Skip to main content
SpringerLink
Log in

Effect of diet-induced weight loss on endothelial dysfunction: early improvement after the first week of dieting

  • Original Article
  • Published:
Heart and Vessels Aims and scope Submit manuscript

Abstract

Obesity is associated with impaired endothelial function, and this may lead to increased cardiovascular risk. To gain insight into the beneficial effects of diet-induced weight loss on endothelial function, endothelium-dependent, flow-mediated dilation (FMD) of the brachial artery and several metabolic and inflammatory markers were assessed in 40 obese women (BMI 34.9 ± 4.88 kg/m2) at baseline, after the 1st week and after 5 months on a low-calorie diet of 5.0 MJ/day. Twenty lean women served as controls. At entry, the obese women had a lower FMD than the lean women (7.7 ± 1.8 vs. 11.5 ± 4.2%, p < 0.001). After 1 week of the intervention and 4% reduction of BMI, FMD improved by 22% (p = 0.005), and a decrease in circulating triglycerides, insulin, leptin, tissue type plasminogen activator and its inhibitor, von Willebrand factor, C-reactive protein and tumor necrosis factor receptor 1 was observed. Improvement of FMD was associated only with a decrease in BMI (r = 0.39, p = 0.03). Twenty-two women completed the weight reduction program and reduced their BMI by 16%. FMD was further improved by 64% (to 12.4 ± 5.3%, p = 0.001) and became comparable to that of lean women. None of the significant changes in the observed parameters was associated with improvement of FMD at the end of the program. Improvements in obesity-related endothelial dysfunction began in the 1st week of dieting and continued during the following months of this simple non-pharmacological lifestyle modification to reach normalisation of endothelial function. The favourable effect of dieting on endothelial function is independent of the accompanying improvement of classical risk factors.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. National Task Force on the Prevention, Treatment of Obesity (2000) Overweight, obesity and health risk. Arch Intern Med 160:898–904

    Article  Google Scholar 

  2. Mavri A, Alessi MC, Juhan-Vague I (2004) Hypofibrinolysis in the insulin resistance syndrome: implication in cardiovascular diseases. J Intern Med 255:448–456

    Article  CAS  PubMed  Google Scholar 

  3. Poredos P (2001) Endothelial dysfunction in the pathogenesis of atherosclerosis. Clin Appl Thromb Haemost 7:276–280

    Article  CAS  Google Scholar 

  4. Poredos P (2002) Endothelial dysfunction and cardiovascular disease. Pathophysiol Haemost Thromb 32:274–277

    Article  CAS  PubMed  Google Scholar 

  5. Simova I, Denchev S (2008) Endothelial functional and structural impairment in patients with different degrees of coronary artery disease development. Heart Vessels 23:308–315

    Article  PubMed  Google Scholar 

  6. Suwaidi JA, Hamasaki S, Higano ST, Nishimura RA, Holmes DR Jr, Lerman A (2000) Long-term follow-up of patients with mild coronary artery disease and endothelial dysfunction. Circulation 101:948–954

    CAS  PubMed  Google Scholar 

  7. Schachinger V, Britten MB, Zeiher AM (2000) Prognostic impact of coronary vasodilator dysfunction on adverse long-term outcome of coronary heart disease. Circulation 101:1899–1906

    CAS  PubMed  Google Scholar 

  8. Perticone F, Ceravolo R, Pujia A, Ventura G, Iacopino S, Scozzafava A, Ferraro A, Chello M, Mastroroberto P, Verdecchia P, Schillaci G (2001) Prognostic significance of endothelial dysfunction in hypertensive patients. Circulation 104:191–196

    CAS  PubMed  Google Scholar 

  9. Steinberg HO, Chaker H, Leaming R, Johnson A, Brechtel G, Baron AD (1996) Obesity/insulin resistance is associated with endothelial dysfunction. Implications for the syndrome of insulin resistance. J Clin Invest 97:2601–2610

    Article  CAS  PubMed  Google Scholar 

  10. Arcaro G, Zamboni M, Rossi L, Turcato E, Covi G, Armellini F, Bosello O, Lechi A (1999) Body fat distribution predicts the degree of endothelial dysfunction in uncomplicated obesity. Int J Obes Relat Metab Disord 23:936–942

    Article  CAS  PubMed  Google Scholar 

  11. Hashimoto M, Akishita M, Eto M, Kozaki K, Ako J, Sugimoto N, Yoshizumi M, Toba K, Ouchi Y (1998) The impairment of flow-mediated vasodilatation in obese men with visceral fat accumulation. Int J Obes Relat Metab Disord 22:477–484

    Article  CAS  PubMed  Google Scholar 

  12. Fujii N, Tsuchihashi K, Sasao H, Eguchi M, Miurakami H, Hase M, Higashiura K, Yuda S, Hashimoto A, Miura T, Ura N, Shimamoto K (2008) Insulin resistance functionally limits endothelium-dependent coronary vasodilation in nondiabetic patients. Heart Vessels 23:9–15

