Weight loss therapy for clinical management of patients with some atherosclerotic diseases: a randomized clinical trial

Kuat Oshakbayev, Bibazhar Dukenbayeva, Nurzhan Otarbayev, Gulnar Togizbayeva, Nariman Tabynbayev, Meruyert Gazaliyeva, Alisher Idrisov, Pernekul Oshakbayev, Kuat Oshakbayev, Bibazhar Dukenbayeva, Nurzhan Otarbayev, Gulnar Togizbayeva, Nariman Tabynbayev, Meruyert Gazaliyeva, Alisher Idrisov, Pernekul Oshakbayev

Abstract

Background: The prevalence and burden of atherosclerotic (AS) diseases are increasing during the last twenty years. Some studies show a close relationship between overweight and AS, but influence on AS diseases of different weight loss methods are still studying. The purpose of the research was to study the effectiveness of a weight loss program in AS patients in randomized controlled trial, and to develop a conception of evolution of AS.

Methods: A randomized controlled prospective clinical trial including 97 people, from them 71 patients with various AS manifestations. Patients were divided in 2 subgroups for non-drug weight loss program, and conventional drug therapy. The weight loss program included calorie restriction with 100-150 kcal/day, fat-free vegetables, salt diet, and optimum physical activity. Statistical analysis was performed using SPSS for Windows version 17.0.

Results: The weight loss subgroup lost ranging between 7-20% from an initial weight (P = 0.016). Weight loss was achieved due to fatty mass reduction only (P = 0.005). Hemoglobin levels (P < 0.001), bone mineral density (P < 0.001), percentages of water (P = 0.006) and muscle masses (P = 0.0038) were increased in weight loss subgroup. Ejection fraction (P < 0.0001), systolic output (P < 0.0001) were increased in patients with coronary artery disease. The weight loss program led to a decrease in symptomatic drugs doses up to total abolition. A conception of AS was developed.

Conclusions: The weight loss program treated the AS diseases; improved laboratory and instrumental parameters, decreased symptomatic drugs doses. AS development is a logical way of ontogenetic ageing of body fat.

Trial international registration: ClinicalTrials.gov NCT01700075.

Trial national registration: State registration is # 0109RK000079, code is O.0475 at the National Center for Scientific and Technical Information of the Republic of Kazakhstan.

Figures

Fig. 1
Fig. 1
The regression correlation between fat mass (in %) and muscle mass (in %), total body water (in %), and bone mass (in %) in the patient group (n = 71). In a) x = fat mass (in %), y1 = muscle mass (in %), y2 = total body water (in %); in b) x = fat mass (in %), y = bone mass (in %)
Fig. 2
Fig. 2
Correlation between metabolic age and fat mass, and visceral fat level in the patient group (n = 71). In a) x = fat mass (in %), y = metabolic age (years); in b) x = visceral fat level (units), y = metabolic age (years)
Fig. 3
Fig. 3
The conception of ontogenetic evolution of Atherosclerosis because of ageing of body fat. Abbreviations: DM, diabetes mellitus; HI, hyperinsulinemia; IFT, Impaired fat tolerance; IGT, Impaired glucose tolerance; IR, insulin resistance

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