{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T11:55:24Z","timestamp":1773662124604,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,6,16]],"date-time":"2022-06-16T00:00:00Z","timestamp":1655337600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100002491","name":"Bristol-Myers Squibb","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100002491","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014461","name":"NIHR Biomedical Research Centre, Royal Marsden NHS Foundation Trust\/Institute of Cancer Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100014461","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000659","name":"Research Trainees Coordinating Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000659","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet Med"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>To investigate the relationship between fibro\u2010inflammatory biomarkers and cardiovascular structure\/function in people with Type 2 Diabetes (T2D) compared to healthy controls and the effect of two lifestyle interventions in T2D.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data were derived from the DIASTOLIC randomised controlled trial (RCT) and includes a comparison between those with T2D and the matched healthy volunteers recruited at baseline. Adults with T2D without cardiovascular disease (CVD) were randomized to a 12\u2010week intervention either: (1) exercise training, (2) a low\u2010energy (\u223c810\u2009kcal\/day) meal\u2010replacement plan (MRP) or (3) standard care. Principal Component and Fisher's linear discriminant analysis were used to investigate the relationships between MRI acquired cardiovascular outcomes and fibro\u2010inflammatory biomarkers in cases versus controls and pre\u2010 and post\u2010intervention in T2D.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At baseline, 83 people with T2D (mean age 50.5\u00a0\u00b1\u20096.4; 58% male) and 36 healthy controls (mean age 48.6\u00a0\u00b1\u20096.2; 53% male) were compared and 76 people with T2D completed the RCT for pre\u2010 post\u2010analysis. Compared to healthy controls, subjects with T2D had adverse cardiovascular remodelling and a fibro\u2010inflammatory profile (20 differentially expressed biomarkers). The 3D data visualisations showed almost complete separation between healthy controls and those with T2D, and a marked shift towards healthy controls following the MRP (15 biomarkers significantly changed) but not exercise training.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Fibro\u2010inflammatory pathways and cardiovascular structure\/function are adversely altered before the onset of symptomatic CVD in middle\u2010aged adults with T2D. The MRP improved the fibro\u2010inflammatory profile of people with T2D towards a more healthy status. Long\u2010term studies are required to assess whether these changes lead to continued reverse cardiac remodelling and prevent CVD.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.14884","type":"journal-article","created":{"date-parts":[[2022,5,19]],"date-time":"2022-05-19T12:54:09Z","timestamp":1652964849000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Fibro\u2010inflammatory recovery and type 2 diabetes remission following a low calorie diet but not exercise training: A secondary analysis of the <scp>DIASTOLIC<\/scp> randomised controlled trial"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4715-9145","authenticated-orcid":false,"given":"Emer M.","family":"Brady","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Sciences University of Leicester and the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre  Leicester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gaurav S.","family":"Gulsin","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences University of Leicester and the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre  Leicester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evgeny M.","family":"Mirkes","sequence":"additional","affiliation":[{"name":"School of Mathematics and Actuarial Science University of Leicester  Leicester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelly","family":"Parke","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences University of Leicester and the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre  Leicester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prathap","family":"Kanagala","sequence":"additional","affiliation":[{"name":"University of Liverpool Liverpool Centre for Cardiovascular Science  Liverpool UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leong L.","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences University of Leicester and the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre  Leicester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew P. M.","family":"Graham\u2010Brown","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences University of Leicester and the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre  Leicester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lavanya","family":"Athithan","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences University of Leicester and the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre  Leicester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Henson","sequence":"additional","affiliation":[{"name":"Diabetes Research Centre NIHR Leicester Biomedical Research Centre  Leicester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emma","family":"Redman","sequence":"additional","affiliation":[{"name":"Diabetes Research Centre NIHR Leicester Biomedical Research Centre  Leicester UK"},{"name":"University Hospitals of Leicester NHS Trust  Leicester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jang","family":"Yang","sequence":"additional","affiliation":[{"name":"Cardiovascular &amp; Fibrosis Translational Research  Bristol New Jersey USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Zhao","sequence":"additional","affiliation":[{"name":"Cardiovascular &amp; Fibrosis Translational Research  Bristol New Jersey USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stavroula","family":"Argyridou","sequence":"additional","affiliation":[{"name":"Diabetes Research Centre NIHR Leicester Biomedical Research Centre  Leicester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9284-9321","authenticated-orcid":false,"given":"Laura J.","family":"Gray","sequence":"additional","affiliation":[{"name":"Department of Health Sciences University of Leicester  Leicester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Yates","sequence":"additional","affiliation":[{"name":"Diabetes Research Centre NIHR Leicester Biomedical Research Centre  Leicester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9987-9371","authenticated-orcid":false,"given":"Melanie J.","family":"Davies","sequence":"additional","affiliation":[{"name":"Diabetes Research Centre NIHR Leicester Biomedical Research Centre  Leicester UK"},{"name":"University Hospitals of Leicester NHS Trust  Leicester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerry P.","family":"McCann","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences University of Leicester and the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre  Leicester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,6,16]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1800256"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.117.311586"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000691"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.02.092"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/2042018819861593"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.600437"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc20-0129"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-023207"},{"key":"e_1_2_11_10_1","doi-asserted-by":"crossref","unstructured":"Gorban A.N. 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