Prolonged Caloric Restriction in Obese Patients With Type 2 Diabetes Mellitus Decreases Myocardial Triglyceride Content and Improves Myocardial Function

Hammer, Sebastiaan; Snel, Marieke; Lamb, Hildo J.; Jazet, Ingrid M.; Meer, R.W. van der; Pijl, Hanno; Meinders, Edo A.; Romijn, Johannes A.; Roos, Albert de; Smit, Johannes W. A.

doi:10.1016/j.jacc.2008.04.068

Cited by 231 publications

(179 citation statements)

References 40 publications

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“…Hammer and colleagues reported that a shortterm very low-calorie diet increases myocardial triglyceride content and is associated with a decrease in left ventricular diastolic function in patients with well-controlled type 2 diabetes [76] . Furthermore prolonged caloric restriction improves 1114 www.nature.com/aps Han X et al Acta Pharmacologica Sinica npg glucoregulation associated with decreased myocardial triglyceride content and favorable effects on blood pressure and myocardial function in insulin-treated obese patients with type 2 diabetes [77] . These data prove that myocardial triglyceride stores in obese patients with type 2 diabetes are flexible and amendable to therapeutic intervention by caloric restriction.…”

Section: Diabetes Mellitus and Metabolic Syndromementioning

confidence: 99%

Caloric restriction and heart function: is there a sensible link?

Han

Ren

2010

Acta Pharmacol Sin

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Calorie restriction (CR) is defined as a reduction in calorie intake below the usual ad libitum intake without malnutrition. In general, the daily caloric intake subjected to CR has been restricted to 50% to 70% of the average food intake in subjects eating ad libitum [1,2] . CR was first reported to retard aging and prolong median and maximal life span in the 1930s [3] . Over the last several decades, CR has been widely studied which exhibits an apparent beneficial impact on longevity, ageassociated diseases, and attenuation of functional decline, across a broad variety of species (including rats, mice, fish, flies, worms and yeast) [4,5] . Moreover, CR provides protection against a cadre of chronic diseases including diabetes mellitus, neurodegenerative diseases, autoimmune disorders [6][7][8] and cancer [9][10][11][12] . CR has been shown to alter a variety of physiological parameters especially reduced metabolic rate and oxidative damage, resulting in a decrease in the incidence of cardiovascular diseases [13] . In response to energy deficiency, experimental animals experience a drastic decrease in both fat mass and lean body mass. Muscle mass is overtly reduced, although the rate of loss of function and mass/body weight with the aging process is attenuated [9,[14][15][16] . Metabolic rate may decrease transiently although studies have indicated similar metabolic rate per kg lean body mass to that of ad libitum fed rodents in longterm CR protocol [17] . Body temperature, systolic and diastolic blood pressure all decrease [18,19] along with the reduced sympathetic activity [20] . CR-treated animals are more spontaneously active and display superior cognitive abilities compared to their ad libitum counterparts [21,22] .The most prominent mechanism that may be responsible for the beneficial health and physiological effects of CR are usually mediated through increased insulin sensitivity which results in reduced plasma glucose and insulin concentrations and improved glucose tolerance [23] ; reduced levels of oxidative stress (decreased oxidative damage to proteins, lipids and DNA) [24] , increased resistance to various types of stress including heat, oxidative and metabolic stress [25] as well as enhanced immune function [26] . Impact of CR on agingAn inverse relationship between calorie intake and lifespan has been revealed in mice, suggesting a key role for regulators of energy metabolism in the mechanism of CR. Accordingly, CR-induced metabolic reprogramming may be a key event in the mechanism of lifespan extension [27,28] . The age when CR is started, the severity of restriction, and strain or genetic background of animals determine the magnitude of life extension. The only mammals in which CR has clearly been shown ReviewCaloric restriction and heart function: is there a sensible link? Calorie restriction (CR) is defined as a reduction in calorie intake below the usual ad libitum intake without malnutrition. Ample of clinical and experimental evidence has demonstrated that CR is capable of retarding aging p...

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Section: Diabetes Mellitus and Metabolic Syndromementioning

confidence: 99%

Caloric restriction and heart function: is there a sensible link?

