Sustained cardiac remodeling after a short-term very low calorie diet in type 2 diabetes mellitus patients

• J.T. Jonker
• M. Snel
• S. Hammer
• I.M. Jazet
• R.W. van der Meer
• H. Pijl
• A.E. Meinders
• A. de Roos
• J.W. Smit
• J.A. Romijn
• H.J. Lamb

Abstract

A very low calorie diet (VLСD) 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 VLСD on cardiac dimensions and function in type 2 diabetes mellitus (T2DM) patients. Fourteen insulin-dependent T2DM patients (mean±СОС: age 53±2 years; BMI 35±1 kg/m 2 ) were treated by a VLСD (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 VLСD and after 14 months of follow-up on a regular diet. BMI decreased from 35±1 to 28±1 kg/m 2 after VLСD and increased again to 32±1 kg/m 2 at 18 months (both p<0,05 vs. baseline). Left ventricular (LV) enddiastolic volume index increased after the 16-week ОНД (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 VLСD, was sustained at 18 months [early (E)/atrial (A) diastolic filling phase ratio: 0,96±0,07 (baseline); 1,12±0,06 (after VLСD); 1,06±0,07 (18 months, p<0,05 vs. baseline)]. Myocardial TG content decreased after the 16-week VLСD [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 VLСD 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.

Keywords:сardiac remodeling, diabetes mellitus, follow-up studies, diet, magnetic resonance imaging