Table 2.
Metabolic and anthropometric parameters at baseline, after 3 months, after 6 months, and at follow-up
| Parameter | Group | V0 | V3 | V6 | V7 |
|---|---|---|---|---|---|
| Glycemia | |||||
| FPG, mg/dL | M-Diet | 158.4 ± 10.6 (19) | 149.1 ± 11.4 (18) | 151.2 ± 12.1 (16) | 167.5 ± 18.2 (15) |
| FMD | 162.1 ± 9.7 (21) | 146.7 ± 13.8 (20) | 137.4 ± 12.7 (17) | 151.9 ± 8.5 (16) | |
| HbA1c, % | M-Diet | 7.7 ± 0.3 (19) | 7.2 ± 0.3 (18) | 7.7 ± 0.3 (16) | 8.0 ± 0.4 (15) |
| FMD | 8.1 ± 0.4 (21) | 7.2 ± 0.3 (20) | 6.7 ± 0.3 (17)* | 7.6 ± 0.4 (16) | |
| C-peptid, ng/mL | M-Diet | 3.3 ± 0.4 (19) | 2.9 ± 0.4 (18) | 3.2 ± 0.6 (16) | 3 ± 0.5 (14) |
| FMD | 3.1 ± 0.4 (21) | 2.3 ± 0.4 (20) | 2.0 ± 0.3 (17) | 2.7 ± 0.3 (15) | |
| HOMA-IR | M-Diet | 6.1 ± 0.9 (13) | 6.0 ± 0.9 (13) | 5.7 ± 1.0 (11) | 6.1 ± 0.9 (10) |
| FMD | 6.4 ± 1.9 (14) | 4.9 ± 2.7 (14) | 2.6 ± 0.6 (12)** | 5.1 ± 1.7 (10)* | |
| Blood pressure | |||||
| Systolic BP | M-Diet | 142.0 ± 3.8 (19) | 144.6 ± 5.9 (18) | 142.5 ± 4.1 (16) | 136.6 ± 2.9 (14) |
| FMD | 142.9 ± 3.1 (21) | 135.9 ± 3.2 (19) | 141.3 ± 3.2 (16) | 142.6 ± 5.3 (14) | |
| Diastolic BP | M-Diet | 81.8 ± 1.7 (19) | 81.3 ± 2.1 (18) | 81.8 ± 2.4 (16) | 80.5 ± 2.3 (14) |
| FMD | 85.3 ± 1.8 (21) | 81.6 ± 1.5 (19) | 83.2 ± 1.8 (16) | 85.6 ± 2.3 (14) | |
| Lipidemia | |||||
| Cholesterol, mg/dL | M-Diet | 174.8 ± 10.4 (19) | 171.7 ± 9.9 (18) | 184.2 ± 11.2 (16) | 188.7 ± 13.4 (15) |
| FMD | 184.6 ± 18.3 (21) | 164.7 ± 13.1 (20) | 160.2 ± 10.3 (17) | 177.8 ± 11.9 (16) | |
| LDL, mg/dL | M-Diet | 94.3 ± 8.9 (18) | 90.2 ± 7.5 (18) | 96.6 ± 8.4 (16) | 103.8 ± 12.3 (13) |
| FMD | 87.8 ± 8.5 (20) | 95.2 ± 11.5 (19) | 87.2 ± 9.6 (17) | 84.6 ± 10.0 (14) | |
| HDL, mg/dL | M-Diet | 43.0 ± 2.5 (19) | 44.3 ± 2.7 (18) | 46.8 ± 2.6 (16) | 45.7 ± 3.7 (15) |
| FMD | 44.3 ± 2.8 (21) | 43.3 ± 2.6 (20) | 48.8 ± 3.3 (17) | 51.7 ± 3.8 (16) | |
| TG, mg/dL | M-Diet | 205.6 ± 25.8 (19) | 185.5 ± 20.5 (18) | 204.8 ± 24.6 (16) | 214.7 ± 35.2 (15) |
| FMD | 277.2 ± 75.6 (21) | 166.8 ± 37.5 (20) | 121.2 ± 12.4 (17) | 209.4 ± 35.8 (16) | |
| Lp(a), mg/dL | M-Diet | 30.3 ± 8.7 (19) | 35.6 ± 10.5 (17) | 33.6 ± 9.7 (16) | 34.6 ± 10.7 (14) |
| FMD | 16.3 ± 3.5 (21) | 20.6 ± 4.4 (20) | 17.5 ± 2.1 (17) | 14.3 ± 1.7 (15) | |
| Liver parameters | |||||
| AST, U/L | M-Diet | 27.5 ± 1.7 (19) | 31.1 ± 3.0 (18) | 27.2 ± 1.6 (16) | 26.3 ± 1.5 (15) |
| FMD | 27.5 ± 3.3 (21) | 29.9 ± 2.4 (20) | 25.5 ± 1.4 (17) | 23.0 ± 1.6 (16) | |