Han

Ren

2010

Acta Pharmacol Sin

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“…This is a challenging approach as the heart is always in motion owing to contraction and breathing, and because previous studies have already shown that myocardial TG stores may change rapidly depending on nutritional conditions. [27][28][29][30] MRI was recently used in mildly obese patients to suggest that the increase in MTGC could be associated with cardiac dysfunction. [31][32][33] To date, no study has addressed the relationship between EFV and MTGC in morbidly obese patients, a population with an abundance of fat in different depots and a high risk of cardiac failure, 34 because of the relatively small diameter of the MRI magnet bore.…”

Section: Introductionmentioning

confidence: 99%

Assessment of epicardial fat volume and myocardial triglyceride content in severely obese subjects: relationship to metabolic profile, cardiac function and visceral fat

et al. 2011

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Objective: To assess epicardial fat volume (EFV), myocardial TG content (MTGC) and metabolic profile in severely obese patients, and to determine whether ectopic fat depots are linked to metabolic disorders or myocardial function. Research design and methods: Sixty-three subjects with normal LV function and no coronary artery disease, including 33 lean (BMI: 21.4 ± 2.0 kg m À2 ) and 30 obese (BMI: 41.8 ± 6 kg m À2 ) patients, underwent 3-T cardiovascular MRI, and anthropometric, biological and visceral abdominal fat (VAT) assessments. EFV was measured by short-axis slice imaging and myocardial (intra-myocellular) TG content was measured by proton magnetic resonance spectroscopy. Results: EFV and MTGC were positively correlated (r ¼ 0.52, Po0.0001), and were both strongly correlated with age, BMI, waist circumference and VAT, but not with severity of obesity. EFV and MTGC were significantly higher in obese patients than in lean controls (141±18 versus 79±7 ml, P ¼ 0.0001; 1.0±0.1 versus 0.6±0.1%, P ¼ 0.01, respectively), but some differences were found between the two cardiac depots: EFV was higher in diabetic obese subjects as compared with that in non-diabetic obese subjects (213±34 versus 141±18 ml, P ¼ 0.03), and was correlated with parameters of glucose tolerance (fasting plasma glucose, insulin and HOMA-IR), whereas MTGC was not. EFV and MTGC were both associated with parameters of lipid profile or inflammation (TGs, CRP). Remarkably, this was VAT-dependent, as only VAT remained independently associated with metabolic parameters (Po0.01). Concerning myocardial function, MTGC was the only parameter independently associated with stroke volume (b ¼ À0.38, P ¼ 0.01), suggesting an impact of cardiac steatosis in cardiac function. Conclusions: These data show that VAT dominates the relationship between EFV, MTGC and metabolic measures, and uncover specific partitioning of cardiac ectopic lipid deposition.

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“…Nevertheless, the quantification of cardiac steatosis remains challenging, essentially because the acquisition of the spectra needs a double trigger (ECG and respiratory). It has also been shown that myocardial triglycerides decrease after energy restriction in obese type 2 diabetes patients 33,34 and that this decrease in myocardial triglycerides is associated with better cardiac function.…”

Section: Fat Deposits and Fat Imagingmentioning

confidence: 97%

The role of imaging and molecular imaging in the early detection of metabolic and cardiovascular dysfunctions

et al. 2010

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Despite intense effort, obesity is still rising throughout the world. Links between obesity and cardiovascular diseases are now well established. Most of the cardiovascular changes related to obesity can be followed by magnetic resonance imaging (MRI) or by magnetic resonance spectroscopy (MRS). In particular, we will see in this review that MRI/MRS is extremely well suited to depict (1) changes in cardiac mass and function, (2) changes in stroke volume, (3) accumulation of fat inside the mediastinum or even inside the cardiomyocytes, (4) cell viability and (5) molecular changes during early cardiovascular diseases.

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Prolonged Caloric Restriction in Obese Patients With Type 2 Diabetes Mellitus Decreases Myocardial Triglyceride Content and Improves Myocardial Function

Cited by 231 publications

References 40 publications

Caloric restriction and heart function: is there a sensible link?

Caloric restriction and heart function: is there a sensible link?

Assessment of epicardial fat volume and myocardial triglyceride content in severely obese subjects: relationship to metabolic profile, cardiac function and visceral fat

The role of imaging and molecular imaging in the early detection of metabolic and cardiovascular dysfunctions

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