Weight Loss in Combination With Physical Activity Improves Endothelial Dysfunction in Human Obesity

• Published in: Diabetes care Vol. 26; no. 6; pp. 1673 - 1678
• Main Authors: SCIACQUA, Angela, CANDIGLIOTA, Mafalda, CERAVOLO, Roberto, SCOZZAFAVA, Angela, SINOPOLI, Flora, CORSONELLO, Andrea, SESTI, Giorgio, PERTICONE, Francesco
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01.06.2003
• Subjects: Acetylcholine - pharmacology; Adult; Biological and medical sciences; Body Constitution; Body Mass Index; Care and treatment; Combined Modality Therapy; Diabetics; Diet; Diet, Reducing; Endothelium, Vascular - physiopathology; European Continental Ancestry Group; Exercise; Fibroblast Growth Factors - blood; Fibroblast Growth Factors - drug effects; Forearm - blood supply; Health aspects; Humans; Insulin Resistance; Italy; Medical sciences; Metabolic diseases; Middle Aged; Multivariate Analysis; Nitroprusside - pharmacology; Obesity; Obesity - physiopathology; Obesity - therapy; Overweight persons; Oxidative Stress; Physical fitness; Regression Analysis; Type 2 diabetes; Vasodilation - drug effects; Vasodilation - physiology; Weight control; Weight Loss; Italy; Physical exercise; Human; Obesity; Statistical analysis; Body weight; Nutrition disorder; Weight loss; Vasodilation; Blood flow; Endothelium; Improvement; Forearm; Dysfunction; Influence; Hemodynamics; Nutritional status
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/diacare.26.6.1673

Weight Loss in Combination With Physical Activity Improves Endothelial Dysfunction in Human Obesity Angela Sciacqua , MD 1 , Mafalda Candigliota , MD 1 , Roberto Ceravolo , MD 1 , Angela Scozzafava , MD 1 , Flora Sinopoli , PHD 1 , Andrea Corsonello , MD 2 , Giorgio Sesti , MD 1 and Francesco Perticone , MD 1 1 Department of Experimental and Clinical Medicine “G. Salvatore,” University Magna Græcia of Catanzaro, Catanzaro, Italy 2 Italian National Research Centers on Aging, Cosenza, Italy Abstract OBJECTIVE —To test whether weight loss may improve endothelial dysfunction in human obesity, we recruited 28 healthy obese subjects, aged 30–46 years, with BMI 30–43 kg/m 2 . RESEARCH DESIGN AND METHODS —Endothelium-dependent and -independent vasodilation were investigated by intra-arterial infusion of increasing doses of acetylcholine (ACh; 7.5, 15, and 30 μg · ml −1 · min −1 ) and sodium nitroprusside (0.8, 1.6, and 3.2 μg · ml −1 · min −1 ). Insulin resistance was estimated by homeostasis model assessment (HOMA). Weight loss was obtained by caloric restriction and physical activity. RESULTS —We observed a significant reduction in BMI (from 33.1 ± 4.2 to 27.5 ± 4.5 kg/m 2 , −16.9%, P < 0.0001) and in waist circumference (from 108.2 ± 12.1 to 96.8 ± 12.9 cm, −10.5%, P < 0.0001). Weight loss was also associated with a significant increase in ACh-stimulated forearm blood flow (FBF), from 7.4 ± 2.8 to 12.9 ± 3.4 ml · 100 ml −1 of tissue · min −1 kg/m 2 ( P < 0.0001). Multivariate regression analysis demonstrated that the only independent predictor of FBF was HOMA, accounting for 44.5% of the variation, whereas the addition of BMI explained another 2.3% of the variation. CONCLUSIONS —Our data demonstrate that energy-restricted diet associated with physical activity induce a significant and clinically relevant improvement in ACh-stimulated vasodilation in obese healthy subjects. ACh, acetylcholine BP, blood pressure FBF, forearm blood flow HOMA, homeostasis model assessment IR, insulin resistance SNP, sodium nitroprusside SNS, sympathetic nervous system VR, vascular resistance WHR, waist-to-hip ratio Footnotes Address correspondence and reprint requests to Francesco Perticone, MD, Department of Medicina Sperimentale e Clinica, Policlinico Mater Domini - Via Tommaso Campanella, 88100 - Catanzaro, Italy. E-mail: perticone{at}unicz.it . Received for publication 2 February 2003 and accepted in revised form 4 March 2003. A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances. DIABETES CARE