| ALT, U/L | M-Diet | 31.3 ± 2.8 (19) | 32.8 ± 4.4 (18) | 30.4 ± 2.8 (16) | 30.7 ± 2.7 (15) |
| FMD | 30.6 ± 3.1 (21) | 34.7 ± 3.5 (20) | 25.6 ± 1.9 (17) | 23.3 ± 2.4 (16) | |
| Liver stiffness, kPa | M-Diet | 6.9 ± 0.8 (19) | 6.4 ± 0.6 (18) | 6.0 ± 0.6 (16) | 7.2 ± 1.2 (14) |
| FMD | 8.1 ± 1 (21) | 6.2 ± 0.6 (19) | 6.4 ± 0.7 (17) | 7.1 ± 0.8 (15) | |
| Protein level | |||||
| Plasma-albumin, g/L | M-Diet | 44.3 ± 0.7 (19) | 44.8 ± 0.6 (18) | 44.9 ± 0.7 (16) | 44.6 ± 0.7 (15) |
| FMD | 45.9 ± 0.4 (21) | 46.7 ± 0.5 (20) | 47.3 ± 0.6 (17) | 45.5 ± 0.5 (16) | |
| Plasma-total protein, g/L | M-Diet | 72.9 ± 1.4 (19) | 72.8 ± 1.4 (18) | 72.4 ± 1.5 (16) | 71.5 ± 1.4 (15) |
| FMD | 73.3 ± 0.9 (21) | 74.6 ± 1.1 (20) | 72.9 ± 0.9 (17) | 69.5 ± 0.8 (16) | |
| Renal parameters | |||||
| uACR, mg/g | M-Diet | 73.4 (205.6) (19) | 72.7 (125.8) (18) | 63.1 (353.6) (16) | 76.0 (149.9) (15) |
| FMD | 51.3 (116.0) (21) | 34.8 (43.6) (20) | 25.6 (40.3) (17) | 36.5 (137.8) (16) | |
| Micro.uACR, mg/g | M-Diet | 44.8 (49.2) (14) | 35.8 (58.0) (13) | 37.2 (50.5) (11) | 22.9 (65.6) (11) |
| FMD | 43.7 (39.6) (17) | 29.1 (36.1) (16)* | 23.4 (30.3) (14)* | 27.4 (27.1) (13) | |
| Macro.uACR, mg/g | M-Diet | 359.3 (1888.5) (4) | 249.2 (2533.6) (4) | 430.3 (592.5) (3) | 399.8 (143.4) (3) |
| FMD | 555.2 (593.2) (3) | 666.1 (575.0) (3) | 1034.7 (591.1) (3) | 915.4 (905.8) (3) | |
| Urea, mg/dL | M-Diet | 39.1 ± 3.2 (19) | 38.1 ± 2.9 (18) | 48.8 ± 8.7 (16) | 35.9 ± 2.3 (15) |
| FMD | 38.8 ± 4 (21) | 25.6 ± 1.9 (20)** | 26.2 ± 2.1 (17)* | 38.2 ± 2.9 (16) | |
| Creatinine, mg/dL | M-Diet | 0.8 ± 0.1 (19) | 0.9 ± 0.1 (18) | 0.8 ± 0.1 (16) | 0.8 ± 0.1 (15) |
| FMD | 0.9 ± 0.1 (21) | 0.9 ± 0.1 (20) | 0.9 ± 0.1 (17) | 0.9 ± 0.1 (16) | |
| eGFR CKD-EPI (creatinine), mL/min/1.73 m² | M-Diet | 87 ± 4.3 (19) | 85 ± 4.5 (18) | 86.4 ± 4.7 (16) | 87.7 ± 4.3 (15) |
| FMD | 84.6 ± 4.3 (21) | 83.2 ± 4.2 (20) | 81.8 ± 4.8 (17) | 82.3 ± 4.7 (16) | |
| Cystatin C, mg/L | M-Diet | 1 ± 0.1 (19) | 1.1 ± 0.1 (18) | 1.2 ± 0.1 (16) | 1.1 ± 0.1 (15) |
| FMD | 1.1 ± 0.1 (21) | 1.1 ± 0.1 (20) | 1.1 ± 0.1 (17)* | 1.1 ± 0.1 (16) | |
| eGFR (cystatin C), mL/min/1.73 m² | M-Diet | 84.6 ± 4.5 (19) | 80 ± 4.3 (18) | 72.9 ± 5.6 (16) | 73.3 ± 4.9 (15) |
| FMD | 79.5 ± 4.6 (21) | 77.2 ± 4.5 (20) | 77.4 ± 5.1 (17)* | 71.2 ± 4.9 (16) | |
| sUPAR, pg/mL | M-Diet | 3040.5 ± 218.0 (19) | 3106.0 ± 335.6 (17) | 2975.4 ± 187.6 (16) | 3052.8 ± 197.0 (14) |
