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J Endocr Soc. 2017 Apr 25;1(6):625-637. doi: 10.1210/js.2017-00020. eCollection 2017 Jun 1.

Effects of Rapid Weight Loss on Systemic and Adipose Tissue Inflammation and Metabolism in Obese Postmenopausal Women.

Author information

Laboratory of Biochemical Genetics and Metabolism, Rockefeller University, New York, New York 10065.
Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York 10065.
Department of Medicine, Weill Cornell Medical College, New York, New York 10065.
Rockefeller Hospital, Rockefeller University, New York, New York 10065.
Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, Tennessee 37232.
Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York 10065.
Department of Health Care Policy and Research, Weill Cornell Medical College, New York, New York 10065.
Departments of Medicine and Oncology, McGill University, Montreal, Quebec H3T 1E2, Canada.



Obesity is associated with subclinical white adipose tissue inflammation, as defined by the presence of crown-like structures (CLSs) consisting of dead or dying adipocytes encircled by macrophages. In humans, bariatric surgery-induced weight loss leads to a decrease in CLSs, but the effects of rapid diet-induced weight loss on CLSs and metabolism are unclear.


To determine the effects of rapid very-low-calorie diet-induced weight loss on CLS density, systemic biomarkers of inflammation, and metabolism in obese postmenopausal women.


Prospective cohort study.


Rockefeller University Hospital, New York, NY.


Ten obese, postmenopausal women with a mean age of 60.6 years (standard deviation, ±3.6 years).

Main Outcome Measures:

Effects on CLS density and gene expression in abdominal subcutaneous adipose tissue, cardiometabolic risk factors, white blood count, circulating metabolites, and oxidative stress (urinary isoprostane-M) were measured.


Obese subjects lost approximately 10% body weight over a mean of 46 days. CLS density increased in subcutaneous adipose tissue without an associated increase in proinflammatory gene expression. Weight loss was accompanied by decreased fasting blood levels of high-sensitivity C-reactive protein, glucose, lactate, and kynurenine, and increased circulating levels of free fatty acids, glycerol, β-hydroxybutyrate, and 25 hydroxyvitamin D. Levels of urinary isoprostane-M declined.


Rapid weight loss stimulated lipolysis and an increase in CLS density in subcutaneous adipose tissue in association with changes in levels of circulating metabolites, and improved systemic biomarkers of inflammation and insulin resistance. The observed change in levels of metabolites (i.e., lactate, β-hydroxybutyrate, 25 hydroxyvitamin D) may contribute to the anti-inflammatory effect of rapid weight loss.


crown-like structure; inflammation; metabolism; weight loss

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