The Role of Insulin Sensitivity in Lean Mass Changes During Weight Loss With or Without Exercise.

Obesity (Silver Spring, Md.) Pub Date : 2025-09-02 DOI:10.1002/oby.70010

Ciera L Bartholomew, Catia Martins, Barbara Gower

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Abstract

Objective: This study aimed to investigate the association between baseline insulin sensitivity (S_I) and changes in total lean mass (LM) and appendicular LM (ALM) during a diet-induced weight loss program with or without exercise.

Methods: We conducted a secondary data analysis from a controlled weight loss study in premenopausal women with overweight aged 21-41. Women were randomized into three groups: diet-only, diet plus aerobic exercise, or diet plus resistance exercise. Body composition was assessed using dual-absorptiometry X-ray and S_I using an intravenous glucose tolerance test. Multiple linear regression was used to determine if baseline S_I was predictive of changes in total LM and ALM.

Results: There were significant group-S_I interactions on changes in total LM (β = 0.474, p = 0.003, adjusted r² = 0.371) and ALM (β = 0 0.462, p = 0.009, adjusted r² = 0.231) after adjusting for covariates, indicating that greater baseline S_I was associated with less LM loss only in women who did not exercise.

Conclusions: Higher baseline S_I is associated with greater retention of LM when weight loss is induced with diet alone, but not when exercise (aerobic or resistance) is included. This reinforces the importance of including exercise in all weight loss interventions.

Trial registration: ClinicalTrials.gov identifier: NCT00067873.

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胰岛素敏感性在运动或不运动减肥期间瘦质量变化中的作用。

目的：本研究旨在探讨在有或没有运动的饮食诱导减肥计划中，基线胰岛素敏感性（SI）与总瘦质量（LM）和阑尾瘦质量（ALM）变化之间的关系。方法：我们对21-41岁绝经前超重妇女的对照减肥研究进行了二次数据分析。女性被随机分为三组：只节食、节食加有氧运动、节食加抗阻运动。采用x线双吸收仪和静脉葡萄糖耐量试验的SI评估体成分。使用多元线性回归来确定基线SI是否可以预测总LM和ALM的变化。结果：校正协变量后，总LM （β = 0.474, p = 0.003，校正r2 = 0.371）和ALM （β = 0 0.462, p = 0.009，校正r2 = 0.231）的变化存在显著的组间SI相互作用，表明仅在不运动的女性中，较高的基线SI与较少的LM损失相关。结论：当仅通过饮食减肥时，较高的基线SI与更大的LM保留率相关，但当包括运动（有氧或抵抗）时则无关。这加强了在所有减肥干预措施中包括锻炼的重要性。试验注册：ClinicalTrials.gov标识符：NCT00067873。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Obesity (Silver Spring, Md.)

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