Brady, Emer M, Gulsin, Gaurav S, Mirkes, Evgeny M, Parke, Kelly, Kanagala, Prathap 
ORCID: 0000-0001-6739-5607, Ng, Leong L, Graham-Brown, Matthew PM, Athithan, Lavanya, Henson, Joseph, Redman, Emma et al (show 7 more authors)
(2022)
Fibro-inflammatory recovery and type 2 diabetes remission following a low calorie diet but not exercise training: A secondary analysis of the DIASTOLIC randomised controlled trial.
DIABETIC MEDICINE, 39 (8).
e14884-.
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Abstract
<h4>Aims</h4>To investigate the relationship between fibro-inflammatory biomarkers and cardiovascular structure/function in people with Type 2 Diabetes (T2D) compared to healthy controls and the effect of two lifestyle interventions in T2D.<h4>Methods</h4>Data were derived from the DIASTOLIC randomised controlled trial (RCT) and includes a comparison between those with T2D and the matched healthy volunteers recruited at baseline. Adults with T2D without cardiovascular disease (CVD) were randomized to a 12-week intervention either: (1) exercise training, (2) a low-energy (∼810 kcal/day) meal-replacement plan (MRP) or (3) standard care. Principal Component and Fisher's linear discriminant analysis were used to investigate the relationships between MRI acquired cardiovascular outcomes and fibro-inflammatory biomarkers in cases versus controls and pre- and post-intervention in T2D.<h4>Results</h4>At baseline, 83 people with T2D (mean age 50.5 ± 6.4; 58% male) and 36 healthy controls (mean age 48.6 ± 6.2; 53% male) were compared and 76 people with T2D completed the RCT for pre- post-analysis. Compared to healthy controls, subjects with T2D had adverse cardiovascular remodelling and a fibro-inflammatory profile (20 differentially expressed biomarkers). The 3D data visualisations showed almost complete separation between healthy controls and those with T2D, and a marked shift towards healthy controls following the MRP (15 biomarkers significantly changed) but not exercise training.<h4>Conclusions</h4>Fibro-inflammatory pathways and cardiovascular structure/function are adversely altered before the onset of symptomatic CVD in middle-aged adults with T2D. The MRP improved the fibro-inflammatory profile of people with T2D towards a more healthy status. Long-term studies are required to assess whether these changes lead to continued reverse cardiac remodelling and prevent CVD.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | cardiovascular MRI, diabetic cardiomyopathy, fibrosis, inflammation, type 2 diabetes, type 2 diabetes remission |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Clinical Directorate |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 10 Oct 2022 08:30 |
| Last Modified: | 18 Jan 2023 20:37 |
| DOI: | 10.1111/dme.14884 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3165286 |
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