Prolonged caloric restriction in obese patients with type 2 diabetes mellitus decreases myocardial triglyceride content and improves myocardial function.
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.
Hammer
Sebastiaan
S
Department of Endocrinology and Metabolism, Leiden University Medical Center, Leiden, the Netherlands. S.Hammer@LUMC.nl
Snel
Marieke
M
Lamb
Hildo J
HJ
Jazet
Ingrid M
IM
van der Meer
Rutger W
RW
Pijl
Hanno
H
Meinders
Edo A
EA
Romijn
Johannes A
JA
de Roos
Albert
A
Smit
Johannes W A
JW
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
D014280:Triglycerides