therapy strategies. In this study the effects of weight reduction in obese patients with and without metabolic disorders in the short and long term were compared. Different definitions of obesity-associated changes were to be examined with regard to their suitability for the discrimination of patients with and without metabolic improvement under weight reduction. Methods: In this paper
more » ... ds: In this paper data from the MAINTAIN study were evaluated in a secondary analysis. The study population was subdivided into metabolically healthy (MHO) and metabolically unhealthy (MUHO) participants based on the IDF criteria of metabolic syndrome, HOMA-IR and insulin sensitivity index (ISI) of the euglycemic hyperinsulinemic clamp. The percentage change of the investigated anthropometric and metabolic parameters was compared between MHO and MUHO in the short-term course of the 3-month weight reduction and 18 months after its completion. Intra- and inter-group comparisons were performed using T-tests and Mann-Whitney-U-tests. Results: In the short-term MUHO(IDF) showed a significantly stronger improvement in whole-body and muscular insulin sensitivity, fasting blood glucose and lipid profile compared to MHO(IDF) (p < 0.05). When classified according to the HOMA-IR or the ISIClamp, a significantly stronger improvement in whole-body and muscular insulin sensitivity was also observed in the respective MUHO group as well as in fasting blood glucose in the case of MUHO(HOMA-IR) compared to the respective MHO group (p < 0.05). In the long-term analysis MHO(IDF) and MUHO(IDF) only differed significantly in the improvement of fasting blood glucose after 18 months. MUHO(HOMA-IR) and MUHO(ISI) showed a significantly stronger improvement in whole-body insulin sensitivity (HOMA-IR) compared to the respective MHO group. Conclusion: Particularly in the short term we observed a significantly greater benefit from weight loss for parti [...]
doi:10.17169/refubium-28806 fatcat:i47scl4qjzftjfukgr5jt5erza