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DOI: 10.1055/s-0031-1271778
© Georg Thieme Verlag KG Stuttgart · New York
Weight Loss Improves Endothelial Function Independently of ADMA Reduction in Severe Obesity
Publikationsverlauf
received 22.11.2010
accepted 27.01.2011
Publikationsdatum:
01. März 2011 (online)

Abstract
This prospective study was performed in order to establish whether improvement of endothelial function after weight reduction can be explained by a decrease of elevated asymmetric dimethyl arginine (ADMA), an inhibitor of endogenous NO-synthase (eNOS). Therefore, 21 obese subjects (BMI: 41.1±6.4 kg/m2) were studied at baseline and after 12 weeks of weight reduction with a very low calorie diet. Biochemical and clinical parameters of endothelial function were assessed before and after weight loss. Biochemical parameters were determined by measurement of ADMA and soluble intercellular adhesion molecule (sICAM). Clinical parameters were assessed by pulse wave analysis (PWA). Weight intervention resulted in a 21.4±6.8 kg reduction of body weight from 119.7±12.8 kg at study start to 98.3±11.6 kg at study end (p<0.001). Accordingly, biochemical markers improved under weight reduction (ADMA from 0.47±0.07 mmol/l to 0.42±0.08 mmol/l; p=0.002; ICAM from 276±42 ng/ml to 236±29 ng/ml; p<0.001). Further, clinical parameters of functional endothelial function improved with an increase of deltaRI after salbutamol inhalation from −1% before to −9% after weight reduction (p=0.02). Interestingly, improvement of endothelial function correlated with improved HOMA index only (r=−0.60, p=0.04) but not with reduced ADMA levels, improved hypertension or reduced body weight. In conclusion, weight reduction with a very low calorie diet improves endothelial function measured by pulse wave velocity. The missing correlation with ADMA suggests possible further mechanisms underlying this observed effect, for example, improvement of insulin resistance.
Key words
weight loss - pulse wave analysis - ADMA - sICAM - obesity - endothelial dysfunction
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Correspondence
G. RudofskyMD
Department of Medicine I and
Clinical Chemistry
Im Neuenheimer Feld 410
69120 Heidelberg
Germany
Telefon: +49/6221/563 86 20
Fax: +49/6221/565 793
eMail: gottfried_rudofsky@med.uni-heidelberg.de