Progressive Weight Loss-Induced Remission of Insulin Resistance/Hyperinsulinemia and Improvements in Cardiovascular Risk Factors.

Background: Hyperinsulinemia (HI) is a common endocrine metabolic disorder in obesity and is closely associated with cardiovascular disease.

Aim: This study aims to investigate the effects of progressive weight reduction on HI and cardiovascular risk factors.

Methods: We enrolled 68 patients with overweight or obesity. Body composition assessments, clinical indicator sampling and a 75g-oral glucose tolerance test were conducted at baseline and after 12-month weight loss to assess HI and insulin sensitivity. And the people were divided into four groups based on the percent of weight loss (<10%, ~20%, ~30%, >30%) to study the remission of HI and changes in body composition and cardiovascular risk factors.

Results: A total of 66 participants were studied at the end. Progressive weight loss significantly reduced plasma glucose and insulin (P<0.001, P _{for trend} <0.001) and did not progressively reduce cardiovascular risk factors (P _{for trend} <0.001). The greater the percentage of weight loss, the greater the remission rate of insulin resistance and hyperinsulinemia (P _{for trend} <0.001), which reaches 100% when weight loss exceeds 30%. After adjusting for factors such as age, gender, and medication usage, remission of HI was still associated with progressive weight loss.

Conclusion: With progressive weight loss, people with overweight or obesity experienced further improvements in glycemic outcomes, body compositions, HI and insulin resistance.