| FMD | 3122 ± 375 (21) | 2998.6 ± 216.9 (20)* | 2737.1 ± 117.8 (17)* | 3036.7 ± 180.4 (15) | |
| Ketogenesis | |||||
| Blood ketones, mmol/L | M-Diet | 0.1 ± 0.0 (19) | 0.2 ± 0.0 (18) | 0.1 ± 0.0 (16) | 0.1 ± 0.0 (14) |
| FMD | 0.2 ± 0.0 (21) | 0.5 ± 0.1 (20)** | 0.5 ± 0.1 (17)** | 0.1 ± 0.0 (15) | |
| Urine ketones, mg/dL | M-Diet | 0.3 ± 0.3 (19) | 2.2 ± 0.9 (18) | 2.5 ± 1.3 (16) | 1.8 ± 1.1 (14) |
| FMD | 1.2 ± 0.8 (21) | 5.8 ± 1.5 (20) | 7.9 ± 3.2 (17) | 1.0 ± 0.5 (15) | |
| Other parameters | |||||
| Uric acid, mg/dL | M-Diet | 6.0 ± 0.3 (19) | 6.1 ± 0.3 (18) | 6.0 ± 0.4 (16) | 5.9 ± 0.3 (14) |
| FMD | 6.6 ± 0.4 (21) | 6.4 ± 0.3 (20) | 6.8 ± 0.4 (17) | 6.4 ± 0.5 (15) | |
| hsCRP, mg/L | M-Diet | 1.9 ± 0.4 (19) | 2.1 ± 0.5 (18) | 2.2 ± 0.6 (16) | 3.2 ± 1.0 (15) |
| FMD | 5.1 ± 1.6 (21) | 3.2 ± 1.0 (20) | 2.6 ± 1.2 (17) | 2.3 ± 0.9 (16) | |
| hsTNT, pg/mL | M-Diet | 15.9 ± 2.2 (19) | 17.0 ± 2.5 (18) | 18.3 ± 3.6 (16) | 17.1 ± 3.1 (15) |
| FMD | 12.6 ± 1.5 (21) | 12.7 ± 1.6 (20) | 13.0 ± 1.3 (17) | 15.9 ± 2.7 (16) | |
| IGF-1, ng/mL | M-Diet | 111.9 ± 8.5 (19) | 117.2 ± 9.8 (18) | 115.1 ± 10.3 (16) | 123.7 ± 12.6 (14) |
| FMD | 135.1 ± 8.7 (21) | 127.8 ± 7.0 (20) | 127.9 ± 9.1 (16) | 137.2 ± 7.7 (15) | |
| IL-6, pg/mL | M-Diet | 3.0 ± 0.6 (19) | 3.8 ± 0.6 (18) | 3.2 ± 0.8 (15) | 2.9 ± 0.4 (14) |
| FMD | 2.9 ± 0.4 (21) | 3.5 ± 0.6 (20) | 2.3 ± 0.1 (17) | 2.3 ± 0.2 (14) | |
| NT-proBNP, ng/L | M-Diet | 149.7 ± 39.1 (19) | 169.2 ± 34.1 (17) | 129.0 ± 32.2 (16) | 140.4 ± 41.4 (15) |
| FMD | 198.5 ± 100.3 (21) | 202.2 ± 70.0 (19) | 173.5 ± 57.4 (17) | 252.8 ± 111.2 (16) | |
| Plasma MG-H1, nM | M-Diet | 217.9 ± 36.0 (19) | 132.7 ± 15.4 (18) | 246.0 ± 27.9 (16) | 281.1 ± 37.6 (15) |
| FMD | 213.3 ± 32.0 (21) | 81.7 ± 10.7 (20)*** | 297.4 ± 72.0 (17) | 294.7 ± 50.31 (15) | |
| Body weight | |||||
| Body weight, kg | M-Diet | 93.3 ± 3.6 (19) | 93.0 ± 3.9 (18) | 93.1 ± 4.4 (16) | 90.5 ± 4.5 (14) |
| FMD | 95.7 ± 3.6 (21) | 90.0 ± 3.8 (20)*** | 85.8 ± 3.6 (17)*** | 91.4 ± 3.7 (15) | |
| BMI, kg/m2 | M-Diet | 30.2 ± 1.0 (19) | 30.1 ± 1.1 (18) | 30.2 ± 1.2 (16) | 29.8 ± 1.3 (14) |
| FMD | 31 ± 0.9 (21) | 29.1 ± 1.1 (20)*** | 27.7 ± 1.0 (17)*** | 29.4 ± 1.1 (15) | |
| Body composition (BIA) | |||||
| Fat mass, % | M-Diet | 29.9 ± 1.9 (18) | 30.1 ± 1.9 (17) | 30.2 ± 2.1 (15) | 30.3 ± 2.2 (14) |
| FMD | 31.9 ± 1.8 (21) | 31.1 ± 1.9 (20) | 29.6 ± 2.0 (16) | 30.1 ± 2.2 (15) | |
