Weight loss improves fasting flow-mediated vasodilation in adults: A meta-analysis of intervention studies

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Abstract

BACKGROUND: Obesity is associated with vascular endothelial dysfunction. Effects of weight loss on endothelial function are however not clear. Therefore, we performed a meta-analysis to quantify effects of weight loss on flow-mediated vasodilation (FMD) of the brachial artery, a measurement of endothelial function. METHODS: Studies with experimental (RCTs) and quasi-experimental designs published before June 2014 were identified by a systematic search. Changes in FMD were defined as the difference between measurements before and after the study. For RCTs, changes were corrected for those in the no-weight loss control group. Summary estimates of weighted mean differences (WMDs) in FMD and 95% confidence intervals (CIs) were calculated using random-effect meta-analyses. The impact of subject characteristics, type of weight-loss treatment, and dietary composition on changes in FMD was also investigated. RESULTS: Four RCTs involving 265 subjects were included. Weight loss increased FMD vs. control by 3.29% (95% CI: 0.98-5.59%; P = 0.005; mean weight loss: 8.6 kg). A total of 1517 subjects participated in 33 studies with 49 relevant study arms. It was estimated that each 10 kg decrease in body weight increased fasting FMD by 1.11% (95% CI: 0.47-1.76%; P = 0.001). Effects were more pronounced when participants had coexisting obesity-related morbidities. Also, effects may be larger when subjects received low-fat diets or weight-reduction regimens including exercise therapy or weight-loss medication. CONCLUSION: Weight loss significantly improves fasting FMD in adults, which is a risk marker for cardiovascular disease. Effects may depend on subject characteristics, type of weight-loss treatment, and dietary composition.
Original languageEnglish
Pages (from-to)21-30
Number of pages10
JournalAtherosclerosis
Volume239
Issue number1
DOIs
Publication statusPublished - Mar 2015

Keywords

  • Flow-mediated vasodilation
  • Endothelial function
  • Weight loss
  • Intervention studies
  • Meta-analysis
  • LOW-FAT DIETS
  • VASCULAR ENDOTHELIAL FUNCTION
  • LOW-CARBOHYDRATE DIET
  • VERY-LOW-CARBOHYDRATE
  • LIFE-STYLE INTERVENTION
  • CORONARY-HEART-DISEASE
  • METABOLIC SYNDROME
  • OVERWEIGHT ADULTS
  • OXIDATIVE-STRESS
  • OBESE-PATIENTS

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