Changes in skeletal muscle and organ size after a weight-loss intervention in overweight and obese type 2 diabetic patients1

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Abstract

Background: The effect of a weight-loss intervention on the masses of lean tissues and organs in humans is not well known.

Objective: We studied the effects of a diet and exercise weight-loss intervention on skeletal muscle (SM) mass and selected organs over 2 y using MRI in overweight adults with type 2 diabetes.

Design: Participants were 53 women and 39 men [mean ± SD: age 58 ± 7 y; body mass index (BMI; in kg/m2) 32 ± 3] enrolled in the Look AHEAD (Action for Health in Diabetes) trial and randomly assigned to an intensive lifestyle intervention (ILI) or diabetes support and education (DSE) on whom 2 y of data were collected. MRI-derived measurements of SM, heart, liver, kidney, spleen, and pancreas were acquired.

Results: Adjusted for baseline weight, height, age, sex, and ethnicity, the ILI group weighed (mean ± SE) 6.6 ± 0.7 kg less after 1 y and 5.2 ± 0.7 kg less after 2 y, whereas the DSE group did not change significantly (−0.4 ± 0.6 and −1.0 ± 0.7 kg after 1 and 2 y, respectively; P-interaction < 0.001). Total SM decreased in both groups during year 1 (−1.4 ± 0.2 kg; P < 0.001) with appendicular SM regained during year 2. Liver and spleen masses decreased in the ILI group (−0.12 ± 0.02 and −0.006 ± 0.003 kg, respectively) but were unchanged in the DSE group (0.00 ± 0.02 and 0.004 ± 0.003 kg, respectively). Kidney mass decreased by 0.013 ± 0.003 kg (P < 0.001) over 2 y in both groups.

Conclusions: Decreases in liver (in Caucasians but not African Americans) and spleen were detected after a 6.2-kg weight reduction compared with a control group. SM and kidney mass decreased in both groups. Appendicular SM was regained during the second year whereas trunk SM was not. No evidence of a disproportionate loss of high–metabolic rate organs (heart, liver, kidney, spleen) compared with SM was found.

Keywords

type 2 diabetes
magnetic resonance imaging
body composition
skeletal muscle
organ mass
weight loss
Look AHEAD trial

ABBREVIATIONS

DSE
diabetes support and education
HMR
high metabolic rate
ILI
intensive lifestyle intervention
LBM
lean body mass
REE
resting energy expenditure
SM
skeletal muscle
T0
baseline
T12
1 y
T24
2 y

Cited by (0)

1

Supported in part by NIH grants RO1-HL-70298, P30-DK-26687, P30- DK-46204, RR24156, U01DK057178, and U01DK057002.

8

Present address: Diabetes and Endocrinology, Merck Research Laboratories, 900 East Scott Avenue, Rahway, NJ 07065.

9

Present address: Department of Radiology, Englewood Hospital, 350 Engle Street, Englewood, NJ 07631.