Two patterns of adipokine and other biomarker dynamics in a long-term weight loss intervention

Matthias Blüher*, Assaf Rudich, Nora Klöting, Rachel Golan, Yaakov Henkin, Eitan Rubin, Dan Schwarzfuchs, Yftach Gepner, Meir J. Stampfer, Martin Fiedler, Joachim Thiery, Michael Stumvoll, Iris Shai

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


OBJECTIVE - Long-term dietary intervention frequently induces a rapid weight decline followed by weight stabilization/regain. Here, we sought to identify adipokine biomarkers thatmay reflect continued beneficial effects of dieting despite partial weight regain. RESEARCH DESIGN AND METHODS - We analyzed the dynamics of fasting serum levels of 12 traditionalmetabolic biomarkers and novel adipokines among 322 participants in the 2-year Dietary Intervention Randomized Controlled Trial (DIRECT) of low-fat, Mediterranean, or low-carbohydrate diets for weight loss. RESULTS - We identified two distinct patterns: Pattern A includes biomarkers (insulin, triglycerides, leptin, chemerin,monocyte chemoattractant protein 1, and retinol-binding protein 4) whose dynamics tightly correspond to changes in body weight, with the trend during the weight loss phase (months 0-6) going in the opposite direction to that in the weightmaintenance/regain phase (months 7-24) (P < 0.05 between phases, all biomarkers). Pattern B includes biomarkers (high molecular weight adiponectin, HDL cholesterol [HDL-C], high-sensitivity C-reactive protein [hsCRP], fetuin-A, progranulin, and vaspin) that displayed a continued, cumulative improvement (P < 0.05 compared with baseline, all biomarkers) throughout the intervention. These patterns were consistent across sex, diabetic groups, and diet groups, although the magnitude of change varied. Hierarchical analysis suggested similar clusters, revealing that the dynamic of leptin (pattern A) was most closely linked to weight change and that the dynamic of hsCRP best typified pattern B. CONCLUSIONS - hsCRP, HDL-C, adiponectin, fetuin-A, progranulin, and vaspin levels display a continued long-term improvement despite partial weight regain. This may likely reflect either a delayed effect of the initial weight loss or a continuous beneficial response to switching to healthier dietary patterns.

Original languageEnglish
Pages (from-to)342-349
Number of pages8
JournalDiabetes Care
Issue number2
StatePublished - Feb 2012
Externally publishedYes


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