    Article  PubMed  Google Scholar 

  13. Shimabukuro M, Higa N, Asahi T, Oshiro Y, Takasu N, Tagawa T, Ueda S, Shimomura I, Funahashi T, Matsuzawa Y (2003) Hypoadiponectinemia is closely linked to endothelial dysfunction in man. J Clin Endocrinol Metab 88:3236–3240

    Article  CAS  PubMed  Google Scholar 

  14. Selcuk H, Selcuk MT, Temizhan A, Maden O, Saydam GS, Ulupinar H, Dogan M, Aydin C, Topcu DI, Sasmaz A (2009) Decreased plasma concentrations of adiponectin in patients with slow coronary flow. Heart Vessels 24:1–7

    Article  PubMed  Google Scholar 

  15. Sciacqua A, Candigliota M, Ceravolo R, Scozzafava A, Sinopoli F, Corsonello A, Sesti G, Perticone F (2003) Weight loss in combination with physical activity improves endothelial dysfunction in human obesity. Diabetes Care 26:1673–1678

    Article  PubMed  Google Scholar 

  16. Hamdy O, Ledbury S, Mullooly C, Jarema C, Porter S, Ovalle K, Moussa A, Caselli A, Caballero AE, Economides PA, Veves A, Horton ES (2003) Lifestyle modification improves endothelial function in obese subjects with the insulin resistance syndrome. Diabetes Care 26:2119–2125

    Article  PubMed  Google Scholar 

  17. Ziccardi P, Nappo F, Giugliano G, Esposito K, Marfella R, Cioffi M, D’Andrea F, Molinari AM, Giugliano D (2002) Reduction of inflammatory cytokine concentrations and improvement of endothelial functions in obese women after weight loss over one year. Circulation 105:804–809

    Article  CAS  PubMed  Google Scholar 

  18. Brook RD, Bard RL, Glazewski L, Kehrer C, Bodary PF, Eitzman DL, Rajagopalan S (2004) Effect of short-term weight loss on the metabolic syndrome and conduit vascular endothelial function in overweight adults. Am J Cardiol 93:1012–1016

    Article  CAS  PubMed  Google Scholar 

  19. Raitakari M, Ilvonen T, Ahotupa M, Lehtimaki T, Harmoinen A, Suominen P, Elo J, Hartiala J, Raitakari OT (2004) Weight reduction with very-low-caloric diet and endothelial function in overweight adults: role of plasma glucose. Arterioscler Thromb Vasc Biol 24:124–128

    Article  CAS  PubMed  Google Scholar 

  20. Sasaki S, Higashi Y, Nakagawa K, Kimura M, Noma K, Sasaki S, Hara K, Matsuura H, Goto C, Oshima T, Chayama K (2002) A low-calorie diet improves endothelium-dependent vasodilation in obese patients with essential hypertension. Am J Hypertens 15:302–309

    Article  CAS  PubMed  Google Scholar 

  21. Mavri A, Stegnar M, Krebs M, Sentocnik JT, Geiger M, Binder BR (1999) Impact of adipose tissue on plasma plasminogen activator inhibitor-1 in dieting obese women. Arterioscler Thromb Vasc Biol 19:1582–1587

    CAS  PubMed  Google Scholar 

  22. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC (1985) Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28:412–419

    Article  CAS  PubMed  Google Scholar 

  23. Chauhan A, Mullins PA, Taylor G, Petch MC, Schofield PM (1997) Both endothelium-dependent and endothelium-independent function is impaired in patients with angina pectoris and normal coronary angiograms. Eur Heart J 18:60–68

    CAS  PubMed  Google Scholar 

  24. Williams IL, Wheatcroft SB, Shah AM, Kearney MT (2002) Obesity, atherosclerosis and the vascular endothelium: mechanisms of reduced nitric oxide bioavailability in obese humans. Int J Obes Relat Metab Disord 26:754–764

    Article  CAS  PubMed  Google Scholar 

  25. Zeng G, Quon MJ (1996) Insulin-stimulated production of nitric oxide is inhibited by wortmannin. Direct measurement in vascular endothelial cells. J Clin Invest 98:894–898

    Article  CAS  PubMed  Google Scholar 

  26. Aljada A, Dandona P (2000) Effect of insulin on human aortic endothelial nitric oxide synthase. Metabolism 49:147–150

    Article  CAS  PubMed  Google Scholar 

  27. Zeng G, Nystrom FH, Ravichandran LV, Cong LN, Kirby M, Mostowski H, Quon MJ (2000) Roles for insulin receptor, PI3-kinase, and Akt in insulin-signaling pathways related to production of nitric oxide in human vascular endothelial cells. Circulation 101:1539–1545

    CAS  PubMed  Google Scholar 

  28. Kuboki K, Jiang ZY, Takahara N, Ha SW, Igarashi M, Yamauchi T, Feener EP, Herbert TP, Rhodes CJ, King GL (2000) Regulation of endothelial constitutive nitric oxide synthase gene expression in endothelial cells and in vivo: a specific vascular action of insulin. Circulation 101:676–681

