title: Long-term beneficial effect of a 16-week very low calorie diet on pericardial fat in obese type 2 diabetes mellitus patients.
abstract: Pericardial fat accumulation has been associated with an increased cardiovascular risk. A very low calorie diet (VLCD) improves the cardiovascular risk profile in patients with type 2 diabetes mellitus (T2DM), by improving the metabolic profile, heart function, and triglyceride (TG) stores in (non)adipose tissues. However, long-term effects of a VLCD on pericardial fat volume and tissue-specific TG accumulation have not been documented. The aim of this study was therefore to assess the effects of a 16-week VLCD and of subsequent 14 months follow-up on a regular diet on pericardial fat in relation to other TG stores in obese T2DM patients. We included 14 obese patients with insulin-treated T2DM (mean ± s.e.m.: age 53 ± 2 years; BMI 35 ± 1 kg/m(2)). Pericardial fat and other (non)adipose TG stores were measured using magnetic resonance (MR) imaging and proton spectroscopy before and after a 16-week VLCD and after a 14-month follow-up without dietary interventions. A 16-week VLCD reduced body weight, pericardial fat, hepatic TG content, visceral and subcutaneous abdominal fat volumes to 78, 83, 16, 40, and 53% of baseline values respectively, (all P < 0.05). After an additional 14 months of follow-up on a regular diet, the reduction in pericardial fat volume sustained, despite a substantial regain in body weight, visceral abdominal fat, and hepatic TG content (respectively 90, 83 and 73% of baseline values). In conclusion, VLCD-induced weight loss in obese T2DM patients is accompanied by a substantial decrease in pericardial fat volume, which is sustained even after subsequent weight regain.
authors.affiliation: Department of General Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands. m.snel@lumc.nl
authors.forename: Marieke
authors.initials: M
authors.lastname: Snel
authors.forename: Jacqueline T
authors.initials: JT
authors.lastname: Jonker
authors.forename: Sebastian
authors.initials: S
authors.lastname: Hammer
authors.forename: Gijs
authors.initials: G
authors.lastname: Kerpershoek
authors.forename: Hildo J
authors.initials: HJ
authors.lastname: Lamb
authors.forename: A Edo
authors.initials: AE
authors.lastname: Meinders
authors.forename: Hanno
authors.initials: H
authors.lastname: Pijl
authors.forename: Albert
authors.initials: A
authors.lastname: de Roos
authors.forename: Johannes A
authors.initials: JA
authors.lastname: Romijn
authors.forename: Johannes W A
authors.initials: JW
authors.lastname: Smit
authors.forename: Ingrid M
authors.initials: IM
authors.lastname: Jazet
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism*; D031204:Caloric Restriction; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000178:diet therapy* / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D050152:Intra-Abdominal Fat / Q000378:metabolism; D008099:Liver / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000178:diet therapy* / Q000378:metabolism; D010496:Pericardium / Q000378:metabolism*; D050151:Subcutaneous Fat / Q000378:metabolism; D013997:Time Factors; D016896:Treatment Outcome; D014280:Triglycerides / Q000378:metabolism*; D015430:Weight Gain; D015431:Weight Loss / Q000502:physiology*
chemical_list: D007328:Insulin; D014280:Triglycerides