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

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Abstract

A very low calorie diet (VLCD) 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 VLCD on cardiac dimensions and function in type 2 diabetes mellitus (T2DM) patients. Fourteen insulin-dependent T2DM patients (mean ± SEM: age 53 ± 2 years; BMI 35 ± 1 kg/m2) were treated by a VLCD (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 VLCD and after 14 months of follow-up on a regular diet. BMI decreased from 35 ± 1 to 28 ± 1 kg/m2 after VLCD and increased again to 32 ± 1 kg/m2 at 18 months (both P < 0.05 vs. baseline). Left ventricular (LV) end-diastolic volume index increased after the 16-week VLCD (80 ± 3 to 89 ± 4 ml/m2, P < 0.05) and remained increased after follow-up (90 ± 3 ml/m2; P < 0.05 vs. baseline) at comparable filling pressures. The improvement in LV diastolic function after the 16-week VLCD, was sustained at 18 months [early (E)/atrial (A) diastolic filling phase ratio: 0.96 ± 0.07 (baseline); 1.12 ± 0.06 (after VLCD); 1.06 ± 0.07 (18 months, P < 0.05 vs. baseline)]. Myocardial TG content decreased after the 16-week VLCD [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 VLCD 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.

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Acknowledgments

This research was performed within the framework of CTMM, the Center for Translational Molecular Medicine (www.ctmm.nl), project PREDICCt (grant 01C-104), and supported by the Netherlands Heart Foundation, Dutch Diabetes Research Foundation and Dutch Kidney Foundation. Financial support was also given by Roba Metals B.V. Nutrition & Santé freely supplied the Modifast.

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Authors and Affiliations

  1. Department of Endocrinology and Metabolism, Leiden University Medical Center, Leiden, The Netherlands

    Jacqueline T. Jonker

  2. Department of General Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands

    Marieke Snel, Ingrid M. Jazet, Hanno Pijl & A. Edo Meinders

  3. Department of Radiology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands

    Sebastiaan Hammer, Rutger W. van der Meer, Albert de Roos & Hildo J. Lamb

  4. Department of General Internal Medicine, UMC St Radboud Nijmegen, Nijmegen, The Netherlands

    Johannes W. A. Smit

  5. Department of General Internal Medicine, Academic Medical Center, Amsterdam, The Netherlands

    Johannes A. Romijn

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  1. Jacqueline T. Jonker
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  2. Marieke Snel
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  3. Sebastiaan Hammer
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  4. Ingrid M. Jazet
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  5. Rutger W. van der Meer
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  9. Johannes W. A. Smit
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Correspondence to Hildo J. Lamb.

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Jacqueline T. Jonker and Marieke Snel have contributed equally to this study.

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Jonker, J.T., Snel, M., Hammer, S. et al. Sustained cardiac remodeling after a short-term very low calorie diet in type 2 diabetes mellitus patients. Int J Cardiovasc Imaging 30, 121–127 (2014). https://doi.org/10.1007/s10554-013-0302-y

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