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- Title
A Diet Rich in Medium-Chain Fatty Acids Improves Systolic Function and Alters the Lipidomic Profile in Patients With Type 2 Diabetes: A Pilot Study.
- Authors
Airhart, Sophia; Cade, W Todd; Jiang, Hui; Coggan, Andrew R; Racette, Susan B; Korenblat, Kevin; Spearie, Catherine Anderson; Waller, Suzanne; O'Connor, Robert; Bashir, Adil; Ory, Daniel S; Schaffer, Jean E; Novak, Eric; Farmer, Marsha; Waggoner, Alan D; Dávila-Román, Víctor G; Javidan-Nejad, Cylen; Peterson, Linda R
- Abstract
<bold>Context: </bold>Excessive cardiac long-chain fatty acid (LCFA) metabolism/storage causes cardiomyopathy in animal models of type 2 diabetes. Medium-chain fatty acids (MCFAs) are absorbed and oxidized efficiently. Data in animal models of diabetes suggest MCFAs may benefit the heart.<bold>Objective: </bold>Our objective was to test the effects of an MCFA-rich diet vs an LCFA-rich diet on plasma lipids, cardiac steatosis, and function in patients with type 2 diabetes.<bold>Design: </bold>This was a double-blind, randomized, 2-week matched-feeding study.<bold>Setting: </bold>The study included ambulatory patients in the general community.<bold>Patients: </bold>Sixteen patients, ages 37-65 years, with type 2 diabetes, an ejection fraction greater than 45%, and no other systemic disease were included.<bold>Intervention: </bold>Fourteen days of a diet rich in MCFAs or LCFAs, containing 38% as fat in total, was undertaken.<bold>Main Outcome Measures: </bold>Cardiac steatosis and function were the main outcome measures, with lipidomic changes considered a secondary outcome.<bold>Results: </bold>The relatively load-independent measure of cardiac contractility, S', improved in the MCFA group (P < .05). Weight-adjusted stroke volume and cardiac output decreased in the LCFA group (both P < .05). The MCFA, but not the LCFA, diet decreased several plasma sphingolipids, ceramide, and acylcarnitines implicated in diabetic cardiomyopathy, and changes in several sphingolipids correlated with improved fasting insulins.<bold>Conclusions: </bold>Although a diet high in MCFAs does not change cardiac steatosis, our findings suggest that the MCFA-rich diet alters the plasma lipidome and may benefit or at least not harm cardiac function and fasting insulin levels in humans with type 2 diabetes. Larger, long-term studies are needed to further evaluate these effects in less-controlled settings.
- Subjects
FATTY acids; BLOOD pressure; COMPARATIVE studies; DIET; GENETIC disorders; CARDIAC contraction; HEART function tests; LIPID metabolism disorders; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; TYPE 2 diabetes; RESEARCH; RESEARCH funding; PILOT projects; EVALUATION research; RANDOMIZED controlled trials; TREATMENT effectiveness; BLIND experiment; STROKE volume (Cardiac output); DIABETIC cardiomyopathy; THERAPEUTICS
- Publication
Journal of Clinical Endocrinology & Metabolism, 2016, Vol 101, Issue 2, p504
- ISSN
0021-972X
- Publication type
journal article
- DOI
10.1210/jc.2015-3292