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Huang W, Gan Z, Gao Z, Lin Q, Li X, Xie W, Gao Z, Zhou Z, Qiu Z, Qiu W, Du S, Chen L, Hong H, Ye W. Discrepancies between general and central obesity in arterial stiffness: observational studies and Mendelian randomization study. BMC Med 2024; 22:325. [PMID: 39113079 PMCID: PMC11304581 DOI: 10.1186/s12916-024-03546-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 07/29/2024] [Indexed: 08/11/2024] Open
Abstract
BACKGROUND Obesity has been linked to arterial stiffness, while no consensus was reached on the association. We aimed to clarify the association of general and central obesity with arterial stiffness by combining observational studies and Mendelian randomization (MR) study. METHODS Two cross-sectional studies were performed in UK Biobank and Fuqing Cohort, respectively. Two-sample MR study was conducted using summary data of GWASs from GIANT consortium and UK Biobank. General obesity and central obesity were measured using body mass index (BMI) and waist circumference (WC), respectively. Arterial stiffness was measured by arterial stiffness index (ASI) in UK Biobank or branchial-ankle pulse wave velocity (baPWV) in Fuqing Cohort. RESULTS Two observational studies found a consistent positive association of BMI and WC with arterial stiffness when adjusting for age, sex, education, smoking, alcohol drinking, physical activity, and LDL cholesterol. However, when additionally adjusting for metabolic traits (i.e., systolic blood pressure, diastolic blood pressure, blood glucose, triglycerides, high-density lipoprotein cholesterol, and WC or BMI), the association with BMI changed to be inverse. As compared to the lowest quintile group, the adjusted ORs across groups of second to fifth quintile were 0.93, 0.90, 0.83, and 0.72 in UK Biobank and 0.88, 0.65, 0.63, and 0.50 in Fuqing Cohort. In contrast, the positive relationship with WC remained stable with the adjusted ORs of 1.23, 1.46, 1.60, and 1.56 in UK Biobank and 1.35, 1.44, 1.77, and 1.64 in Fuqing Cohort. MR analyses provided supportive evidence of the negative association with BMI (OR = 0.97, 95%CI = 0.94-1.00) and the positive association with WC (OR = 1.14, 95%CI = 1.08-1.20). CONCLUSIONS Observational and genetic analyses provide concordant results that central obesity is independently related to arterial stiffness, while the role of general obesity depends on metabolic status.
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Affiliation(s)
- Wuqing Huang
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, University Town, No 1, Xue Yuan Road, Fujian, 350108, China
| | - Zhaojing Gan
- Department of Geriatrics, Fujian Key Laboratory of Vascular Aging, Fujian Institute of Geriatrics, Union Hospital, Fujian Medical University,, Fujian, 350001, China
| | - Ziting Gao
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, University Town, No 1, Xue Yuan Road, Fujian, 350108, China
| | - Qiaofen Lin
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, University Town, No 1, Xue Yuan Road, Fujian, 350108, China
| | - Xiaojiang Li
- Department of Geriatrics, Fujian Key Laboratory of Vascular Aging, Fujian Institute of Geriatrics, Union Hospital, Fujian Medical University,, Fujian, 350001, China
| | - Wenhui Xie
- Department of Geriatrics, Fujian Key Laboratory of Vascular Aging, Fujian Institute of Geriatrics, Union Hospital, Fujian Medical University,, Fujian, 350001, China
| | - Zesen Gao
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, University Town, No 1, Xue Yuan Road, Fujian, 350108, China
| | - Zhixian Zhou
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, University Town, No 1, Xue Yuan Road, Fujian, 350108, China
| | - Ziyi Qiu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, University Town, No 1, Xue Yuan Road, Fujian, 350108, China
| | - Weihong Qiu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, University Town, No 1, Xue Yuan Road, Fujian, 350108, China
| | - Shanshan Du
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, University Town, No 1, Xue Yuan Road, Fujian, 350108, China
| | - Liangwan Chen
- Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, No. 29 Xinquan Road, Fuzhou , Fujian, 350001, China.
- Key Laboratory of Cardio-Thoracic Surgery, Fujian Medical University, Fuzhou, Fujian, China.
| | - Huashan Hong
- Department of Geriatrics, Fujian Key Laboratory of Vascular Aging, Fujian Institute of Geriatrics, Union Hospital, Fujian Medical University,, Fujian, 350001, China.
| | - Weimin Ye
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, University Town, No 1, Xue Yuan Road, Fujian, 350108, China.
- Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China.
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
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Burden SJ, Alshehri R, Lamata P, Poston L, Taylor PD. Maternal obesity and offspring cardiovascular remodelling - the effect of preconception and antenatal lifestyle interventions: a systematic review. Int J Obes (Lond) 2024; 48:1045-1064. [PMID: 38898228 PMCID: PMC11281905 DOI: 10.1038/s41366-024-01536-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 05/02/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Preconception or antenatal lifestyle interventions in women with obesity may prevent adverse cardiovascular outcomes in the child, including cardiac remodelling. We undertook a systematic review of the existing data to examine the impact of randomised controlled trials of lifestyle interventions in pregnant women with obesity on offspring cardiac remodelling and related parameters of cardiovascular health. METHODS This review was registered with PROSPERO (CRD42023454762) and aligns with PRISMA guidelines. PubMed, Embase, and previous reviews were systematically searched. Follow-up studies from randomised trials of lifestyle interventions in pregnant women with obesity, which included offspring cardiac remodelling or related cardiovascular parameters as outcome measures, were included based on pre-defined inclusion criteria. RESULTS Eight studies from five randomised controlled trials were included after screening 3252 articles. Interventions included antenatal exercise (n = 2), diet and physical activity (n = 2), and preconception diet and physical activity (n = 1). Children were <2-months to 3-7-years-old, with sample sizes ranging between n = 18-404. Reduced cardiac remodelling, with reduced interventricular septal wall thickness, was consistently reported. Some studies identified improved systolic and diastolic function and a reduced resting heart rate. Risk of bias analyses rated all studies as 'fair' (some risk of bias). A high loss-to-follow-up was a common limitation. CONCLUSION Although there is some evidence to suggest that lifestyle interventions in women with obesity may limit offspring cardiac remodelling, further high-quality longitudinal studies with larger sample sizes are required to confirm these observations and to determine whether these changes persist to adulthood. Child offspring cardiovascular health benefits of preconception and antenatal lifestyle interventions in women with obesity.
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Affiliation(s)
- Samuel J Burden
- Department of Women and Children's Health, School of Life Course & Population Sciences, King's College London, London, UK.
| | - Rahaf Alshehri
- Cardiovascular Medicine and Science Research, School of Cardiovascular and Metabolic Medicine & Sciences, King's College London, London, UK
| | - Pablo Lamata
- Biomedical Engineering, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Lucilla Poston
- Department of Women and Children's Health, School of Life Course & Population Sciences, King's College London, London, UK
| | - Paul D Taylor
- Department of Women and Children's Health, School of Life Course & Population Sciences, King's College London, London, UK
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Hill H, Elliot CA, Lizamore CA, Hamlin MJ. Physical activity has a stronger correlation with arterial stiffness than strength, balance, or BMI in an older population. FRONTIERS IN AGING 2023; 4:1279479. [PMID: 38162458 PMCID: PMC10755870 DOI: 10.3389/fragi.2023.1279479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 12/04/2023] [Indexed: 01/03/2024]
Abstract
Background: Arterial stiffness is associated with an array of debilitating health conditions. While exercise typically has beneficial effects on both arterial stiffness and overall health, more research is needed to understand the associations of different types of fitness indices with arterial stiffness. Aim: To investigate the relationship between balance, strength, cardiovascular fitness and physical activity with arterial stiffness (as measured by pulse wave velocity (PWV)) in older adults. Method: Eighty retirement-village residents (24 males, 56 females, age: 78.2 ± 6.4 years, weight: 69.4 ± 12.5 kg, height: 162.9 ± 8.5 cm) completed the Yale Physical Activity Survey, PWV measurement, 30-s sit-to-stand leg strength test, hand grip strength assessment, 4-stage balance test, and a 6-min walk fitness test. The number of exiting risk factors (smoking, previous heart incidents, previous stroke(s), having hypertension, or taking anti-hypertension medication) were tallied. Pearson's correlations were used to assess the relationship between PWV and health and fitness parameters. Results were interpreted using qualitative inference. Results: The number of risk factors (r = 0.57, p < 0.001), age (r = 0.51, p < 0.001) and systolic blood pressure (r = 0.50, p = 0.001) had strong, harmful associations with PWV. Total physical activity minutes/week (r = -0.31 p = 0.01), total energy expenditure Kcal/week (r = -0.30, p = 0.01), and the 6-min walk test (r = -0.29, p = 0.01) had a moderate, beneficial association with PWV, while sit-to-stand (r = -0.27, p = 0.02) and balance (r = -0.27, p = 0.01) had a weak, beneficial association with PWV. Hand grip strength (r = 0.02, p = 0.94) and body mass index (r = -0.04, p = 0.75) had no significant associations with PWV. Discussion: All measured fitness indices had beneficial associations with PWV. However, having more risk factors, increased age, and higher systolic blood pressure had significant (harmful) associations with PWV in our older population. Conclusion: Controlling cardiovascular risk factors, especially high systolic blood pressure, is likely to have the largest beneficial effect on PWV. Improving general physical activity, including walking capacity, may prove beneficial in improving PWV in an older population.
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Affiliation(s)
- Hannah Hill
- Department of Tourism, Sport, and Society, Lincoln University, Lincoln, New Zealand
| | - Catherine A. Elliot
- Department of Tourism, Sport, and Society, Lincoln University, Lincoln, New Zealand
| | - Catherine A. Lizamore
- Department of Applied Science and Social Practice, Ara Institute of Canterbury, Christchurch, New Zealand
| | - Michael J. Hamlin
- Department of Tourism, Sport, and Society, Lincoln University, Lincoln, New Zealand
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Le Grand Q, Ecker Ferreira L, Metso TM, Schilling S, Tatlisumak T, Grond-Ginsbach C, Engelter ST, Lyrer P, Majersik JJ, Worrall BB, Southerland AM, Markus HS, Lathrop M, Thijs V, Leys D, Amouyel P, Dallongeville J, Dichgans M, Pezzini A, Bersano A, Sargurupremraj M, Debette S. Genetic Insights on the Relation of Vascular Risk Factors and Cervical Artery Dissection. J Am Coll Cardiol 2023; 82:1411-1423. [PMID: 37758436 DOI: 10.1016/j.jacc.2023.07.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/16/2023] [Accepted: 07/24/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND The association between vascular risk factors and cervical artery dissections (CeADs), a leading cause of ischemic stroke (IS) in the young, remains controversial. OBJECTIVES This study aimed to explore the causal relation of vascular risk factors with CeAD risk and recurrence and compare it to their relation with non-CeAD IS. METHODS This study used 2-sample Mendelian randomization analyses to explore the association of blood pressure (BP), lipid levels, type 2 diabetes, waist-to-hip ratio, smoking, and body mass index with CeAD and non-CeAD IS. To simulate effects of the most frequently used BP-lowering drugs, this study constructed genetic proxies and tested their association with CeAD and non-CeAD IS. In analyses among patients with CeAD, the investigators studied the association between weighted genetic risk scores of vascular risk factors and the risk of multiple or early recurrent dissections. RESULTS Genetically determined higher systolic BP (OR: 1.51; 95% CI: 1.32-1.72) and diastolic BP (OR: 2.40; 95% CI: 1.92-3.00) increased the risk of CeAD (P < 0.0001). Genetically determined higher body mass index was inconsistently associated with a lower risk of CeAD. Genetic proxies for β-blocker effects were associated with a lower risk of CeAD (OR: 0.65; 95% CI: 0.50-0.85), whereas calcium-channel blockers were associated with a lower risk of non-CeAD IS (OR: 0.75; 95% CI: 0.63-0.90). Weighted genetic risk scores for systolic BP and diastolic BP were associated with an increased risk of multiple or early recurrent CeAD. CONCLUSIONS These results are supportive of a causal association between higher BP and increased CeAD risk and recurrence and provide genetic evidence for lower CeAD risk under β-blockers. This may inform secondary prevention strategies and trial design for CeAD.
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Affiliation(s)
- Quentin Le Grand
- University of Bordeaux, Institut National de la Santé et de la Recherche Médicale (INSERM), Bordeaux Population Health Center (BPH), Unité Mixte de Recherche (U) 1219, Bordeaux, France
| | - Leslie Ecker Ferreira
- Department of Medicine and Joinville Stroke Biobank, University of Region of Joinville, Joinville, Brazil
| | - Tiina M Metso
- Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland
| | - Sabrina Schilling
- University of Bordeaux, Institut National de la Santé et de la Recherche Médicale (INSERM), Bordeaux Population Health Center (BPH), Unité Mixte de Recherche (U) 1219, Bordeaux, France
| | - Turgut Tatlisumak
- Department of Clinical Neurosciences/Neurology, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Caspar Grond-Ginsbach
- Department of Vascular and Endovascular Surgery, University of Heidelberg, Heidelberg, Germany
| | - Stefan T Engelter
- Neurology and Neurorehabilitation, University Department of Geriatric Medicine Felix Platter, University of Basel, Basel, Switzerland; Department of Neurology and Stroke Center, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Philippe Lyrer
- Department of Neurology and Stroke Center, University Hospital Basel, University of Basel, Basel, Switzerland
| | | | - Bradford B Worrall
- Department of Neurology, University of Virginia, Charlottesville, Virginia, USA; Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia, USA
| | - Andrew M Southerland
- Department of Neurology, University of Virginia, Charlottesville, Virginia, USA; Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia, USA
| | - Hugh S Markus
- Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Mark Lathrop
- Department of Human Genetics, McGill University, Montreal, Quebec, Canada; Victor Phillip Dahdaleh Institute of Genomic Medicine at McGill University, Montreal, Quebec, Canada
| | - Vincent Thijs
- Stroke Division, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria, Australia; Department of Neurology, Austin Health, Melbourne, Victoria, Australia
| | - Didier Leys
- INSERM U1172, Lille Neuroscience and Cognition, University of Lille, Lille, France
| | - Philippe Amouyel
- Laboratory of Excellence Development of Innovative Strategies for a Transdisciplinary Approach to Alzheimer's Disease (LabEx DISTALZ), University of Lille, Lille, France; INSERM U1167 (Risk Factors and Molecular Determinants of Aging-Related Diseases - RID-AGE), Lille, France; Centre Hospitalier Universitaire Lille, Lille, France; Institut Pasteur de Lille, Lille, France
| | - Jean Dallongeville
- Laboratory of Excellence Development of Innovative Strategies for a Transdisciplinary Approach to Alzheimer's Disease (LabEx DISTALZ), University of Lille, Lille, France; INSERM U1167 (Risk Factors and Molecular Determinants of Aging-Related Diseases - RID-AGE), Lille, France; Centre Hospitalier Universitaire Lille, Lille, France; Institut Pasteur de Lille, Lille, France
| | - Martin Dichgans
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany; Munich Cluster for Systems Neurology, Munich, Germany; German Center for Neurodegenerative Diseases, Munich, Germany
| | - Alessandro Pezzini
- Department of Clinical and Experimental Sciences, Neurology Unit, University of Brescia, Brescia, Italy
| | - Anna Bersano
- Cerebrovascular Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy
| | - Muralidharan Sargurupremraj
- University of Bordeaux, Institut National de la Santé et de la Recherche Médicale (INSERM), Bordeaux Population Health Center (BPH), Unité Mixte de Recherche (U) 1219, Bordeaux, France; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, Texas
| | - Stéphanie Debette
- University of Bordeaux, Institut National de la Santé et de la Recherche Médicale (INSERM), Bordeaux Population Health Center (BPH), Unité Mixte de Recherche (U) 1219, Bordeaux, France; Department of Neurology, Institute of Neurodegenerative Diseases, Bordeaux University Hospital, Bordeaux, France.
