Skip to main content
SpringerLink
Log in

Body Weight Loss by Very-Low-Calorie Diet Program Improves Small Artery Reactive Hyperemia in Severely Obese Patients

  • Clinical Research
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Background

Endothelial dysfunction is a major underlying mechanism for the elevated cardiovascular risk associated with increased body weight. We aimed to assess the impact of weight loss induced by an intensive very-low-calorie diet (VLCD) on arterial wall function in severely obese patients (SOP).

Methods

Thirty-four SOP were admitted to the metabolic ward of the hospital for a 3-week period. A VLCD characterized by a liquid diet providing 800 kcal/day was administered. The small artery reactivity to postischemic hyperemia index (saRHI), a surrogate marker of endothelial function, was assessed before and 1 week after hospital discharge. Anthropometry and biochemical parameters were also measured. Obese and non-obese age- and gender-matched groups were recruited for baseline comparisons.

Results

SOP had significantly lower saRHI compared with obese and non-obese individuals. SaRHI significantly increased after the intervention in SOP (1.595 ± 0.236 vs. 1.737 ± 0.417, p = 0.015). A significant improvement in glucose (p = 0.026), systolic blood pressure (p = 0.049), LDLc (p < 0.001), and inflammatory parameters was observed. Body weight loss was associated with a higher saRHI (r = −0.385, p = 0.033), and it was the main determinant of saRHI variation independently of confounders (β −0.049, IC 95 % −0.091–0.008, p = 0.021).

Conclusions

Weight loss induced by a VLCD in SOP improved small artery reactivity, and it was associated with the amelioration of metabolic and inflammation markers. Endothelial dysfunction may be softened by body weight loss interventions and useful in the management of cardiovascular risk factors in SOP.

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. Koplan JP, Dietz WH. Caloric imbalance and public health policy. JAMA. 1999;282:1579–81.

    Article  PubMed  CAS  Google Scholar 

  2. Pi-Sunyer X, Kris-Etherton PM. Improving health outcomes: future directions in the field. J Am Diet Assoc. 2005;105:S14–6.

    Article  PubMed  Google Scholar 

  3. Salas-Salvado J, Rubio MA, Barbany M, et al. SEEDO 2007 consensus for the evaluation of overweight and obesity and the establishment of therapeutic intervention criteria. Med Clin (Barc). 2007;128:184–96.

    Article  Google Scholar 

  4. Grassi G, Seravalle G, Scopelliti F, et al. Structural and functional alterations of subcutaneous small resistance arteries in severe human obesity. Obesity (Silver Spring). 2010;18:92–8.

    Article  CAS  Google Scholar 

  5. Brook RD. Obesity, weight loss, and vascular function. Endocrine. 2006;29:21–5.

    Article  PubMed  CAS  Google Scholar 

  6. Mavri A, Poredos P, Suran D, et al. Effect of diet-induced weight loss on endothelial dysfunction: early improvement after the first week of dieting. Hear Vessel. 2011;26:31–8.

    Article  Google Scholar 

  7. Nerla R, Tarzia P, Sestito A, et al. Effect of bariatric surgery on peripheral flow-mediated dilation and coronary microvascular function. Nutr Metab Cardiovasc Dis. 2012;8:626–34.

    Google Scholar 

  8. Shechter M, Beigel R, Freimark D, et al. Short-term sibutramine therapy is associated with weight loss and improved endothelial function in obese patients with coronary artery disease. Am J Cardiol. 2006;97:1650–3.

    Article  PubMed  CAS  Google Scholar 

  9. Hamburg NM, Keyes MJ, Larson MG, et al. Cross-sectional relations of digital vascular function to cardiovascular risk factors in the Framingham Heart Study. Circulation. 2008;117:2467–74.

    Article  PubMed  Google Scholar 

  10. Hamburg NM, Palmisano J, Larson MG, et al. Relation of brachial and digital measures of vascular function in the community: the Framingham Heart Study. Hypertension. 2011;57:390–6.

    Article  PubMed  CAS  Google Scholar 

  11. Boari GE, Rizzoni D, De Ciuceis C, et al. Structural alterations in subcutaneous small resistance arteries predict changes in the renal function of hypertensive patients. J Hypertens. 2010;28:1951–8.

    Article  PubMed  CAS  Google Scholar 

  12. Ferre R, Aragones G, Plana N, et al. High-density lipoprotein cholesterol and apolipoprotein A1 levels strongly influence the reactivity of small peripheral arteries. Atherosclerosis. 2011;216:115–9.

    Article  PubMed  CAS  Google Scholar 

  13. Ferre R, Plana N, Merino J, et al. Effects of therapeutic lifestyle changes on peripheral artery tonometry in patients with abdominal obesity. Nutr Metab Cardiovasc Dis. 2012;2:95–102.

    Google Scholar 

  14. Sjostrom L, Lindroos AK, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10years after bariatric surgery. N Engl J Med. 2004;351:2683–93.

    Article  PubMed  Google Scholar 

  15. Athyros VG, Tziomalos K, Karagiannis A, et al. Cardiovascular benefits of bariatric surgery in morbidly obese patients. Obes Rev. 2011;12:515–24.

