(04-11-11) Effects of a 2-y dietary weight-loss intervention on cholesterol metabolism in moderately obese men

1. Alexander B Leichtle,
2. Christin Helmschrodt,
3. Uta Ceglarek,
4. Iris Shai,
5. Yaakov Henkin,
6. Dan Schwarzfuchs,
7. Rachel Golan,
8. Yftach Gepner,
9. Meir J Stampfer,
10. Matthias Bl?her,
11. Michael Stumvoll,
12. Joachim Thiery, and
13. Georg M Fiedler
+ Author Affiliations
1. 1From the University Institute of Clinical Chemistry, Inselspital ? Bern University Hospital, Bern, Switzerland (ABL and GMF); the Institute of Laboratory Medicine, Clinical Chemistry, and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany (CH, UC, and JT); The S. Daniel Abraham Center for Health and Nutrition, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (IS, RG, and YG); the Department of Cardiology, Soroka University Medical Center, Beer-Sheva, Israel (YH); the Nuclear Research Center Negev, Dimona, Israel (DS); the Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, and Departments of Epidemiology and Nutrition, Harvard School of Public Health, Boston, MA (MJS); and the Department of Endocrinology, University of Leipzig, Leipzig, Germany (MB and MS).
+ Author Notes
↵2 ABL and CH contributed equally to this work.
↵3 Supported by grants from The Israeli Ministry of Health, Chief Scientist Office (project no. 300000-4850) and The Dr. Robert C. and Veronica Atkins Research Foundation.
↵4 Address reprint requests and correspondence to AB Leichtle, Center of Laboratory Medicine, University Institute of Clinical Chemistry, Inselspital ? Bern University Hospital, Inselspital INO-F 502, CH-3010 Bern, Switzerland. E-mail: [email protected].
Abstract
Background: Long-term dietary weight loss results in complex metabolic changes. However, its effect on cholesterol metabolism in obese subjects is still unclear.
Objective: We assessed the effects of 2 y of weight loss achieved with various diet regimens on phytosterols (markers of intestinal cholesterol absorption), lanosterol (marker of de novo cholesterol synthesis), and changes in apolipoprotein concentrations.
Design: We conducted the 2-y Dietary Intervention Randomized Controlled Trial (DIRECT?a study of low-fat, Mediterranean, and low-carbohydrate diets). We assessed circulating phytosterol and lanosterol concentrations and their ratios to cholesterol and apolipoproteins A-I and B-100 in 90 DIRECT participants at 0, 6, and 24 mo.
Results: We observed a significant upregulation of the markers of cholesterol absorption (campesterol: +16.8%, P < 0.001) and a downregulation of the markers of cholesterol synthesis (lanosterol: −16.5%, P = 0.008) during the active weight-loss phase (first 6 mo, weight loss of 5%, 6%, and 10% in the 3 diet groups, respectively), followed by a rebound (campesterol: −6.2%, P = 0.045; lanosterol: +43.7%, P < 0.001) during the next 18 mo (weight gain of 1%, 1%, and 2% in the 3 diet groups, respectively). HDL cholesterol continuously increased during the study (17.0%, P < 0.001), whereas LDL cholesterol remained constant. At the end of the 24-mo follow-up period, campesterol (P < 0.001) and lanosterol (P = 0.016) amounts were significantly higher than baseline values. The concentration of apolipoprotein B-100 correlated with cholesterol metabolism (ρ = 0.299 and P = 0.020 for lanosterol; ρ = −0.105 and NS for campesterol), and the homeostasis model assessment of insulin resistance correlated with lanosterol (ρ = 0.09, P = 0.001).
Conclusions: Long-term weight loss is related to a characteristic response suggestive of altered cholesterol and apolipoprotein metabolism. Various diets have a similar effect on these effects.

Fonte: ? 2011 American Society for Nutrition

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