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Hauser JA, Burden SJ, Karunakaran A, Muthurangu V, Taylor AM, Jones A. Whole-Body Magnetic Resonance Imaging Assessment of the Contributions of Adipose and Nonadipose Tissues to Cardiovascular Remodeling in Adolescents. J Am Heart Assoc 2023; 12:e030221. [PMID: 37489750 PMCID: PMC10492986 DOI: 10.1161/jaha.123.030221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 06/27/2023] [Indexed: 07/26/2023]
Abstract
Background Greater body mass index is associated with cardiovascular remodeling in adolescents. However, body mass index cannot differentiate between adipose and nonadipose tissues. We examined how visceral and subcutaneous adipose tissue are linked with markers of early cardiovascular remodeling, independently from nonadipose tissue. Methods and Results Whole-body magnetic resonance imaging was done in 82 adolescents (39 overweight/obese; 36 female; median age, 16.3 [interquartile range, 14.4-18.1] years) to measure body composition and cardiovascular remodeling markers. Left ventricular diastolic function was assessed by echocardiography. Waist, waist:height ratio, and body mass index z scores were calculated. Residualized nonadipose tissue, subcutaneous adipose tissue, and visceral adipose tissue variables, uncorrelated with each other, were constructed using partial regression modeling to allow comparison of their individual contributions in a 3-compartment body composition model. Cardiovascular variables mostly related to nonadipose rather than adipose tissue. Nonadipose tissue was correlated positively with left ventricular mass (r=0.81), end-diastolic volume (r=0.70), stroke volume (r=0.64), left ventricular mass:end-diastolic volume (r=0.37), and systolic blood pressure (r=0.35), and negatively with heart rate (r=-0.33) (all P<0.01). Subcutaneous adipose tissue was associated with worse left ventricular diastolic function (r=-0.42 to -0.48, P=0.0007-0.02) and higher heart rates (r=0.34, P=0.007) but linked with better systemic vascular resistance (r=-0.35, P=0.006). There were no significant relationships with visceral adipose tissue and no associations of any compartment with pulse wave velocity. Conclusions Simple anthropometry does not reflect independent effects of nonadipose tissue and subcutaneous adipose tissue on the adolescent cardiovascular system. This could result in normal cardiovascular adaptations to growth being misinterpreted as pathological sequelae of excess adiposity in studies reliant on such measures.
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Affiliation(s)
- Jakob A. Hauser
- Centre for Translational Cardiovascular ImagingUniversity College LondonLondonUnited Kingdom
| | - Samuel J. Burden
- Department of PaediatricsUniversity of Oxford, John Radcliffe HospitalOxfordUnited Kingdom
- Department of Women and Children’s HealthKing’s College London, St Thomas’ HospitalLondonUnited Kingdom
| | - Ajanthiha Karunakaran
- Centre for Translational Cardiovascular ImagingUniversity College LondonLondonUnited Kingdom
| | - Vivek Muthurangu
- Centre for Translational Cardiovascular ImagingUniversity College LondonLondonUnited Kingdom
| | - Andrew M. Taylor
- Centre for Translational Cardiovascular ImagingUniversity College LondonLondonUnited Kingdom
- Great Ormond Street Hospital for Children NHS Foundation TrustLondonUnited Kingdom
| | - Alexander Jones
- Centre for Translational Cardiovascular ImagingUniversity College LondonLondonUnited Kingdom
- Department of PaediatricsUniversity of Oxford, John Radcliffe HospitalOxfordUnited Kingdom
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Pucci G, Martina MR, Bianchini E, D’abbondanza M, Curcio R, Battista F, Anastasio F, Crapa ME, Sanesi L, Gemignani V, Vaudo G. Relationship between measures of adiposity, blood pressure and arterial stiffness in adolescents. The MACISTE study. J Hypertens 2023; 41:1100-1107. [PMID: 37071447 PMCID: PMC10241423 DOI: 10.1097/hjh.0000000000003433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 03/06/2023] [Indexed: 04/19/2023]
Abstract
OBJECTIVE Children and adolescents with adiposity excess are at increased risk of future cardiovascular (CV) disease. Fat accumulation promotes the development of elevated blood pressure (BP) and arterial stiffness, two main determinants of CV risk which are strongly inter-related. We aimed at investigating whether the association between overweight and arterial stiffness, taken at different arterial segments, is mediated by increased BP or is BP-independent. METHODS Three hundred and twenty-two Italian healthy adolescents (mean age 16.9±1.4 years, 12% with overweight) attending the "G. Donatelli" High School in Terni, Italy, underwent measurement of arterial stiffness by arterial tonometry (aortic stiffness) and semiautomatical detection of pressure-volume ratio of the common carotid (carotid stiffness). The mediator effect of BP was tested for each anthropometric or biochemical measure of fat excess related to arterial stiffness. RESULTS Both carotid and aortic stiffness showed positive correlations with body mass index, waist, hip, and neck circumferences (NC). Only carotid stiffness, but not aortic stiffness, was associated with serum markers of fat accumulation and metabolic impairment such as insulin, homeostatic model of insulin resistance (HOMA-IR), serum gamma-glutamyl transferase (sGGT) and uric acid. The association with NC was stronger for carotid than for aortic stiffness (Fisher z -to- R 2.07, P = 0.04), and independent from BP. CONCLUSIONS In healthy adolescents, fat accumulation is associated with arterial stiffness. The degree of this association differs by arterial segments, since carotid stiffness is more strongly associated to adipose tissue excess than aortic stiffness and shows a BP-independent association with NC whereas aortic stiffness does not.
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Affiliation(s)
- Giacomo Pucci
- Department of Medicine and Surgery, University of Perugia – Unit of Internal Medicine, “Santa Maria” University Hospital, Terni
| | - Maria R. Martina
- Institute of Clinical Physiology, Italian National Research Council, Pisa
| | | | - Marco D’abbondanza
- Department of Medicine and Surgery, University of Perugia – Unit of Internal Medicine, “Santa Maria” University Hospital, Terni
| | - Rosa Curcio
- Department of Medicine and Surgery, University of Perugia – Unit of Internal Medicine, “Santa Maria” University Hospital, Terni
| | - Francesca Battista
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, Padova
| | | | - Mariano E. Crapa
- U.O. Medicina Interna, Asl Taranto, Presidio Ospedaliero Occidentale, Castellaneta, Italy
| | - Leandro Sanesi
- Department of Medicine and Surgery, University of Perugia – Unit of Internal Medicine, “Santa Maria” University Hospital, Terni
| | - Vincenzo Gemignani
- Institute of Clinical Physiology, Italian National Research Council, Pisa
| | - Gaetano Vaudo
- Department of Medicine and Surgery, University of Perugia – Unit of Internal Medicine, “Santa Maria” University Hospital, Terni
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Can M, Kocabas M, Yarar Z, Burgucu HÇ, Karaköse M, Yerlikaya FH, Türkmen K, Kulaksızoğlu M, Karakurt F. Evaluation of subclinical atherosclerosis in obese patients with three noninvasive methods: Arterial stiffness, carotid intima-media thickness, and biomarkers of endothelial dysfunction. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2023; 67:e000622. [PMID: 37252704 PMCID: PMC10665069 DOI: 10.20945/2359-3997000000622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 07/05/2022] [Indexed: 05/31/2023]
Abstract
Objective In this study, we aimed to evaluate subclinical atherosclerosis in patients with obesity who had cardiovascular disease risk indicators such as arterial stiffness, which is evaluated using pulse wave velocity (PWV), carotid intima-media thickness (CIMT), and biomarkers of endothelial dysfunction such as endocan, ADAMTS97, and ADAMTS9. Subjects and methods Sixty obese subjects, including 23 subjects with body mass index (BMI) ≥ 40, 37 subjects with BMI ≥ 30 but < 40, and 60 age-and sex-matched control subjects, were included in our study. Serum endocan, ADAMTS97, and ADAMTS9 levels as well as PWV and CIMT measurements of the subjects in the obese and control groups were performed. Results In the obesity group, PWV levels were significantly higher than they were in the control group and endocan levels were significantly lower than they were in the control group. When we compared the obese group with BMI ≥ 40 and the control group, the BMI ≥ 40 group had significantly higher PWV and CIMT levels than the control group had, whereas endocan, ADAMTS7, and ADAMTS9 levels were similar to those of the control group. When we compared the obese group with BMI ≥ 30 < 40 to the control group, endocan levels were lower in the group with BMI ≥30 < 40, and PWV and CIMT levels were similar to the control group. Conclusion We found that arterial stiffness and CIMT increased in obese patients with BMI ≥ 40 and that increased arterial stiffness was associated with age, systolic blood pressure, and HBA1C. In addition, we found that the endocan levels were lower in obese patients than they were in nonobese control individuals.
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Affiliation(s)
- Mustafa Can
- Department of Endocrinology and Metabolism, Muş State Hospital, Muş, Turkey,
| | - Muhammet Kocabas
- Department of Endocrinology and Metabolism, Tokat State Hospital, Tokat, Turkey
| | - Zeliha Yarar
- Department of Endocrinology and Metabolism, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Hatice Çalışkan Burgucu
- Department of Endocrinology and Metabolism, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Melia Karaköse
- Department of Endocrinology and Metabolism, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | | | - Kültigin Türkmen
- Department of Nephrology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Mustafa Kulaksızoğlu
- Department of Endocrinology and Metabolism, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Feridun Karakurt
- Department of Endocrinology and Metabolism, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
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Prognostic Significance of Plasma Insulin Level for Deep Venous Thrombosis in Patients with Severe Traumatic Brain Injury in Critical Care. Neurocrit Care 2022; 38:263-278. [PMID: 36114315 DOI: 10.1007/s12028-022-01588-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 08/10/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Whether insulin resistance underlies deep venous thrombosis (DVT) development in patients with severe traumatic brain injury (TBI) is unclear. In this study, the association between plasma insulin levels and DVT was analyzed in patients with severe TBI. METHODS A prospective observational study of 73 patients measured insulin, glucose, glucagon-like peptide 1 (GLP-1), inflammatory factors, and hematological profiles within four preset times during the first 14 days after TBI. Ultrasonic surveillance of DVT was tracked. Two-way analysis of variance was used to determine the factors that discriminated between patients with and without DVT or with and without insulin therapy. Partial correlations of insulin level with all the variables were conducted separately in patients with DVT or patients without DVT. Factors associated with DVT were analyzed by multivariable logistic regression. Neurological outcomes 6 months after TBI were assessed. RESULTS Among patients with a mean (± standard deviation) age of 53 (± 16 years), DVT developed in 20 patients (27%) on median 10.4 days (range 4-22), with higher Acute Physiology and Chronic Health Evaluation II scores but similar Sequential Organ Failure Assessment scores and TBI severity. Patients with DVT were more likely to receive insulin therapy than patients without DVT (60% vs. 28%; P = 0.012); hence, they had higher 14-day insulin levels. However, insulin levels were comparable between patients with DVT and patients without DVT in the subgroups of patients with insulin therapy (n = 27) and patients without insulin therapy (n = 46). The platelet profile significantly discriminated between patients with and without DVT. Surprisingly, none of the coagulation profiles, blood cell counts, or inflammatory mediators differed between the two groups. Patients with insulin therapy had significantly higher insulin (P = 0.006), glucose (P < 0.001), and GLP-1 (P = 0.01) levels and were more likely to develop DVT (60% vs. 15%; P < 0.001) along with concomitant platelet depletion. Insulin levels correlated with glucose, GLP-1 levels, and platelet count exclusively in patients without DVT. Conversely, in patients with DVT, insulin correlated negatively with GLP-1 levels (P = 0.016). Age (P = 0.01) and elevated insulin levels at days 4-7 (P = 0.04) were independently associated with DVT. Patients with insulin therapy also showed worse Glasgow Outcome Scale scores (P = 0.001). CONCLUSIONS Elevated insulin levels in the first 14 days after TBI may indicate insulin resistance, which is associated with platelet hyperactivity, and thus increasing the risk of DVT.
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White SE, Kiley JX, Visniauskas B, Lindsey SH, Miller KS. Biaxial Murine Vaginal Remodeling With Reproductive Aging. J Biomech Eng 2022; 144:061010. [PMID: 35425969 PMCID: PMC10782864 DOI: 10.1115/1.4054362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 01/27/2022] [Indexed: 01/13/2024]
Abstract
Higher reproductive age is associated with an increased risk of gestational diabetes, pre-eclampsia, and severe vaginal tearing during delivery. Further, menopause is associated with vaginal stiffening. However, the mechanical properties of the vagina during reproductive aging before the onset of menopause are unknown. Therefore, the first objective of this study was to quantify the biaxial mechanical properties of the nulliparous murine vagina with reproductive aging. Menopause is further associated with a decrease in elastic fiber content, which may contribute to vaginal stiffening. Hence, our second objective was to determine the effect of elastic fiber disruption on the biaxial vaginal mechanical properties. To accomplish this, vaginal samples from CD-1 mice aged 2-14 months underwent extension-inflation testing protocols (n = 64 total; n = 16/age group). Then, half of the samples were randomly allocated to undergo elastic fiber fragmentation via elastase digestion (n = 32 total; 8/age group) to evaluate the role of elastic fibers. The material stiffness increased with reproductive age in both the circumferential and axial directions within the control and elastase-treated vaginas. The vagina demonstrated anisotropic mechanical behavior, and anisotropy increased with age. In summary, vaginal remodeling with reproductive age included increased direction-dependent material stiffness, which further increased following elastic fiber disruption. Further work is needed to quantify vaginal remodeling during pregnancy and postpartum with reproductive aging to better understand how age-related vaginal remodeling may contribute to an increased risk of vaginal tearing.