    CAS  PubMed  Google Scholar 

  29. Bastelica D, Mavri A, Verdier M, Bergoin M, Berthet B, Juhan-Vague I, Alessi MC (2002) Relationships between fibrinolytic and inflammatory parameters in human adipose tissue: strong contribution of TNFα receptors to PAI-1 levels. Thromb Haemost 88:481–487

    CAS  PubMed  Google Scholar 

  30. Dandona P, Weinstock R, Thusu K, Abdel-Rahman E, Aljada A, Wadden T (1998) Tumor necrosis factor-alpha in sera of obese patients: fall with weight loss. J Clin Endocrinol Metab 83:2907–2910

    Article  CAS  PubMed  Google Scholar 

  31. Yoshizumi M, Perrella MA, Burnett JC Jr, Lee ME (1993) Tumor necrosis factor downregulates an endothelial nitric oxide synthase mRNA by shortening its half-life. Circ Res 73:205–209

    CAS  PubMed  Google Scholar 

  32. Hürlimann D, Forster A, Noll G, Enseleit F, Chenevard R, Distler O, Béchir M, Spieker LE, Neidhart M, Michel BA, Gay RE, Lüscher TF, Gay S, Ruschitzka F (2002) Anti-tumor necrosis factor-α treatment improves endothelial function in patients with rheumatoid arthritis. Circulation 106:2184–2187

    Article  PubMed  Google Scholar 

  33. Brook RD, Bard RL, Rubenfire M, Ridker PM, Rajagopalan S (2001) Usefulness of visceral obesity (waist/hip ratio) in predicting vascular endothelial function in healthy overweight adults. Am J Cardiol 88:1264–1269

    Article  CAS  PubMed  Google Scholar 

  34. Pierce GL, Beske SD, Lawson BR, Southall KL, Benay FJ, Donato AJ, Seals DR (2008) Weight loss alone improves conduit and resistance artery endothelial function in young and older overweight/obese adults. Hypertension 52:72–79

    Article  CAS  PubMed  Google Scholar 

  35. Brook RD (2006) Obesity, weight loss, and vascular function. Endocrine 29:21–25

    Article  CAS  PubMed  Google Scholar 

  36. Fuentes F, López-Miranda J, Sánchez E, Sánchez F, Paez J, Paz-Rojas E, Marín C, Gómez P, Jimenez-Perepérez J, Ordovás JM, Pérez-Jiménez F (2001) Mediterranean and low-fat diets improve endothelial function in hypercholesterolemic men. Ann Intern Med 134:1115–1119

    CAS  PubMed  Google Scholar 

  37. Esposito K, Marfella R, Ciotola M, Di Palo C, Giugliano F, Giugliano G, D’Armiento M, D’Andrea F, Giugliano D (2004) Effect of a mediterranean-style diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome: a randomized trial. JAMA 292:1440–1446

    Article  CAS  PubMed  Google Scholar 

  38. Tripathy D, Mohanty P, Dhindsa S, Syed T, Ghanim H, Aljada A, Dandona P (2003) Elevation of free fatty acids induces inflammation and impairs vascular reactivity in healthy subjects. Diabetes 52:2882–2887

    Article  CAS  PubMed  Google Scholar 

  39. Dandona P, Mohanty P, Ghanim H, Aljada A, Browne R, Hamouda W, Prabhala A, Afzal A, Garg R (2001) The suppressive effect of dietary restriction and weight loss in the obese on the generation of reactive oxygen species by leukocytes, lipid peroxidation, and protein carbonylation. J Clin Endocrinol Metab 86:355–362

    Article  CAS  PubMed  Google Scholar 

  40. Cangemi R, Angelico F, Loffredo L, Del Ben M, Pignatelli P, Martini A, Violi F (2007) Oxidative stress-mediated arterial dysfunction in patients with metabolic syndrome: effect of ascorbic acid. Free Radic Biol Med 43:853–859

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

We thank Dr. J.T. Sentočnik, Medico-aesthetic Centre, Ljubljana, for allowing us to study her patients and M. Verdier for excellent technical assistance.

Author information

Authors and Affiliations

  1. Department of Vascular Disease, University Medical Centre Ljubljana, Zaloška 2, 1000, Ljubljana, Slovenia

    Alenka Mavri, Peter Poredoš, David Šuran & Pavel Poredoš

  2. Service d’endocrinologie, CHU Nord, Marseille, France

    Benedicte Gaborit

  3. Laboratoire d’Hematologie, CHU Timone, AP-HM, Marseille, France

    Alenka Mavri & Irène Juhan-Vague

Authors
  1. Alenka Mavri
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Peter Poredoš
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. David Šuran
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Benedicte Gaborit
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Irène Juhan-Vague
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Pavel Poredoš
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alenka Mavri.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mavri, A., Poredoš, P., Šuran, D. et al. Effect of diet-induced weight loss on endothelial dysfunction: early improvement after the first week of dieting. Heart Vessels 26, 31–38 (2011). https://doi.org/10.1007/s00380-010-0016-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00380-010-0016-1

Keywords

Search

Navigation