PMID- 23847327
OWN - NLM
STAT- MEDLINE
DCOM- 20131119
LR  - 20161018
IS  - 1479-683X (Electronic)
IS  - 0804-4643 (Linking)
VI  - 169
IP  - 4
DP  - 2013 Oct
TI  - Autonomic nervous system activity in diabetic and healthy obese female subjects 
      and the effect of distinct weight loss strategies.
PG  - 383-90
LID - 10.1530/EJE-13-0506 [doi]
AB  - OBJECTIVE: Obesity and type 2 diabetes mellitus (T2DM) are reported to be 
      associated with relative overactivity of the sympathetic nervous system (SNS), 
      which is reversible by weight loss. However, direct effects of weight loss by 
      calorie restriction vs Roux-en-Y gastric bypass (RYGB) on SNS overactivity were 
      not studied in parallel. This study compared the effects of RYGB vs restrictive 
      weight loss in obese patients with normal glucose tolerance (NGT) and with T2DM 
      on SNS function as measured by heart rate variability (HRV). DESIGN AND METHODS: 
      Lean (n=12), obese NGT (n=27) and T2DM (n=27) subjects were included in this 
      study. Weight reduction in NGT subjects was achieved by gastric banding (GB) or 
      RYGB and in T2DM subjects by RYGB or high-protein very-low-calorie diet (VLCD). 
      HRV analysis was performed and blood samples were taken at baseline, 3 weeks and 
      3 months after intervention. RESULTS: At baseline, T2DM subjects showed SNS 
      overactivity and NGT subjects showed similar, but non-significant, findings when 
      compared with lean controls. Weight loss after 3 weeks was comparable in all 
      treatment groups, whereas after 3 months, weight loss was most in VLCD and RYGB 
      subjects. RYGB and VLCD treatment reduced SNS activity within 3 weeks in T2DM 
      patients. After 3 months, restoration to normal autonomic nervous system activity 
      was evident for all groups, except for the NGT-GB group. CONCLUSION: We can 
      conclude that SNS overactivity is more pronounced in obese T2DM subjects when 
      compared with NGT subjects. Reduction of SNS overactivity coincides with weight 
      loss with the time-course of reduction dependent on the type of intervention. 
      Surgery or caloric restriction may transiently induce SNS overactivity but do not 
      prevent a direct restoration of sympathovagal balance.
FAU - Lips, Mirjam A
AU  - Lips MA
AD  - Department of Endocrinology and Metabolism, Leiden University Medical Center, 
      C-04-R-83, Albinusdreef 2, PO Box 9600, 2333 ZA Leiden, The Netherlands.
FAU - de Groot, Gerrit H
AU  - de Groot GH
FAU - De Kam, Marieke
AU  - De Kam M
FAU - Berends, Frits J
AU  - Berends FJ
FAU - Wiezer, Renee
AU  - Wiezer R
FAU - Van Wagensveld, Bart A
AU  - Van Wagensveld BA
FAU - Swank, Dingeman J
AU  - Swank DJ
FAU - Luijten, Arijan
AU  - Luijten A
FAU - Pijl, Hanno
AU  - Pijl H
FAU - Burggraaf, Jacobus
AU  - Burggraaf J
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
DEP - 20130912
PL  - England
TA  - Eur J Endocrinol
JT  - European journal of endocrinology
JID - 9423848
RN  - 0 (Hypoglycemic Agents)
SB  - IM
MH  - Adult
MH  - *Autonomic Nervous System Diseases/diet therapy/etiology/surgery
MH  - Caloric Restriction
MH  - Diabetes Mellitus, Type 2/*complications/drug therapy
MH  - *Diet, Reducing
MH  - Female
MH  - *Gastric Bypass
MH  - Glucose Tolerance Test
MH  - Humans
MH  - Hypoglycemic Agents/therapeutic use
MH  - Middle Aged
MH  - Obesity/complications/*diet therapy/surgery
MH  - Sympathetic Nervous System/physiopathology
MH  - Treatment Outcome
MH  - Vagus Nerve/physiopathology
MH  - Weight Loss
EDAT- 2013/07/13 06:00
MHDA- 2013/11/20 06:00
CRDT- 2013/07/13 06:00
PHST- 2013/07/13 06:00 [entrez]
PHST- 2013/07/13 06:00 [pubmed]
PHST- 2013/11/20 06:00 [medline]
AID - EJE-13-0506 [pii]
AID - 10.1530/EJE-13-0506 [doi]
PST - epublish
SO  - Eur J Endocrinol. 2013 Sep 12;169(4):383-90. doi: 10.1530/EJE-13-0506. Print 2013 
      Oct.