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Affiliation(s)
- Shelby E. White
- Department of Biomedical Engineering, Tulane University, 6823 St Charles Ave, New Orleans, LA 70118
| | - Jasmine X. Kiley
- Department of Biology, Tulane University, 6823 St Charles Ave, New Orleans, LA 70118
| | - Bruna Visniauskas
- Department of Pharmacology, Tulane University, 1430 Tulane Ave, New Orleans, LA 70118
| | - Sarah H. Lindsey
- Department of Pharmacology, Tulane University, 1430 Tulane Ave, New Orleans, LA 70118
| | - Kristin S. Miller
- Department of Biomedical Engineering, Tulane University, 6823 St Charles Ave, New Orleans, LA 70118
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10
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Kim S, Singh H. Sex-specific associations among total bone-specific physical activity score, aortic parameters, and body composition in healthy young adults. J Exerc Sci Fit 2022; 20:27-31. [PMID: 34976077 PMCID: PMC8683586 DOI: 10.1016/j.jesf.2021.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 11/22/2021] [Accepted: 12/06/2021] [Indexed: 11/12/2022] Open
Abstract
Background/Objective Physical inactivity is one of the major cardiovascular disease risk factors; however, not much is known regarding lifetime bone-specific physical activity and arterial stiffness. The aim of this cross-sectional study was to determine whether total bone-specific physical activity score (tBPAQ) was related to arterial stiffness and body composition in healthy young adults. Methods Healthy young women (n = 56, 20.3 ± 1.3 years) and men (n = 52, 21.0 ± 1.2 years) between 18 and 25 years were recruited for this study. The tBPAQ was used to obtain a comprehensive account of lifetime bone-loading physical activity. We measured the carotid to femoral pulse wave velocity (cfPWV) to evaluate arterial stiffness using the novel oscillometric device (SphygmoCor XCEL). Dual energy X-ray absorptiometry was used to measure bone free lean body mass (BFLBM, kg) and % total body fat. Results Partial correlations analyses showed a significant inverse relationship between tBPAQ and cfPWV (r = - 0.371, p = 0.007) in young women; however, this relationship was not found in young men (p > 0.05). There were significant negative correlations between tBPAQ and % total body fat in both young women (r = - 0.265, p = 0.048) and men (r = - 0.327, p = 0.018). No significant relationships were found between tBPAQ and BFLBM (p > 0.05). Conclusion Our study provides preliminary evidence of sex-specificity of negative relationships of tBPAQ with i) cfPWV (women only) and ii) % total body fat (men and women). Whether bone-loading physical activity can lead to better cardiometabolic outcomes needs to be examined.
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Affiliation(s)
- SoJung Kim
- Department of Health and Exercise Science, School of Nursing & Health Professions, Rowan University, Glassboro, NJ, 08028, USA
| | - Harshvardhan Singh
- Department of Physical Therapy, University of Alabama, 1716 9th Avenue South, Birmingham, AL, 35294, USA
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11
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Derella CC, Blanks AM, Wang X, Tucker MA, Horsager C, Jeong JH, Rodriguez-Miguelez P, Looney J, Thomas J, Pollock DM, Harris RA. Endothelin receptor blockade blunts the pressor response to acute stress in men and women with obesity. J Appl Physiol (1985) 2022; 132:73-83. [PMID: 34762528 PMCID: PMC8742738 DOI: 10.1152/japplphysiol.00156.2021] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Obesity is associated with dysregulation of the endothelin system. In individuals with obesity, an exaggerated pressor response to acute stress is accompanied by increased circulating endothelin-1 (ET-1). The impact of combined endothelin A/B receptor (ETA/B) antagonism on the stress-induced pressor response in overweight/obese (OB) individuals is unknown. The objective of this study is to test the hypothesis that treatment with an ETA/B antagonist (bosentan) would reduce the stress-induced pressor response and arterial stiffness in overweight/obese compared with normal weight (NW) individuals. Forty participants [normal weight (NW): n = 20, body mass index (BMI): 21.7 ± 2.4 kg/m2 and overweight/obese (OB): n = 20, BMI: 33.8 ± 8.2 kg/m2] were randomized to placebo or 125 mg of bosentan twice a day (250 mg total) for 3 days. Hemodynamics were assessed before, during, and after a cold pressor test (CPT). Endothelin-1 was assessed at baseline and immediately after CPT. Following a washout period, the same protocol was repeated with the opposite treatment. The change from baseline in mean arterial pressure (MAP) during CPT following bosentan was significantly lower (P = 0.039) in the OB group than in the NW group (OB: 28 ± 12 vs. NW: 34 ± 15 mmHg). These results suggest that ETA/B antagonism favorably blunts the pressor response to acute stress in overweight/obese individuals.NEW & NOTEWORTHY Findings from our current translational investigation demonstrate that dual endothelin A/B receptor antagonism blunts the pressor response to acute stress in overweight/obese individuals. These results suggest that modulation of the endothelin system may represent a novel therapeutic target to reduce cardiovascular disease (CVD) risk by blunting the stress response in overweight/obese individuals.
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Affiliation(s)
- Cassandra C. Derella
- 1Department of Medicine, Georgia Prevention Institute, Augusta University, Augusta, Georgia
| | - Anson M. Blanks
- 1Department of Medicine, Georgia Prevention Institute, Augusta University, Augusta, Georgia
| | - Xiaoling Wang
- 1Department of Medicine, Georgia Prevention Institute, Augusta University, Augusta, Georgia
| | - Matthew A. Tucker
- 1Department of Medicine, Georgia Prevention Institute, Augusta University, Augusta, Georgia
| | - Chase Horsager
- 1Department of Medicine, Georgia Prevention Institute, Augusta University, Augusta, Georgia
| | - Jin Hee Jeong
- 1Department of Medicine, Georgia Prevention Institute, Augusta University, Augusta, Georgia
| | - Paula Rodriguez-Miguelez
- 1Department of Medicine, Georgia Prevention Institute, Augusta University, Augusta, Georgia,2Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, Virginia
| | - Jacob Looney
- 1Department of Medicine, Georgia Prevention Institute, Augusta University, Augusta, Georgia
| | - Jeffrey Thomas
- 1Department of Medicine, Georgia Prevention Institute, Augusta University, Augusta, Georgia
| | - David M. Pollock
- 3Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Ryan A. Harris
- 1Department of Medicine, Georgia Prevention Institute, Augusta University, Augusta, Georgia,4Sport and Exercise Science Research Institute, Ulster University, Jordanstown, United Kingdom
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12
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Osimo EF, Sweeney M, de Marvao A, Berry A, Statton B, Perry BI, Pillinger T, Whitehurst T, Cook SA, O'Regan DP, Thomas EL, Howes OD. Adipose tissue dysfunction, inflammation, and insulin resistance: alternative pathways to cardiac remodelling in schizophrenia. A multimodal, case-control study. Transl Psychiatry 2021; 11:614. [PMID: 34873143 PMCID: PMC8648771 DOI: 10.1038/s41398-021-01741-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 11/17/2021] [Accepted: 11/23/2021] [Indexed: 12/12/2022] Open
Abstract
Cardiovascular diseases are the leading cause of death in schizophrenia. Patients with schizophrenia show evidence of concentric cardiac remodelling (CCR), defined as an increase in left-ventricular mass over end-diastolic volumes. CCR is a predictor of cardiac disease, but the molecular pathways leading to this in schizophrenia are unknown. We aimed to explore the relevance of hypertensive and non-hypertensive pathways to CCR and their potential molecular underpinnings in schizophrenia. In this multimodal case-control study, we collected cardiac and whole-body fat magnetic resonance imaging (MRI), clinical measures, and blood levels of several cardiometabolic biomarkers known to potentially cause CCR from individuals with schizophrenia, alongside healthy controls (HCs) matched for age, sex, ethnicity, and body surface area. Of the 50 participants, 34 (68%) were male. Participants with schizophrenia showed increases in cardiac concentricity (d = 0.71, 95% CI: 0.12, 1.30; p = 0.01), indicative of CCR, but showed no differences in overall content or regional distribution of adipose tissue compared to HCs. Despite the cardiac changes, participants with schizophrenia did not demonstrate activation of the hypertensive CCR pathway; however, they showed evidence of adipose dysfunction: adiponectin was reduced (d = -0.69, 95% CI: -1.28, -0.10; p = 0.02), with evidence of activation of downstream pathways, including hypertriglyceridemia, elevated C-reactive protein, fasting glucose, and alkaline phosphatase. In conclusion, people with schizophrenia showed adipose tissue dysfunction compared to body mass-matched HCs. The presence of non-hypertensive CCR and a dysmetabolic phenotype may contribute to excess cardiovascular risk in schizophrenia. If our results are confirmed, acting on this pathway could reduce cardiovascular risk and resultant life-years lost in people with schizophrenia.
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Affiliation(s)
- Emanuele F Osimo
- MRC London Institute of Medical Sciences and Imperial College London Institute of Clinical Sciences, Hammersmith Campus, Du Cane Road, London, W12 0NN, UK. .,Department of Psychiatry, University of Cambridge, Cambridge, UK. .,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK. .,South London and Maudsley NHS Foundation Trust, London, UK.
| | - Mark Sweeney
- MRC London Institute of Medical Sciences and Imperial College London Institute of Clinical Sciences, Hammersmith Campus, Du Cane Road, London, W12 0NN, UK.,Imperial College London, London, UK
| | - Antonio de Marvao
- MRC London Institute of Medical Sciences and Imperial College London Institute of Clinical Sciences, Hammersmith Campus, Du Cane Road, London, W12 0NN, UK
| | - Alaine Berry
- MRC London Institute of Medical Sciences and Imperial College London Institute of Clinical Sciences, Hammersmith Campus, Du Cane Road, London, W12 0NN, UK
| | - Ben Statton
- MRC London Institute of Medical Sciences and Imperial College London Institute of Clinical Sciences, Hammersmith Campus, Du Cane Road, London, W12 0NN, UK
| | - Benjamin I Perry
- Department of Psychiatry, University of Cambridge, Cambridge, UK.,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Toby Pillinger
- MRC London Institute of Medical Sciences and Imperial College London Institute of Clinical Sciences, Hammersmith Campus, Du Cane Road, London, W12 0NN, UK.,South London and Maudsley NHS Foundation Trust, London, UK.,Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Thomas Whitehurst
- MRC London Institute of Medical Sciences and Imperial College London Institute of Clinical Sciences, Hammersmith Campus, Du Cane Road, London, W12 0NN, UK
| | - Stuart A Cook
- MRC London Institute of Medical Sciences and Imperial College London Institute of Clinical Sciences, Hammersmith Campus, Du Cane Road, London, W12 0NN, UK
| | - Declan P O'Regan
- MRC London Institute of Medical Sciences and Imperial College London Institute of Clinical Sciences, Hammersmith Campus, Du Cane Road, London, W12 0NN, UK
| | - E Louise Thomas
- Research Centre for Optimal Health, School of Life Sciences, University of Westminster, London, UK
| | - Oliver D Howes
- MRC London Institute of Medical Sciences and Imperial College London Institute of Clinical Sciences, Hammersmith Campus, Du Cane Road, London, W12 0NN, UK. .,South London and Maudsley NHS Foundation Trust, London, UK. .,Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
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13
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Sugiura T, Dohi Y, Takagi Y, Yokochi T, Yoshikane N, Suzuki K, Tomiishi T, Nagami T, Iwase M, Takase H, Seo Y, Ohte N. A body shape index could serve to identify individuals with metabolic syndrome and increased arterial stiffness in the middle-aged population. Clin Nutr ESPEN 2021; 46:251-258. [PMID: 34857205 DOI: 10.1016/j.clnesp.2021.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 10/01/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND A body shape index (ABSI) is a novel anthropometric measure calculated using waist circumference (WC), body mass index (BMI), and body height. This study investigated the usefulness of ABSI to identify individuals with metabolic syndrome (MetS) and increased arterial stiffness in the middle-aged population. METHODS Middle-aged workers who underwent periodic health check-ups and who were without previous cardiovascular events were enrolled (n = 10,182). In addition to ABSI, visceral fat area (VFA) was evaluated using computed tomography. Obesity and MetS were diagnosed on the basis of WC, VFA, and ABSI. Arterial stiffness was examined by measuring the cardio-ankle vascular index (CAVI). RESULTS ABSI was significantly associated with CAVI in multivariable regression analysis. Logistic regression analysis revealed that ABSI was independently associated with the presence of MetS diagnosed on the basis of WC or VFA after adjustment for potential confounders, including BMI. Subjects with MetS diagnosed on the basis of each obesity index showed higher CAVI values than those without. Among subjects with MetS diagnosed on the basis of WC or VFA, those with MetS who met the definition of ABSI obesity showed significantly higher CAVI than those who did not. The other logistic regression analysis demonstrated that CAVI was independently associated with MetS defined on the basis of ABSI. CONCLUSIONS ABSI was significantly associated with CAVI and the presence of MetS in the middle-aged population and helped to discriminate individuals with MetS and increased CAVI. ABSI could serve to identify individuals with MetS and increased arterial stiffness.
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Affiliation(s)
- Tomonori Sugiura
- Department of Cardiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Health Support Center WELPO, Toyota Motor Corporation, Toyota, Japan.
| | - Yasuaki Dohi
- Department of Internal Medicine, Faculty of Rehabilitation Sciences, Nagoya Gakuin University, Nagoya, Japan; Health Support Center WELPO, Toyota Motor Corporation, Toyota, Japan
| | - Yasuyuki Takagi
- Health Support Center WELPO, Toyota Motor Corporation, Toyota, Japan; Toyota Memorial Hospital, Toyota, Japan
| | - Takashi Yokochi
- Midtown Clinic Meieki, Nagoya, Japan; Health Support Center WELPO, Toyota Motor Corporation, Toyota, Japan
| | - Naofumi Yoshikane
- Health Support Center WELPO, Toyota Motor Corporation, Toyota, Japan
| | - Kenji Suzuki
- Health Support Center WELPO, Toyota Motor Corporation, Toyota, Japan
| | - Takamasa Tomiishi
- Health Support Center WELPO, Toyota Motor Corporation, Toyota, Japan
| | - Takashi Nagami
- Health Support Center WELPO, Toyota Motor Corporation, Toyota, Japan
| | | | - Hiroyuki Takase
- Department of Internal Medicine, Enshu Hospital, Hamamatsu, Japan; Department of Cardiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Yoshihiro Seo
- Department of Cardiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Nobuyuki Ohte
- Department of Cardiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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14
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Hong JY, Park KY, Kim JD, Hwang WM, Lim DM. Response: Effects of 6 Months of Dapagliflozin Treatment on Metabolic Profile and Endothelial Cell Dysfunction for Obese Type 2 Diabetes Mellitus Patients without Atherosclerotic Cardiovascular Disease (J Obes Metab Syndr 2020;29:215-21). J Obes Metab Syndr 2021; 30:74-75. [PMID: 33746116 PMCID: PMC8017330 DOI: 10.7570/jomes21006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 02/10/2021] [Accepted: 03/18/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
- Ju-Young Hong
- Division of Endocrinology, Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea
| | - Keun-Young Park
- Division of Endocrinology, Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea
| | - Jong-Dai Kim
- Division of Endocrinology, Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea
| | - Won-Min Hwang
- Division of Nephrology, Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea
| | - Dong-Mee Lim
- Division of Endocrinology, Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea.,Konyang University Myunggok Medical Research Institute, Daejeon, Korea
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15
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Qiao W, Zhang X, Kan B, Vuong AM, Xue S, Zhang Y, Li B, Zhao Q, Guo D, Shen X, Yang S. Hypertension, BMI, and cardiovascular and cerebrovascular diseases. Open Med (Wars) 2021; 16:149-155. [PMID: 33585690 PMCID: PMC7862997 DOI: 10.1515/med-2021-0014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 10/24/2020] [Accepted: 11/06/2020] [Indexed: 11/24/2022] Open
Abstract
Hypertension is associated with body mass index (BMI) and cardiovascular and cerebrovascular diseases (CCDs). Whether hypertension modifies the relationship between BMI and CCDs is still unclear. We examined the association between BMI and CCDs and tested whether effect measure modification was present by hypertension. We identified a population-based sample of 3,942 participants in Shuncheng, Fushun, Liaoning, China. Hypertension was defined as any past use of antihypertensive medication or having a measured systolic/diastolic blood pressure ≥130/80 mm Hg. BMI was calculated from measured body weight and body height. Data on diagnosed CCDs were self-reported and validated in the medical records. We used logistic regression models to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for associations between BMI and CCDs. Higher BMI was associated with increased odds of having CCDs (OR = 1.19, 95% CI: 1.07–1.31). This association was significantly modified by hypertension (P for interaction <0.001), with positive associations observed among hypertensive individuals (OR = 1.28, 95% CI: 1.14–1.42). Age, sex, and diabetic status did not modify the relationship between BMI and CCDs (all P for interaction >0.10). Although higher BMI was associated with increased odds of CCDs, the relationship was mainly limited to hypertensive patients.
