Abstract P108: Cardiac Interventions Differing in Lifestyle Modification Intensity Improve Insulin Resistance Through Changes in Lipoprotein Profiles

• Published in: Circulation (New York, N.Y.) N.Y.), 2016-03, Vol.133 (suppl_1)
• Main Authors: Ellsworth, Darrell L, Costantino, Nicholas S, Blackburn, Heather L, Engler, Renata J, Vernalis, Marina N
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.133.suppl_1.p108

Abstract only Background: Metabolic dysfunction characterized by insulin resistance (IR) is an important risk factor for type-2 diabetes and coronary artery disease (CAD). The Lipoprotein Insulin Resistance (LP-IR) index, derived from measures of lipoprotein subclass particle concentration and size, is useful for assessing IR and identifying patients with increased diabetes/CAD risk. Hypothesis: This study addressed the hypothesis that lifestyle modification programs differing in scope and intensity both improve IR through changes in lipoprotein profiles. Methods: Patients with CAD or significant CAD risk factors participated in one of two clinical lifestyle interventions: 1) an intensive nonrandomized program with a strict vegetarian diet (n=90 subjects, 90 matched controls) or 2) a moderate randomized trial following a Mediterranean-style diet (n=89 participants, 58 controls). On-treatment and intention-to-treat analyses used regression modelling adjusted for CAD risk factors and lipid-lowering medication use to assess changes over one year in LP-IR, lipoprotein profiles, and CAD risk factors in intervention and control participants in both programs. Results: Participants in the intensive lifestyle intervention had poorer baseline cardiovascular health than patients in the moderate program. In the on-treatment analysis, both lifestyle interventions led to weight loss [-8.9% (95% CI: -10.3, -7.4), intensive program; -2.8% (95% CI: -3.8, -1.9), moderate program; adjusted p