J Endocrinol Metab

Journal of Endocrinology and Metabolism, ISSN 1923-2861 print, 1923-287X online, Open Access

Article copyright, the authors; Journal compilation copyright, J Endocrinol Metab and Elmer Press Inc

Journal website https://jem.elmerpub.com

Original Article

Volume 16, Number 2, April 2026, pages 82-92

Weight Loss Intervention and Early Biomarker Search in Middle-Aged and Elderly Women: Early Signs of Body Composition Changes Indicated by Blood Cholinesterase and Cystatin C

↓ Figure 1. Correlation between changes in body fat mass and changes in blood parameters. The relationship between the change (Δ) in body fat mass (y) and the change (Δ) in various blood parameters (x) in study participants is shown. (a) ΔRed blood cell count (RBC); (b) ΔWhite blood cell count (WBC); (c) ΔTotal protein; (d) ΔAspartate aminotransferase (AST); (e) ΔAlanine aminotransferase (ALT); (f) ΔCholinesterase; (g) ΔCystatin C; (h) ΔHigh-sensitivity C-reactive protein (CRP).

↓ **Table 1.** Subject Characteristics
Data are presented as means ± SD (Min–Max). BMI: body mass index; SD: standard deviation; Min: minimum; Max: maximum.
Age, years	60.9 ± 11.0 (37–83)
Height, cm	157.0 ± 5.4 (147.3–167.7)
Body weight, kg	61.3 ± 8.8 (42.5–81.8)
BMI, kg/m²	24.8 ± 3.2 (18.5–30.6)
Diabetes, n (%)	2 (6.1)
Hypertension, n (%)	6 (18.2)
Dyslipidemia, n (5)	13 (30.3)

↓ Table 1. Subject Characteristics

Data are presented as means ± SD (Min–Max). BMI: body mass index; SD: standard deviation; Min: minimum; Max: maximum.

Age, years

60.9 ± 11.0 (37–83)

Height, cm

157.0 ± 5.4 (147.3–167.7)

Body weight, kg

61.3 ± 8.8 (42.5–81.8)

BMI, kg/m²

24.8 ± 3.2 (18.5–30.6)

Diabetes, n (%)

2 (6.1)

Hypertension, n (%)

6 (18.2)

Dyslipidemia, n (5)

13 (30.3)

↓ **Table 2.** Body Composition and Changes Before and After the Course
	Pre-intervention	Post-intervention	P value
Comparison between the two groups was performed using the Mann–Whitney U test. Data are presented as means ± SD (Min–Max). BMI: body mass index; SD: standard deviation; Min: minimum; Max: maximum.
Age, years	60.9 ± 11.0 (37–83)
Body weight, kg	61.3 ± 8.8 (42.5–81.8)	58.7 ± 7.7 (41.8–72.5)	< 0.001
BMI, kg/m²	24.8 ± 3.2 (18.5–30.6)	23.8 ± 2.9 (18.2–28.7)	< 0.001
Body fat mass, kg	21.4 ± 6.0 (8.3–32.7)	19.2 ± 5.5 (8.3–28.1)	< 0.001
Body fat percent, %	34.3 ± 6.1 (19.6–43.9)	32.2 ± 6.5 (17.1–42.6)	< 0.001
Skeletal muscle mass, kg	21.5 ± 2.6 (17.9–27.0)	21.2 ± 2.6 (17.7–26.2)	0.010
Muscle mass, kg	37.6 ± 4.1 (32.1–46.3)	37.2 ± 4.0 (31.7–45.0)	0.017
Upper limb fat mass, kg	3.1 ± 1.1 (1.0–5.3)	2.7 ± 0.9 (1.0–4.6)	< 0.001
Trunk fat mass, kg	10.5 ± 3.1 (3.4–16.5)	9.3 ± 2.9 (3.3–14.0)	< 0.001
Lower limb fat mass, kg	6.7 ± 1.7 (3.0–9.6)	6.1 ± 1.6 (3.0–9.6)	< 0.001
Upper limb muscle mass, kg	3.8 ± 0.6 (2.8–5.4)	3.7 ± 0.6 (2.8–5.0)	0.002
Trunk muscle mass, kg	17.6 ± 2.0 (14.7–22.3)	17.2 ± 1.8 (14.6–21.4)	< 0.001
Lower limb muscle mass, kg	12.3 ± 1.9 (9.4–16.2)	12.2 ± 1.9 (9.4–16.3)	0.096
Waist circumference, cm	92.7 ± 8.8 (70.0–109.4)	89.0 ± 8.8 (68.7–105.0)	< 0.001

↓ Table 2. Body Composition and Changes Before and After the Course

Pre-intervention

Post-intervention

P value

Comparison between the two groups was performed using the Mann–Whitney U test. Data are presented as means ± SD (Min–Max). BMI: body mass index; SD: standard deviation; Min: minimum; Max: maximum.

