Hormonal
Weight loss interventions improve cardiovascular vascular function (endothelial health) only in obese individuals with baseline hyperinsulinemia (fasting insulin >12 mIU/ml), whereas those with lower insulin levels derive no vascular benefit.
If you are obese and undergoing weight loss, ask your doctor to check your fasting insulin levels. If your levels are high (>12 mIU/ml), weight loss is likely to significantly improve your blood vessel health and cardiovascular risk. If your levels are normal, you may not see vascular improvements from weight loss alone, suggesting you might need to focus on other metabolic markers or interventions.
obese individuals with high baseline plasma insulin levels (above median >12 mIU/ml) achieved significant improvement in both macro- and microvascular endothelial function following weight loss... while weight reduction did not confer vascular benefit to subjects with lower plasma insulin (≤12 mIU/ml).
Why this rating
Based on observational cohort data (Swedish Obesity Study) and a specific clinical study (Bigornia et al.) with >200 subjects, but lacks large-scale randomized controlled trial (RCT) evidence for the specific insulin-stratified protocol.
Source
Insulin resistance: a key therapeutic target for cardiovascular risk reduction in obese patients?
Shakun Karki et al. · Expert Review of Endocrinology & Metabolism · 2014
DOI 10.1586/17446651.2014.878646
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