Obesity
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Randomized Controlled Trial
Association of type 2 diabetes susceptibility loci with one-year weight loss in the look AHEAD clinical trial.
The importance of lifestyle intervention for the prevention and treatment of type 2 diabetes (T2D) has been underscored by the limited benefit of pharmacologic therapies. We sought to determine whether genetic variants that contribute to T2D risk modify the response of weight and waist circumference to an intensive lifestyle intervention (ILI) in patients with obesity and T2D. Look AHEAD (Action for Health in Diabetes) is a randomized clinical trial comparing an ILI with a control condition on the risk of cardiovascular disease in overweight adults with T2D. ⋯ Nominally significant genotype-by-intervention interactions were detected for 1-year change in waist circumference with JAZF1, MTNR1B, and IRS1, and BMI with JAZF1. Highest GRS was associated with a greater reduction in waist circumference at year 1, although the variance in change attributable to the GRS was small. This study shows that the genetic burden associated with T2D risk does not undermine the effect of lifestyle intervention and suggests the existence of additional genomic regions, distinct from the T2D-susceptibility loci, which may enhance or mitigate weight loss.
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The rising prevalence of generalized obesity is well documented, but less is known about trends in abdominal obesity. Levels of abdominal obesity and overweight are reported for adults in the Health Survey for England (HSE) by survey year and age for 1993-2008. HSE is a nationally representative cross-sectional population survey using an interviewer-administered questionnaire and measurement of waist circumference (WC) by nurse, allowing calculation of abdominal overweight and obesity (≥94 cm and ≥102 cm in men, and ≥80 cm and ≥88 cm in women). ⋯ Between 1993 and 2008 abdominal overweight rose from 44.9% to 62.3% in men, and from 46.6% to 66.8% in women, while abdominal obesity rose from 19.2% to 35.7% in men, and from 23.8% to 43.9% women. However, the rates of increase over time in England appear to be slowing down: curves with a less than linear increase each year were a better fit to the data than a linear trend. There was some variation across the age range in the time trend in abdominal obesity and overweight, in that the absolute increases over time were slightly less for younger adults.