Age, years

60.9 ± 11.0 (37–83)

Body weight, kg

61.3 ± 8.8 (42.5–81.8)

58.7 ± 7.7 (41.8–72.5)

< 0.001

BMI, kg/m²

24.8 ± 3.2 (18.5–30.6)

23.8 ± 2.9 (18.2–28.7)

< 0.001

Body fat mass, kg

21.4 ± 6.0 (8.3–32.7)

19.2 ± 5.5 (8.3–28.1)

< 0.001

Body fat percent, %

34.3 ± 6.1 (19.6–43.9)

32.2 ± 6.5 (17.1–42.6)

< 0.001

Skeletal muscle mass, kg

21.5 ± 2.6 (17.9–27.0)

21.2 ± 2.6 (17.7–26.2)

0.010

Muscle mass, kg

37.6 ± 4.1 (32.1–46.3)

37.2 ± 4.0 (31.7–45.0)

0.017

Upper limb fat mass, kg

3.1 ± 1.1 (1.0–5.3)

2.7 ± 0.9 (1.0–4.6)

< 0.001

Trunk fat mass, kg

10.5 ± 3.1 (3.4–16.5)

9.3 ± 2.9 (3.3–14.0)

< 0.001

Lower limb fat mass, kg

6.7 ± 1.7 (3.0–9.6)

6.1 ± 1.6 (3.0–9.6)

< 0.001

Upper limb muscle mass, kg

3.8 ± 0.6 (2.8–5.4)

3.7 ± 0.6 (2.8–5.0)

0.002

Trunk muscle mass, kg

17.6 ± 2.0 (14.7–22.3)

17.2 ± 1.8 (14.6–21.4)

< 0.001

Lower limb muscle mass, kg

12.3 ± 1.9 (9.4–16.2)

12.2 ± 1.9 (9.4–16.3)

0.096

Waist circumference, cm

92.7 ± 8.8 (70.0–109.4)

89.0 ± 8.8 (68.7–105.0)