| Fat mass, kg | M-Diet | 28.4 ± 2.7 (18) | 28.4 ± 2.8 (17) | 28.5 ± 2.9 (15) | 27.9 ± 3.0 (14) |
| FMD | 30.7 ± 2.1 (21) | 28.4 ± 2.4 (20) | 25.3 ± 2.2 (16) | 27.7 ± 2.4 (15) | |
| Fat-free mass, % | M-Diet | 70.1 ± 1.9 (18) | 69.9 ± 1.9 (17) | 69.7 ± 2.1 (15) | 70.4 ± 2.6 (14) |
| FMD | 68.1 ± 1.8 (21) | 68.9 ± 1.9 (20) | 70.5 ± 2.1 (16) | 69.9 ± 2.2 (15) | |
| Fat-free mass, kg | M-Diet | 64.8 ± 2.4 (18) | 63.8 ± 2.4 (17) | 63.7 ± 2.8 (15) | 62.7 ± 3.0 (14) |
| FMD | 64.9 ± 2.7 (21) | 61.5 ± 2.6 (20) | 59.4 ± 2.7 (16) | 63.7 ± 3.1 (15) | |
| Body liquid, % | M-Diet | 53.2 ± 1.6 (18) | 52.9 ± 1.5 (17) | 52.5 ± 1.6 (15) | 52.4 ± 1.8 (14) |
| FMD | 51 ± 1.4 (21) | 51.2 ± 1.4 (20) | 51.7 ± 1.5 (16) | 52.7 ± 1.5 (15) | |
| Body liquid, L | M-Diet | 49.2 ± 1.9 (18) | 48.3 ± 1.8 (17) | 48.0 ± 2.2 (15) | 47.2 ± 2.4 (14) |
| FMD | 48.8 ± 2.4 (21) | 46.0 ± 2.3 (20) | 43.8 ± 2.3 (16) | 48.2 ± 2.5 (15) | |
| Phase angle | M-Diet | 5.8 ± 0.1 (18) | 5.8 ± 0.1 (17) | 5.8 ± 0.1 (15) | 5.6 ± 0.1 (14) |
| FMD | 5.8 ± 0.2 (21) | 5.7 ± 0.2 (20) | 5.7 ± 0.2 (16) | 5.5 ± 0.2 (15) |
Data are shown as mean ± SE of the mean of unadjusted values of variable for normally distributed variables or as median (interquartile range) for log-normally distributed variables. Statistically significant values are written in bold and indicate significance level of intervention effect on change of parameter compared to baseline and are based on M-Diet corrected analysis of covariance with adjustment for age, sex, and weight loss. ***P ≤ 0.001, **P ≤ 0.01, *P ≤ 0.05.
Abbreviations: ALT, alanine aminotransferase; AST, aspartate aminotransferase; BIA, bioimpedance analysis; BMI, body mass index; BP, blood pressure; CKD-EPI, Chronic Kidney Disease Epidemiology Collaboration; eGFR, estimated glomerular filtration rate; FMD, fasting-mimicking diet; FPG, fasting plasma glucose; HDL, high-density lipoprotein; HOMA-IR, homeostatic model assessment of insulin resistance; hsCRP, high-sensitivity C-reactive protein; hsTNT, high-sensitivity troponin T; IL-6, interleukin 6; Lp(a), lipoprotein (a); LDL, low-density lipoprotein; Macro.uACR, macroalbuminuria; M-Diet, Mediterranean diet; Micro.uACR, microalbuminuria; NT-proBNP, N-terminal prohormone of brain natriuretic peptide; sUPAR, soluble urokinase-type plasminogen activator receptor; TG, triglyceride; uACR, urinary albumin-to-creatinine ratio; V0, baseline; V3, after 3 diet cycles; V6, after 6 diet cycles; V7, follow-up.