Abstract
Background: Weight loss in obese individuals aims to reduce the risk of type 2 diabetes by improving glycemic control. Yet, significant intersubject variability is observed, and the outcomes remain poorly predictable.
Objective: The aim of the study was to predict whether an individual will show improvements in insulin sensitivity above or below the median population change at 6 mo after a low-calorie-diet (LCD) intervention.
Design: With the use of plasma lipidomics and metabolomics for 433 subjects from the Diet, Obesity, and Genes (DiOGenes) Study, we attempted to predict good or poor Matsuda index improvements 6 mo after an 8-wk LCD intervention (800 kcal/d). Three independent analysis groups were defined: "training" (n = 119) for model construction, "testing" (n = 162) for model comparison, and "validation" (n = 152) to validate the final model.
Results: Initial modeling with baseline clinical variables (body mass index, Matsuda index, total lipid concentrations, sex, age) showed limited performance [area under the curve (AUC) on the "testing dataset" = 0.69; 95% CI: 0.61, 0.77]. Significantly better performance was achieved with an omics model based on 27 variables (AUC = 0.77; 95% CI: 0.70, 0.85; P = 0.0297). This model could be greatly simplified while keeping the same performance. The simplified model relied on baseline Matsuda index, proline, and phosphatidylcholine 0-34: 1. It successfully replicated on the validation set (AUC = 0.75; 95% CI: 0.67, 0.83) with the following characteristics: specificity = 0.73, sensitivity = 0.68, negative predictive value = 0.60, and positive predictive value = 0.80. Marginally lower performance was obtained when replacing the Matsuda index with homeostasis model assessment of insulin resistance (AUC = 0.72; 95% CI: 0.64, 0.80; P = 0.08).
Conclusions: Our study proposes a model to predict insulin sensitivity improvements, 6 mo after LCD completion in a large population of overweight or obese nondiabetic subjects. It relies on baseline information from 3 variables, accessible from blood samples. This model may help clinicians assessing the large variability in dietary interventions and predict outcomes before an intervention.
Original language | English |
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Pages (from-to) | 13-23 |
Number of pages | 11 |
Journal | American Journal of Clinical Nutrition |
Volume | 108 |
Issue number | 1 |
DOIs | |
Publication status | Published - Jul 2018 |
Keywords
- obesity
- insulin resistance
- low-calorie diet
- lipidomics
- metabolomics
- plasma
- predictive models
- TYPE-2 DIABETES-MELLITUS
- AMINO-ACID-METABOLISM
- WEIGHT-LOSS PROGRAM
- GASTRIC BYPASS
- BRANCHED-CHAIN
- CALORIE DIETS
- RISK-FACTORS
- PROFILES
- PHOSPHOLIPIDS
- MAINTENANCE