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Affiliation(s)
- Wenjing Qiao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 232-1163 Xinmin Street, Changchun, 130021, Jilin, China
| | - Xinyi Zhang
- Department of Noninfectious Chronic Diseases Control, Disease Prevention and Control Center, Fushun, Liaoning, China
| | - Bo Kan
- Department of Clinical Laboratory, The Bethune Second Affiliated Hospital, Jilin University, Changchun, Jilin, China
| | - Ann M Vuong
- Department of Epidemiology and Biostatistics, School of Public Health, University of Nevada, Las Vegas, United States of America
| | - Shanshan Xue
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 232-1163 Xinmin Street, Changchun, 130021, Jilin, China
| | - Yuzheng Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 232-1163 Xinmin Street, Changchun, 130021, Jilin, China
| | - Binbin Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 232-1163 Xinmin Street, Changchun, 130021, Jilin, China
| | - Qianqian Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 232-1163 Xinmin Street, Changchun, 130021, Jilin, China
| | - Dingjie Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 232-1163 Xinmin Street, Changchun, 130021, Jilin, China
| | - Xue Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 232-1163 Xinmin Street, Changchun, 130021, Jilin, China
| | - Shuman Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 232-1163 Xinmin Street, Changchun, 130021, Jilin, China
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16
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Hemoglobin, hematocrit and plasma volume variations following combined sprint and strength: Effect of advanced age. Sci Sports 2021. [DOI: 10.1016/j.scispo.2019.10.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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17
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Wang FM, Yang C, Tanaka H, Coresh J, Ndumele CE, Matsushita K. Increase in arterial stiffness measures after bariatric surgery. Atherosclerosis 2021; 320:19-23. [PMID: 33508519 DOI: 10.1016/j.atherosclerosis.2021.01.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 12/15/2020] [Accepted: 01/12/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND AIMS The relationship between obesity and arterial stiffness is complex, with a potential interaction by age (inverse association at younger age and positive at older age) and conflicting reports on the effect of lifestyle-based weight loss on arterial stiffness. Little is understood about post-bariatric surgery changes in arterial stiffness. This study aimed to examine post-bariatric surgery changes in arterial stiffness and identify factors associated with greater changes in arterial stiffness. METHODS In 72 patients (mean age 44.5 years, 72.2% female), we evaluated two arterial stiffness measures, cardio-ankle vascular index (CAVI) and heart-ankle pulse wave velocity (haPWV), one month prior to and 6 months after bariatric surgery. Another follow-up visit was conducted 12 months after bariatric surgery in a subset of 58 participants. RESULTS Six months after bariatric surgery, an evident decrease was seen in body mass index, heart rate, and systolic blood pressure. In contrast, both CAVI and haPWV significantly increased at 6 months (+0.64 [0.42, 0.87] and +0.24 [0.04, 0.44] m/s, respectively). Among 58 patients with relevant data, CAVI and haPWV remained elevated 12 months after bariatric surgery (+0.80 [0.53, 1.07] and +0.40 [0.17, 0.62] m/s, respectively). Being non-diabetic and having larger decreases in post-surgery heart rate were independently associated with greater increases in post-surgical CAVI. CONCLUSIONS Arterial stiffness measures, CAVI and haPWV, were elevated after bariatric surgery despite other favorable cardiometabolic changes. Further studies are necessary to elucidate the underlying mechanism and prognostic implications of this elevation in arterial stiffness measures after bariatric surgery.
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Affiliation(s)
- Frances M Wang
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Chao Yang
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Josef Coresh
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Chiadi E Ndumele
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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18
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Evseveva ME, Eremin MV, Rostovtseva MV, Sergeeva OV, Fursova EN, Rusidi VA, Galkova IY, Kudryavtseva VD. Phenotypes of early and favorable vascular aging in young people depending on the risk factors and presence of connective tissue dysplasia. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2020. [DOI: 10.15829/1728-8800-2020-2524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Aim. To study the main risk factors and signs of connective tissue dysplasia (CTD) in young people according to quartile analysis of cardioankle vascular index (CAVI).Material and methods. The study involved 243 young people (men, 81; women, 162) aged 18-25 years. All subjects were divided into quartile groups depending on CAVI on both sides, or CAVI-R and CAVI-L, determined using the VaSera-1500 system (Fucuda Denshia,Japan). According to the latest guidelines, the 4th quartile of this distribution among persons of the same sex and age corresponds to early vascular aging (EVA) syndrome. The 1st quartile corresponds to favorable vascular aging. We analyzed the main RFs and CTD signs in each of the 4 CAVI quartiles. Data processing was carried out using the Statistica 10.0 software package (StatSoft Inc,USA).Results. The minimum and maximum CAVI in the sample were 3,2 and 7,9. The overwhelming majority of studied risk factors in both sexes were not associated with the stiffness. Only body mass and body mass index increasedwith a decrease in vascular stiffness and vice versa. The average number of external stigmas of dysembryogenesis in young people increased from the 1st to the 4th CAVI quartile, with significant differences in the extreme groups. Such CTD signs as a carpal tunnel syndrome and thumb sign also significantly differed between the 1st and 4th quartiles.Conclusion. The presented results can be used for prevention among young people to form more individualized programs taking into account a comprehensive assessment of vascular aging phenotype and the level of external stigmatization of each young person.
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Affiliation(s)
| | - M. V. Eremin
- Regional Clinical Hospital of the Stavropol Krai
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19
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Abstract
: Hypertension is a worldwide known cause of morbidity and mortality in the elderly and is a major risk factor for cardiovascular complications such as stroke, myocardial infarction, renal complications and heart failure. Although the mechanisms of hypertension remain largely unknown, a recent new concept is that aortic stiffening is a cause of hypertension in middle-aged and older individuals, which highlighted the importance of aortic stiffening in the development of age-related hypertension. Understanding the pathogenesis of aortic stiffness therefore became one of the important approaches to preventing and controlling hypertension. This review discusses the recent progress of the potential causes of aortic stiffening and its implication on the pathogenesis of hypertension, in terms of aging, inflammation, metabolic syndromes, neuroendocrine and the interaction among these causes.
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Affiliation(s)
- John O. ONUH
- Center for Molecular and Translational Medicine, Georgia State University, Atlanta, GA, USA, 30303
| | - Hongyu QIU
- Center for Molecular and Translational Medicine, Georgia State University, Atlanta, GA, USA, 30303
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20
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Qin P, Shi J, Cao L, Li X, Lou Y, Wang C, Ma J, Wang L, Peng X, Chen H, Xu S, Zhao P, Hu D, Hu F. Low-Density Lipoprotein Cholesterol/High-Density Lipoprotein Cholesterol Ratio and Carotid Intima-Media Thickness: A Cohort Study in China. Lipids 2020; 56:59-68. [PMID: 32856731 DOI: 10.1002/lipd.12274] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 07/19/2020] [Accepted: 07/21/2020] [Indexed: 11/10/2022]
Abstract
Low-density lipoprotein cholesterol to high-density lipoprotein cholesterol (LDL-C/HDL-C) ratio may carry additional information and has been suggested as a better predictor for atherosclerosis progression and cardiovascular disease (CVD) than LDL-C and HDL-C alone. Therefore, we aim to explore the association between LDL-C/HDL-C ratio and high carotid intima-media thickness (CIMT) risk in a large Cohort in Beijing, China. This cohort study included 13,612 adults without high CIMT at first entry and who attended the baseline examination and at least one follow-up annual examination between 2009 and 2016. We used multivariable Cox regression to estimate hazard ratios (HR) with their 95% confidence intervals (CI) for the association between LDL-C/HDL-C ratio and risk of high CIMT. During 37,912 person-years of follow-up, 1996 (1268 men and 728 women) developed high CIMT. Compared with the first quartile of LDL-C/HDL-C ratio, the risk of high CIMT was significantly increased for the fourth quartile of LDL-C/HDL-C ratio (HR = 1.51, 95% CI: 1.29-1.78). We observed a significant association between LDL-C/HDL-C ratio and high CIMT risk comparing LDL-C/HDL-C ratio >2.78 with LDL-C/HDL-C ratio ≤2.78 and significant dose-response relationship between LDL-C/HDL-C ratio and risk of high CIMT. The restricted cubic spline showed a significant nonlinear association between LDL-C/HDL-C ratio and the risk of high CIMT (pnon-linearity = 0.009). We identify a significant association between LDL-C/HDL-C ratio and the risk of high CIMT in the Chinese Cohort study. Future studies are needed to evaluate the effectiveness of reducing LDL-C/HDL-C ratio treatment on the development of high CIMT.
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Affiliation(s)
- Pei Qin
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, No.1066 Xueyuan Avenue, Nanshan District, Shenzhen, Guangdong, 518060, People's Republic of China
| | - Jing Shi
- Department of Epidemiology, College of Public Health, Harbin Medical University, No.157 Health Road, Harbin, Heilongjiang, 150000, People's Republic of China
| | - Liming Cao
- Department of Epidemiology, College of Public Health, Harbin Medical University, No.157 Health Road, Harbin, Heilongjiang, 150000, People's Republic of China
| | - Xue Li
- Department of Epidemiology, College of Public Health, Harbin Medical University, No.157 Health Road, Harbin, Heilongjiang, 150000, People's Republic of China
| | - Yanmei Lou
- Department of Health Management, Beijing Xiaotangshan Hospital, Xiaotangshan Town, Changping, Beijing, 102200, People's Republic of China
| | - Changyi Wang
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic disease, No.7 Huaming Road, Shenzhen, Guangdong, 102200, People's Republic of China
| | - Jianping Ma
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic disease, No.7 Huaming Road, Shenzhen, Guangdong, 102200, People's Republic of China
| | - Li Wang
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic disease, No.7 Huaming Road, Shenzhen, Guangdong, 102200, People's Republic of China
| | - Xiaolin Peng
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic disease, No.7 Huaming Road, Shenzhen, Guangdong, 102200, People's Republic of China
| | - Hongen Chen
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic disease, No.7 Huaming Road, Shenzhen, Guangdong, 102200, People's Republic of China
| | - Shan Xu
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic disease, No.7 Huaming Road, Shenzhen, Guangdong, 102200, People's Republic of China
| | - Ping Zhao
- Department of Health Management, Beijing Xiaotangshan Hospital, Xiaotangshan Town, Changping, Beijing, 102200, People's Republic of China
| | - Dongsheng Hu
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, No.1066 Xueyuan Avenue, Nanshan District, Shenzhen, Guangdong, 518060, People's Republic of China
| | - Fulan Hu
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, No.1066 Xueyuan Avenue, Nanshan District, Shenzhen, Guangdong, 518060, People's Republic of China
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21
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Osimo EF, Brugger SP, de Marvao A, Pillinger T, Whitehurst T, Statton B, Quinlan M, Berry A, Cook SA, O'Regan DP, Howes OD. Cardiac structure and function in schizophrenia: cardiac magnetic resonance imaging study. Br J Psychiatry 2020; 217:450-457. [PMID: 31915079 PMCID: PMC7511899 DOI: 10.1192/bjp.2019.268] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Heart disease is the leading cause of death in schizophrenia. However, there has been little research directly examining cardiac function in schizophrenia. AIMS To investigate cardiac structure and function in individuals with schizophrenia using cardiac magnetic resonance imaging (CMR) after excluding medical and metabolic comorbidity. METHOD In total, 80 participants underwent CMR to determine biventricular volumes and function and measures of blood pressure, physical activity and glycated haemoglobin levels. Individuals with schizophrenia ('patients') and controls were matched for age, gender, ethnicity and body surface area. RESULTS Patients had significantly smaller indexed left ventricular (LV) end-diastolic volume (effect size d = -0.82, P = 0.001), LV end-systolic volume (d = -0.58, P = 0.02), LV stroke volume (d = -0.85, P = 0.001), right ventricular (RV) end-diastolic volume (d = -0.79, P = 0.002), RV end-systolic volume (d = -0.58, P = 0.02), and RV stroke volume (d = -0.87, P = 0.001) but unaltered ejection fractions relative to controls. LV concentricity (d = 0.73, P = 0.003) and septal thickness (d = 1.13, P < 0.001) were significantly larger in the patients. Mean concentricity in patients was above the reference range. The findings were largely unchanged after adjusting for smoking and/or exercise levels and were independent of medication dose and duration. CONCLUSIONS Individuals with schizophrenia show evidence of concentric cardiac remodelling compared with healthy controls of a similar age, gender, ethnicity, body surface area and blood pressure, and independent of smoking and activity levels. This could be contributing to the excess cardiovascular mortality observed in schizophrenia. Future studies should investigate the contribution of antipsychotic medication to these changes.
