Effect of lifestyle intervention on mobilization of fat storage pools in individuals with abdominal obesity: a prospective study

Objective The effect of lifestyle intervention on the reduction of fat in specific body areas for individuals with abdominal obesity has not been thoroughly studied. In this study, we evaluate if lifestyle intervention can uniquely influence various fat storage areas and to explore the relationships between fat loss in specific locations and health results. Methods In this prospective cohort study conducted at a single center, 39 individuals with abdominal obesity participated in a lifestyle intervention from October 18, 2022, to April 20, 2023. Magnetic resonance imaging was used to measure subcutaneous fat area (SFA), visceral fat area (VFA), and the proton density fat fraction (PDFF) of the liver and pancreas at the baseline and six months post-intervention. This study's protocol was documented on clinicaltrials.gov. Results Out of 39 individuals, the median age was 28.0 years with an interquartile range (IQR) of 22.0 to 37.5 years. The median body mass index (BMI) was 30.4 kg/m2, with an IQR of 28.5 to 33.2 kg/m2, and 41.0% of the participants were female. The median (IQR) reduction in hepatic PDFF was highest after lifestyle intervention at 46.5% (28.8%-68.4%), followed by pancreatic PDFF reduction at 24.9% (10.4%-45.0%), VFA reduction at 19.5% (7.2%-32.3%), and SFA reduction at 12.2% (6.7%-18.9%) (P < 0.001). Using the Pearson correlation coefficient, positive relationships were identified between variations in VFA and alterations in fasting glucose and HOMA-IR (r = 0.401, P = 0.01; r = 0.830, P < 0.001), as well as between changes in hepatic PDFF and HOMA-IR (r = 0.520, P < 0.001). Conclusion Lifestyle intervention primarily reduced liver fat, then pancreatic fat and visceral fat, while subcutaneous fat was the least affected in individuals with abdominal obesity. Decreases in VAT and liver fat are independently linked to the improvement of glucose metabolism following lifestyle intervention.