Cardiometabolic Gains Unrelated to Weight Loss-Adjusted Body Fat or Distribution Changes in Adults With and Without Diabetes.

Body weight decreased substantially in both intervention studies, with fat mass accounting for the majority of weight lost.

• Body weight decreased by 9.8% in Study I (1-year lifestyle intervention in adults with obesity and type 2 diabetes) and 5.3% in Study II (12-week hypocaloric diet in adults with overweight/obesity without diabetes).
• Fat mass accounted for 64% (95% CI: 0.51%-0.77%) of weight lost in Study I.
• Fat mass accounted for 77% (95% CI: 0.68%-0.86%) of weight lost in Study II.
• Body composition was assessed by DXA and fat distribution by either abdominal computed tomography (Study I) or DXA-derived trunk to total fat ratio (Study II).

Insulin sensitivity improved substantially following weight loss interventions in both studies.

• Clamp-derived insulin sensitivity increased by 50% in Study I.
• HOMA-IR decreased by 26% in both studies.
• Insulin sensitivity was assessed by glucose clamp in Study I and HOMA-IR in both studies.

No cardiometabolic changes were associated with weight loss-adjusted changes in body fat percentage or fat distribution.

• Changes in body composition and fat distribution were adjusted for baseline values and weight loss using regression analysis.
• This finding held across both Study I (adults with type 2 diabetes) and Study II (adults without diabetes).
• Additional cardiometabolic markers examined included glucose, lipids, and blood pressure.
• Fat distribution was assessed by abdominal computed tomography in Study I and DXA-derived trunk to total fat ratio in Study II.

The study design involved two distinct populations and intervention durations to assess the relationship between body composition changes and cardiometabolic improvements.

• Study I involved adults with obesity and type 2 diabetes undergoing a 1-year lifestyle intervention.
• Study II involved adults with overweight/obesity without diabetes undergoing a 12-week hypocaloric diet intervention.
• The primary analytical approach adjusted changes in body composition and fat distribution for both baseline values and weight loss magnitude using regression analysis.