In obese patients with type 2 diabetes, increased triglyceride stores in the heart can be mobilized by therapeutic prolonged caloric restriction.
Lead investigator Sebastiaan Hammer, stated that, "As this mobilization is accompanied by improvements in diastolic function, "the study implicates the possibility of reversing, at least to some extent, the effects of obesity and diabetes on the heart."
Hammer and colleagues studied 12 obese insulin-treated patients who adhered to a very low calorie diet (450 kcal/day; Modifast, Nutrition & Sante) for 16 weeks. Insulin treatment was stopped during this period.
At the end of the intervention period, mean body mass index had fallen from 35.6 to 27.5 kg/m, and mean hemoglobin A1c had dropped from 7.9% to 6.3%.
The researchers also found that myocardial triglyceride content had fallen from 0.88% to 0.64%, in association with improved diastolic function (as reflected by the ratio between the early and atrial filling phase).
Hammer mentioned that, the magnetic resonance spectroscopy techniques his team used to determine myocardial triglyceride content "show the potential of metabolic cardiovascular imaging in detecting the effects of metabolic disease on the heart."
In particular, he said, "quantification of myocardial triglyceride stores may in the future be used as a new marker for the risk of heart disease in metabolic disease."
J Am Coll Cardiol 2008;52:1006-1012.
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