< 0.001

↓ **Table 3.** Blood Parameters Before and After the Course
	Pre-intervention	Post-intervention	P value
Data are presented as means ± SD (Min–Max). Comparison between the two groups was performed using the Mann-Whitney U test. P values are for comparisons between pre- and post-intervention measurements. WBC: white blood cell; RBC: red blood cell; Hb: hemoglobin; MCV: mean corpuscular volume; MCH: mean corpuscular hemoglobin; MCHC: mean corpuscular hemoglobin concentration; AST: aspartate aminotransferase; ALT: alanine aminotransferase; GGT: gamma-glutamyl transpeptidase; HDL: high-density lipoprotein; LDL: low-density lipoprotein; eGFR: estimated glomerular filtration rate; HbA1c: glycated hemoglobin; CRP: C-reactive protein; Min: minimum; Max: maximum.
WBC, /mL	5,776 ± 1,291 (3,800–8,900)	5,503 ± 1,332 (3,700–8,700)	0.039
RBC, 10⁴/mL	440.5 ± 29.3 (360–499)	438.9 ± 33.7 (341–514)	< 0.001
Hb, g/dL	13.3 ± 0.8 (11.7–15.0)	13.3 ± 1.0 (10.9–15.4)	0.800
Hematocrit, %	41.4 ± 2.3 (36.7–45.9)	41.3 ± 2.9 (33.7–47.6)	0.495
Platelets, 10⁴/mL	26.5 ± 5.6 (13.5–41.9)	26.1 ± 5.2 (16.5–40.8)	0.235
MCV, fL	94.3 ± 3.5 (84–102)	94.2 ± 3.6 (85–100)	1.000
MCH, pg	30.2 ± 1.4 (26.2–32.5)	30.3 ± 1.5 (26.4–32.6)	0.530
MCHC, %	32.0 ± 0.7 (30.9–33.7)	32.1 ± 0.8 (30.5–33.7)	0.750
Total protein, g/dL	7.1 ± 0.3 (6.6–7.8)	7.2 ± 0.4 (6.4–8.2)	0.260
Albumin, g/dL	4.3 ± 0.2 (3.8–4.7)	4.3 ± 0.3 (3.9–4.8)	0.391
AST, U/L	23.1 ± 5.5 (17.0–44.0)	21.1 ± 6.5 (15.0–48.0)	0.011
ALT, U/L	21.3 ± 10.1 (10.0–53.0)	18.2 ± 9.3 (8.0–58.0)	0.005
GGT, U/L	30.6 ± 27.0 (10.0–146.0)	26.4 ± 17.4 (9.0–73.0)	0.283
Cholinesterase, U/L	349.4 ± 74.9 (155–598)	338.7 ± 76.4 (142–567)	0.007
Triglycerides, mg/dL	144.9 ± 88.2 (25–435)	129.2 ± 69.4 (39–338)	0.177
HDL-cholesterol, mg/dL	67.2 ± 15.4 (41.0–100.0)	68.5 ± 15.6 (42.0–116.0)	0.357
LDL-cholesterol, mg/dL	130.9 ± 34.4 (82.0–206.0)	132.8 ± 38.9 (77.0–243.0)	0.918
Calcium, mg/dL	9.3 ± 0.3 (8.7–10.0)	9.3 ± 0.3 (8.8–10.0)	0.595
Inorganic phosphate, mg/dL	3.7 ± 0.5 (2.9–4.8)	3.8 ± 0.5 (2.9–4.8)	0.218
Creatinine, mg/dL	0.7 ± 0.1 (0.5–0.9)	0.7 ± 0.1 (0.5–0.9)	0.180
Urea nitrogen, mg/dL	15.0 ± 3.7 (7.2–24.4)	15.1 ± 3.0 (8.2–21.9)	0.986
Uric acid, mg/dL	4.8 ± 1.0 (1.6–7.2)	4.9 ± 1.3 (1.8–7.3)	0.444
eGFR, mL/min/1.73 m²	75.7 ± 12.7 (49.4–106.7)	74.7 ± 12.9 (50.9–108.0)	0.213
Cystatin C, mg/dL	0.77 ± 0.17 (0.51–1.15)	0.77 ± 0.18 (0.50–1.27)	0.961
HbA1c, %	5.5 ± 0.3 (5.0–6.3)	5.6 ± 0.3 (5.1–6.2)	0.274
High-sensitivity CRP, mg/dL	0.07 ± 0.08 (0.004–0.361)	0.07 ± 0.08 (0.009–0.329)	0.144

↓ Table 3. Blood Parameters Before and After the Course

Pre-intervention

Post-intervention

P value

Data are presented as means ± SD (Min–Max). Comparison between the two groups was performed using the Mann-Whitney U test. P values are for comparisons between pre- and post-intervention measurements. WBC: white blood cell; RBC: red blood cell; Hb: hemoglobin; MCV: mean corpuscular volume; MCH: mean corpuscular hemoglobin; MCHC: mean corpuscular hemoglobin concentration; AST: aspartate aminotransferase; ALT: alanine aminotransferase; GGT: gamma-glutamyl transpeptidase; HDL: high-density lipoprotein; LDL: low-density lipoprotein; eGFR: estimated glomerular filtration rate; HbA1c: glycated hemoglobin; CRP: C-reactive protein; Min: minimum; Max: maximum.

WBC, /mL

5,776 ± 1,291 (3,800–8,900)

5,503 ± 1,332 (3,700–8,700)

0.039

RBC, 10⁴/mL

440.5 ± 29.3 (360–499)

438.9 ± 33.7 (341–514)

< 0.001

Hb, g/dL

13.3 ± 0.8 (11.7–15.0)

13.3 ± 1.0 (10.9–15.4)

0.800

Hematocrit, %

41.4 ± 2.3 (36.7–45.9)

41.3 ± 2.9 (33.7–47.6)

0.495

Platelets, 10⁴/mL

26.5 ± 5.6 (13.5–41.9)

26.1 ± 5.2 (16.5–40.8)

0.235

MCV, fL

94.3 ± 3.5 (84–102)

94.2 ± 3.6 (85–100)

1.000

MCH, pg

30.2 ± 1.4 (26.2–32.5)

30.3 ± 1.5 (26.4–32.6)

0.530

MCHC, %

32.0 ± 0.7 (30.9–33.7)

32.1 ± 0.8 (30.5–33.7)

0.750

Total protein, g/dL

7.1 ± 0.3 (6.6–7.8)

7.2 ± 0.4 (6.4–8.2)

0.260

Albumin, g/dL

4.3 ± 0.2 (3.8–4.7)

