Effects of an interdisciplinary weight loss program on fibroblast growth factor 21 and inflammatory biomarkers in women with overweight and obesity

Dâmaso, Ana Raimunda; Machado, Paola Próspero; Rhein, Samantha Ottani; Masquio, Deborah Cristina Landi; Oyama, Lila Missae; Boldarine, Valter Tadeu; Oliveira, Gabriela Iervolino de; Tock, Lian; Thivel, David; Campos, Raquel Munhoz da Silveira

doi:10.20945/2359-3997000000419

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Original Article • Arch. Endocrinol. Metab. 65 (6) • Nov-Dec 2021 • https://doi.org/10.20945/2359-3997000000419 copy

Effects of an interdisciplinary weight loss program on fibroblast growth factor 21 and inflammatory biomarkers in women with overweight and obesity

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To investigate the effects of an interdisciplinary intervention on biomarkers of inflammation and their relationship with fibroblast growth factor 21 (FGF21) concentrations in women with overweight and obesity.

Subjects and methods:

Thirty-one women were enrolled in a 12-week interdisciplinary weight loss program delivered by a team comprising an endocrinologist, nutritionist and exercise physiologist. Body composition; anthropometric measures; metabolic and inflammatory markers including adiponectin, leptin, and atrial natriuretic peptide (ANP) were assessed at baseline and post-therapy. The homeostasis model assessment of insulin resistance (HOMA-IR) and the homeostasis model assessment of adiponectin (HOMA-AD) were calculated. The participants were divided into two groups: those with increased FGF21, and those with decreased FGF21.

Results:

The sample comprised women aged 32 ± 5 years with a body mass index of 33.64 ± 3.49 kg/m². Body weight, waist circumference and leptin concentration were decreased in the whole sample after therapy. However, only the group with an increase in FGF21 concentration presented significant improvements in adiponectin concentration and adiponectin/leptin ratio. Moreover, although there was a reduction of leptin in both groups, it was greater in the increased FGF21 groups. There was a reduction in ANP in the decreased FGF21 group.

Conclusions:

Changes in FGF21 concentrations were different among the women participating in the weight loss program, with some having increased levels and some reduced levels. Furthermore, improvements in adiponectin and the adiponectin/leptin ratio were found only in the group with increased FGF21 concentration.

Keywords
Adiposity; inflammation; weight loss

	All sample (n = 31)		Increased FGF21 group (n = 16)		decreased FGF21 group (n=15)
	Baseline	After intervention	Baseline	After intervention	Baseline	After intervention
Body weight (kg)	89.73 ± 9.02	86.54 ± 9.04^a a Statistical difference between baseline and after intervention condition in the same group.	88.35 ± 8.84	85.67 ± 8.78^a a Statistical difference between baseline and after intervention condition in the same group.	91.20 ± 9.27	87.46 ± 9.53^a a Statistical difference between baseline and after intervention condition in the same group.
Body mass index (kg/m²)^* * Non-parametric data normalized by Z-score.	33.64 ± 3.49	32.44 ± 3.48	32.61 ± 3.97	31.62 ± 3.88	34.74 ± 2.60	33.31 ± 2.87
Neck circumference (cm)	35.94 ± 1.53	35.07 ± 1.39^a a Statistical difference between baseline and after intervention condition in the same group.	35.78 ± 1.49	34.84 ± 1.28^a a Statistical difference between baseline and after intervention condition in the same group.	36.11 ± 1.60	35.33 ± 1.52^a a Statistical difference between baseline and after intervention condition in the same group.
Waist circumference (cm)	93.91 ± 7.14	90.10 ± 6.12^a a Statistical difference between baseline and after intervention condition in the same group.	91.78 ± 6.53	88.39 ± 6.19^a a Statistical difference between baseline and after intervention condition in the same group.	96.19 ± 7.26	92.08 ± 5.62^a a Statistical difference between baseline and after intervention condition in the same group.
Abdominal circumference (cm)	106.93 ± 8.14	103.19 ± 7.51^a a Statistical difference between baseline and after intervention condition in the same group.	105.79 ± 8.17	101.51 ± 7.13^a a Statistical difference between baseline and after intervention condition in the same group.	108.13 ± 8.21	105.14 ± 7.74^a a Statistical difference between baseline and after intervention condition in the same group.
Hip circumference (cm)	120.22 ± 8.03	117.34 ± 7.93^a a Statistical difference between baseline and after intervention condition in the same group.	119.22 ± 8.85	117.01 ± 8.50	121.29 ± 7.20	117.72 ± 7.54^a a Statistical difference between baseline and after intervention condition in the same group.
Body fat mass (%)^* * Non-parametric data normalized by Z-score.	37.44 ± 4.37	35.75 ± 4.52	36.74 ± 4.57	35.12 ± 4.75	38.17 ± 4.17	36.43 ± 4.32
Body lean mass (kg)^* * Non-parametric data normalized by Z-score.	56.48 ± 4.86	55.72 ± 4.55	56.73 ± 5.39	55.70 ± 5.07	56.22 ± 4.39	55.73 ± 4.16
Glucose (mg/dL)^* * Non-parametric data normalized by Z-score.	93.10 ± 10.61	93.52 ± 7.15	89.75 ± 6.94	92.25 ± 6.74	96.67 ± 12.77^b b Statistical difference between groups in baseline condition.	94.87 ± 7.56
Insulin (μU/mL)^* * Non-parametric data normalized by Z-score.	10.83 ± 4.61	10.28 ± 4.36	10.33 ± 4.12	10.45 ± 3.93	11.36 ± 5.18	10.11 ± 4.88
HOMA-IR	2.51 ± 1.23	2.38 ± 1.01	2.32 ± 1.09	2.39 ± 0.90	2.72 ± 1.37	2.37 ± 1.14
HOMA-AD	0.89 ± 0.85	0.53 ± 0.30	0.86 ± 0.80	0.50 ± 0.23	0.91 ± 0.93	0.55 ± 0.35
Adiponectin (pg/mL)	3.78 ± 1.54	5.04 ± 2.04^a a Statistical difference between baseline and after intervention condition in the same group.	3.44 ± 1.25	5.34 ± 2.38^a a Statistical difference between baseline and after intervention condition in the same group.	4.11 ± 1.76	4.74 ± 1.68
Leptin (ng/mL)	51.48 ± 18.20	37.00 ± 14.22^a a Statistical difference between baseline and after intervention condition in the same group.	56.46 ± 17.12	36.03 ± 13.75^a a Statistical difference between baseline and after intervention condition in the same group.	46.50 ± 18.45	37.97 ± 15.09^a a Statistical difference between baseline and after intervention condition in the same group.
Adiponectin/leptin	0.08 ± 0.04	0.15 ± 0.09^a a Statistical difference between baseline and after intervention condition in the same group.	0.06 ± 0.03	0.17 ± 0.011^a a Statistical difference between baseline and after intervention condition in the same group.	0.09 ± 0.05	0.14 ± 0.06
ANP (pg/mL)^* * Non-parametric data normalized by Z-score.	373.18 ± 290.21	349.80 ± 313.17^a a Statistical difference between baseline and after intervention condition in the same group.	353.34 ± 203.10	384.64 ± 363.58	391.59 ± 360.01	309.59 ± 251.34^a a Statistical difference between baseline and after intervention condition in the same group.
FGF21 (pg/mL)	74.32 ± 44.15	127.89 ± 151.55^a a Statistical difference between baseline and after intervention condition in the same group.	68.68 ± 50.11	197.86 ± 185.71^a a Statistical difference between baseline and after intervention condition in the same group.	80.33 ± 37.58	53.26 ± 26.49^c c Statistical difference between groups in after intervention condition.

