Endocrine Abstracts

Introduction: Obesity is defined as a chronic disease by AACE/ACE. Includes presence/severity of complications. VLCD diets induce relevant weight loss by improving these complications. PA is a bioelectric measure of the cell mass and it is marker a global prognostic factor of cellular functionalism.

Methods: Case-control retrospective study of severe obesity in a weight loss program comparing intensive intervention (41 cases, VLCD 800 kcal/d, 1g protein/kg) vs conventional (22 controls, cardiac rehabilitation program with Mediterranean diet and exercise). Clinical variables (AACE), anthropometric (impedance measurement), analytical and pharmacological changes are measured.

Objective: To evaluate anthropometric changes, body composition and bioelectrical measures such as PA, resistance (Rz) and reactance (Xc), analytical changes and effects on obesity complications and therapeutic changes in both groups.

Results: Average age in cases 58.0 ± 13.5 years, (59% women) with a BMI of 46.3 ± 10.0 kg/m². 79.3% arterial hypertension, 93% carbohydrate alterations (82.7% T2DM, 10.3% Prediabetes), 82.8% dyslipidaemia, 44.5% steatosis, 10.3% polycystic ovary, 55.1% SAHS, 55.2% osteoarthritis, 27.5% gastroesophageal reflux, 34.5% urinary incontinence, 20.7% immobility, 86.2% psychological disorder. 55% used ≥3 antihypertensive drugs, 48% insulin, 59% statins and 18% fibrates. 6 months after intervention: We observed a weight loss of 16.9 ± 12.8 kg with a BMI reduction of 6.24 ± 4.69 kg/m² in cases compared to –2.7 ± 0.9 kg and –0.92 ± 0.3 kg/m² in controls. In cases, there was a decrease in Fat-Mass (FM) of – 14.7 ± 10.2 kg with a slight decrease in Fat-Free-mass (FFM) –2.3 ± 7.0 kg and a rise in Body-Cell-Mass (BCM) + 3.0 ± 6.4 kg. In VLCD group, there was a significant increment in PA + 1.18 ± 0.98 associated with an increase in Rz +35.0 ± 59.9 and Xc +11, 8 ± 10.2 (P < 0.05), related with hydration –3.8 ± 4.6% and nutrition changes + 93.0 ± 195.2 Ucr/m, without changes in control group. An important improvement in glycaemia, cholesterol, triglycerides, transaminases and microalbuminuria was evident in both groups, being more relevant with intensive intervention. Reduction HbA1c 2.1 ± 0.4% (P < 0.001) vs 0.4 ± 0.4% (P = 0.36).

Conclusions: VLCD produces an improvement in body composition (PA and BCM) with reduction in obesity complications (2 stage of AACE), associated a reduction in treatments needs (insulin therapy suspension in 84% of cases, reduction in others drugs) and metabolic changes (HbA1c): fundamental objectives in the intervention.