4.3 ± 0.3 (3.9–4.8)

0.391

AST, U/L

23.1 ± 5.5 (17.0–44.0)

21.1 ± 6.5 (15.0–48.0)

0.011

ALT, U/L

21.3 ± 10.1 (10.0–53.0)

18.2 ± 9.3 (8.0–58.0)

0.005

GGT, U/L

30.6 ± 27.0 (10.0–146.0)

26.4 ± 17.4 (9.0–73.0)

0.283

Cholinesterase, U/L

349.4 ± 74.9 (155–598)

338.7 ± 76.4 (142–567)

0.007

Triglycerides, mg/dL

144.9 ± 88.2 (25–435)

129.2 ± 69.4 (39–338)

0.177

HDL-cholesterol, mg/dL

67.2 ± 15.4 (41.0–100.0)

68.5 ± 15.6 (42.0–116.0)

0.357

LDL-cholesterol, mg/dL

130.9 ± 34.4 (82.0–206.0)

132.8 ± 38.9 (77.0–243.0)

0.918

Calcium, mg/dL

9.3 ± 0.3 (8.7–10.0)

9.3 ± 0.3 (8.8–10.0)

0.595

Inorganic phosphate, mg/dL

3.7 ± 0.5 (2.9–4.8)

3.8 ± 0.5 (2.9–4.8)

0.218

Creatinine, mg/dL

0.7 ± 0.1 (0.5–0.9)

0.180

Urea nitrogen, mg/dL

15.0 ± 3.7 (7.2–24.4)

15.1 ± 3.0 (8.2–21.9)

0.986

Uric acid, mg/dL

4.8 ± 1.0 (1.6–7.2)

4.9 ± 1.3 (1.8–7.3)

0.444

eGFR, mL/min/1.73 m²

75.7 ± 12.7 (49.4–106.7)

74.7 ± 12.9 (50.9–108.0)

0.213

Cystatin C, mg/dL

0.77 ± 0.17 (0.51–1.15)

0.77 ± 0.18 (0.50–1.27)

0.961

HbA1c, %

5.5 ± 0.3 (5.0–6.3)

5.6 ± 0.3 (5.1–6.2)

0.274

High-sensitivity CRP, mg/dL

0.07 ± 0.08 (0.004–0.361)

0.07 ± 0.08 (0.009–0.329)

0.144

↓ **Table 4.** The Relationship Between Baseline Body Composition and Blood Parameters
	Body weight	BMI	Body fat mass	Body fat percent	Skeletal muscle mass	Muscle mass	Waist circumference
Values are presented as Spearman’s rank correlation coefficient (r). P < 0.05; * P <0.01. WBC: white blood cell; RBC: red blood cell; Hb: hemoglobin; MCV: mean corpuscular volume; MCH: mean corpuscular hemoglobin; MCHC: mean corpuscular hemoglobin concentration; AST: aspartate aminotransferase; ALT: alanine aminotransferase; GGT: gamma-glutamyl transpeptidase; HDL: high-density lipoprotein; LDL: low-density lipoprotein; eGFR: estimated glomerular filtration rate; HbA1c: glycated hemoglobin; CRP: C-reactive protein.
WBC	0.328	0.374*	0.376*	0.344	0.113	0.140	0.456**
RBC	0.517**	0.432*	0.627**	0.552**	0.160	0.168	0.565**
Hb	0.540**	0.549**	0.660**	0.618**	0.146	0.155	0.539**
Hematocrit	0.509**	0.524**	0.663**	0.662**	0.068	0.082	0.593**
Platelets	0.215	0.148	0.223	0.235	0.143	0.173	0.221
MCV	–0.122	0.018	–0.069	0.038	–0.167	–0.167	–0.120
MCH	–0.010	0.124	–0.041	–0.027	0.070	0.062	–0.131
MCHC	0.108	0.150	0.034	–0.049	0.222	0.221	–0.043
Total protein	0.058	0.066	0.185	0.130	–0.118	–0.119	0.188
Albumin	–0.047	–0.093	0.001	–0.120	0.041	0.028	0.044
AST	0.219	0.175	0.185	0.097	0.126	0.098	0.115
ALT	0.295	0.266	0.276	0.224	0.145	0.127	0.250
GGT	0.226	0.251	0.329	0.284	0.018	0.010	0.241
Cholinesterase	0.323	0.427*	0.341	0.376*	0.058	0.057	0.542**
Triglycerides	0.109	0.074	0.077	0.043	0.078	0.078	0.323
HDL-cholesterol	–0.296	–0.207	–0.228	–0.136	–0.259	–0.245	–0.280
LDL-cholesterol	0.106	0.077	0.158	0.197	–0.010	–0.015	0.173
Calcium	–0.247	–0.138	–0.121	–0.011	–0.348*	–0.323	0.048
Inorganic phosphate	–0.369*	–0.245	–0.381*	–0.234	–0.262	–0.230	–0.366*
Creatinine	0.209	0.294	0.131	0.049	0.221	0.244	0.253
Urea nitrogen	–0.104	0.017	–0.190	–0.154	0.058	0.060	–0.025
Uric acid	0.329	0.466**	0.453**	0.445**	0.018	–0.005	0.534**
eGFR	–0.209	–0.294	–0.131	–0.049	–0.221	–0.244	–0.253
Cystatin C	0.072	0.241	0.148	0.227	–0.116	–0.044	0.334
HbA1c	0.321	0.362*	0.362*	0.252	0.073	0.089	0.264
High-sensitivity CRP	0.360*	0.506**	0.568**	0.690**	–0.164	–0.154	0.609**

