Cardiac autonomic neuropathy (CAN) has been linked to negative outcomes in diabetic patients, where it is associated with a high risk of cardiac arrhythmia and sudden death. Our previous research showed that prediabetic rats develop CAN in absence of overt signs of metabolic derangement or change in body weight. This was associated with vascular dysfunction and perivascular adipose tissue (PVAT) inflammation, which preceded inflammatory changes in other adipose pools, possibly linked to increased Uncoupling protein 1 (UCP1) and hypoxia‐inducible factor (HIF1‐a) expression. In parallel, phosphate supplementation is a simple intervention to improve body weight, energy metabolism, and glucose tolerance. Moreover, inorganic phosphate acts as a UCP1 inhibitor. Here, we examined the role of phosphate supplementation in ameliorating the early signs of cardiovascular dysfunction in metabolically challenged rats. Male SD rats (5–6 weeks) were randomly allocated into four groups fed either control diet (group 1) or high‐calorie (HC) diet for 12 weeks with three different levels of dietary phosphate; group 2: low phosphate (LP)‐ 0.37 mg/KCal, group 3: intermediate phosphate (IP)‐0.7 mg/KCal, group 4: high phosphate (HP)‐ 1.5 mg/KCal. Daily food intake, body weight, and body composition were recorded. Serum insulin was measured by ELISA. Invasive hemodynamic measurements were done and baroreceptor sensitivity (BRS) was assessed by the vasoactive method. After sacrifice, organs were collected for immunohistochemistry and western blotting. No changes in caloric intake, body weight, blood pressure, and blood glucose levels were observed. However, rats on HC diet showed an increase in serum insulin level and fat/lean ratio. Consistent with our previous work, HC‐feeding was associated with significant reduction in parasympathetic BRS in both the LP and IP groups. This was also accompanied by a reduced left ventricular systolic function. On the cellular level, Oil Red O stain showed a significant increase in the diameter of PVAT adipocytes in LP condition, together with increased expression of HIF‐1α, IL‐1β and UCP‐1. Of note, inflammatory changes observed in the PVAT were not detected in neither white nor brown adipose tissue. Furthermore, higher macrophage infiltration and total ROS score in the PVAT, heart mid‐section and brainstem were observed in LP when compared to control. Our present results highlight a role of phosphate supplementation in the amelioration of the HC induced parasympathetic dysfunction. This could be due to the reported ability of dietary phosphate to improve the assimilation of fat and reduce adipose tissue hypoxia possibly via UCP1 inhibition.Support or Funding InformationFunded by an AUB CRS grantIL1‐UCP1 for perivascular adipose tissue (PVAT), white adipose tissue (WAT), and brown adipose tissue (BAT)Figure 1
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