Reversal of metabolic syndrome with weight loss decreases epicardial fat more than weight loss alone in women with obesity

OBJECTIVE
In this study, we aimed to investigate the impact of weight loss with diet and exercise on echocardiographically measured epicardial fat thickness (EFT) in women with obesity and whether the change in EFT can be different between the groups whose metabolic syndrome (MetS) status has changed or remained the same with weight loss.

METHODS
Seventy four women with obesity who were scheduled for a one-year weight reduction (WR) program were prospectively enrolled in the study. Anthropometric, laboratory, clinical, and echocardiographic parameters were assessed at baseline and after one year for twenty eight women who completed the program and had weight reduction. At the end of one year, all the participants were divided into two groups on the basis of whether their MetS status had changed or remained the same.

RESULTS
Body mass index was significantly reduced from 37.17±5.94 to 31.61±5.55 kg/m2 (p<0.001) after the oneyear WR program. A significant reduction in EFT was noted after weight loss compared with baseline measurements
(0.51±0.15 cm to 0.39±0.14 cm, p=0.001). The decrease in EFT was significantly higher in the patient group with reversal of MetS than in the group whose MetS status did not change with weight loss (0.16±0.68 cm vs. 0.09±0.07 cm, p=0.018, respectively). Reversal of MetS was found to be an independent predictor of the change in EFT.

CONCLUSION
Long-term, sustained weight loss can significantly reduce echocardiographic EFT, and EFT can be used as an indicator of metabolic profile for WR interventions in women with obesity