↓ Table 4. The Relationship Between Baseline Body Composition and Blood Parameters

Body weight

BMI

Body fat mass

Body fat percent

Skeletal muscle mass

Muscle mass

Waist circumference

Values are presented as Spearman’s rank correlation coefficient (r). *P < 0.05; ** P <0.01. WBC: white blood cell; RBC: red blood cell; Hb: hemoglobin; MCV: mean corpuscular volume; MCH: mean corpuscular hemoglobin; MCHC: mean corpuscular hemoglobin concentration; AST: aspartate aminotransferase; ALT: alanine aminotransferase; GGT: gamma-glutamyl transpeptidase; HDL: high-density lipoprotein; LDL: low-density lipoprotein; eGFR: estimated glomerular filtration rate; HbA1c: glycated hemoglobin; CRP: C-reactive protein.

WBC

0.328

0.374*

0.376*

0.344

0.113

0.140

0.456**

RBC

0.517**

0.432*

0.627**

0.552**

0.160

0.168

0.565**

0.540**

0.549**

0.660**

0.618**

0.146

0.155

0.539**

Hematocrit

0.509**

0.524**

0.663**

0.662**

0.068

0.082

0.593**

Platelets

0.215

0.148

0.223

0.235

0.143

0.173

0.221

MCV

–0.122

0.018

–0.069

0.038

–0.167

–0.120

MCH

–0.010

0.124

–0.041

–0.027

0.070

0.062

–0.131

MCHC

0.108

0.150

0.034

–0.049

0.222

0.221

–0.043

Total protein

0.058

0.066

0.185

0.130

–0.118

–0.119

0.188

Albumin

–0.047

–0.093

0.001

–0.120

0.041

0.028

0.044

AST

0.219

0.175

0.185

0.097

0.126

0.098

0.115

ALT

0.295

0.266

0.276

0.224

0.145

0.127

0.250

GGT

0.226

0.251

0.329

0.284

0.018

0.010

0.241

Cholinesterase

0.323

0.427*

0.341

0.376*

0.058

0.057

0.542**

Triglycerides

0.109

0.074

0.077

0.043

0.078

0.323

HDL-cholesterol

–0.296

–0.207

–0.228

–0.136

–0.259

–0.245

–0.280

LDL-cholesterol

0.106

0.077

0.158

0.197

–0.010

–0.015

0.173

Calcium

–0.247

–0.138

–0.121

–0.011

–0.348*

–0.323

0.048

Inorganic phosphate

–0.369*

–0.245

–0.381*

–0.234

–0.262

–0.230

–0.366*

Creatinine

0.209

0.294

0.131

0.049

0.221

0.244

0.253

Urea nitrogen

–0.104

0.017

–0.190

–0.154

0.058

0.060

–0.025

Uric acid

0.329

0.466**

0.453**

0.445**

0.018

–0.005

0.534**

eGFR

–0.209

–0.294

–0.131

–0.049

–0.221

–0.244

–0.253

Cystatin C

0.072

0.241

0.148

0.227

–0.116

–0.044

0.334

HbA1c

0.321

0.362*

0.252

0.073

0.089

0.264

High-sensitivity CRP

0.360*

0.506**

0.568**

0.690**

–0.164

–0.154

0.609**

↓ **Table 5.** Correlation Between Changes in Body Composition and Changes in Blood Parameters
	ΔBody weight	ΔBMI	ΔBody fat mass	ΔBody fat percent	ΔSkeletal muscle mass	ΔMuscle mass	ΔWaist circumference
