THE EFFICACY OF VERY LOW CALORIE KETOGENIC DIET (VLCKD) ON CARDIO–METABOLIC PROFILE IN PATIENTS WITH OBESITY

Abstract

Abstract Background Obesity is associated with alterations in cardiac structure and haemodynamics leading to cardiovascular mortality and morbidity. Very low calorie ketogenic diet (VLCKD) has been proposed as an effective intervention to achieve a significant weight loss in obese patients in a short time period. Furthermore, hyperketonemia induced by VLCKD is associated with beneficial cardiovascular effects. In addition, ketogenic diet is able to prevent mitochondrial fission, improve mitochondrial function, suppress oxidative stress and attenuate cardiac myocytes apoptosis in the heart of mice. Aim To evaluate the role of VLCKD on cardio–metabolic risk factors, cardiac dysfunction and myocardial remodelling in obese patients. Materials and Methods Ten obese patients treated with VLCKD were enrolled. All patients were characterized from an anthropometric, cardio–metabolic and echocardiographic point of view at baseline and 8 weeks after VLCKD treatment. In addition, each patient underwent measurement of global myocardial work efficiency (GWE), a novel indicator that accounts for deformation and afterload, which may provide additional value for assessment of myocardial function. The insulin resistance (IR) was evaluated by HOMA–IR. Results As expected, all the patients showed a significant reduction in body weight and an overall improvement of body composition parameters after VLCKD. Weight (kg) (from 105.1 ± 18.2 to 83.7 ± 16.7, P <0.05), BMI (kg/m2) (from 40.1 ± 4.7 to 31.8 ± 4.8, P= 0.002) and waist circumference (cm) (from 115 ± 13.6 to 101.8 ± 12.4, p < 0.05) were significantly lower after VLCKD treatment. VLCKD treatment improved also significantly fasting glucose levels (P <0.05), fasting insulin levels (P =0.004), HOMA–IR values (P <0.001), lipid profile and systolic and diastolic blood pressure levels. In addition, the echocardiogram evaluation showed an improved in end–diastolic left ventricular volume, end–systolic left ventricular volume, left ventricular mass and left ventricular mass index. Interestingly, a significantly changes in GWE was observed (P<0.05). Conclusion Although preliminary, our data suggest that VLCKD treatment is able to reduce cardio–metabolic risk factors and to improve cardiac dysfunction and myocardial function.