    Article  PubMed  CAS  Google Scholar 

  16. Baker S, Jerums G, Proietto J. Effects and clinical potential of very-low-calorie diets (VLCDs) in type 2 diabetes. Diabetes Res Clin Pract. 2009;85:235–42.

    Article  PubMed  CAS  Google Scholar 

  17. Keogh JB, Brinkworth GD, Noakes M, et al. Effects of weight loss from a very-low-carbohydrate diet on endothelial function and markers of cardiovascular disease risk in subjects with abdominal obesity. Am J Clin Nutr. 2008;87:567–76.

    PubMed  CAS  Google Scholar 

  18. Matthews DR, Hosker JP, Rudenski AS, et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28:412–9.

    Article  PubMed  CAS  Google Scholar 

  19. Pierce GL, Beske SD, Lawson BR, et al. Weight loss alone improves conduit and resistance artery endothelial function in young and older overweight/obese adults. Hypertension. 2008;52:72–9.

    Article  PubMed  CAS  Google Scholar 

  20. Habib P, Scrocco JD, Terek M, et al. Effects of bariatric surgery on inflammatory, functional and structural markers of coronary atherosclerosis. Am J Cardiol. 2009;104:1251–5.

    Article  PubMed  CAS  Google Scholar 

  21. Raitakari M, Ilvonen T, Ahotupa M, et al. Weight reduction with very-low-caloric diet and endothelial function in overweight adults: role of plasma glucose. Arterioscler Thromb Vasc Biol. 2004;24:124–8.

    Article  PubMed  CAS  Google Scholar 

  22. Rudofsky G, Roeder E, Merle T, et al. Weight loss improves endothelial function independently of ADMA reduction in severe obesity. Horm Metab Res. 2011;43:343–8.

    Article  PubMed  CAS  Google Scholar 

  23. Aragonès G, Ferré R, Girona J, et al. Small artery dilation and endothelial markers in cardiovascular risk patients. Eur J Clin Invest. 2012;1:34–41.

    Google Scholar 

  24. Tanigaki K, Mineo C, Yuhanna IS, et al. C-reactive protein inhibits insulin activation of endothelial nitric oxide synthase via the immunoreceptor tyrosine-based inhibition motif of FcgammaRIIB and SHIP-1. Circ Res. 2009;104:1275–82.

    Article  PubMed  CAS  Google Scholar 

  25. Heilbronn LK, Campbell LV. Adipose tissue macrophages, low grade inflammation and insulin resistance in human obesity. Curr Pharm Des. 2008;14:1225–30.

    Article  PubMed  CAS  Google Scholar 

  26. Hamburg NM, Benjamin EJ. Assessment of endothelial function using digital pulse amplitude tonometry. Trends Cardiovasc Med. 2009;19:6–11.

    Article  PubMed  CAS  Google Scholar 

  27. Tuck ML. Obesity, the sympathetic nervous system, and essential hypertension. Hypertension. 1992;19:I67–77.

    Article  PubMed  CAS  Google Scholar 

  28. Grassi G, Seravalle G, Colombo M, et al. Body weight reduction, sympathetic nerve traffic, and arterial baroreflex in obese normotensive humans. Circulation. 1998;97:2037–42.

    Article  PubMed  CAS  Google Scholar 

  29. Landsberg L. Insulin-mediated sympathetic stimulation: role in the pathogenesis of obesity-related hypertension (or, how insulin affects blood pressure, and why). J Hypertens. 2001;19:523–8.

    Article  PubMed  CAS  Google Scholar 

  30. Handa P, Tateya S, Rizzo NO, et al. Reduced vascular nitric oxide-cGMP signaling contributes to adipose tissue inflammation during high-fat feeding. Arterioscler Thromb Vasc Biol. 2011;31:2827–35.

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of Interest

There was no funding or external support for this study. All contributing authors declare that they have no conflicts of interest.

Author information

Authors and Affiliations

  1. Vascular Medicine and Metabolism Unit, Lipids and Atherosclerosis Research Unit, Sant Joan University Hospital, Institut d’Investigació Sanitària Pere Virgili (IISPV), Faculty of Medicine, Universitat Rovira i Virgili—Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Barcelona, Spain

    J. Merino, R. Ferré, N. Plana, J. Girona, G. Aragonés, A. Cabré, M. Heras & L. Masana

  2. Dietetics and Nutrition Unit, Sant Joan University Hospital—Reus, Reus, Spain

    I. Megias-Rangil, A. Rabasa & A. Bonada

Authors
  1. J. Merino
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. I. Megias-Rangil
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. R. Ferré
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. N. Plana
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J. Girona
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. A. Rabasa
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. G. Aragonés
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. A. Cabré
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. A. Bonada
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. M. Heras
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. L. Masana
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J. Merino.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Merino, J., Megias-Rangil, I., Ferré, R. et al. Body Weight Loss by Very-Low-Calorie Diet Program Improves Small Artery Reactive Hyperemia in Severely Obese Patients. OBES SURG 23, 17–23 (2013). https://doi.org/10.1007/s11695-012-0729-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-012-0729-6

Keywords

Search

Navigation