Values are presented as Spearman’s rank correlation coefficient (r). P < 0.05; *P < 0.01. WBC: white blood cell; RBC: red blood cell; Hb: hemoglobin; MCV: mean corpuscular volume; MCH: mean corpuscular hemoglobin; MCHC: mean corpuscular hemoglobin concentration; AST: aspartate aminotransferase; ALT: alanine aminotransferase; GGT: gamma-glutamyl transpeptidase; HDL: high-density lipoprotein; LDL: low-density lipoprotein; eGFR: estimated glomerular filtration rate; HbA1c: glycated hemoglobin; CRP: C-reactive protein.
ΔWBC	0.102	0.102	0.181	0.241	–0.280	–0.290	0.231
ΔRBC	0.190	0.166	0.356*	0.431*	–0.245	–0.325	0.187
ΔHb	0.215	0.188	0.333	0.391*	–0.195	–0.253	0.035
ΔHematocrit	0.118	0.094	0.263	0.382*	–0.240	–0.329	0.031
ΔPlatelets	0.210	0.233	0.348*	0.374*	–0.211	–0.245	0.293
ΔMCV	–0.149	–0.144	–0.263	–0.248	0.101	0.084	–0.310
ΔMCH	–0.083	–0.079	–0.184	–0.238	0.117	0.141	–0.348*
ΔMCHC	0.107	0.116	0.041	–0.098	0.121	0.166	0.074
ΔTotal protein	0.329	0.343	0.523**	0.604**	–0.316	–0.313	0.234
ΔAlbumin	0.196	0.217	0.263	0.306	–0.156	–0.155	0.165
ΔAST	0.480**	0.505**	0.357*	0.120	0.261	0.272	0.313
ΔALT	0.450**	0.461**	0.315	0.128	0.188	0.180	0.235
ΔGGT	0.337	0.359*	0.225	0.081	0.195	0.167	0.126
ΔCholinesterase	0.382*	0.353*	0.483**	0.511**	–0.084	–0.147	0.201
ΔTriglycerides	0.273	0.249	0.286	0.247	0.075	0.112	0.258
ΔHDL–cholesterol	–0.076	–0.064	–0.163	–0.202	0.182	0.092	–0.086
ΔLDL–cholesterol	0.150	0.134	0.207	0.257	–0.040	–0.116	–0.126
ΔCalcium	0.164	0.186	0.119	0.034	0.112	0.069	0.532**
ΔInorganic phosphate	0.168	0.148	0.181	0.276	–0.064	–0.155	0.249
ΔCreatinine	0.022	0.001	0.163	0.171	–0.362*	–0.349*	–0.191
ΔUrea nitrogen	0.163	0.157	0.144	0.221	0.041	0.057	0.271
ΔUric acid	0.223	0.175	0.194	0.203	0.107	0.057	0.024
ΔeGFR	0.049	0.072	–0.088	–0.158	0.355*	0.361*	0.278
ΔCystatin C	0.321	0.331	0.445**	0.420*	–0.146	–0.164	0.501**
ΔHbA1c	–0.029	–0.046	–0.030	–0.104	–0.080	–0.003	–0.031
ΔHigh–sensitivity CRP	0.355*	0.369*	0.316	0.192	0.179	0.233	0.300

↓ Table 5. Correlation Between Changes in Body Composition and Changes in Blood Parameters

ΔBody weight

ΔBMI

ΔBody fat mass

ΔBody fat percent

ΔSkeletal muscle mass

ΔMuscle mass

ΔWaist circumference

Values are presented as Spearman’s rank correlation coefficient (r). *P < 0.05; **P < 0.01. WBC: white blood cell; RBC: red blood cell; Hb: hemoglobin; MCV: mean corpuscular volume; MCH: mean corpuscular hemoglobin; MCHC: mean corpuscular hemoglobin concentration; AST: aspartate aminotransferase; ALT: alanine aminotransferase; GGT: gamma-glutamyl transpeptidase; HDL: high-density lipoprotein; LDL: low-density lipoprotein; eGFR: estimated glomerular filtration rate; HbA1c: glycated hemoglobin; CRP: C-reactive protein.

