The effect of weight-loss interventions on cervical and chin subcutaneous fat depots; the central randomized controlled trial

Gal Tsaban*, Avital Bilitzky-Kopit, Anat Yaskolka Meir, Hila Zelicha, Yftach Gepner, Ilan Shelef, Omri Orr, Yoash Chassidim, Benjamin Sarusi, Uta Ceglarek, Michael Stumvoll, Matthias Blüher, Meir J. Stampfer, Iris Shai, Dan Schwarzfuchs

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Accumulation of cervical and chin subcutaneous adipose tissues (SAT) represent known phenotypes of obesity. We aimed to evaluate the sensitivity of these fat storages to long-term weight-loss directed lifestyle-intervention and to assess their relations to bodily-adiposity, insulin-resistance, and cardiometabolic risk; We randomly assigned 278 participants with abdominal-obesity/dyslipidemia to low-fat or Mediterranean/low-carbohydrate diets +/− physical-activity. All participants underwent an 18 month whole-body magnetic resonance imaging follow-up, from which we assessed cervical and chin SAT-areas; Participants (age = 48 years; 90% men; body-mass-index = 30.9 kg/m2) had an 18-month adherence-rate of 86%. Cervical-SAT and chin-SAT decreased after 6-months (−13.1% and −5.3%, respectively, p < 0.001). After 18-months only cervical-SAT remained decreased compared to baseline (−5%, p < 0.001). Cervical and chin-SAT 18-month changes were associated with changes in weight (r = 0.70, r = 0.66 respectively; <0.001 for both) and visceral-adipose-tissue (VAT; r = 0.35, r = 0.42 respectively; <0.001 for both). After adjustment to VAT, waist-circumference, or weight-changes, chin-SAT 18-month reduction was associated with favorable changes in fasting-glucose (β = 0.10; p = 0.05), HbA1c (β = 0.12; p = 0.03), and homeostasis-model-assessment-of-insulin-resistance (β = 0.12; p = 0.03). Cervical-SAT 18-month reduction was associated with decreased triglycerides (β = 0.16; p = 0.02) and leptin (β = 0.19; p = 0.01) independent of VAT; Cervical and chin-SATs are dynamic fat depots that correspond with weight-loss and are associated with changes in cardiometabolic profile. In long-term, chin-SAT displays a larger rebound compared with cervicalSAT. Chin-SAT accumulation is associated with in insulin-resistance, independent of central obesity. (ClinicalTrials identifier NCT01530724).

Original languageEnglish
Article number3827
JournalNutrients
Volume13
Issue number11
DOIs
StatePublished - Nov 2021

Funding

FundersFunder number
Robert C. and Veronica Atkins Research Foundation
Deutsche ForschungsgemeinschaftSFB1052
Israel Science Foundation
Ministry of Science and Technology, Israel3-13604

    Keywords

    • Cervical subcutaneous fat
    • Chin subcutaneous fat
    • Dietary intervention
    • Insulin resistance
    • Magnetic resonance imaging
    • Weight loss

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