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Affiliation(s)
- Emanuele F. Osimo
- Academic Clinical Fellow in Psychiatry, MRC London Institute of Medical Sciences, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus; and Department of Psychiatry, University of Cambridge; and Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Stefan P. Brugger
- Academic Clinical Fellow in Psychiatry, MRC London Institute of Medical Sciences, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, UK
| | - Antonio de Marvao
- Clinical Lecturer in Cardiology, MRC London Institute of Medical Sciences, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, UK
| | - Toby Pillinger
- Academic Clinical Fellow in Psychiatry, MRC London Institute of Medical Sciences, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus; and Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Thomas Whitehurst
- Clinical Research Fellow, MRC London Institute of Medical Sciences, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, UK
| | - Ben Statton
- Lead MR Radiographer, MRC London Institute of Medical Sciences, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, UK
| | - Marina Quinlan
- MR Radiographer, MRC London Institute of Medical Sciences, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, UK
| | - Alaine Berry
- MR Radiographer, MRC London Institute of Medical Sciences, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, UK
| | - Stuart A. Cook
- Professor of Clinical and Molecular Cardiology, MRC London Institute of Medical Sciences, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, UK
| | - Declan P. O'Regan
- Reader in Imaging Sciences (Consultant Radiologist), MRC London Institute of Medical Sciences, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, UK
| | - Oliver D. Howes
- Professor of Molecular Psychiatry, MRC London Institute of Medical Sciences, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus; and Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK,Correspondence: Professor Oliver Howes.
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22
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Lou Y, Li X, Cao L, Qin P, Shi J, Zhang Y, Wang C, Ma J, Wang L, Peng X, Chen H, Xu S, Hu F, Zhao Y, Zhao P. LDL-cholesterol to HDL-cholesterol ratio discordance with lipid parameters and carotid intima-media thickness: a cohort study in China. Lipids Health Dis 2020; 19:141. [PMID: 32552893 PMCID: PMC7302368 DOI: 10.1186/s12944-020-01324-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 06/12/2020] [Indexed: 12/15/2022] Open
Abstract
Background The discordance of the low-density lipoprotein cholesterol-to-high-density lipoprotein cholesterol (LDL-C/HDL-C) ratio with alterative lipid parameters may explain the inconsistent association of CIMT with the LDL-C/HDL-C ratio. Therefore, this study aimed to explore the associations between LDL-C/HDL-C ratio discordance with alternative lipid parameters and elevated carotid intima-media thickness (CIMT) risk in a large cohort in Beijing, China. Methods In total, 13,612 adults who didn’t have elevated CIMT at baseline and who participated in at least one follow-up of annual examination between 2009 and 2016 were included in this cohort study. A multivariable Cox regression model was utilized to evaluate the associations of discordance of the LDL-C/HDL-C ratio with TC, TGs, LDL-C and HDL-C with elevated CIMT risk. Results During 37,999 person-years of follow-up, 2004 individuals (1274 men and 730 women) developed elevated CIMT. Among individuals with normal TC and TGs, 16.6 and 15.2% individuals had a discordantly high LDL-C/HDL-C ratio, respectively, and the risk of elevated CIMT increased by 1.54 (95% CI 1.33, 1.77) and 1.53 (95% CI 1.33, 1.76), respectively, comparing to individuals with a concordantly low LDL-C/HDL-C ratio. A high LDL-C/HDL-C ratio could significantly increase elevated CIMT risk regardless of discordance/concordance with LDL-C and HDL-C (P < 0.001). A low LDL-C/HDL-C ratio with discordantly normal HDL-C and high LDL-C (13.2% of individuals) had a 32% (HR = 1.32, 95% CI 1.11, 1.57) higher risk of elevated CIMT than concordantly low LDL-C and normal HDL-C. Sensitivity analysis by excluding CIMT developed in the first 2 years follow-up further confirmed the above results. Conclusions A high LDL-C/HDL-C ratio could significantly increase elevated CIMT risk regardless of discordance/concordance with TC, TGs, LDL-C and HDL-C Even a low LDL-C/HDL-C ratio with discordantly high LDL-C and normal HDL-C could also significantly increase CIMT risk. Individuals should maintain both the LDL-C/HDL-C ratio and LDL-C at normal levels to prevent elevated CIMT.
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Affiliation(s)
- Yanmei Lou
- Department of Health Management, Beijing Xiao Tang Shan Hospital, Beijing, People's Republic of China
| | - Xue Li
- Department of Epidemiology, College of Public Health, Harbin Medical University, Harbin, Heilongjiang, People's Republic of China
| | - Liming Cao
- Department of Epidemiology, College of Public Health, Harbin Medical University, Harbin, Heilongjiang, People's Republic of China
| | - Pei Qin
- School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Jing Shi
- Department of Epidemiology, College of Public Health, Harbin Medical University, Harbin, Heilongjiang, People's Republic of China
| | - Yanyan Zhang
- School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Changyi Wang
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic disease, Shenzhen, Guangdong, People's Republic of China
| | - Jianping Ma
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic disease, Shenzhen, Guangdong, People's Republic of China
| | - Li Wang
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic disease, Shenzhen, Guangdong, People's Republic of China
| | - Xiaolin Peng
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic disease, Shenzhen, Guangdong, People's Republic of China
| | - Hongen Chen
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic disease, Shenzhen, Guangdong, People's Republic of China
| | - Shan Xu
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic disease, Shenzhen, Guangdong, People's Republic of China
| | - Fulan Hu
- School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China.
| | - Yashuang Zhao
- Department of Epidemiology, College of Public Health, Harbin Medical University, Harbin, Heilongjiang, People's Republic of China.
| | - Ping Zhao
- Department of Health Management, Beijing Xiao Tang Shan Hospital, Beijing, People's Republic of China.
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23
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Logan JG, Kang H, Kim S, Duprez D, Kwon Y, Jacobs DR, Forbang N, Lobo JM, Sohn MW. Association of obesity with arterial stiffness: The Multi-Ethnic Study of Atherosclerosis (MESA). Vasc Med 2020; 25:309-318. [PMID: 32484395 DOI: 10.1177/1358863x20918940] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Arterial stiffness (AS) and obesity are recognized as important risk factors of cardiovascular disease (CVD). The purpose of this study was to investigate the relationship between AS and obesity. AS was defined as high augmentation index (AIx) and low elasticity (C1, large artery elasticity; C2, small artery elasticity) in participants enrolled in the Multi-Ethnic Study of Atherosclerosis at baseline. We compared AIx, C1, and C2 by body mass index (BMI) (< 25, 25-29.9, 30-39.9, ⩾ 40 kg/m2) and waist-hip ratio (WHR) (< 0.85, 0.85-0.99, ⩾ 1). The obesity-AS association was tested across 10-year age intervals. Among 6177 participants (62 ± 10 years old, 52% female), a significant inverse relationship was observed between obesity and AS. After adjustments for CVD risk factors, participants with a BMI > 40 kg/m2 had 5.4% lower AIx (mean difference [Δ] = -0.82%; 95% CI: -1.10, -0.53), 15.4% higher C1 (Δ = 1.66 mL/mmHg ×10; 95% CI: 1.00, 2.33), and 40.2% higher C2 (Δ = 1.49 mL/mmHg ×100; 95% CI: 1.15, 1.83) compared to those with a BMI < 25 kg/m2 (all p for trend < 0.001). Participants with a WHR ⩾ 1 had 5.6% higher C1 (∆ = 0.92 mL/mmHg ×10; 95% CI: 0.47, 1.37) compared to those with a WHR < 0.85. The WHR had a significant interaction with age on AIx and C2, but not with BMI; the inverse relationships of the WHR with AIx and C2 were observed only in participants < 55 years between the normal (WHR < 0.85) and the overweight (0.85 ⩽ WHR < 0.99) groups. Different associations of WHR and BMI with arterial stiffness among older adults should be further investigated.
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Affiliation(s)
- Jeongok G Logan
- School of Nursing, University of Virginia, Charlottesville, VA, USA
| | - Hyojung Kang
- College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Soyoun Kim
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Daniel Duprez
- Cardiovascular Division, University of Minnesota, Minneapolis, MN, USA
| | - Younghoon Kwon
- UVA Heart and Vascular Center Fontaine, University of Virginia, Charlottesville, VA, USA
| | - David R Jacobs
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Nketi Forbang
- Department of Family Medicine and Public Health, Division of Preventive Medicine, UC San Diego, La Jolla, CA, USA
| | - Jennifer Mason Lobo
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Min-Woong Sohn
- Department of Health Management and Policy, University of Kentucky, Lexington, KY, USA
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24
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Sugiura T, Dohi Y, Takagi Y, Yoshikane N, Ito M, Suzuki K, Nagami T, Iwase M, Seo Y, Ohte N. Relationships of Obesity-Related Indices and Metabolic Syndrome with Subclinical Atherosclerosis in Middle-Aged Untreated Japanese Workers. J Atheroscler Thromb 2019; 27:342-352. [PMID: 31462618 PMCID: PMC7192820 DOI: 10.5551/jat.50633] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Aim: Obesity is a social problem due to the prevalence of the Western lifestyle. In particular, visceral fat accumulation, which is a main component of metabolic syndrome, is closely associated with the progression of atherosclerosis. This study aimed to investigate the relationships of obesity-related indices and metabolic syndrome with subclinical atherosclerosis in middle-aged untreated workers. Methods: Employees undergoing their periodic health check-up but without previous cardiovascular events or cardiovascular medications were enrolled in this study (n = 7,750). Body mass index (BMI), percent body fat, waist circumference, and visceral fat area were evaluated as obesity-related indices. Assessment of visceral fat area was performed by computed tomography (CT). Subclinical atherosclerosis was assessed by measuring arterial stiffness using cardio-ankle vascular index (CAVI) and by ultrasound examination of carotid intima-media thickness (IMT). Results: Obesity-related indices were significantly correlated with each other and were positively associated with carotid IMT but negatively associated with CAVI in multivariate regression analysis. In a logistic regression analysis including CAVI and carotid IMT simultaneously, CAVI was negatively associated, but carotid IMT was positively associated, with obesity defined by each obesity-related index. In contrast, both CAVI and carotid IMT were positively associated with the presence of metabolic syndrome based on visceral fat accumulation. Conclusions: Obesity-related indices were negatively associated with CAVI and positively associated with carotid IMT in middle-aged untreated workers, while both CAVI and carotid IMT were worsened in the presence of metabolic syndrome.
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Affiliation(s)
- Tomonori Sugiura
- Department of Cardiology, Nagoya City University Graduate School of Medical Sciences.,Health Support Center WELPO, Toyota Motor Corporation
| | - Yasuaki Dohi
- Department of Internal Medicine, Faculty of Rehabilitation Science, Nagoya Gakuin University.,Health Support Center WELPO, Toyota Motor Corporation
| | - Yasuyuki Takagi
- Health Support Center WELPO, Toyota Motor Corporation.,Toyota Memorial Hospital
| | | | - Mitsuhisa Ito
- Health Support Center WELPO, Toyota Motor Corporation
| | - Kenji Suzuki
- Health Support Center WELPO, Toyota Motor Corporation
| | | | | | - Yoshihiro Seo
- Department of Cardiology, Nagoya City University Graduate School of Medical Sciences
| | - Nobuyuki Ohte
- Department of Cardiology, Nagoya City University Graduate School of Medical Sciences
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25
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Huang J, Chen Z, Yuan J, Zhang C, Chen H, Wu W, Chen Z, Liu Y, Zheng M, Chen S, Wu S, Chen Y. Association Between Body Mass Index (BMI) and Brachial-Ankle Pulse Wave Velocity (baPWV) in Males with Hypertension: A Community-Based Cross-Section Study in North China. Med Sci Monit 2019; 25:5241-5257. [PMID: 31303640 PMCID: PMC6647924 DOI: 10.12659/msm.914881] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Accepted: 03/21/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The aim of this study was to investigate the association between body mass index (BMI) and brachial-ankle pulse wave velocity (baPWV) in hypertensive males. MATERIAL AND METHODS Altogether, 14 866 male hypertensive participants were included in the analysis. Participants were divided into 3 groups: low BMI group (BMI <24 kg/m²), moderate BMI group (24 kg/m² ≤BMI <28 kg/m²), and high BMI group (BMI ≥28 kg/m²). According to baPWV values, arteriosclerosis (AS) was set as 3 degrees: mild AS (baPWV ≥1400 cm/s), moderate AS (baPWV ≥1700 cm/s) and severe AS (baPWV ≥2000 cm/s). Multivariate logistic regression analysis was used to explore the effect of different BMI groups on different degrees of AS. The multivariate linear regression analysis was used to explore the relationship between BMI and baPWV. RESULTS Among low BMI, moderate BMI, and high BMI groups, the average baPWV values were 1824±401 cm/s, 1758±363 cm/s, and 1686±341 cm/s, respectively. Prevalence in the mild, moderate and high BMI groups were 91.0%, 87.8%, 81.5%, respectively for mild AS; 55.3%, 48.8%, and 40.0% respectively for moderate AS; and 25.9%, 20.2%, and 14.9% respectively for severe AS. Compared to the low BMI group, multivariate logistic regression analysis showed that odds ratio (OR) and 95% confidence intervals (95%CI) in the moderate BMI group and the high BMI were 0.71 (95%Cl, 0.62-0.80), 0.43 (95%Cl, 0.38-0.50) for mild AS; and similar trends were shown for moderate AS and severe AS. Based on age-stratification, a negative relationship remained for 35-55 years old participants for different degrees of AS among the moderate BMI group and the high BMI group. A negative relationship was detected between BMI and baPWV in total and different age-stages. CONCLUSIONS Among male hypertension participants in this study, there was a negative relationship between BMI and baPWV. High BMI was found to be a protective factor for AS especially in the age range of 35-55 years.
