Cardiovascular flexibility in middle-aged overweight South Asians vs. white Caucasians: Response to short-term caloric restriction

• Cardiovascular disease (CVD) risk in South Asians is higher than in white Caucasians.
• This high risk might be related to higher cardiac susceptibility to metabolic disorders.
• Caloric restriction can be used as a metabolic stress test to study cardiac flexibility.
• This study shows comparable cardiac flexibility after caloric restriction in middle-aged overweight South Asians and Caucasians.
• Caloric restriction as a preventive and/or therapeutic strategy against CVD is as valuable in South Asians as in Caucasians.

Background and aimsSouth Asians have a higher risk of developing cardiovascular disease than white Caucasians. The underlying cause is unknown, but might be related to higher cardiac susceptibility to metabolic disorders. Short-term caloric restriction (CR) can be used as a metabolic stress test to study cardiac flexibility. We assessed whether metabolic and functional cardiovascular flexibility to CR differs between South Asians and white Caucasians.Methods and resultsCardiovascular function and myocardial triglycerides were assessed using a 1.5T-MRI/S-scanner in 12 middle-aged overweight male South Asians and 12 matched white Caucasians before and after an 8-day very low calorie diet (VLCD). At baseline South Asians were more insulin resistant than Caucasians. Cardiac dimensions were smaller, despite correction for body surface area, and pulse wave velocity (PWV) in the distal aorta was higher in South Asians. Systolic and diastolic function, myocardial triglycerides and pericardial fat did not differ significantly between groups. After the VLCD body weight reduced on average by 4.0 ± 0.2 kg. Myocardial triglycerides increased in both ethnicities by 69 ± 18%, and diastolic function decreased although this was not significant in South Asians. However, pericardial fat and PWV in the proximal and total aorta were reduced in Caucasians only.ConclusionMyocardial triglyceride stores in middle-aged overweight and insulin resistant South Asians are as flexible and amenable to therapeutic intervention by CR as age-, sex- and BMI-matched but less insulin resistant white Caucasians. However, paracardial fat volume and PWV showed a differential effect in response to an 8-day VLCD in favor of Caucasians.Clinical Trial RegistrationNTR 2473 (URL: http://www.trialregister.nl/trialreg/admin/rctsearch.asp?Term=2473).