Intermittent fasting and the digestive adaptation III surgery: translational assessment of its effects on cardiovascular risk factors and atherogenesis

Abstract

Primary prevention is the main strategy to control the global burden of cardiovascular disease. In clinical practice, food restriction represents a valuable preventive resource. However, low adhesion rates and diet abandonment are considered important obstacles in treatment. Considering the discovery of new markers and mechanisms that relate food restriction and to all other cardiovascular risk factors, it is possible and necessary to seek for efficient alternatives to increase adherence and effectiveness of the preventive dietetic treatment. Intermittent fasting is an option in which individuals are subject to fasting in alternate days only. Previous studies reported a higher adherence to this kind of diet. For more severe cases refractory to treatment of obesity and its comorbidities, such as Type II diabetes, there is the alternative of surgery. The technique known as Digestive Adaptations III is directed to this group of patients. This surgical intervention modifies intestinal tract by reducing gastric volume and performing an anastomosis between ileum and stomach, creating a bipartition in the gut. This structural modification promotes satiety and increased insulin sensitivity more intensely than other surgical strategies. Objectives - To investigate the mechanisms and genetic and molecular bases related to food restriction and its relationship with cardiovascular risk factors. Methods - We will carry out an experiment in mice and a clinical trial. In mice (mouse LDL r-/-), we will do a genetic analysis through a "genetic screening" followed by confirmation of groups of genes of interest by RT-PCR and Western Blotting, we will analyze by flow cytometry apoptosis of lymphocytes, monocytes and endothelial progenitor cells, rate of lipid peroxidation, vascular reactivity of aorta and zymography of metalloproteinases 2 and 9, in addition to insulin, glucose, lipid profile, blood pressure and heart rate. In the clinical trial, besides lipidic profile and glucose, we will determine incretin hormones, adipokines and amount of epicardial fat tissue, before and after surgery. (AU)