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Affiliation(s)
- Jianhuan Huang
- Shantou University Medical College, Shantou, Guangdong, P.R. China
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, P.R. China
| | - Zekai Chen
- Shantou University Medical College, Shantou, Guangdong, P.R. China
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, P.R. China
| | - Jinhuan Yuan
- North China University of Science and Technology, Tangshan, Hebei, P.R. China
| | - Changyi Zhang
- Shantou University Medical College, Shantou, Guangdong, P.R. China
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, P.R. China
| | - Haojia Chen
- Shantou University Medical College, Shantou, Guangdong, P.R. China
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, P.R. China
| | - Weiqiang Wu
- Shantou University Medical College, Shantou, Guangdong, P.R. China
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, P.R. China
| | - Zhichao Chen
- Shantou University Medical College, Shantou, Guangdong, P.R. China
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, P.R. China
| | - Yingchi Liu
- North China University of Science and Technology, Tangshan, Hebei, P.R. China
| | - Mengyi Zheng
- North China University of Science and Technology, Tangshan, Hebei, P.R. China
| | - Shuohua Chen
- Department of Cardiology, Kailuan Hospital, Hebei United University, Tangshan, Hebei, P.R. China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, Hebei United University, Tangshan, Hebei, P.R. China
| | - Youren Chen
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, P.R. China
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26
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Dangardt F, Charakida M, Georgiopoulos G, Chiesa ST, Rapala A, Wade KH, Hughes AD, Timpson NJ, Pateras K, Finer N, Sattar N, Davey Smith G, Lawlor DA, Deanfield JE. Association between fat mass through adolescence and arterial stiffness: a population-based study from The Avon Longitudinal Study of Parents and Children. THE LANCET. CHILD & ADOLESCENT HEALTH 2019; 3:474-481. [PMID: 31126896 PMCID: PMC6558973 DOI: 10.1016/s2352-4642(19)30105-1] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 03/10/2019] [Accepted: 03/18/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND The link between adiposity, metabolic abnormalities, and arterial disease progression in children and adolescents remains poorly defined. We aimed to assess whether persistent high adiposity levels are associated with increased arterial stiffness in adolescence and any mediation effects by common metabolic risk factors. METHODS We included participants from the Avon Longitudinal Study of Parents and Children (ALSPAC) who had detailed adiposity measurements between the ages 9-17 years and arterial stiffness (carotid to femoral pulse wave velocity [PWV]) measured at age 17 years. Body-mass index (BMI) and waist-to-height ratio were calculated from weight, height, and waist circumference measurements whereas fat mass was assessed using repeated dual-energy x-ray absorptiometry (DEXA) scans. We used total and trunk fat mass indices (FMIs) to classify participants as normal (<75th percentile) or high (>75th percentile) FMI. We classified participants as being metabolically unhealthy if they had three or more of the following risk factors: high levels of systolic blood pressure, triglycerides, or glucose (all >75th percentile) or low levels of high-density lipoprotein (<25th percentile). We used multivariable linear regression analysis to assess the relationship between PWV and exposure to adiposity, and tested for linear trend of PVW levels across ordinal groups. We used latent class growth mixture modelling analysis to assess the effect of longitudinal changes in adiposity indices through adolescence on arterial stiffness. FINDINGS We studied 3423 participants (1866 [54·5%] female and 1557 [45·5%] male). Total fat mass was positively associated with PWV at age 17 years (0·004 m/s per kg, 95% CI 0·001-0·006; p=0·0081). Persistently high total FMI and trunk FMI between ages 9 and 17 years were related to greater PWV (0·15 m/s per kg/m2, 0·05-0·24; p=0·0044 and 0·15 m/s per kg/m2, 0·06-0·25; p=0·0021) compared with lower FMI. Metabolic abnormalities amplified the adverse effect of high total FMI on arterial stiffness (PWV 6·0 m/s [95% CI 5·9-6·0] for metabolically healthy participants and 6·2 m/s [5·9-6·4] for metabolically unhealthy participants). Participants who restored normal total FMI in adolescence (PWV 5·8 m/s [5·7-5·9] for metabolically healthy and 5·9 m/s [5·6-6·1] for metabolically unhealthy) had comparable PWV to those who had normal FMI throughout (5·7 m/s [5·7-5·8] for metabolically healthy and 5·9 m/s [5·8-5·9] for metabolically unhealthy). INTERPRETATION Persistently high fat mass during adolescence was associated with greater arterial stiffness and was further aggravated by an unfavourable metabolic profile. Reverting to normal FMI in adolescence was associated with normal PWV, suggesting adolescence as an important period for interventions to tackle obesity in the young to maximise long-term vascular health. FUNDING UK Medical Research Council, Wellcome Trust, British Heart Foundation, and AFA Insurances.
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Affiliation(s)
- Frida Dangardt
- Vascular Physiology Unit, Institute of Cardiovascular Science, University College London, London, UK; Department of Paediatric Clinical Physiology, The Queen Silvia Children's Hospital, Sahlgrenska Academy and University Hospital, Gothenburg, Sweden
| | - Marietta Charakida
- Vascular Physiology Unit, Institute of Cardiovascular Science, University College London, London, UK; School of Biomedical Engineering and Imaging Sciences, King's College London, UK
| | - Georgios Georgiopoulos
- School of Biomedical Engineering and Imaging Sciences, King's College London, UK; Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
| | - Scott T Chiesa
- Vascular Physiology Unit, Institute of Cardiovascular Science, University College London, London, UK
| | - Alicja Rapala
- Vascular Physiology Unit, Institute of Cardiovascular Science, University College London, London, UK
| | - Kaitlin H Wade
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Alun D Hughes
- Department of Population Science and Experimental Medicine, UCL Institute of Cardiovascular Science, University College London, London, UK; MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
| | - Nicholas J Timpson
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Konstantinos Pateras
- Department of Biostatistics and Research Support, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Nick Finer
- Vascular Physiology Unit, Institute of Cardiovascular Science, University College London, London, UK
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, British Heart Foundation Glasgow, Cardiovascular Research Centre, University of Glasgow, Glasgow, UK
| | - George Davey Smith
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Debbie A Lawlor
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - John E Deanfield
- Vascular Physiology Unit, Institute of Cardiovascular Science, University College London, London, UK.
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Li CH, Lu FH, Yang YC, Wu JS, Chang CJ. Increased Arterial Stiffness in Prediabetic Subjects Recognized by Hemoglobin A1c with Postprandial Glucose but Not Fasting Glucose Levels. J Clin Med 2019; 8:jcm8050603. [PMID: 31052480 PMCID: PMC6571836 DOI: 10.3390/jcm8050603] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 04/24/2019] [Accepted: 04/30/2019] [Indexed: 01/09/2023] Open
Abstract
Previous studies exploring the association between arterial stiffness and prediabetes remain controversial. This study aimed to investigate the association of the different domains of prediabetes categorized by glycated hemoglobin A1c (A1c) 5.7–6.4%, impaired fasting glucose (IFG), fasting plasma glucose of 5.6–6.9 mmol/L, and impaired glucose tolerance (IGT), two-hour post-load glucose of 7.8–11.0 mmol/L, on arterial stiffness. These were measured by brachial–ankle pulse-wave velocity (baPWV). We enrolled 4938 eligible subjects and divided them into the following nine groups: (1) normoglycemic; (2) isolated A1c 5.7–6.4%; (3) isolated IFG; (4) IFG with A1c 5.7–6.4%; (5) isolated IGT; (6) combined IGT and IFG with A1c <5.7%; (7) IGT with A1c 5.7–6.4%; (8) combined IGT and IFG with A1c 5.7–6.4%; and (9) newly diagnosed diabetes (NDD). The baPWV values were significantly high in subjects with NDD (β = 47.69, 95% confidence interval (CI) = 29.02–66.37, p < 0.001), those with IGT with A1c 5.7–6.4% (β = 36.02, 95% CI = 19.08–52.95, p < 0.001), and those with combined IGT and IFG with A1c 5.7–6.4% (β = 27.72, 95% CI = 0.68–54.76, p = 0.044), but not in the other subgroups. These findings suggest that increased arterial stiffness was found in prediabetes individuals having an A1c 5.7–6.4% with IGT, but not IFG. Isolated A1c 5.7–6.4% and isolated IGT were not associated with elevated arterial stiffness.
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Affiliation(s)
- Chung-Hao Li
- Department of Health Management Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan.
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan.
| | - Feng-Hwa Lu
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan.
- Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan.
| | - Yi-Ching Yang
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan.
- Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan.
| | - Jin-Shang Wu
- Department of Health Management Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan.
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan.
- Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan.
| | - Chih-Jen Chang
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan.
- Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan.
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Styczyński G, Kalinowski P, Michałowski Ł, Paluszkiewicz R, Ziarkiewicz-Wróblewska B, Zieniewicz K, Tataj E, Szmigielski C, Jędrusik P. No association between aortic stiffness and liver steatosis in morbidly obese patients. Atherosclerosis 2019; 287:165-170. [PMID: 31040024 DOI: 10.1016/j.atherosclerosis.2019.04.206] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 03/10/2019] [Accepted: 04/04/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND AIMS Patients with non-alcoholic fatty liver disease are characterized by increased aortic stiffness, but it is unclear whether this is related to non-alcoholic fatty liver disease itself or concomitant metabolic syndrome components, including hypertension and diabetes. Previous studies were methodologically limited by ultrasound-based assessment of liver steatosis or performing liver biopsy in patients with more severe disease. Therefore, we prospectively measured aortic pulse wave velocity (aPWV) in non-selected obese subjects admitted for bariatric surgery with liver biopsy, allowing assessment of the association between aortic stiffness and biopsy-confirmed liver steatosis. METHODS We evaluated 120 consecutive severely obese patients (79 females; mean age 42 ± 10 years, mean body mass index 45.0 ± 5.3 kg/m2) without cardiac disease or alcohol-induced liver disease, who were admitted for bariatric surgery. The presence or absence of liver steatosis was defined by wedge liver biopsy. aPWV was measured with the Doppler method at the time of preoperative transthoracic echocardiography. RESULTS Based on liver biopsy results, 82 patients (68%) had liver steatosis and 38 (32%) had no steatosis. Univariate linear regression analysis showed that age, mean arterial pressure, liver steatosis, heart rate, female gender, and diabetes were significantly associated with aPWV. However, only age, mean arterial pressure, heart rate, and diabetes remained significant in the multivariate model (p ≤ 0.001). CONCLUSIONS We found no independent association between biopsy-confirmed liver steatosis and aortic stiffness measured by Doppler aPWV in morbidly obese individuals. Aortic stiffness in these subjects is related to comorbidities and not to non-alcoholic fatty liver disease itself.
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Affiliation(s)
- Grzegorz Styczyński
- Department of Internal Medicine, Hypertension and Angiology, Medical University of Warsaw, Banacha 1a, 02-097, Warsaw, Poland
| | - Piotr Kalinowski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Banacha 1a, 02-097, Warsaw, Poland
| | - Łukasz Michałowski
- Department of Pathology, Center for Biostructure Research, Medical University of Warsaw, Banacha 1a, 02-097, Warsaw, Poland
| | - Rafał Paluszkiewicz
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Banacha 1a, 02-097, Warsaw, Poland
| | - Bogna Ziarkiewicz-Wróblewska
- Department of Pathology, Center for Biostructure Research, Medical University of Warsaw, Banacha 1a, 02-097, Warsaw, Poland
| | - Krzysztof Zieniewicz
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Banacha 1a, 02-097, Warsaw, Poland
| | - Emanuel Tataj
- Department of Medical Informatics and Telemedicine, Medical University of Warsaw, Banacha 1a, 02-097, Warsaw, Poland
| | - Cezary Szmigielski
- Department of Internal Medicine, Hypertension and Angiology, Medical University of Warsaw, Banacha 1a, 02-097, Warsaw, Poland
| | - Piotr Jędrusik
- Department of Internal Medicine, Hypertension and Angiology, Medical University of Warsaw, Banacha 1a, 02-097, Warsaw, Poland.
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Sung J, Cho SJ, Hong KP. Relationship between fitness and arterial stiffness according to hypertensive state. Clin Exp Hypertens 2018; 41:733-738. [PMID: 30501136 DOI: 10.1080/10641963.2018.1545849] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: There is a well-established relationship between cardiorespiratory fitness (CRF) and arterial stiffness. However, it is unclear whether this relationship differs significantly between hypertensive and non-hypertensive patients.Methods: Adults without a history of ischemic heart disease or stroke and normal exercise test results who underwent health screening were included. Cardiopulmonary function test was performed using the Bruce protocol. Peak oxygen consumption (VO2peak) was measured. Arterial stiffness was evaluated using the brachial-ankle pulse wave velocity (baPWV).Results: Study subjects were 9232 participants (M:F = 71:29%) with a mean age of 53 ± 6 years. Thirty-four percent had hypertension. There was an inverse relationship between the peak oxygen consumption and baPWV (r = - 0.21, p < 0.001) This relationship persisted after adjusting for age, gender, body mass index, smoking, diabetes mellitus, hemoglobin A1c, LDL-cholesterol, mean blood pressure, and hypertension (p < 0.0001). The regression coefficient of VO2peak was significantly more negative among hypertensive subjects than it was in non-hypertensive subjects in the regression coefficient (-9.2 vs. -4.2, p for interaction <0.001). The difference in arterial stiffness between hypertensive and non-hypertensive groups decreased as the CRF increased.Conclusion: Arterial stiffness decreased as CRF increased among participants without overt cardiovascular disease. The effect of hypertension on arterial stiffness also decreased as the CRF increased.
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Affiliation(s)
- Jidong Sung
- Division of Cardiology, Department of Medicine, Sungkyunkwan University School of Medicine, Prevention & Rehabilitation Center, Heart Vascular & Stroke Institute, Samsung Medical Center, Seoul, Republic of Korea
| | - Soo Jin Cho
- Department of Medicine, Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyong Pyo Hong
- Division of Cardiology, Department of Medicine, Sungkyunkwan University School of Medicine, Prevention & Rehabilitation Center, Heart Vascular & Stroke Institute, Samsung Medical Center, Seoul, Republic of Korea
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Wade KH, Chiesa ST, Hughes AD, Chaturvedi N, Charakida M, Rapala A, Muthurangu V, Khan T, Finer N, Sattar N, Howe LD, Fraser A, Lawlor DA, Davey Smith G, Deanfield JE, Timpson NJ. Assessing the causal role of body mass index on cardiovascular health in young adults: Mendelian randomization and recall-by-genotype analyses. Circulation 2018; 138:2187-2201. [PMID: 30524135 PMCID: PMC6250296 DOI: 10.1161/circulationaha.117.033278] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 06/12/2018] [Indexed: 01/19/2023]
Abstract
Background Body mass index (BMI) has been suggested to be causally related to cardiovascular health in mid-to-late life, but this has not been explored systematically at younger ages - nor with detailed cardiovascular phenotyping. Recall-by-Genotype (RbG) is an approach that enables the collection of precise phenotypic measures in smaller studies, whilst maintaining statistical power and ability for causal inference. Methods In this study, we used a combination of conventional multivariable regression analysis, Mendelian randomization (MR) and sub-sample RbG methodologies to estimate the causal effect of BMI on gross-level and detailed cardiovascular health in healthy participants from the Avon Longitudinal Study of Parents and Children at age 17 (N=1420-3108 for different outcomes) and an independent sample from the same cohort (for RbG) study at age 21 (N=386-418). Results In both MR and RbG analyses, results suggested that higher BMI causes higher blood pressure (BP) and left ventricular mass index (LVMI) in young adults (e.g., difference in LVMI per kg/m2 using MR: 1.07g/m2.7; 95% CI: 0.62, 1.52; P=3.87x10-06 and per 3.58kg/m2 using RbG: 1.65g/m2.7 95% CI: 0.83, 2.47; P=0.0001). Additionally, RbG results suggested a causal role of higher BMI on higher stroke volume (SV: difference per 3.58kg/m2: 1.49ml/m2.04; 95% CI: 0.62, 2.35; P=0.001) and cardiac output (CO: difference per 3.58kg/m2: 0.11l/min/m1.83; 95% CI: 0.03, 0.19; P=0.01) but no strong evidence for a causal role on systemic vascular resistance or total arterial compliance. Neither analysis supported a causal role of higher BMI on heart rate. Conclusions Complementary MR and RbG causal methodologies, together with a range of sensitivity analyses, suggest that higher BMI is likely to cause worse cardiovascular health, specifically higher BP and LVMI, even in youth. Higher BMI also resulted in increased CO in the RbG study, which appeared to be solely driven by SV, as neither MR nor RbG analyses suggested a causal effect of BMI on heart rate. These consistent results support efforts to reduce BMI from a young age to prevent later adverse cardiovascular health and illustrate the potential for phenotypic resolution with maintained analytical power using RbG.
