Insulin status is important determinant of weight reduction on vascular function

September 3, 2013, Boston University Medical Center

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: Lap band surgery helps combat diabetes

Related Stories

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.

Being underweight increases death risk of CAD women by two-fold

September 3, 2013
Being underweight increases the death risk of women with coronary artery disease (CAD) by 2-fold, according to research presented at the ESC Congress today by Dr Aziza Azimi from Denmark. The study suggests that underweight ...

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 ...

Bariatric surgical procedures have similar therapeutic benefits in obese adults

November 26, 2012
Obesity is associated with insulin resistance and type 2 diabetes, both of which can be significantly improved by weight loss. Gastric bypass and adjustable gastric banding are two bariatric surgery techniques that are frequently ...

Study suggests focus on lifestyle changes—not weight loss—is key to kids' health

August 22, 2013
A UCLA School of Nursing study has found that both healthy-weight and obese children who participated in an intensive lifestyle modification program significantly improved their metabolic and cardiovascular health despite ...

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

July 4, 2011
Researchers at Boston University School of Medicine (BUSM) and Boston Medical Center (BMC) have shown that the quality – not just the quantity – of adipose, or fat, tissue is a significant contributing factor in ...

Recommended for you

Starting periods before age of 12 linked to heightened risk of heart disease and stroke

January 15, 2018
Starting periods early—before the age of 12—is linked to a heightened risk of heart disease and stroke in later life, suggests an analysis of data from the UK Biobank study, published online in the journal Heart.

'Decorated' stem cells could offer targeted heart repair

January 10, 2018
Although cardiac stem cell therapy is a promising treatment for heart attack patients, directing the cells to the site of an injury - and getting them to stay there - remains challenging. In a new pilot study using an animal ...

Two simple tests could help to pinpoint cause of stroke

January 10, 2018
Detecting the cause of the deadliest form of stroke could be improved by a simple blood test added alongside a routine brain scan, research suggests.

Exercise is good for the heart, high blood pressure is bad—researchers find out why

January 10, 2018
When the heart is put under stress during exercise, it is considered healthy. Yet stress due to high blood pressure is bad for the heart. Why? And is this always the case? Researchers of the German Centre for Cardiovascular ...

Heart-muscle patches made with human cells improve heart attack recovery

January 10, 2018
Large, human cardiac-muscle patches created in the lab have been tested, for the first time, on large animals in a heart attack model. This clinically relevant approach showed that the patches significantly improved recovery ...

Place of residence linked to heart failure risk

January 9, 2018
Location. Location. Location.

0 comments

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.