ΔWBC

0.102

0.181

0.241

–0.280

–0.290

0.231

ΔRBC

0.190

0.166

0.356*

0.431*

–0.245

–0.325

0.187

ΔHb

0.215

0.188

0.333

0.391*

–0.195

–0.253

0.035

ΔHematocrit

0.118

0.094

0.263

0.382*

–0.240

–0.329

0.031

ΔPlatelets

0.210

0.233

0.348*

0.374*

–0.211

–0.245

0.293

ΔMCV

–0.149

–0.144

–0.263

–0.248

0.101

0.084

–0.310

ΔMCH

–0.083

–0.079

–0.184

–0.238

0.117

0.141

–0.348*

ΔMCHC

0.107

0.116

0.041

–0.098

0.121

0.166

0.074

ΔTotal protein

0.329

0.343

0.523**

0.604**

–0.316

–0.313

0.234

ΔAlbumin

0.196

0.217

0.263

0.306

–0.156

–0.155

0.165

ΔAST

0.480**

0.505**

0.357*

0.120

0.261

0.272

0.313

ΔALT

0.450**

0.461**

0.315

0.128

0.188

0.180

0.235

ΔGGT

0.337

0.359*

0.225

0.081

0.195

0.167

0.126

ΔCholinesterase

0.382*

0.353*

0.483**

0.511**

–0.084

–0.147

0.201

ΔTriglycerides

0.273

0.249

0.286

0.247

0.075

0.112

0.258

ΔHDL–cholesterol

–0.076

–0.064

–0.163

–0.202

0.182

0.092

–0.086

ΔLDL–cholesterol

0.150

0.134

0.207

0.257

–0.040

–0.116

–0.126

ΔCalcium

0.164

0.186

0.119

0.034

0.112

0.069

0.532**

ΔInorganic phosphate

0.168

0.148

0.181

0.276

–0.064

–0.155

0.249

ΔCreatinine

0.022

0.001

0.163

0.171

–0.362*

–0.349*

–0.191

ΔUrea nitrogen

0.163

0.157

0.144

0.221

0.041

0.057

0.271

ΔUric acid

0.223

0.175

0.194

0.203

0.107

0.057

0.024

ΔeGFR

0.049

0.072

–0.088

–0.158

0.355*

0.361*

0.278

ΔCystatin C

0.321

0.331

0.445**

0.420*

–0.146

–0.164

0.501**

ΔHbA1c

–0.029

–0.046

–0.030

–0.104

–0.080

–0.003

–0.031

ΔHigh–sensitivity CRP

0.355*

0.369*

0.316

0.192

0.179

0.233

0.300

↓ **Table 6.** Relationship Between Body Composition Change and Blood Parameter Change
Independent variable	Dependent variable
Multiple linear regression analysis shows independent predictors of anthropometric and body composition changes (Δ). BMI: body mass index; RBC: red blood cell; AST: aspartate aminotransferase; ALT: alanine aminotransferase; CRP: C-reactive protein.
(Constant)		0.117		0.099		0.190		0.382		0.435		0.128
Age	0.238	0.277	0.245	0.260	0.166	0.419	0.194	0.462	0.167	0.516	0.157	0.508
ΔRBC	–0.156	0.533	–0.187	0.453	–0.025	0.914	–0.215	0.479	–0.295	0.324	–0.147	0.591
ΔTotal protein	–0.230	0.340	–0.217	0.363	–0.043	0.850	–0.485	0.103	–0.449	0.122	–0.403	0.130
ΔAST	0.475	0.047	0.485	0.042	0.262	0.235	0.548	0.059	0.589	0.039	0.296	0.246
ΔALT	–0.159	0.492	–0.135	0.556	–0.021	0.922	–0.297	0.293	–0.339	0.223	–0.099	0.696
ΔCholinesterase	0.483	0.007	0.451	0.011	0.505	0.003	0.046	0.821	0.053	0.789	0.254	0.170
ΔCystatin C	0.295	0.229	0.322	0.188	0.266	0.251	0.068	0.818	0.095	0.741	0.712	0.012
ΔHigh-sensitivity CRP	0.079	0.614	0.096	0.540	0.066	0.658	0.063	0.741	0.075	0.687	0.068	0.689
	R²	P value	R²	P value	R²	P value	R²	P value	R²	P value	R²	P value
	0.506	0.016	0.513	0.014	0.558	0.005	0.274	0.378	0.304	0.286	0.410	0.078

↓ Table 6. Relationship Between Body Composition Change and Blood Parameter Change

Independent variable

Dependent variable

ΔBody weight

ΔBMI

ΔBody fat mass

ΔSkeletal muscle mass

ΔMuscle mass

ΔWaist circumference

P value

Multiple linear regression analysis shows independent predictors of anthropometric and body composition changes (Δ). BMI: body mass index; RBC: red blood cell; AST: aspartate aminotransferase; ALT: alanine aminotransferase; CRP: C-reactive protein.