	All sample (n = 31)	Increased FGF21 (n = 16)	Decreased FGF21 (n = 15)
Body weight (kg)	-3.19 ± 2.99	-2.68 ± 2.61	-3.74 ± 3.35
Body mass index (kg/m²)	-1.20 ± 1.14	-0.99 ± 0.97	-1.43 ± 1.30
Neck circumference (cm)	-0.75 ± 0.81	-0.79 ± 0.67	-0.72 ± 0.98
Waist circumference (cm)	-3.51 ± 3.48	-3.07 ± 3.04	-4.02 ± 4.00
Abdominal circumference (cm)	-3.15 ± 3.78	-3.99 ± 3.16	-2.17 ± 4.32
Hip circumference (cm)	-2.93 ± 3.90	-2.03 ± 3.13	-3.97 ± 4.54
Body fat mass (%)	-1.68 ± 4.21	-1.63 ± 5.06	-1.74 ± 3.25
Body lean mass (kg)	-0.89 ± 3.96	-1.29 ± 5.13	-0.49 ± 2.43
Glucose (mg/dL)	0.42 ± 10.09	2.50 ± 8.74	-1.80 ± 11.23
Insulin (uIU/mL)	-0.52 ± 4.77	0.20 ± 3.30	-1.25 ± 5.92
HOMA-IR	-0.144 ± 1.24	0.06 ± 0.8	-0.35 ± 1.54
HOMA-AD	-0.35 ± 0.84	-0.36 ± 0.81	-0.35 ± 0.90
Adiponectin (pg/mL)	1.26 ± 2.11	1.90 ± 2.30	0.63 ± 1.74
Leptin (ng/mL)	-14.48 ± 13.75	-20.44 ± 14.65	-8.53 ± 10.05^d d Statistical difference between increased and decreased FGF21 groups. Comparisons between groups were performed by T-test for independent groups.
Adiponectin/leptin	0.07 ± 0.09	0.10 ± 0.11	0.04 ± 0.05^d d Statistical difference between increased and decreased FGF21 groups. Comparisons between groups were performed by T-test for independent groups.
ANP (pg/mL)	-18.40 ± 443.04	16.16 ± 436.48	-52.96 ± 464.57
FGF21 (pg/mL)	53.58 ± 140.09	129.19 ± 161.46	-27.08 ± 24.86^d d Statistical difference between increased and decreased FGF21 groups. Comparisons between groups were performed by T-test for independent groups.

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[1] Correspondence to: Ana Raimunda Dâmaso, Programa de Pós-graduação em Nutrição, Escola Paulista de Medicina, Universidade Federal de São Paulo, Rua Botucatu, 862, 2° andar – Departamento de Fisiologia – Vila Clementino 04020-060 – São Paulo, SP, Brasil. ana.damaso@unifesp.br