Document Detail


Reducing visceral adipose tissue mass is essential for improving endothelial function in type 2 diabetes prone individuals.
MedLine Citation:
PMID:  20667538     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
OBJECTIVE: In obesity, particularly increased visceral- (VAT), but not total (TAT) adipose tissue mass is a major source of proinflammatory cytokine expression and secretion. VAT, more than TAT, is associated with endothelial dysfunction (ED), which is an accepted risk factor for atherosclerosis. Consequently, we hypothesized that during a lifestyle intervention specifically a decrease in VAT, rather than TAT, is associated with improved ED and vascular adhesion molecules in type 2 diabetes prone subjects.
METHODS: Analyses were done in 189 individuals (age: 45.4±0.8 years) at increased risk of type 2 diabetes, who underwent a 9-month lifestyle intervention. ED expressed as flow mediated dilation (FMD) of the brachial artery, sE-selectin, sV-CAM, sI-CAM, TAT and VAT (measured by magnetic resonance tomography) was determined.
RESULTS: There was a mean decrease in body weight (-3%, p<0.0001), TAT (-7.6%, p<0.0001) and VAT (-12.5%, p<0.0001), while FMD increased (+9.1%, p=0.04). The change in FMD was not associated with change in body weight (p=0.35) or TAT (p=0.21) but with a decrease in VAT (r=-0.19, p=0.009). In a post hoc analysis, the subjects were divided by the median change in VAT into responders and non-responders. FMD increased only in the responders (from 6.2±0.4% to 8.0±0.5%, p=0.0005) but not in the non-responders (p=0.15). Also sE-selectin significantly decreased only in the responders (from 54±4 ng/ml to 47±3 ng/ml; p=0.03).
CONCLUSION: During a lifestyle intervention, not weight loss or decrease in TAT, but decrease in VAT is associated with improved ED in individuals prone to type 2 diabetes. Therefore, primary cardiovascular prevention should focus specifically on reducing VAT rather than body weight alone.
Authors:
K Rittig; A Hieronimus; C Thamer; J Machann; A Peter; J Stock; F Schick; A Fritsche; N Stefan; H-U Häring; B Balletshofer
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-07-08
Journal Detail:
Title:  Atherosclerosis     Volume:  212     ISSN:  1879-1484     ISO Abbreviation:  Atherosclerosis     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0242543     Medline TA:  Atherosclerosis     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  575-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Department of Endocrinology and Diabetes, Vascular Medicine, Nephrology and Clinical Chemistry, University of Tübingen, Otfried-Müller Straße 10, 72076 Tübingen, Germany.
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