Weight Loss Reduces Liver Fat and Improves Hepatic and Skeletal Muscle Insulin Sensitivity in Obese Adolescents

Abstract

Obesity in adolescents is associated with metabolic risk factors for type 2 diabetes, particularly insulin resistance and excessive accumulation of intrahepatic triglyceride (IHTG). The purpose of this study was to evaluate the effect of moderate weight loss on IHTG content and insulin sensitivity in obese adolescents who had normal oral glucose tolerance. Insulin sensitivity, assessed by using the hyperinsulinemic–euglycemic clamp technique in conjunction with stable isotopically labeled tracer infusion, and IHTG content, assessed by using magnetic resonance spectroscopy, were evaluated in eight obese adolescents (BMI ≥95th percentile for age and sex; age 15.3 ± 0.6 years) before and after moderate diet‐induced weight loss (8.2 ± 2.0% of initial body weight). Weight loss caused a 61.6 ± 8.5% decrease in IHTG content (P = 0.01), and improved both hepatic (56 ± 18% increase in hepatic insulin sensitivity index, P = 0.01) and skeletal muscle (97 ± 45% increase in insulin‐mediated glucose disposal, P = 0.01) insulin sensitivity. Moderate diet‐induced weight loss decreases IHTG content and improves insulin sensitivity in the liver and skeletal muscle in obese adolescents who have normal glucose tolerance. These results support the benefits of weight loss therapy in obese adolescents who do not have evidence of obesity‐related metabolic complications during a standard medical evaluation.

Type 2 diabetes: remission in just a week

“…insulin sensitivity of lipolysis) is enhanced [9]. Plasma NEFA levels also increased during the first week and then decreased in the study of Lim et al The latter is consistent with previous weight loss studies of longer duration, in which NEFA levels remained unchanged or decreased [10,11]. Regardless of the diet used to induce weight loss, liver fat content decreases and the ability of insulin to suppress hepatic glucose production increases.…”

Síndrome metabólica: comparação de critérios diagnósticos

“…30 observed reduction in intrahepatic triglycerides in magnetic resonance, as well as improvement in insulin sensitivity in obese adolescents after a weight management program. In the present study, hepatic steatosis was detected by ultrasound, which can be easily performed;…”

Metabolic syndrome: comparison of diagnosis criteria

“…No estudo de Schwimmer et al 29 , as crianças e os adolescentes que apresentavam DGFNA tinham valores absolutos mais altos para marcadores de risco cardiovascular, além de maior frequência da SM. Vitola et al 30 verificaram diminuição de TG intra-hepáticos, pela ressonância magnética, assim como melhora da sensibilidade à insulina em adolescentes obesos após programa de perda de peso. No presente estudo, a esteatose hepática foi detectada pela ultrassonografia, que é um método de fácil realização, mas, segundo Saadeh et al 31 , ele detecta alterações quando já ocorreu comprometimento do parênquima hepático maior do que 33%, revelado pela biópsia.…”