Weight loss with daily caloric restriction and intermittent fasting and association with kidney growth
(A) Percent weight loss according to group randomization (daily caloric restriction, DCR [orange], or intermittent fasting, IMF [blue]) at 3 months and 12 months; lines represent means with individual participants shown by dots. Clinically significant weight loss (>5%) was achieved in both groups at month 3. At 12 months, the DCR group lost additional weight, whereas weight loss in the IMF group plateaued.
(B) Height-adjusted total kidney volume (htTKV) according to group randomization (DCR or IMF) at baseline (0 months) and 12 months (lines represent median with individual participants shown by dots).
(C) Subcutaneous (SAT), visceral (VAT), and total adipose tissue (TAT) volume measured by abdominal MRI at baseline (0 months) and 12 months in pooled groups (lines represent mean with individual participants shown by dots). SAT, VAT, and TAT were all significantly reduced at 12 months.
(D) Representative MRI image of a DCR participant, with muscle in red (baseline: 87 cm2/m; 12 months: 84 cm2/m), SAT in green (baseline: 296 cm2/m; 12 months: 253 cm2/m), visceral organ in blue (baseline: 155 cm2/m; 12 months: 162 cm2/m), VAT in yellow (baseline: 108 cm2/m; 12 months: 84 cm2/m), and bone in white (baseline: 24 cm2/m; 12 months: 23 cm2/m).
(E and G–I) Association of percent change in weight (E), change in SAT (G), VAT (H), and TAT (I) at 12 months with annual percent change in htTKV. Among all participants, annual change in htTKV was correlated with change in weight, VAT, and TAT, but not SAT.
(F) When participants were categorized as losing clinically significant weight (≥5%; n = 12) at 12 months or not achieving this goal (n = 8), annual percent change in htTKV was significantly lower in the former group (Panel F). Statistics: Mixed effects model in repeated measures (panels A and B), paired t test (panel C), independent samples t test (panel F) and Pearson’s bivariate correlation (panels E, G-I). P ∗<0.05 for group × time interaction based on a mixed effects model in repeated measures for weight at 12 months or t test.