Insulin status is important determinant of weight reduction on vascular function

September 3, 2013

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).

Explore further: Study shows answers for treating obesity-related diseases may reside in fat tissue

Related Stories

Liraglutide augments weight loss in pre-type 2 diabetes

August 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 in insulin ...

Lap band surgery helps combat diabetes

September 2, 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 plans.

Recommended for you

Artificial heart design features porous plastic foam

October 2, 2015

Artificial hearts with multiple moving parts increase the chance of failure; scientists have worked up a device which is a single piece. No less interesting is the material they used; the team is taking a page out of soft ...

What powers the pumping heart?

September 25, 2015

Researchers at the Ted Rogers Centre for Heart Research have uncovered a treasure trove of proteins, which hold answers about how our heart pumps—a phenomenon known as contractility.

Sticky gel helps stem cells heal rat hearts

September 24, 2015

A sticky, protein-rich gel created by Johns Hopkins researchers appears to help stem cells stay on or in rat hearts and restore their metabolism after transplantation, improving cardiac function after simulated heart attacks, ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.