Insulin status is important determinant of weight reduction on vascular function

Researchers from Boston University School of Medicine (BUSM) and Boston Medical Center (BMC) have found that among obese people who had lost considerable weight, those with high insulin levels—a marker of insulin resistance in the body—were the most likely to experience better blood vessel function following the weight loss. These findings appear online in the Journal of the American College of Cardiology.

Obesity has emerged as one of the most critical health care problems in the U.S. and worldwide with nearly 70 percent of the U.S. population currently overweight or obese. Of major concern are the disproportionate cases of severe obesity ( [BMI] ? 40 kg/m2), which tripled during the 1990s. Nearly a third of adults and 17 percent of children in the U.S. are now obese with 65 million additional cases estimated by 2030. While obesity confers serious health concerns and increased all-cause mortality, the vast majority of deaths are due to cardiovascular causes such as ischemic heart disease and stroke.

Researcher prospectively followed 208 overweight or (BMI ?25 kg/m2) receiving medical/dietary (48 percent) or bariatric surgical (52 percent) weight loss treatment during a period of approximately one year. They measured plasma metabolic parameters and vascular endothelial function using ultrasound at baseline and following weight loss intervention, and stratified analyses by median plasma levels.

They found that individuals with higher baseline plasma insulin levels (above median >12 uIU/ml), who had greater than 10 percent weight loss had significantly improved brachial artery macro-vascular flow-mediated and micro-vascular reactive hyperemia. In contrast, did not change significantly in the lower insulin group (?12 uIU/mL) despite similar degree of weight loss. In analyses using a five percent weight loss cut-point, only micro-vascular responses improved in the higher insulin group.

"Our study has shown that insulin status is an important determinant of the positive effect of weight reduction on vascular function with hyperinsulinemic patients deriving the greatest benefit," explained corresponding author Noyan Gokce, MD, FACC, associate professor of medicine at BUSM and Director of Echocardiography at BMC. "Reversal of and endothelial dysfunction may represent key therapeutic targets for cardiovascular risk reduction in obesity," he added. Their data also suggest that at least 10% is needed for comprehensive vascular benefit, which may in part explain the negative findings of the recently published Look Ahead study findings (NEJM 2013).

add to favorites email to friend print save as pdf

Related Stories

Lap band surgery helps combat diabetes

Sep 02, 2013

(Medical Xpress)—A trial of gastric band surgery in overweight people with type 2 diabetes has found the surgery resulted in better outcomes for diabetes and weight loss than standard exercise and diet ...

Liraglutide augments weight loss in pre-type 2 diabetes

Aug 15, 2013

(HealthDay)—For patients at high risk of type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD), liraglutide in additional to calorie restriction is associated with more weight loss and improvements ...

Recommended for you

Gene variant raises risk for aortic tear and rupture

Apr 17, 2014

Researchers from Yale School of Medicine and Celera Diagnostics have confirmed the significance of a genetic variant that substantially increases the risk of a frequently fatal thoracic aortic dissection or full rupture. ...

Considerable variation in CT use in ischemic stroke

Apr 17, 2014

(HealthDay)—For patients with ischemic stroke there is considerable variation in the rates of high-intensity computed tomography (CT) use, according to a study published online April 8 in Circulation: Ca ...

Beating the clock for ischemic stroke sufferers

Apr 17, 2014

A ground-breaking computer technology raises hope for people struck by ischemic stroke, which is a very common kind of stroke accounting for over 80 per cent of overall stroke cases. Developed by research experts at The Hong ...

User comments