TY - JOUR
T1 - A diet rich in medium-chain fatty acids improves systolic function and alters the lipidomic profile in patients with type 2 diabetes
T2 - A pilot study
AU - Airhart, Sophia
AU - Cade, W. Todd
AU - Jiang, Hui
AU - Coggan, Andrew R.
AU - Racette, Susan B.
AU - Korenblat, Kevin
AU - Spearie, Catherine Anderson
AU - Waller, Suzanne
AU - O'Connor, Robert
AU - Bashir, Adil
AU - Ory, Daniel S.
AU - Schaffer, Jean E.
AU - Novak, Eric
AU - Farmer, Marsha
AU - Waggoner, Alan D.
AU - Dávila-Román, Víctor G.
AU - Javidan-Nejad, Cylen
AU - Peterson, Linda R.
N1 - Funding Information:
The authors thank Ava Ysaguirre for her assistance in manuscript preparation and Dr. Julio Pérez and Joshua Leibowitz for assistance with the study. The Human Imaging and the Cardiovascular Imaging Research Cores were instrumental in completing this study. This work was funded by grants from the Diabetic Cardiovascular Disease Center (St. Louis, Missouri) and the National Institutes of Health (P20 HL113444, P30 DK 020579, P30 DK 056341, UL1 TR000448). Cognis contributed some of the medium chain triglycerides for the study. Cognis did not have access to our data or the manuscript before publication. Cognis has since been acquired by BASF.
Funding Information:
The authors thank Ava Ysaguirre for her assistance in manuscript preparation and Dr. Julio P?rez and Joshua Leibowitz for assistance with the study. The Human Imaging and the Cardiovascular Imaging Research Cores were instrumental in completing this study. This work was funded by grants from the Diabetic Cardiovascular Disease Center (St. Louis, Missouri) and the National Institutes of Health (P20 HL113444, P30 DK 020579, P30 DK 056341, UL1 TR000448). Cognis contributed some of the medium chain triglycerides for the study. Cognis did not have access to our data or the manuscript before publication. Cognis has since been acquired by BASF.
PY - 2016/2
Y1 - 2016/2
N2 - Context: 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. Objective: 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. Design: This was a double-blind, randomized, 2-week matched-feeDing study. Setting: The study included ambulatory patients in the general community. Patients: Sixteen patients, ages 37-65 years, with type 2 diabetes, an ejection fraction greater than 45%, and no other systemic disease were included. Intervention: Fourteen days of a diet rich in MCFAs or LCFAs, containing 38% as fat in total, was undertaken. Main Outcome Measures: Cardiac steatosis and function were the main outcome measures, with lipidomic changes considered a secondary outcome. Results: The relatively load-independent measure of cardiac contractility, S, improved in theMCFA 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. Conclusions: Although a diet high inMCFAsdoes 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.
AB - Context: 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. Objective: 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. Design: This was a double-blind, randomized, 2-week matched-feeDing study. Setting: The study included ambulatory patients in the general community. Patients: Sixteen patients, ages 37-65 years, with type 2 diabetes, an ejection fraction greater than 45%, and no other systemic disease were included. Intervention: Fourteen days of a diet rich in MCFAs or LCFAs, containing 38% as fat in total, was undertaken. Main Outcome Measures: Cardiac steatosis and function were the main outcome measures, with lipidomic changes considered a secondary outcome. Results: The relatively load-independent measure of cardiac contractility, S, improved in theMCFA 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. Conclusions: Although a diet high inMCFAsdoes 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.
UR - http://www.scopus.com/inward/record.url?scp=84959431623&partnerID=8YFLogxK
U2 - 10.1210/jc.2015-3292
DO - 10.1210/jc.2015-3292
M3 - Article
C2 - 26652763
AN - SCOPUS:84959431623
SN - 0021-972X
VL - 101
SP - 504
EP - 512
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 2
ER -