title: Sustained cardiac remodeling after a short-term very low calorie diet in type 2 diabetes mellitus patients.
abstract: A very low calorie diet (VLCD) results in cardiac remodeling and improved diastolic function. It is unknown how long these effects sustain after reintroduction of a regular diet. We aimed to assess the long-term effects of initial weight loss by VLCD on cardiac dimensions and function in type 2 diabetes mellitus (T2DM) patients. Fourteen insulin-dependent T2DM patients (mean ± SEM: age 53 ± 2 years; BMI 35 ± 1 kg/m(2)) were treated by a VLCD (450 kcal/day) during 16 weeks. Cardiac function and myocardial triglyceride (TG) content were measured by magnetic resonance imaging and spectroscopy at baseline, after a 16-week VLCD and after 14 months of follow-up on a regular diet. BMI decreased from 35 ± 1 to 28 ± 1 kg/m(2) after VLCD and increased again to 32 ± 1 kg/m(2) at 18 months (both P < 0.05 vs. baseline). Left ventricular (LV) end-diastolic volume index increased after the 16-week VLCD (80 ± 3 to 89 ± 4 ml/m(2), P < 0.05) and remained increased after follow-up (90 ± 3 ml/m(2); P < 0.05 vs. baseline) at comparable filling pressures. The improvement in LV diastolic function after the 16-week VLCD, was sustained at 18 months [early (E)/atrial (A) diastolic filling phase ratio: 0.96 ± 0.07 (baseline); 1.12 ± 0.06 (after VLCD); 1.06 ± 0.07 (18 months, P < 0.05 vs. baseline)]. Myocardial TG content decreased after the 16-week VLCD [0.74 (0.41-1.10) to 0.45 (0.31-0.54) %, P < 0.05], but returned to baseline levels at 18 months [0.76 (0.65-1.32) %]. Weight reduction by a 16-week VLCD in T2DM patients results in sustained cardiac remodeling and improved diastolic function after 14 months of follow-up, despite weight regain on a regular diet.
authors.affiliation: Department of Endocrinology and Metabolism, Leiden University Medical Center, Leiden, The Netherlands, j.t.jonker@lumc.nl.
authors.forename: Jacqueline T
authors.initials: JT
authors.lastname: Jonker
authors.forename: Marieke
authors.initials: M
authors.lastname: Snel
authors.forename: Sebastiaan
authors.initials: S
authors.lastname: Hammer
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: A Edo
authors.initials: AE
authors.lastname: Meinders
authors.forename: Albert
authors.initials: A
authors.lastname: de Roos
authors.forename: Johannes W A
authors.initials: JW
authors.lastname: Smit
authors.forename: Johannes A
authors.initials: JA
authors.lastname: Romijn
authors.forename: Hildo J
authors.initials: HJ
authors.lastname: Lamb
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000175:diagnosis / Q000178:diet therapy* / Q000188:drug therapy; D050528:Diet, Carbohydrate-Restricted; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism / Q000473:pathology; D009426:Netherlands; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome; D014280:Triglycerides / Q000378:metabolism; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology*; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling; D015431:Weight Loss
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin; D014280:Triglycerides