Effects of weight loss and insulin reduction on arterial stiffness in the SAVE trial

Chronic arterial stiffness contributes to the negative health effects of obesity and insulin resistance, which include hypertension, stroke, and increased cardiovascular and all-cause mortality. Weight loss and improved insulin sensitivity are individually associated with improved central arterial s...

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Published in:	Cardiovascular diabetology 2012-09, Vol.11 (1), p.114-114
Main Authors:	Hughes, Timothy M, Althouse, Andrew D, Niemczyk, Nancy A, Hawkins, Marquis S, Kuipers, Allison L, Sutton-Tyrrell, Kim
Format:	Article
Language:	eng
Subjects:	Adult Ankle Brachial Index Arterial Pressure Biomarkers - blood Body Mass Index Diabetes Down-Regulation Fasting - blood Female Humans Hypertension Insulin Insulin - blood Insulin resistance Linear Models Male Middle Aged Multivariate Analysis Obesity Obesity - blood Obesity - diagnosis Obesity - physiopathology Obesity - therapy Original Investigation Pennsylvania Pulse Wave Analysis Pulse wave velocity Time Factors Treatment Outcome Vascular Stiffness Weight control Weight Loss Weight loss and arterial stiffness Young Adult
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Summary:	Chronic arterial stiffness contributes to the negative health effects of obesity and insulin resistance, which include hypertension, stroke, and increased cardiovascular and all-cause mortality. Weight loss and improved insulin sensitivity are individually associated with improved central arterial stiffness; however, their combined effects on arterial stiffness are poorly understood. The purpose of this study was to determine how insulin levels modify the improvements in arterial stiffness seen with weight loss in overweight and obese young adults. To assess the effects of weight loss and decreased fasting insulin on vascular stiffness, we studied 339 participants in the Slow the Adverse Effects of Vascular Aging (SAVE) trial. At study entry, the participants were aged 20-45, normotensive, non-diabetic, and had a body-mass index of 25-39.9 kg/m2. Measures of pulse wave velocity (PWV) in the central (carotid-femoral (cfPWV)), peripheral (femoral-ankle (faPWV)), and mixed (brachial-ankle (baPWV)) vascular beds were collected at baseline and 6 months. The effects of 6-month change in weight and insulin on measures of PWV were estimated using multivariate regression. After adjustment for baseline risk factors and change in systolic blood pressure, 6-month weight loss and 6-month change in fasting insulin independently predicted improvement in baPWV but not faPWV or cfPWV. There was a significant interaction between 6-month weight change and change in fasting insulin when predicting changes in baPWV (p
ISSN:	1475-2840 1475-2840