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Affiliation(s)
- Kaitlin H. Wade
- Medical Research Council Integrative Epidemiology Unit (K.H.W., L.D.H., A.F., D.A.L., G.D.S., N.J.T.)
- Population Health Sciences, Bristol Medical School, Faculty of Health Sciences, University of Bristol, UK (K.H.W., L.D.H., D.A.L., G.D.S., N.J.T.)
| | - Scott T. Chiesa
- Vascular Physiology Unit, Institute of Cardiovascular Science, University College London, UK (S.T.C, M.C., A.R., V.M., T.K., N.F., J.E.D.)
| | - Alun D. Hughes
- Cardiometabolic Phenotyping Group, Institute of Cardiovascular Science, University College London, UK (A.D.H., A.R., N.C.)
| | - Nish Chaturvedi
- Cardiometabolic Phenotyping Group, Institute of Cardiovascular Science, University College London, UK (A.D.H., A.R., N.C.)
| | - Marietta Charakida
- Vascular Physiology Unit, Institute of Cardiovascular Science, University College London, UK (S.T.C, M.C., A.R., V.M., T.K., N.F., J.E.D.)
| | - Alicja Rapala
- Vascular Physiology Unit, Institute of Cardiovascular Science, University College London, UK (S.T.C, M.C., A.R., V.M., T.K., N.F., J.E.D.)
- Cardiometabolic Phenotyping Group, Institute of Cardiovascular Science, University College London, UK (A.D.H., A.R., N.C.)
| | - Vivek Muthurangu
- Vascular Physiology Unit, Institute of Cardiovascular Science, University College London, UK (S.T.C, M.C., A.R., V.M., T.K., N.F., J.E.D.)
| | - Tauseef Khan
- Vascular Physiology Unit, Institute of Cardiovascular Science, University College London, UK (S.T.C, M.C., A.R., V.M., T.K., N.F., J.E.D.)
| | - Nicholas Finer
- Vascular Physiology Unit, Institute of Cardiovascular Science, University College London, UK (S.T.C, M.C., A.R., V.M., T.K., N.F., J.E.D.)
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, British Heart Foundation (BHF) Glasgow Cardiovascular Research Centre, University of Glasgow, UK (N.S.)
| | - Laura D. Howe
- Medical Research Council Integrative Epidemiology Unit (K.H.W., L.D.H., A.F., D.A.L., G.D.S., N.J.T.)
- Population Health Sciences, Bristol Medical School, Faculty of Health Sciences, University of Bristol, UK (K.H.W., L.D.H., D.A.L., G.D.S., N.J.T.)
| | - Abigail Fraser
- Medical Research Council Integrative Epidemiology Unit (K.H.W., L.D.H., A.F., D.A.L., G.D.S., N.J.T.)
- Population Health Sciences, Bristol Medical School, Faculty of Health Sciences, University of Bristol, UK (K.H.W., L.D.H., D.A.L., G.D.S., N.J.T.)
| | - Debbie A. Lawlor
- Medical Research Council Integrative Epidemiology Unit (K.H.W., L.D.H., A.F., D.A.L., G.D.S., N.J.T.)
- Population Health Sciences, Bristol Medical School, Faculty of Health Sciences, University of Bristol, UK (K.H.W., L.D.H., D.A.L., G.D.S., N.J.T.)
| | - George Davey Smith
- Medical Research Council Integrative Epidemiology Unit (K.H.W., L.D.H., A.F., D.A.L., G.D.S., N.J.T.)
- Population Health Sciences, Bristol Medical School, Faculty of Health Sciences, University of Bristol, UK (K.H.W., L.D.H., D.A.L., G.D.S., N.J.T.)
| | - John E. Deanfield
- Vascular Physiology Unit, Institute of Cardiovascular Science, University College London, UK (S.T.C, M.C., A.R., V.M., T.K., N.F., J.E.D.)
| | - Nicholas J. Timpson
- Medical Research Council Integrative Epidemiology Unit (K.H.W., L.D.H., A.F., D.A.L., G.D.S., N.J.T.)
- Population Health Sciences, Bristol Medical School, Faculty of Health Sciences, University of Bristol, UK (K.H.W., L.D.H., D.A.L., G.D.S., N.J.T.)
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Isaykina OY, Rozanov VB, Alexandrov AA, Ivanova EI, Pugoeva HS. Influence of Childhood and Adulthood Obesity on Arterial Stiffnes and Central Blood Pressure in Men. RATIONAL PHARMACOTHERAPY IN CARDIOLOGY 2018. [DOI: 10.20996/1819-6446-2018-14-4-543-551] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Maritz M, Fourie CMT, Van Rooyen JM, Schutte AE. Evaluating several biomarkers as predictors of aortic stiffness in young and older Africans, not consuming alcohol based on self-report. Diabetes Res Clin Pract 2018; 142:312-320. [PMID: 29906479 DOI: 10.1016/j.diabres.2018.05.048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 05/02/2018] [Accepted: 05/30/2018] [Indexed: 12/17/2022]
Abstract
AIMS Black populations from sub-Saharan Africa have a high prevalence of cardiovascular disease, which places significant strain on public health systems. Aortic stiffness is a prominent risk factor for cardiovascular disease development. We reported earlier that excessive alcohol use predicts aortic stiffness. However, we require a better understanding of other biomarkers involved in stiffness development, beyond alcohol use. Therefore, we determined which biomarkers (metabolic, inflammatory, endothelial activation and oxidative stress) relate to aortic stiffness in young and older black South Africans, self-reporting no alcohol-use. METHODS We included cross-sectional data from young (aged 24.7 ± 3.24 years) black adults participating in the African Prospective study on the Early Detection and Identification of Cardiovascular Disease and Hypertension (African-PREDICT) study (N = 216), and five-year follow-up data from older (aged 61.6 ± 9.77 years) black adults (N = 322) participating in the South African leg of the Prospective Urban and Rural Epidemiology study, conducted in the North West Province (PURE-SA-NWP). We excluded all participants self-reporting alcohol use. We determined biomarkers from blood samples, and measured carotid-femoral pulse wave velocity (PWV). RESULTS Of all biomarkers investigated in multivariable-adjusted regression analyses, only plasma glucose (R2 = 0.24, β = 0.21, p < 0.001) and glycated haemoglobin (R2 = 0.22, β = 0.17, p = 0.002) independently predicted PWV five years later in older adults. We found no other associations in young or older black adults. CONCLUSION Dysglycaemia independently predicted aortic stiffness after five years in older black adults. Life-course management of body weight and sugar intake are important in preventing early vascular ageing and subsequent cardiovascular disease development in Africa.
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Affiliation(s)
- Melissa Maritz
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa
| | - Carla M T Fourie
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa; MRC Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa.
| | - Johannes M Van Rooyen
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa; MRC Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Aletta E Schutte
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa; MRC Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
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Association between abdominal adiposity and 20-year subsequent aortic stiffness in an initially healthy population-based cohort. J Hypertens 2018; 36:2077-2084. [PMID: 29878971 DOI: 10.1097/hjh.0000000000001796] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Aortic stiffness is a feature of arterial aging and is associated with dismal cardiovascular prognosis. We examined whether central and general adiposity is an independent predictor of accelerated aortic stiffening 20 years later in initially healthy midlife individuals. METHODS Participants from the STANISLAS cohort study (826 initially healthy participants aged 30-60 from the Lorraine region in France) underwent clinical and biological measurements at baseline (1994-1995) and after ≈20 years (2011-2016). Adiposity measurements included waist circumference/BMI ratio, BMI, waist circumference, and 'body shape index' [waist circumference/(BMI height)]. Real carotid-femoral pulse wave velocity (cfPWV) was measured at end of follow-up. Our primary analysis was to test the association between waist circumference/BMI ratio and cfPWV. RESULTS In a multiple linear regression model adjusted for sex, age and mean arterial pressure, waist circumference -to-BMI ratio was positively associated (for 1SD increase) with higher cfPWV [regression coefficient β = 0.32, 95% confidence interval (CI) 0.19-0.45, P < 0.001]. The cfPWV was less strongly associated with body shape index (β = 0.17, 95% CI 0.022-0.32, P < 0.05) and negatively associated with BMI (-0.20, 95% CI -0.31 to -0.093, P < 0.001) and waist circumference (-0.14, 95% CI -0.28 to 0.00, P < 0.05). Sensitivity analyses demonstrated that the risk of cfPWV associated with waist circumference-to-BMI ratio remained significant after adjustment for heart rate, metabolic risk factors and inflammatory markers. CONCLUSION Central adiposity (and more specifically waist circumference-to-BMI ratio) is an independent predictor of 20-year subsequent aortic stiffness in initially healthy midlife subjects.
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Miao R, Wu L, Ni P, Zeng Y, Chen Z. The comorbidity of increased arterial stiffness and microalbuminuria in a survey of middle-aged adults in China. BMC Cardiovasc Disord 2018; 18:83. [PMID: 29728070 PMCID: PMC5935953 DOI: 10.1186/s12872-018-0817-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 04/24/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Increased arterial stiffness (iAS) and microalbuminuria (MAU), which may occur simultaneously or separately in the general population and share similar risk factors, are markers of macro- and microvascular injuries. Our research investigated the comorbidity of iAS and MAU in the middle-aged population and examined the heterogeneous effects of metabolic risk factors on iAS and MAU. METHODS We selected 11,911 individuals aged 45 to 60 years who underwent a health examination at the 3rd Xiangya Hospital between 2010 and 2014. Metabolic syndrome (MetS) was determined according to IDF/NHLBI/AHA-2009 criteria. Multinomial logistic regression was applied to evaluate the influence of MetS, components of MetS and clusters of MetS on the co-occurrence (MAU(+)/iAS(+)) or non-co-occurrence (MAU(+)/iAS(-) and MAU(-)/iAS(+)) of MAU and iAS. RESULTS Reference group was MAU(-)/iAS(-). A positive effect of MetS on the presence of MAU(+)/iAS(-), MAU(-)/iAS(+), or MAU(+)/iAS(+) is listed in ascending order based on odds ratios (ORs = 2.11, 2.41, 4.61, respectively; P < 0.05). Compared with MAU(+)/iAS(-), Elevated blood pressure (BP) (OR = 1.62 vs. 4.83, P < 0.05), triglycerides(TG) (OR = 1.20 vs. 1.37, P < 0.05) were more strongly associated with MAU(-)/iAS(+), whereas fasting blood glucose (FBG) was less associated (OR = 1.37 vs. 1.31, P < 0.05). Decreased high-density lipoprotein cholesterol(HDL-c) (OR = 1.84, P < 0.01) and elevated waist circumference(WC) (OR = 1.28 P < 0.01) were the most strongly associated with MAU(+)/iAS(-). Compared with the individuals without MetS, individuals with the elevated BP, FBG, TG and decreased HDL-c cluster had the greatest likelihood of presenting a MAU(-)/iAS(+) (OR = 5.98, P < 0.01) and MAU(+)/iAS(+) (OR = 13.17, P < 0.01), these likelihood was even greater than the cluster with simultaneous alteration in all five MetS components (OR = 3.89 and 10.77, respectively, P < 0.01), which showed the most strongly association with MAU(+)/iAS(+) (OR = 5.22, P < 0.01). CONCLUSION Based on the heterogeneous influences of MetS-related risk factors on MAU and iAS, these influences could be selectively targeted to identify different types of vascular injuries.
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Affiliation(s)
- Rujia Miao
- Department of Health Management, the Third Xiangya Hospital, Central South University, Tongzipo Road 138, Changsha, 410013, Hunan Province, China
| | - Liuxin Wu
- Institute of Aviation Medicine, Beijing, China
| | - Ping Ni
- Statistics Department, Public Health Academy, Central South University, Changsha, Hunan, China
| | - Yue Zeng
- Department of Health Management, the Third Xiangya Hospital, Central South University, Tongzipo Road 138, Changsha, 410013, Hunan Province, China
| | - Zhiheng Chen
- Department of Health Management, the Third Xiangya Hospital, Central South University, Tongzipo Road 138, Changsha, 410013, Hunan Province, China.
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Königstein K, Infanger D, Klenk C, Hinrichs T, Rossmeissl A, Baumann S, Hafner B, Hanssen H, Schmidt-Trucksäss A. Does obesity attenuate the beneficial cardiovascular effects of cardiorespiratory fitness? Atherosclerosis 2018; 272:21-26. [PMID: 29544085 DOI: 10.1016/j.atherosclerosis.2018.03.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 02/09/2018] [Accepted: 03/07/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND AND AIMS Higher cardiorespiratory fitness is associated with lower pulse wave velocity and arterial stiffness in normal weight individuals, and this has not been examined in obese individuals. It is unclear whether an altered body composition acts as a modifier of the association between cardiorespiratory fitness and arterial stiffness. We examined the association between peak oxygen uptake and brachial-ankle pulse wave velocity and analysed whether body composition attenuates this association in obese middle-aged individuals. METHODS Bio-impedance analysis-derived body composition assessment in 212 healthy and sedentary either overweight or obese individuals was followed by measurement of brachial-ankle pulse wave velocity and spiroergometric peak oxygen uptake. Multivariate analysis was performed to analyse the association between peak oxygen uptake and brachial-ankle pulse wave velocity and to assess the moderating effect of several body composition-related interaction terms (BMI, total body mass, body fat mass, waist circumference, waist-to-height ratio) on this association. RESULTS Peak oxygen uptake was inversely associated with brachial-ankle pulse wave velocity (β = -0.059, 95% CI = -0.099; -0.018, p = 0.005). Testing for the impact of different body composition-related interaction terms on this association showed no significance, 95% CI lateralized towards positivity. CONCLUSIONS This study shows an inverse association between cardiorespiratory fitness and arterial stiffness in middle-aged obese individuals. We also found a tendency towards an attenuating impact of an obese body composition on this association. Physical fitness seems to be a stronger modulator of cardiovascular risk than body composition but the success of training efforts may be compromised by obesity.
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Affiliation(s)
- Karsten Königstein
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Basel, Switzerland.
| | - Denis Infanger
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Basel, Switzerland
| | - Christopher Klenk
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Basel, Switzerland
| | - Timo Hinrichs
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Basel, Switzerland
| | - Anja Rossmeissl
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Basel, Switzerland
| | - Sandra Baumann
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Basel, Switzerland
| | - Benjamin Hafner
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Basel, Switzerland
| | - Henner Hanssen
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Basel, Switzerland
| | - Arno Schmidt-Trucksäss
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Basel, Switzerland.
