title: Cardiovascular flexibility in middle-aged overweight South Asians vs. white Caucasians: response to short-term caloric restriction.
abstract: OBJECTIVE
  South Asians have a higher risk of developing cardiovascular disease than white Caucasians. The underlying cause is unknown, but might be related to higher cardiac susceptibility to metabolic disorders. Short-term caloric restriction (CR) can be used as a metabolic stress test to study cardiac flexibility. We assessed whether metabolic and functional cardiovascular flexibility to CR differs between South Asians and white Caucasians.
  
  
  RESULTS
  Cardiovascular function and myocardial triglycerides were assessed using a 1.5T-MRI/S-scanner in 12 middle-aged overweight male South Asians and 12 matched white Caucasians before and after an 8-day very low calorie diet (VLCD). At baseline South Asians were more insulin resistant than Caucasians. Cardiac dimensions were smaller, despite correction for body surface area, and pulse wave velocity (PWV) in the distal aorta was higher in South Asians. Systolic and diastolic function, myocardial triglycerides and pericardial fat did not differ significantly between groups. After the VLCD body weight reduced on average by 4.0 ± 0.2 kg. Myocardial triglycerides increased in both ethnicities by 69 ± 18%, and diastolic function decreased although this was not significant in South Asians. However, pericardial fat and PWV in the proximal and total aorta were reduced in Caucasians only.
  
  
  CONCLUSIONS
  Myocardial triglyceride stores in middle-aged overweight and insulin resistant South Asians are as flexible and amenable to therapeutic intervention by CR as age-, sex- and BMI-matched but less insulin resistant white Caucasians. However, paracardial fat volume and PWV showed a differential effect in response to an 8-day VLCD in favor of Caucasians.
  
  
  BACKGROUND
  NTR 2473 (URL: http://www.trialregister.nl/trialreg/admin/rctsearch.asp?Term=2473).
authors.affiliation: Department of Endocrinology, Leiden University Medical Center (LUMC), 2300 RC Leiden, The Netherlands. Electronic address: l.d.van_schinkel@lumc.nl.
authors.forename: L D
authors.initials: LD
authors.lastname: Van Schinkel
authors.affiliation: Department of Endocrinology, Leiden University Medical Center (LUMC), 2300 RC Leiden, The Netherlands.
authors.forename: L E H
authors.initials: LE
authors.lastname: Bakker
authors.affiliation: Department of Endocrinology, Leiden University Medical Center (LUMC), 2300 RC Leiden, The Netherlands.
authors.forename: J T
authors.initials: JT
authors.lastname: Jonker
authors.affiliation: Department of Radiology, Leiden University Medical Center (LUMC), Leiden, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: De Roos
authors.affiliation: Department of Endocrinology, Leiden University Medical Center (LUMC), 2300 RC Leiden, The Netherlands.
authors.forename: H
authors.initials: H
authors.lastname: Pijl
authors.affiliation: Department of Endocrinology, Leiden University Medical Center (LUMC), 2300 RC Leiden, The Netherlands.
authors.forename: A E
authors.initials: AE
authors.lastname: Meinders
authors.affiliation: Department of Endocrinology, Leiden University Medical Center (LUMC), 2300 RC Leiden, The Netherlands.
authors.forename: I M
authors.initials: IM
authors.lastname: Jazet
authors.affiliation: Department of Radiology, Leiden University Medical Center (LUMC), Leiden, The Netherlands.
authors.forename: H J
authors.initials: HJ
authors.lastname: Lamb
authors.affiliation: Department of Endocrinology, Leiden University Medical Center (LUMC), 2300 RC Leiden, The Netherlands.
authors.forename: J W A
authors.initials: JW
authors.lastname: Smit
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism; D000328:Adult; D044466:Asian People; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D001830:Body Surface Area; D031204:Caloric Restriction; D002319:Cardiovascular System / Q000378:metabolism*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism; D050177:Overweight / Q000097:blood*; D011446:Prospective Studies; D063177:Pulse Wave Analysis; D014280:Triglycerides / Q000097:blood; D044465:White People
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin; D007328:Insulin; D014280:Triglycerides
keywords: Caloric restriction; Cardiovascular disease; Diabetes mellitus; Magnetic resonance imaging and spectroscopy; South Asians; Very low calorie diet