Obesity and the metabolic syndrome Conclusion: IB is effective in reducing weight in morbid obesity patients, but isolated has poor long-term results. Therefore BS after IB removal is recommended and all patients should be carefully selected before IB placement. Disclosure of Interest: None declared
MON-PP217 WHOLE BODY PRODUCTION OF 3-HYDROXY3-METHYLBUTYRATE (HMB) IN OBESE SUBJECTS WITH CHRONIC DISEASE D. Walker1 , A. Wierzchowska1 , M. Engelen1 , N. Deutz1 . 1 Health & Kinesiology, Texas A&M University, College Station, United States Rationale: Metabolic syndrome and chronic disease has been associated with elevated plasma branched-chain amino acids (BCAA: leucine, isoleucine, and valine), their respective branched chain keto acids (BCKA) and muscle loss. The irreversible conversion of leucine to 3-hydroxy-3-methylbutyrate (HMB) is a downstream metabolite of ketoisocapraote. Also, HMB levels are suggested to be related to muscle mass. Therefore, we developed a method to determine the irreversible conversion of leucine to HMB in obese patients with a chronic disease. Methods: In 12 patients with stable chronic heart of lung failure (BMI 36.7±2.5), and 6 healthy age-matched control subjects (BMI 25.04±6.5), whole body production of 3-hydroxy-3-methylbutyrate from leucine was assessed with pulse IV administration of L-[5,5,5-2H3]leucine. The isotope enrichment values in plasma were measured by LC-MS/MS and GC-MS/MS. Statistics by a student t-test for independent samples. Results: Concentrations of HMB were greater in obese subjects with chronic disease than healthy controls (P = 0.05). The production of HMB in obese subjects with chronic disease was not different from healthy controls. Conclusion: These data indicate that in obese patients with chronic disease, HMB concentrations are elevated and production is not different suggesting that further metabolism of HMB is impaired in this patient population. Disclosure of Interest: None declared
MON-PP218 INCREASED WHOLE BODY TRANSAMINATION AND OXIDATION OF LEUCINE IN CHRONIC HEART FAILURE D. Walker1 , A. Wierzchowska1 , M. Engelen1 , N. Deutz1 . 1 Health & Kinesiology, Texas A&M University, College Station, United States Rationale: Metabolic syndrome and chronic disease has been associated with elevated plasma branched-chain amino acids (BCAA: leucine, isoleucine, and valine) and their respective branched chain keto acids [BCKA: ketoisocaproate (KIC), ketomethylvalerate (KMV), ketoisovalerate (KIV)]. However, it is unclear whether the interconversion of Leucine to KIC relates to the changed plasma concentrations. Therefore, we measured the reversible transamination of leucine to KIC and KIC to leucine and BCKA plasma concentrations in obese patients with chronic heart failure (CHF). Methods: In 12 patients with stable CHF (BMI: xx, ejection fraction: 36.2±2.5), and 6 healthy age-matched control
S209 subjects (BMI 25.04±6.5), whole body interconversions of leucine and KIC were assessed with pulse IV administration of L-[5,5,5-2H3]leucine and [1-13C]KIC. Plasma concentrations and enrichments by LC-MS/MS and GC-MS/MS. Statistics by a student t-test for independent samples. Results: Concentrations of keto acids (KIC, KMV, and KIV) were greater in chronic heart failure patients than healthy controls (P = 0.047). The oxidation of leucine was greater in chronic heart failure patients compared to healthy controls (P < 0.05). Conclusion: Chronic disease is associated with disturbances in BCAA metabolism. Our findings suggest that BCAA oxidation is reduced in patients with chronic disease as evident by elevated BCKA concentrations. This leads to increased conversion of KIC to leucine and leucine to KIC. Disclosure of Interest: None declared
MON-PP219 METHODS AND MOTIVES OF WEIGHT LOSS IN SUCCESSFUL WEIGHT LOSS MAINTENANCE E. Mamalaki1 , D. Brikou1 , E. Karfopoulou1 , C. Anastasiou1 , M. Yannakoulia1 . 1 Nutrition and Dietetics, Harokopio University, Athens, Greece Rationale: Weight loss maintenance remains a public health challenge. It is not clear whether the weight loss method affects maintenance results. Hence, we aimed to explore whether weight loss methods and motives differ between weight loss maintainers and regainers. Methods: Present analysis is part of the MedWeight, an observational study. Participants have intentionally lost 10% of their weight and are either maintaining this loss for over a year, or have regained weight. They completed questionnaires through study’s website; among others the main weight loss methods and main motives were evaluated. Results: Study included 278 maintainers and 106 regainers. Maintainers had achieved greater initial weight loss compared to regainers (26% vs. 18%, p = 0.001). The main weight loss method differed between groups: among maintainers, 47% stated that they lost weight by themselves, whereas 34% consulted a dietitian; among regainers, 29% lost weight by themselves and 46% were assisted by a dietitian (p = 0.008). The most prevalent weight loss motives were improving appearance, boosting self-esteem and improving easiness of movement, whereas health as a principal motive was reported only by 4% of participants, with no differences across maintenance status (p = 0.764). Conclusion: Most maintainers lost weight by themselves. It is not clear whether losing weight by oneself is advantageous, or whether the persons choosing to try by themselves are more motivated to achieve weight loss and maintenance. Due to the observational design of the study, etiological conclusions cannot be reached, and further research is required. Disclosure of Interest: E. Mamalaki Grant/Research Support from: IKY fellowships of excellence for postgraduate studies in Greece-Siemens program, D. Brikou: None declared, E. Karfopoulou Grant/Research Support from: Greek State Scholarships Foundation and Coca-Cola Foundation, C. Anastasiou Grant/Research Support from: Coca-Cola Foundation, M. Yannakoulia: None declared