title: Effect of a Mediterranean diet on endothelial progenitor cells and carotid intima-media thickness in type 2 diabetes: Follow-up of a randomized trial.
abstract: Background We assessed the long-term effects of a Mediterranean diet on circulating levels of endothelial progenitor cells (EPCs) and the carotid intima-media thickness (CIMT) in patients with type 2 diabetes. Design This was a parallel, two-arm, single-centre trial. Methods Two hundred and fifteen men and women with newly diagnosed type 2 diabetes were randomized to a Mediterranean diet ( n = 108) or a low-fat diet ( n = 107). The primary outcome measures were changes in the EPC count and the CIMT of the common carotid artery after the treatment period defined as the end of trial (EOT). Results At the EOT, both the CD34+KDR+and CD34+KDR+CD133+counts had increased with the Mediterranean diet compared with the low-fat diet ( p < 0.05 for both). At the EOT evaluation, there was a significant ( p = 0.024) difference of -0.025 mm in the CIMT favouring the Mediterranean diet. Compared with the low-fat diet, the rate of regression in the CIMT was higher in the Mediterranean diet group (51 vs. 26%), whereas the rate of progression was lower (25 vs. 50%) ( p = 0.032 for both). Changes in the CIMT were inversely correlated with the changes in EPC levels (CD34+KDR+, r = -0.24, p = 0.020; CD34+KDR+CD133+, r = -0.28, p = 0.014). At the EOT, changes in levels of HbA1c, HOMA, total cholesterol, high-density lipoprotein cholesterol and systolic blood pressure were significantly greater with the Mediterranean diet than with the low-fat diet. Conclusion Compared with a low-fat diet, a long-term trial with Mediterranean diet was associated with an increase in circulating EPCs levels and prevention of the progression of subclinical atherosclerosis in patients with newly diagnosed type 2 diabetes.
authors: 1 Department of Medical, Surgical, Neurological, Metabolic Sciences and Aging, Second University of Naples, Italy.
authors: Maria Ida
authors: MI
authors: Maiorino
authors: 1 Department of Medical, Surgical, Neurological, Metabolic Sciences and Aging, Second University of Naples, Italy.
authors: Giuseppe
authors: G
authors: Bellastella
authors: 2 Diabetes Unit, Second University of Naples, Italy.
authors: Michela
authors: M
authors: Petrizzo
authors: 2 Diabetes Unit, Second University of Naples, Italy.
authors: Maurizio
authors: M
authors: Gicchino
authors: 1 Department of Medical, Surgical, Neurological, Metabolic Sciences and Aging, Second University of Naples, Italy.
authors: Mariangela
authors: M
authors: Caputo
authors: 1 Department of Medical, Surgical, Neurological, Metabolic Sciences and Aging, Second University of Naples, Italy.
authors: Dario
authors: D
authors: Giugliano
authors: 1 Department of Medical, Surgical, Neurological, Metabolic Sciences and Aging, Second University of Naples, Italy.|2 Diabetes Unit, Second University of Naples, Italy.
authors: Katherine
authors: K
authors: Esposito
mesh_terms: D000328:Adult; D059168:Carotid Intima-Media Thickness; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000178:diet therapy* / Q000473:pathology*; D018752:Diet, Fat-Restricted; D038441:Diet, Mediterranean; D066026:Endothelial Progenitor Cells; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D013997:Time Factors
keywords: Mediterranean diet; carotid intima-media thickness; endothelial progenitor cells; type 2 diabetes