Diabetes, Metabolic Syndrome and Obesity (May 2019)
Obesity: outcome of standardized life-style change in a rehabilitation clinic. An observational study
Abstract
Helmuth Haslacher,1 Hannelore Fallmann,2 Claudia Waldhäusl,3 Edith Hartmann,2 Oswald F Wagner,1 Werner K Waldhäusl2,41Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria; 2Rehabilitation Clinic for Diabetes and Metabolic Diseases, Moorbad Neydhartig, Neydharting, Upper Austria, Austria; 3Department of Radiotherapy, Medical University of Vienna, Vienna, Austria; 4Department of Medicine III, Medical University of Vienna, Vienna, AustriaPurpose: To explore differences in baseline characteristics following three weeks of semi-standardized in-patient care between patients with obesity without and with type 2 diabetes (T2D).Patients and methods: Patients without or with T2D were matched according to age, sex, and BMI. Food intake was restricted to 1,200–1,600 kcal/d to which a 400–600 kcal/d exercise load was added, and data were compared using Student’s t-test, general linear models, and Spearman-rank correlations.Results: At baseline, patients with obesity and T2D displayed, besides elevated blood glucose and HbA1c values, higher serum liver enzymes (p<0.001–0.05), triglycerides, and CRP (p<0.01) and a greater prevalence of treated hyperlipidemia (p<0.001) than those with plain obesity who showed only higher LDL and HDL cholesterol levels (+9.0% and +16.0%). In response to three-weeks of standardized life-style change, both groups improved their vital variables and risk scores (p<0.001). While improvement in cholesterol slightly favored patients with plain obesity, the need for anti-hyperlipidemics (+25%) rose in both groups, albeit that for anti-hypertensives (+50%) increased only in patients with obesity and add-on T2D.Conclusion: Moderate changes in lifestyle improve the clinical condition, including coronary heart disease and premature mortality risk scores (HARD-CHD and ABSI) in patients with obesity both in the absence and presence of T2D, with the latter seemingly increasing the risk of hepatic steatosis and systemic inflammation.Keywords: obesity, standardized life-style change, liver disease, inflammation, rehabilitation clinic
