Penurunan berat badan dapat menurunkan ketebalan lapisan intima media arteri carotis
Circulation 121:1200-1208, March 2010 © 2010 American Heart Association, Inc.
Dietary Intervention to Reverse Carotid Atherosclerosis. Iris Shai, J. David Spence, Dan Schwarzfuchs, et al.
Background— It is currently unknown whether dietary weight loss interventions can induce regression of carotidatherosclerosis.
Methods and Results— In a 2-year Dietary Intervention Randomized Controlled Trial–Carotid (DIRECT-Carotid) study, participants were randomized to low-fat, Mediterranean, or low-carbohydrate diets and were followed for changes in carotid artery intima-media thickness, measured with standard B-mode ultrasound, and carotid vessel wall volume (VWV), measured with carotid 3D ultrasound. Of 140 complete images of participants (aged 51 years; body mass index, 30 kg/m2; 88% men), higher baseline carotid VWV was associated with increased intima-media thickness, age, male sex, baseline weight, blood pressure, and insulin levels (P<0.05 for all). After 2 years of dietary intervention, we observed a significant 5% regression in mean carotidVWV (–58.1 mm3; 95% confidence interval, –81.0 to –35.1 mm3; P<0.001), with no differences in the low-fat, Mediterranean, or low-carbohydrate groups (–60.69 mm3, –37.69 mm3, –84.33 mm3, respectively; P=0.28). Mean change in intima-media thickness was –1.1% (P=0.18). A reduction in the ratio of apolipoprotein B100 to apolipoprotein A1 was observed in the low-carbohydrate compared with the low-fat group (P=0.001). Participants who exhibited carotidVWV regression (mean decrease, –128.0 mm3; 95% confidence interval, –148.1 to –107.9 mm3) compared with participants who exhibited progression (meanincrease, +89.6 mm3; 95% confidence interval, +66.6 to +112.6 mm3) had achieved greater weight loss (–5.3 versus –3.2 kg; P=0.03), greater decreases in systolic blood pressure (–6.8 versus –1.1 mm Hg; P=0.009) and total homocysteine (–0.06 versus +1.44 µmol/L; P=0.04), and a higher increase of apolipoprotein A1 (+0.05 versus –0.00 g/L; P=0.06). In multivariate regression models, only the decrease in systolic blood pressure remained a significant independent modifiablepredictor of subsequent greater regression in both carotid VWV (β=0.23; P=0.01) and intima-media thickness (β=0.28; P=0.008) levels.
Conclusions— Two-year weight loss diets can induce a significant regression of measurable carotid VWV. The effect is similar in low-fat, Mediterranean, or low-carbohydrate strategies and appears to be mediated mainly by the weight loss–induced decline in blood pressure.
--
Salam sehat,
Dr. David Fadjar Putra, MS
Spesialis Gizi Klinik
@
www.kliniknutrisi.com
kliniknutrisi.blogspot.com
No comments:
Post a Comment