Effect of Baseline BMI and IL-6 Subgroup Membership on Gait Speed Response to Caloric Restriction in Older Adults with Obesity - 10/12/24

Doi : 10.1007/s12603-023-1909-1 
Katherine L. Hsieh 1, 2, 6 , R.H. Neiberg 3, K.M. Beavers 4, W.J. Rejeski 4, S.P. Messier 4, B.J. Nicklas 1, D.P. Beavers 5
1 Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, USA 
2 Department of Physical Therapy, College of Nursing and Health Professions, Georgia State University, Atlanta, USA 
3 Department of Biostatistics and Data Science, Division of Public Health Services, Wake Forest School of Medicine, Winston-Salem, USA 
4 Department of Health and Exercise Science, Wake Forest University, Winston-Salem, USA 
5 Department of Statistical Sciences, Wake Forest University, Winston-Salem, USA 
6 Department of Physical Therapy, Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, USA 

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Abstract

Background

Prior work shows caloric restriction (CR) can improve physical function among older adults living with obesity. However, the contribution of starting weight and inflammatory burden to CR-associated functional improvements is unclear. The primary purpose of this study was to determine if CR-associated gait speed change varied by body mass index (BMI) and plasma interleukin 6 (IL-6) at baseline and secondarily to determine the contribution of BMI change and IL-6 change to gait speed change.

Design, Setting, Participants

Data from eight randomized control trials were pooled, with 1184 participants randomized to CR (n=661) and No CR (n=523) conditions. All studies assessed outcomes before and five or six months after assignment to CR or No CR.

Measurements

BMI and IL-6 were assessed at baseline using standard procedures. Gait speed was assessed with the six-minute walk test or 400m walk test. Baseline BMI/IL-6 subgroups were constructed using BMI≥35 kg/m2 and IL-6>2.5 pg/mL thresholds. Participants with BMI≥35 kg/m2 were grouped into class 2+ obesity and BMI<35 kg/m2 into class 1- obesity; IL-6>2.5 pg/mL were grouped into high IL-6, and <2.5 pg/mL as low IL-6 (class 2+ obesity/high IL-6: n=288, class 2+ obesity/low IL-6: n=143, class 1- obesity/high IL-6: n=354, or class 1- obesity/low IL-6: n=399). All analyses used adjusted general linear models.

Results

Gait speed significantly improved with CR versus non-CR [mean difference: +0.02 m/s (95% CI: 0.01, 0.04)]. CR assignment significantly interacted with BMI/IL-6 subgroup membership (p=0.03). Greatest gait speed improvement was observed in the class 2+ obesity/high IL-6 subgroup [+0.07 m/s (0.03, 0.10)]. No other subgroups observed significant gait speed change. For each unit decrease in BMI, gait speed change increased by +0.02 m/s (p<0.001; R2=0.26), while log IL-6 change did not significantly affect gait speed change [+0.01 m/s (p=0.20)].

Conclusions

Only the class 2+ obesity/high IL-6 subgroup significantly improved gait speed in response to CR. Improvement in gait speed in this subgroup was driven by a larger decrease in BMI, but not IL-6, in response to CR. Individuals with class 2+ obesity and high IL-6 are most likely to show improved gait speed in response to CR, with improvement predominantly driven by reductions in BMI.

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Key words : Heterogeneity, physical function, weight loss, obesity, inflammation


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Vol 27 - N° 4

P. 285-290 - avril 2023 Retour au numéro
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