Article

We assessed the long-term effects of a Mediterranean diet on
circulating levels of endothelial progenitor cells (EPCs) and the carotid
intima-media thickness (CIMT) in patients with type 2 diabetes. Design This was a
parallel, two-arm, single-centre trial. Methods Two hundred and fifteen men and
women with newly diagnosed type 2 diabetes were randomized to a Mediterranean
diet ( n = 108) or a low-fat diet
( n = 107). The primary outcome measures were
changes in the EPC count and the CIMT of the common carotid artery after the
treatment period defined as the end of trial (EOT). Results At the EOT, both the
CD34+KDR+ and CD34+KDR+CD133+ counts had increased with the Mediterranean diet
compared with the low-fat diet ( p < 0.05 for both). At the EOT evaluation, there
was a significant ( p = 0.024) difference of -0.025 mm in the CIMT favouring the
Mediterranean diet. Compared with the low-fat diet, the rate of regression in the
CIMT was higher in the Mediterranean diet group (51 vs. 26%), whereas the rate of
progression was lower (25 vs. 50%) ( p = 0.032 for both). Changes in the CIMT
were inversely correlated with the changes in EPC levels (CD34+KDR+, r = -0.24, p
= 0.020; CD34+KDR+CD133+, r = -0.28, p = 0.014). At the EOT, changes in levels of
HbA1c, HOMA, total cholesterol, high-density lipoprotein cholesterol and systolic
blood pressure were significantly greater with the Mediterranean diet than with
the low-fat diet. Conclusion Compared with a low-fat diet, a long-term trial with
Mediterranean diet was associated with an increase in circulating EPCs levels and
prevention of the progression of subclinical atherosclerosis in patients with
newly diagnosed type 2 diabetes.

Langue : ANGLAIS