title: Renal and Systemic Effects of Calorie Restriction in Patients With Type 2 Diabetes With Abdominal Obesity: A Randomized Controlled Trial.
abstract: In individuals with type 2 diabetes with abdominal obesity, hyperfiltration is a risk factor for accelerated glomerular filtration rate (GFR) decline and nephropathy. In this academic, single-center, parallel-group, prospective, randomized, open-label, blinded end point trial, consenting patients with type 2 diabetes aged >18 years, with waist circumference >94 (males) or >80 (females) cm, serum creatinine <1.2 mg/dL, and normoalbuminuria were randomized (1:1) with permuted blocks to 6 months of a 25% calorie restricted (CR) or standard diet (SD). Primary outcome was measured GFR (iohexol plasma clearance). Analyses were by modified intention to treat. At 6 months, GFR significantly decreased in 34 patients on CR and did not change appreciably in 36 on SD. Changes were significantly different between the groups. GFR and body weight reduction were correlated. GFR reduction was larger in hyperfiltering (GFR >120 mL/min) than nonhyperfiltering patients and was associated with BMI, waist circumference, blood pressure, heart rate, HbA1c, blood glucose, LDL-to-HDL cholesterol ratio, C-reactive protein, angiotensin II, and albuminuria reduction and with increased glucose disposal rate (measured by hyperinsulinemic-euglycemic clamps). Protein and sodium intake and concomitant treatments were similar between the groups. CR was tolerated well. In patients with type 2 diabetes with abdominal obesity, CR ameliorates glomerular hyperfiltration, insulin sensitivity, and other cardiovascular risk factors, effects that might translate into long-term nephro- and cardioprotection.
authors.affiliation: IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Centro di Ricerche Cliniche per le Malattie Rare "Aldo e Cele Daccò," Bergamo, Italy.|Unit of Nephrology, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy.
authors.forename: Piero
authors.initials: P
authors.lastname: Ruggenenti
authors.affiliation: IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Centro di Ricerche Cliniche per le Malattie Rare "Aldo e Cele Daccò," Bergamo, Italy.
authors.forename: Manuela
authors.initials: M
authors.lastname: Abbate
authors.affiliation: IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Centro di Ricerche Cliniche per le Malattie Rare "Aldo e Cele Daccò," Bergamo, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Ruggiero
authors.affiliation: Unit of Nephrology, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Rota
authors.affiliation: IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Centro di Ricerche Cliniche per le Malattie Rare "Aldo e Cele Daccò," Bergamo, Italy.
authors.forename: Matias
authors.initials: M
authors.lastname: Trillini
authors.affiliation: IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Centro di Ricerche Cliniche per le Malattie Rare "Aldo e Cele Daccò," Bergamo, Italy.
authors.forename: Carolina
authors.initials: C
authors.lastname: Aparicio
authors.affiliation: IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Centro di Ricerche Cliniche per le Malattie Rare "Aldo e Cele Daccò," Bergamo, Italy.
authors.forename: Aneliya
authors.initials: A
authors.lastname: Parvanova
authors.affiliation: IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Centro di Ricerche Cliniche per le Malattie Rare "Aldo e Cele Daccò," Bergamo, Italy.
authors.forename: Ilian
authors.initials: I
authors.lastname: Petrov Iliev
authors.affiliation: IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Centro di Ricerche Cliniche per le Malattie Rare "Aldo e Cele Daccò," Bergamo, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Pisanu
authors.affiliation: IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Centro di Ricerche Cliniche per le Malattie Rare "Aldo e Cele Daccò," Bergamo, Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Perna
authors.affiliation: IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Centro di Ricerche Cliniche per le Malattie Rare "Aldo e Cele Daccò," Bergamo, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Russo
authors.affiliation: IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Centro di Ricerche Cliniche per le Malattie Rare "Aldo e Cele Daccò," Bergamo, Italy.
authors.forename: Olimpia
authors.initials: O
authors.lastname: Diadei
authors.affiliation: IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Centro di Ricerche Cliniche per le Malattie Rare "Aldo e Cele Daccò," Bergamo, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Martinetti
authors.affiliation: IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Centro di Ricerche Cliniche per le Malattie Rare "Aldo e Cele Daccò," Bergamo, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Cannata
authors.affiliation: IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Centro di Ricerche Cliniche per le Malattie Rare "Aldo e Cele Daccò," Bergamo, Italy.
authors.forename: Fabiola
authors.initials: F
authors.lastname: Carrara
authors.affiliation: IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Centro di Ricerche Cliniche per le Malattie Rare "Aldo e Cele Daccò," Bergamo, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Ferrari
authors.affiliation: IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Centro di Ricerche Cliniche per le Malattie Rare "Aldo e Cele Daccò," Bergamo, Italy.
authors.forename: Nadia
authors.initials: N
authors.lastname: Stucchi
authors.affiliation: IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Centro di Ricerche Cliniche per le Malattie Rare "Aldo e Cele Daccò," Bergamo, Italy giuseppe.remuzzi@marionegri.it.|Unit of Nephrology, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy.|Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Remuzzi
authors.affiliation: Department of Clinical and Experimental Sciences, Brescia University Medical School, Brescia, Italy.|Department of Medicine, Washington University in St. Louis, St. Louis, MO.|CEINGE Biotecnologie Avanzate, Napoli, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Fontana
mesh_terms: D000368:Aged; D000804:Angiotensin II / Q000378:metabolism; D001835:Body Weight / Q000502:physiology; D002097:C-Reactive Protein / Q000378:metabolism; D031204:Caloric Restriction; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D007668:Kidney / Q000378:metabolism* / Q000502:physiology; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000503:physiopathology*; D012307:Risk Factors
chemical_list: D000804:Angiotensin II; D002097:C-Reactive Protein