SFEBES2015 Poster Presentations Obesity, diabetes, metabolism and cardiovascular (108 abstracts)
1Institute of Metabolism and Systems Research, University of Birmingham, and Centre for Endocrinology, Diabetes and Metabolism Birmingham Health Partners, Birmingham B15 2TT, UK; 2Oxford Centre for Diabetes, Endocrinology & Metabolism, University of Oxford, Churchill Hospital, Headington, Oxford OX3 7LJ, UK; 3Neurology Department, University Hospitals Birmingham NHS Trust, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK.
Introduction: Idiopathic intracranial hypertension (IIH) occurs in young obese women (>90%) but little is known about the metabolic characteristics in these patients. We aimed to characterise IIH fat distribution, metabolic phenotype and evaluate alterations following weight loss.
Methods: IIH and matched (BMI/sex) healthy obese controls were recruited. Metabolic indices (fasting lipid, glucose, insulin), anthropological measures and body composition were assessed (dual energy X-ray absorptiometry). IIH patients then underwent a therapeutic diet over 3 months followed by re-evaluation. The diet is a previously validated and nutritionally complete very low calorie total meal replacement liquid (Lipotrim, Howard Foundation, Cambridge, UK), providing 425 Kcal/day.
Results: IIH patients (n=29) had a similar centripetal fat distribution to simple obesity patients (n=47), which is contrary to previous reports of fat distribution measured by waist hip ratios. Lipid and glucose profiles were similar in IIH and normal obesity. Weight loss intervention resulted in a significant loss in body weight (−14.2±7.8%), BMI (−5.8±3.0 kg/m2), and waist circumference (−9.8±5.4 cm) (all P<0.001). Importantly, weight loss resulted in significant amelioration of clinical signs and symptoms of IIH, namely a decrease in intracranial pressure (−8.3±4.1 cm H2O; P<0.001). Following weight loss intervention there was a significant reduction in total fat mass (−9.10±4.7 kg; P<0.001). Interestingly, fat loss occurred predominantly from the truncal regions compared to the limbs (−4.7±37 vs −1.1±2.1; P<0.01).
Conclusions: Fat distribution in IIH patients is centripetal, akin to simple obesity. Clinical resolution of IIH is associated with preferential loss of truncal fat, potentially suggesting a pathogenic role for central adiposity in IIH.