Differential effects of low-carbohydrate and low-fat diets on inflammation and endothelial function in diabetes.
OBJECTIVE
To characterize acute (postprandial) and chronic (after a 6-month period of weight loss) effects of a low-carbohydrate vs. a low-fat diet on subclinical markers of cardiovascular disease (CVD) in adults with type 2 diabetes.


METHODS
At baseline and 6 months, measures of C-reactive protein (CRP), interleukin-6 (IL-6), soluble intercellular adhesion molecule (sICAM) and soluble E-selectin were obtained from archived samples (n = 51) of participants randomized in a clinical trial comparing a low-carbohydrate and a low-fat diet. In a subset of participants (n = 27), postprandial measures of these markers were obtained 3 h after a low-carbohydrate or low-fat liquid meal. Endothelial function was also measured by reactive hyperemic peripheral arterial tonometry during the meal test. Paired t tests and unpaired t tests compared within- and between-group changes.


RESULTS
There were no significant differences observed in postprandial measures of inflammation or endothelial function. After 6 months, CRP (mean ± S.E.) decreased in the low-fat arm from 4.0 ± 0.77 to 3.0 ± 0.77 (P = .01). In the low-carbohydrate arm, sICAM decreased from 234 ± 22 to 199 ± 23 (P = .001), and soluble E-selectin decreased from 93 ± 10 to 82 ± 10 (P = .05.) A significant correlation between change in high-density lipoprotein and change in soluble E-selectin (r = -0.33, P = .04) and with the change in ICAM (r = -0.43, P = .01) was observed.


CONCLUSIONS
Low-carbohydrate and low-fat diets both have beneficial effects on CVD markers. There may be different mechanisms through which weight loss with these diets potentially reduces CVD risk.
Department of Medicine, Albert Einstein College of Medicine, Bronx, NY 10461, USA. ndavis@montefiore.org
Nichola J
NJ
Davis
Jill P
JP
Crandall
Srikanth
S
Gajavelli
Joan W
JW
Berman
Nora
N
Tomuta
Judith
J
Wylie-Rosett
Stuart D
SD
Katz
D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis; D002318:Cardiovascular Diseases / Q000150:complications / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000178:diet therapy* / Q000276:immunology / Q000503:physiopathology; D050528:Diet, Carbohydrate-Restricted / Q000009:adverse effects; D018752:Diet, Fat-Restricted / Q000009:adverse effects; D019040:E-Selectin / Q000097:blood / Q000737:chemistry; D004730:Endothelium, Vascular / Q000276:immunology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood / Q000737:chemistry; D008075:Lipoproteins, HDL / Q000097:blood; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D050177:Overweight / Q000150:complications; D019518:Postprandial Period; D012995:Solubility; D014655:Vascular Resistance; D015431:Weight Loss
D015415:Biomarkers; D019040:E-Selectin; D008075:Lipoproteins, HDL; C546936:SELE protein, human; D018799:Intercellular Adhesion Molecule-1; D002097:C-Reactive Protein