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Effect of Weight Loss with Reduction of Intra-Abdominal Fat on Lipid Metabolism in Older Men¹

Division of Metabolism, Endocrinology, and Nutrition, Department of Medicine, University of Washington (J.Q.P., S.E.K., D.N.N., J.D.B.); Department of Gerontology and Geriatric Medicine, University of Washington (R.S.S.); and Northwest Lipid Research Laboratories, University of Washington (J.J.A.), Seattle, Washington 98195

Address all correspondence and requests for reprints to: Jonathan Q. Purnell, M.D., Division of Metabolism, Endocrinology, and Nutrition, University of Washington, Box 359757, Seattle, Washington 98104. E-mail: purnell{at}u.washington.edu

How weight loss improves lipid levels is poorly understood. Cross-sectional studies have suggested that accumulation of fat in intraabdominal stores (IAF) may lead to abnormal lipid levels, increased hepatic lipase (HL) activity, and smaller low density lipoprotein (LDL) particle size. To determine what effect loss of IAF would have on lipid parameters, 21 healthy older men underwent diet-induced weight loss. During a period of weight stability before and after weight loss, subjects underwent studies of body composition, lipids, measurement of postheparin lipoprotein and HL lipase activities, cholesteryl ester transfer protein activity, and insulin sensitivity (Si). After an average weight loss of 10%, reductions in fat mass, IAF, and abdominal sc fat were seen, accompanied by reductions in levels of triglyceride, very low density lipoprotein cholesterol, apolipoprotein B, and HL activity. High density lipoprotein-2 cholesterol and Si increased. In those subjects with pattern B LDL at baseline, LDL particle size increased. Cholesteryl ester transfer protein activity did not change. Changes in IAF and Si correlated with a decrease in HL activity (although not independently of each other). In summary, in men undergoing diet-induced weight loss, only loss of IAF was found to be associated with a reduction in HL, which is associated with beneficial effects on lipid levels.

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