Predictors of Improvement in Cardiometabolic Risk Factors With Weight Loss in Women

BACKGROUND Weight loss is associated with improvements in cardiometabolic risk factors, including serum glucose, insulin, C-reactive protein, and blood lipids. Few studies have evaluated the long-term (>18 months) effect of weight loss on these risk factors or sought to identify factors associated with sustained improvements in these measures. METHODS AND RESULTS In 417 overweight/obese women (mean [SD] age, 44 [10] years) participating in a weight loss trial, we sought to identify predictors of weight loss-associated cardiometabolic risk factors after 12 and 24 months of intervention. Total cholesterol (TC), low-density lipoprotein (LDL)-cholesterol (LDL-C), high-density lipoprotein (HDL)-cholesterol, non-HDL-cholesterol, triglycerides (TG), insulin, glucose, C-reactive protein (CRP), and cardiopulmonary fitness were measured at baseline and at 12 and 24 months. After 24 months, significant reductions in body weight, waist circumference, CRP, TC, HDL-cholesterol, and non-HDL-cholesterol were observed (P<0.01). After 24 months, mean TC and non-HDL-cholesterol were reduced regardless of the amount of weight lost, whereas reductions in LDL-cholesterol, CRP, insulin, and TG were observed only in those who lost ≥10% body weight. Step-test performance improved only in those who lost ≥10% body weight after 24 months. Change in weight demonstrated a positive predictive value for change in cholesterol, insulin, glucose, and triglycerides. Baseline level of the biomarker showed the greatest predictive value for follow-up measures for insulin, cholesterol, glucose, and triglycerides. CONCLUSIONS Our data extend the results from short-term weight loss trials and suggest that the magnitude of weight loss and baseline values for risk factors are associated with improvements in cardiometabolic risk factors even after 24 months. CLINICAL TRIALS REGISTRATION INFORMATION URL http://www.clinicaltrials.gov/. Unique identifier: NCT00640900.