title: Prolonged caloric restriction in obese patients with type 2 diabetes mellitus decreases myocardial triglyceride content and improves myocardial function.
abstract: OBJECTIVE
  This study sought to assess the effects of prolonged caloric restriction in obese patients with type 2 diabetes mellitus (T2DM) on myocardial triglyceride (TG) content and myocardial function.
  
  
  BACKGROUND
  Myocardial TG content is increased in patients with T2DM and may reflect altered myocardial function. It is unknown whether myocardial TG content is influenced during a therapeutic intervention.
  
  
  METHODS
  Myocardial TG content (magnetic resonance [MR] spectroscopy), myocardial function (MR imaging), plasma hemoglobin A1c, and body mass index (BMI) were measured in 12 obese, insulin-treated T2DM patients before and after a 16-week very-low-calorie diet (VLCD) (450 kcal/day) to achieve substantial weight loss. Insulin was stopped during the VLCD.
  
  
  RESULTS
  The BMI decreased from 35.6 +/- 1.2 kg/m(2) (baseline, mean +/- SEM) to 27.5 +/- 1.3 kg/m(2) (after the VLCD, p < 0.001) and was associated with an improvement in hemoglobin A1c from 7.9 +/- 0.4% (baseline) to 6.3 +/- 0.3% (after the VLCD, p = 0.006). Myocardial TG content decreased from 0.88 +/- 0.12% to 0.64 +/- 0.14%, respectively (p = 0.019), and was associated with improved diastolic function (reflected by the ratio between the early and atrial filling phase) from 1.02 +/- 0.08 to 1.18 +/- 0.06, respectively (p = 0.019).
  
  
  CONCLUSIONS
  Prolonged caloric restriction in obese T2DM patients decreases BMI and improves glucoregulation associated with decreased myocardial TG content and improved diastolic heart function. Therefore, myocardial TG stores in obese patients with T2DM are flexible and amendable to therapeutic intervention by caloric restriction.
authors.affiliation: Department of Endocrinology and Metabolism, Leiden University Medical Center, Leiden, the Netherlands. S.Hammer@LUMC.nl
authors.forename: Sebastiaan
authors.initials: S
authors.lastname: Hammer
authors.forename: Marieke
authors.initials: M
authors.lastname: Snel
authors.forename: Hildo J
authors.initials: HJ
authors.lastname: Lamb
authors.forename: Ingrid M
authors.initials: IM
authors.lastname: Jazet
authors.forename: Rutger W
authors.initials: RW
authors.lastname: van der Meer
authors.forename: Hanno
authors.initials: H
authors.lastname: Pijl
authors.forename: Edo A
authors.initials: EA
authors.lastname: Meinders
authors.forename: Johannes A
authors.initials: JA
authors.lastname: Romijn
authors.forename: Albert
authors.initials: A
authors.lastname: de Roos
authors.forename: Johannes W A
authors.initials: JW
authors.lastname: Smit
mesh_terms: D031204:Caloric Restriction; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000178:diet therapy* / Q000378:metabolism; D003971:Diastole; D005260:Female; D006801:Humans; D008099:Liver / Q000378:metabolism; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism*; D009765:Obesity / Q000150:complications / Q000178:diet therapy* / Q000378:metabolism; D013599:Systole; D014280:Triglycerides / Q000378:metabolism*; D016277:Ventricular Function, Left
chemical_list: D014280:Triglycerides