Weight loss induced by nutritional and exercise intervention decreases arterial stiffness in obese subjects

Abstract

Obesity is associated with increased arterial stiffness, an early marker of vascular wall damage. However, data on the long-term vascular impact of intentional weight loss are limited. The aim of the present study was to evaluate the effect of weight loss induced by nutritional and exercise intervention on arterial compliance, metabolic and inflammatory parameters in obese patients who participated in a weight reduction program. In an open label, prospective study, 37 obese subjects attended a 24 weeks nutritional and exercise interventional program. Arterial elasticity was evaluated using pulse-wave contour analysis (HDI CR-2000, Eagan, Minnesota) at baseline and at the end of the study. Fasting glucose, HbA1C, insulin, lipid profile, hs-CRP, fibrinogen were measured at baseline and after 6 months. Insulin resistance was assessed by homeostasis model assessment-insulin resistance (HOMA-IR). BMI decreased from 36.1 +/- 7.4 kg/m(2) at baseline to 32.8 +/- 7.4 kg/m(2) after 6 months (p<0.0001). Large artery elasticity index (LAEI) increased from 12.1 +/- 4.1 to 15.8 +/- 4.7 ml/mmHg x 10 during the study (p<0.0001). Small artery elasticity index (SAEI) increased from 4.4+/-2.4 to 5.5 +/- 2.7 ml/mmHg x 100 (p<0.0001). There was a significant improvement in fasting hyperglycemia, HbA1C and significant decrease in LDL-cholesterol, fibrinogen and C-reactive protein. Modest reduction in HOMA-IR was observed. The change in weight was positively associated with LAEI, SAEI, total cholesterol, insulin and HOMA-IR. Moderate weight loss induced by nutritional and exercise intervention improved small and large artery elasticity. The increase in arterial elasticity was associated with improvement in glucose and lipids homeostasis as well as markers of inflammation.