Associations of obesity phenotypes with weight change, cardiometabolic benefits, and type 2 diabetes incidence during a lifestyle intervention: results from the PREVIEW study
Authors' conclusion
Individuals with MUO had greater improvements in some cardiometabolic risk factors during the low-energy diet phase, but had smaller improvements during long-term lifestyle intervention than those with MHO.
Study context
- Population
- Participants with overweight/obesity in the PREVIEW randomised trial undergoing a lifestyle intervention
- Participants
- 1,012 vs 1,153
- Comparison
- Metabolically healthy overweight/obesity (MHO) vs metabolically unhealthy overweight/obesity (MUO)
- MHOn = 1,012
- MUOn = 1,153reference
- Primary endpoint
- Change in body weight (%)
- Follow-up
- 156 weeks
Methodological details8-week low-energy diet followed by 148-week lifestyle-based weight-maintenance intervention, adjusted linear mixed models, Cox proportional hazards regression
- 8-week low-energy diet followed by 148-week lifestyle-based weight-maintenance intervention
- Adjusted linear mixed models
- Cox proportional hazards regression
Primary result
As reported in the abstract
Weight loss (%) · end of study (156 weeks)
Further findings
| Outcome | Estimate | P value | |
|---|---|---|---|
| Triglyceride change · after low-energy diet phaseSmaller decreases with MHO | mean difference 0.08 mmol·L-1 (95% CI 0.04–0.12) | P < 0.001 | |
| Triglyceride change · end of weight maintenanceGreater reductions with MHO | mean difference −0.08 mmol·L-1 (CI −0.12--0.04) | P < 0.001 | |
| 2-hour glucose change · end of weight maintenanceGreater reductions with MHO | difference −0.28 mmol·L-1 (CI −0.41--0.16) | P < 0.001 | |
| −0.6−0.4−0.200.2Difference, mmol·L-1 (linear scale) |
| Outcome | aHR (CI) | P value | |
|---|---|---|---|
| T2D incidence · 3 years | 0.37 (0.20–0.66) | P < 0.001 | |
| 0.20.5125Adjusted hazard ratio (log scale) |
Triglyceride change · after low-energy diet phase
- Similar reductions in fasting glucose and HOMA-IR in MHO vs MUO
Triglyceride change · end of weight maintenance
- Greater reductions in fasting glucose and HOMA-IR with MHO vs MUO
Diastolic blood pressure, HbA1c and HDL-C · after weight loss and end of weight maintenance
- MHO had smaller decreases in diastolic blood pressure and HbA1c and greater decreases in HDL-C after weight loss vs MUO; significant differences disappeared at end of weight maintenance
Original publication
Associations of obesity phenotypes with weight change, cardiometabolic benefits, and type 2 diabetes incidence during a lifestyle intervention: results from the PREVIEW study. Int J Obes (Lond). Published 7 July 2023. doi:10.
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