Weight Loss Improves Endothelial Function Independently of ADMA Reduction in Severe Obesity

Abstract

This prospective study was performed in order to establish whether improvement of endothelial function after weight reduction can be explained by a decrease of elevated asymmetric dimethyl arginine (ADMA), an inhibitor of endogenous NO-synthase (eNOS). Therefore, 21 obese subjects (BMI: 41.1±6.4 kg/m(2)) were studied at baseline and after 12 weeks of weight reduction with a very low calorie diet. Biochemical and clinical parameters of endothelial function were assessed before and after weight loss. Biochemical parameters were determined by measurement of ADMA and soluble intercellular adhesion molecule (sICAM). Clinical parameters were assessed by pulse wave analysis (PWA). Weight intervention resulted in a 21.4±6.8 kg reduction of body weight from 119.7±12.8 kg at study start to 98.3±11.6 kg at study end (p<0.001). Accordingly, biochemical markers improved under weight reduction (ADMA from 0.47±0.07 mmol/l to 0.42±0.08 mmol/l; p=0.002; ICAM from 276±42 ng/ml to 236±29 ng/ml; p<0.001). Further, clinical parameters of functional endothelial function improved with an increase of deltaRI after salbutamol inhalation from -1% before to -9% after weight reduction (p=0.02). Interestingly, improvement of endothelial function correlated with improved HOMA index only (r=-0.60, p=0.04) but not with reduced ADMA levels, improved hypertension or reduced body weight. In conclusion, weight reduction with a very low calorie diet improves endothelial function measured by pulse wave velocity. The missing correlation with ADMA suggests possible further mechanisms underlying this observed effect, for example, improvement of insulin resistance.

Adipokines, asymmetrical dimethylarginine, and pulmonary function in adolescents with asthma and obesity

“…In our present study, the obese adolescents with or without asthma showed the increased ADMA serum levels in comparison with the normal weight subjects with or without obesity. This is consistent to our previous studies in obese adolescents and the other previous studies in children and adults [26][27][28]. However, no significant association was observed between serum ADMA and pulmonary function in all study subjects and in the adolescents with asthma.…”

Preserved endothelial function in human obesity in the absence of insulin resistance

“…Supporting our findings there is another study showing that IR and not BMI is the major determinant in the impairment of flow mediated dilation in morbid obese subjects [21]. In this sense, an improvement of the endothelial function after weight reduction in obese patients correlates with reduction in HOMA index rather than with reduction in body weight [22]. …”

Comparison of the Effect of the Metabolic Syndrome and Multiple Traditional Cardiovascular Risk Factors on Vascular Function

“…48 Some studies also have reported that nonpharmacologic and pharmacologic strategies targeting central obesity improved endothelial function and ameliorated low-grade inflammation. [49][50][51][52] Thus, the reversal of some of the parameters of MetS may be associated with a reduction in CV events and may be mediated by improvement in endothelial function. Moreover, the detection of endothelial dysfunction may serve to identify individuals at risk.…”