(Constant)

0.117

0.099

0.190

0.382

0.435

0.128

Age

0.238

0.277

0.245

0.260

0.166

0.419

0.194

0.462

0.167

0.516

0.157

0.508

ΔRBC

–0.156

0.533

–0.187

0.453

–0.025

0.914

–0.215

0.479

–0.295

0.324

–0.147

0.591

ΔTotal protein

–0.230

0.340

–0.217

0.363

–0.043

0.850

–0.485

0.103

–0.449

0.122

–0.403

0.130

ΔAST

0.475

0.047

0.485

0.042

0.262

0.235

0.548

0.059

0.589

0.039

0.296

0.246

ΔALT

–0.159

0.492

–0.135

0.556

–0.021

0.922

–0.297

0.293

–0.339

0.223

–0.099

0.696

ΔCholinesterase

0.483

0.007

0.451

0.011

0.505

0.003

0.046

0.821

0.053

0.789

0.254

0.170

ΔCystatin C

0.295

0.229

0.322

0.188

0.266

0.251

0.068

0.818

0.095

0.741

0.712

0.012

ΔHigh-sensitivity CRP

0.079

0.614

0.096

0.540

0.066

0.658

0.063

0.741

0.075

0.687

0.068

0.689

R²

P value

R²

P value

R²

P value

R²

P value

R²

P value

R²

P value

0.506

0.016

0.513

0.014

0.558

0.005

0.274

0.378

0.304

0.286

0.410

0.078

↓ **Table 7.** Association Between Changes in Body Composition and Changes in Blood Parameters (Stepwise Method)
Independent variable	Dependent variable
Stepwise multiple linear regression analysis was conducted to identify the independent predictors of age, RBC, total protein, AST, ALT, cholinesterase, cystatin C, and high-sensitivity CRP. RBC: red blood cell; AST: aspartate aminotransferase; ALT: alanine aminotransferase; CRP: C-reactive protein.
ΔCystatin C	0.500	0.003
	R²	P value
	0.250	0.003

↓ Table 7. Association Between Changes in Body Composition and Changes in Blood Parameters (Stepwise Method)

Independent variable

Dependent variable

ΔWaist circumference

P value

Stepwise multiple linear regression analysis was conducted to identify the independent predictors of age, RBC, total protein, AST, ALT, cholinesterase, cystatin C, and high-sensitivity CRP. RBC: red blood cell; AST: aspartate aminotransferase; ALT: alanine aminotransferase; CRP: C-reactive protein.

ΔCystatin C

0.500

0.003

R²

P value

0.250

0.003

↓ **Table 8.** Correlation of Cholinesterase and Cystatin C With Changes in Blood Parameters
	ΔWBC	ΔRBC	ΔHb	ΔHematocrit	ΔTotal protein	ΔAlbumin	ΔAST	ΔALT	ΔHigh-sensitivity CRP	ΔCholinesterase	ΔCystatin C
Values are presented as Spearman’s rank correlation coefficient (r). P < 0.05; *P < 0.01. WBC: white blood cell; RBC: red blood cell; Hb: hemoglobin; AST: aspartate aminotransferase; ALT: alanine aminotransferase; CRP: C-reactive protein.
ΔCholinesterase	0.094	0.360*	0.337	0.295	0.383*	0.436*	0.090	0.121	–0.086	–	0.213
ΔCystatin C	0.318	0.405*	0.181	0.287	0.624**	0.555**	0.142	0.048	0.047	0.213	–

↓ Table 8. Correlation of Cholinesterase and Cystatin C With Changes in Blood Parameters

ΔWBC

ΔRBC

ΔHb

ΔHematocrit

ΔTotal protein

ΔAlbumin

ΔAST

ΔALT

ΔHigh-sensitivity CRP

ΔCholinesterase

ΔCystatin C

Values are presented as Spearman’s rank correlation coefficient (r). *P < 0.05; **P < 0.01. WBC: white blood cell; RBC: red blood cell; Hb: hemoglobin; AST: aspartate aminotransferase; ALT: alanine aminotransferase; CRP: C-reactive protein.

ΔCholinesterase

0.094

0.360*

0.337

0.295

0.383*

0.436*

0.090

0.121

–0.086

–

0.213

ΔCystatin C

0.318

0.405*

0.181

0.287

0.624**

0.555**

0.142

0.048

0.047

0.213

–