Effect of Weight Loss, Exercise, or Both on Undercarboxylated Osteocalcin and Insulin Secretion in Frail, Obese Older Adults

Georgia Colleluori, Nicola Napoli, Uma Phadnis, Reina Armamento-Villareal, Dennis T Villareal, Georgia Colleluori, Nicola Napoli, Uma Phadnis, Reina Armamento-Villareal, Dennis T Villareal

Abstract

Background: Obesity exacerbates age-related decline in glucometabolic control. Undercarboxylated osteocalcin (UcOC) regulates pancreatic insulin secretion. The long-term effect of lifestyle interventions on UcOC and insulin secretion has not been investigated.

Methods: One hundred seven frail, obese older adults were randomized into the control (N = 27), diet (N = 26), exercise (N = 26), and diet-exercise (N = 28) groups for 1 year. Main outcomes included changes in UcOC and disposition index (DI).

Results: UcOC increased in the diet group (36 ± 11.6%) but not in the other groups (P < 0.05 between groups). Although similar increases in DI occurred in the diet-exercise and diet groups at 6 months, DI increased more in the diet-exercise group (92.4 ± 11.4%) than in the diet group (61.9 ± 15.3%) at 12 months (P < 0.05). UcOC and body composition changes predicted DI variation in the diet group only (R2 = 0.712), while adipocytokines and physical function changes contributed to DI variation in both the diet (∆R2 = 0.140 and 0.107) and diet-exercise (∆R2 = 0.427 and 0.243) groups (P < 0.05 for all).

Conclusions: Diet, but not exercise or both, increases UcOC, whereas both diet and diet-exercise increase DI. UcOC accounts for DI variation only during active weight loss, while adipocytokines and physical function contribute to diet-exercise-induced DI variation, highlighting different mechanisms for lifestyle-induced improvements in insulin secretion. This trial was registered with ClinicalTrials.gov number NCT00146107.

Figures

Figure 1
Figure 1
Mean percent changes in undercarboxylated osteocalcin (UcOC) (a) and disposition index (DI) (b) during the 1-year interventions. In (a), the changes in UcOC in the diet group differed significantly from the changes in UcOC in the diet-exercise, exercise, and control groups. In (b), the changes in DI in the diet-exercise group differed significantly from the changes in DI in the diet, exercise, and control groups. I bars indicate standard errors.

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Source: PubMed

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