Weight-Loss Diets, Adiponectin, and Changes in Cardiometabolic Risk in the 2-Year POUNDS Lost Trial

Context: Compelling evidence suggests that the beneficial effects of weight-loss diet interventions on improvement of cardiometabolic risk factors may be partly through modulating secretion of adiponectin from adipose tissue. Objective: To investigate the effects of long-term weight-loss diets with different compositions of macronutrients on longitudinal changes in circulating adiponectin concentrations and how such changes, if they exist, affect cardiometabolic risk. Design, Setting, and Participants: In the 2-year Preventing Overweight Using Novel Dietary Strategies trial, 811 overweight or obese adults were randomly assigned to 1 of 4 diets varying in macronutrient intakes. The current analysis was restricted to participants who had baseline adiponectin measurement (n = 768). Circulating concentrations of adiponectin and cardiometabolic outcomes were repeatedly measured at baseline, 6 months, and 2 years. Main Outcome Measures: Circulating concentrations of adiponectin and cardiometabolic risk factors. Results: Weight-loss diet interventions significantly increased circulating adiponectin concentrations over 2 years, similarly in 4 diet groups (P value for difference > .05). We found that the increase of adiponectin was significantly associated with reduction of waist circumference and low-density lipoprotein cholesterol, but associated with increase of high-density lipoprotein cholesterol (P < .001 for each), after adjusting for age, sex, ethnicity, follow-up time, diet group, baseline body mass index, baseline level of respective outcome trait, and concurrent weight change. Conclusions: Our findings indicate that long-term interventions by weight-loss diets varying in macronutrients similarly increase circulating adiponectin, which may particularly improve abdominal fat distribution and lipid metabolism independently of weight change.