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Mestanik M, Jurko A, Spronck B, Avolio AP, Butlin M, Jurko T, Visnovcova Z, Mestanikova A, Langer P, Tonhajzerova I. Improved assessment of arterial stiffness using corrected cardio-ankle vascular index (CAVI 0) in overweight adolescents with white-coat and essential hypertension. Scandinavian Journal of Clinical and Laboratory Investigation 2017; 77:665-672. [PMID: 29103321 DOI: 10.1080/00365513.2017.1397286] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Arterial stiffness is a marker of vascular damage. Although adiposity increases cardiovascular risk, the relationship between paediatric overweight and arterial stiffness is unclear. The study aimed to evaluate the simultaneous effect of hypertension and overweight on arterial stiffness using cardio-ankle vascular index (CAVI) and related novel, theoretically blood pressure (BP)-independent, index CAVI0. CAVI and CAVI0 were measured in 140 adolescent boys (16.0 ± 1.9 years) divided into age-matched groups: normal-weight normotensives, overweight normotensives, overweight white-coat hypertensives, and overweight essential hypertensives. Overweight normotensives had significantly lower CAVI and CAVI0 compared to normal-weight normotensives (4.81 ± 0.64 vs. 5.33 ± 0.66, p < .01; 7.10 ± 0.99 vs. 7.81 ± 1.00, p < .01, respectively). CAVI and CAVI0 in overweight essential hypertensives showed no significant difference compared to normal-weight normotensives and were significantly higher compared to overweight normotensives (5.32 ± 0.77 vs. 4.81 ± 0.64, p < .01; 7.77 ± 1.19 vs. 7.10 ± 0.99, p < .01, respectively). CAVI, but not CAVI0, was associated positively with diastolic pressure (0.022 mmHg-1, p = .002) and negatively with pulse pressure (-0.022 mmHg-1, p = .001), and it was significantly higher in overweight white-coat hypertensives compared to overweight normotensives (5.20 ± 0.63 vs. 4.81 ± 0.64, p < .05). The lowering effect of overweight on arterial stiffness indexed by CAVI and CAVI0 in hypertensive adolescents seems to counterbalance the early arteriosclerotic effect of essential hypertension. The increase in CAVI, but not CAVI0, in overweight white-coat hypertensives could be attributable to residual BP dependence of CAVI, which is not present in CAVI0. Under certain conditions, CAVI0 may offer a clinically relevant improved assessment of arterial stiffness superior to CAVI.
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Affiliation(s)
- Michal Mestanik
- a Biomedical Center Martin , Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin (JFM CU) , Martin , Slovak Republic.,b Department of Physiology , JFM CU , Martin , Slovak Republic
| | | | - Bart Spronck
- d Department of Biomedical Sciences, Faculty of Medicine and Health Sciences , Macquarie University , Sydney , NSW , Australia
| | - Alberto P Avolio
- d Department of Biomedical Sciences, Faculty of Medicine and Health Sciences , Macquarie University , Sydney , NSW , Australia
| | - Mark Butlin
- d Department of Biomedical Sciences, Faculty of Medicine and Health Sciences , Macquarie University , Sydney , NSW , Australia
| | - Tomas Jurko
- e Clinic of Neonatology , JFM CU, University Hospital Martin , Martin , Slovak Republic
| | - Zuzana Visnovcova
- a Biomedical Center Martin , Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin (JFM CU) , Martin , Slovak Republic.,b Department of Physiology , JFM CU , Martin , Slovak Republic
| | - Andrea Mestanikova
- a Biomedical Center Martin , Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin (JFM CU) , Martin , Slovak Republic.,b Department of Physiology , JFM CU , Martin , Slovak Republic
| | - Peter Langer
- f Institute of Scientific Instruments, The Czech Academy of Sciences , Brno , Czech Republic.,g International Clinical Research Center , St. Anne's University Hospital Brno , Brno , Czech Republic
| | - Ingrid Tonhajzerova
- a Biomedical Center Martin , Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin (JFM CU) , Martin , Slovak Republic.,b Department of Physiology , JFM CU , Martin , Slovak Republic
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Ye Z, Pellikka PA, Kullo IJ. Sex differences in associations of cardio-ankle vascular index with left ventricular function and geometry. Vasc Med 2017; 22:465-472. [PMID: 28931350 DOI: 10.1177/1358863x17725810] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
The cardio-ankle vascular index (CAVI) is a measure of global arterial stiffness. We hypothesized that CAVI is associated with left ventricular (LV) function and geometry in individuals without structural heart disease. We measured CAVI in 600 participants (mean age 60.3±14.6 years, 54% men) without history of atherosclerotic cardiovascular disease who were referred for transthoracic echocardiography. Linear regression analysis was used to assess the association of CAVI with LV function (peak mitral annular systolic s' and early diastolic velocity e') and structure (LV mass index (LVMI) and relative wall thickness (RWT)). Older age, male sex, lower body mass index, history of hypertension, diabetes and chronic kidney disease were each associated with a higher CAVI (adjusted R2 = 0.56, all p < 0.01). A higher CAVI was associated with lower s' and e', and greater RWT, independent of age, sex, systolic BP and other conventional cardiovascular risk factors (all p < 0.05); a borderline association of higher CAVI with greater LVMI ( p = 0.05) was present. Associations with e', s' and RWT were similar in women and men but the association with LVMI was stronger in women than in men ( p for interaction = 0.02, multivariable-adjusted β = 6.92, p < 0.001 in women; p > 0.1 in men). In conclusion, a higher CAVI, a measure of global arterial stiffness, is associated with worse LV systolic function, worse diastolic relaxation, and greater LV RWT in both men and women, and with LVMI in women.
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Affiliation(s)
- Zi Ye
- Department of Cardiovascular Diseases and the Gonda Vascular Center, Mayo Clinic, Rochester, MN, USA
| | - Patricia A Pellikka
- Department of Cardiovascular Diseases and the Gonda Vascular Center, Mayo Clinic, Rochester, MN, USA
| | - Iftikhar J Kullo
- Department of Cardiovascular Diseases and the Gonda Vascular Center, Mayo Clinic, Rochester, MN, USA
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Rodríguez AJ, Karim MN, Srikanth V, Ebeling PR, Scott D. Lower muscle tissue is associated with higher pulse wave velocity: A systematic review and meta-analysis of observational study data. Clin Exp Pharmacol Physiol 2017; 44:980-992. [DOI: 10.1111/1440-1681.12805] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 06/11/2017] [Accepted: 06/13/2017] [Indexed: 12/23/2022]
Affiliation(s)
- Alexander J. Rodríguez
- Bone and Muscle Health Research Group; Department of Medicine; School of Clinical Sciences at Monash Health; Faculty of Medicine; Nursing and Health Sciences; Monash University; Clayton Australia
| | - Md N. Karim
- Department of Epidemiology and Preventive Medicine; School of Public Health and Preventive Medicine; Faculty of Medicine; Nursing and Health Sciences; Monash University; Prahan Australia
| | - Velandai Srikanth
- Stroke and Ageing Research Group; Department of Medicine; School of Clinical Sciences; Faculty of Medicine; Nursing and Health Sciences; Monash University; Clayton Australia
| | - Peter R. Ebeling
- Bone and Muscle Health Research Group; Department of Medicine; School of Clinical Sciences at Monash Health; Faculty of Medicine; Nursing and Health Sciences; Monash University; Clayton Australia
- Melbourne Medical School (Western Campus); Department of Medicine; The University of Melbourne; St Albans Australia
| | - David Scott
- Bone and Muscle Health Research Group; Department of Medicine; School of Clinical Sciences at Monash Health; Faculty of Medicine; Nursing and Health Sciences; Monash University; Clayton Australia
- Melbourne Medical School (Western Campus); Department of Medicine; The University of Melbourne; St Albans Australia
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Whole grain consumption is negatively correlated with obesity-associated aortic stiffness: A hypothesis. Nutrition 2017; 45:32-36. [PMID: 29129234 DOI: 10.1016/j.nut.2017.06.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Revised: 06/16/2017] [Accepted: 06/29/2017] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Obesity is a risk factor for cardiovascular disease that increases aortic stiffness, which predicts future cardiovascular events. Additionally, obesity is associated with overconsumption, which contributes to aortic stiffening. Recent work has highlighted the role of various foods and nutrients on aortic stiffness among the general population. The objective of the present study was to explore the influence of dietary factors on obesity-associated aortic stiffness, as food choices might be a potential explanation for accelerated aortic stiffening in obesity rather than overconsumption alone. METHODS Data collected in our laboratory were evaluated in aggregate considering obese men with available measures of aortic stiffness and habitual dietary intake (n = 22). Aortic stiffness was assessed with the gold standard carotid-femoral pulse wave velocity, and habitual dietary intake was determined with the National Institutes of Health's Dietary History Questionnaire-II. RESULTS Whole grain consumption predicted obesity-associated aortic stiffness in regression analyses (R2 = 0.29, P = 0.010). This correlation remained significant after adjusting for traditional risk factors (age, body mass index, blood pressure) (R2 = 0.27, P = 0.027). Overconsumption determined by daily caloric intake was not predictive of aortic stiffness (R2 = 0.09, P = 0.17) nor was total fiber content (R2 = 0.06, P = 0.29). CONCLUSIONS These findings suggest a potential role of whole grains to protect against aortic stiffness even when dietary overconsumption is present. Fiber content has been proposed as a major beneficial component in whole grains, but it did not correlate with obesity-related aortic stiffness, suggesting whole grains may have a unique and potentially synergistic role in the protection of obesity-associated aortic health.
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Kim TJ, Shin HY, Chang Y, Kang M, Jee J, Choi YH, Ahn HS, Ahn SH, Son HJ, Ryu S. Metabolically healthy obesity and the risk for subclinical atherosclerosis. Atherosclerosis 2017; 262:191-197. [DOI: 10.1016/j.atherosclerosis.2017.03.035] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Revised: 02/27/2017] [Accepted: 03/22/2017] [Indexed: 01/23/2023]
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Lovic D, Kallistratos MS, Poulimenos L, Skyrlas A, Stojanov V, Jakovljevic B, Zdravkovic M, Koracevic G, Chamodraka E, Kouremenos N, Pittaras A, Kokkinos P, Tsinivizov P, Manolis A. Pulse Wave Velocity: Retrospective Analysis in a Balkan Normotensive and Hypertensive Population: A Study of 9923 Patients. Angiology 2017; 69:59-64. [PMID: 28514871 DOI: 10.1177/0003319717709859] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We compared pulse wave velocity (PWV) between hypertensive patients and control patients to identify demographics and patient characteristics related to PWV. We retrospectively analyzed 9923 participants (3105 controls and 6818 hypertensive patients) from 5 outpatient hypertensive clinics (in Serbia and Greece). Pulse wave velocity had different distribution between controls and hypertensive patients ( P < .001). The magnitude of PWV increase was related to blood pressure (BP) category (from optimal to stage III hypertension; P < .001). Even in hypertensive patients with systolic BP (SBP) <140 and/or diastolic BP (DBP) <90 mm Hg, PWV was greater than in control patients ( P < .001). Pulse wave velocity was associated with almost all baseline characteristics of hypertensive patients (body mass index [BMI], gender, age, SBP, DBP, smoking status, and heart rate; P < .001). This association remained after adjustment of PWV confounders. There were 2231 (32.7%) hypertensive patients who had reached SBP <140 mm Hg and DBP <90 mm Hg. Pulse wave velocity was increased in hypertensive patients, and the degree of PWV increase was associated with baseline BP as well as with anthropometric parameters (eg, BMI, gender, age, heart rate, and smoking status).
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Affiliation(s)
- Dragan Lovic
- 1 Clinic for Internal Disease Intermedica, Niš, Serbia.,2 Veterans Affairs Medical Center, Washington, DC, USA
| | | | | | - Aggelos Skyrlas
- 3 Department of Cardiology, Asklepieion General Hospital, Athens, Greece
| | - V Stojanov
- 4 Internal Medicine Department, Clinical Center Serbia, University Belgrade Medical School, Belgrade, Serbia
| | - B Jakovljevic
- 4 Internal Medicine Department, Clinical Center Serbia, University Belgrade Medical School, Belgrade, Serbia
| | - M Zdravkovic
- 5 Internal Medicine Department, Clinical Hospital Bezanijska Kosa, University Belgrade Medical School, Belgrade, Serbia
| | - G Koracevic
- 6 Internal Medicine Department, Clinical Center Niš, University Niš Medical School, Niš, Serbia
| | | | - Nikos Kouremenos
- 3 Department of Cardiology, Asklepieion General Hospital, Athens, Greece
| | - Andreas Pittaras
- 2 Veterans Affairs Medical Center, Washington, DC, USA.,3 Department of Cardiology, Asklepieion General Hospital, Athens, Greece
| | | | - Pavlos Tsinivizov
- 3 Department of Cardiology, Asklepieion General Hospital, Athens, Greece
| | - Athanasios Manolis
- 3 Department of Cardiology, Asklepieion General Hospital, Athens, Greece
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Li P, Wang L, Liu C. Overweightness, obesity and arterial stiffness in healthy subjects: a systematic review and meta-analysis of literature studies. Postgrad Med 2016; 129:224-230. [PMID: 27915493 DOI: 10.1080/00325481.2017.1268903] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The relationship between overweightness, obesity and arterial stiffness remains unclear. We performed a meta-analysis evaluating the impact of obesity/overweightness on arterial stiffness in healthy subjects. METHODS Literature searches were conducted using databases (eg, MEDLINE, EMBASE) and citations cross-referenced. Studies evaluating the relationship between obesity/overweightness and cfPWV, baPWV, and AIx were systematically searched. A total of 10 studies (1,124 obese/overweight subjects, 1,884 controls) were included. RESULTS Compared to controls, obese/overweight subjects showed a significantly higher cfPWV (SMD 0.50 m/s; 95%CI 0.15, 0.86; P = 0.005), baPWV (SMD 0.41 m/s; 95% CI 0.08, 0.74; P = 0.014), and AIx (SMD 1.02;95%CI 0.16, 1.87; P < 0.0001). When analyzing 'high quality' studies, the difference in arterial stiffness among obese/overweight subjects and controls remain (SMD 0.73 m/s; 95%CI 0.16, 1.30; P = 0.013). CONCLUSION Arterial stiffness, a recognized marker of cardio vascular risk, is increased in obese/overweight subjects without overt cardiovascular diseases.
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Affiliation(s)
- Ping Li
- a Department of Endocrinology, Beijing Shijitan Hospital , Capital Medical University , Beijing , China
| | - Lei Wang
- b Department of Radiology , Hebei General Hospital , Hebei Province , China
| | - Chao Liu
- c Department of Endocrinology , Hebei Medical University , Hebei Province , China
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Mitra S, Fernandez-Del-Valle M, Hill JE. The role of MRI in understanding the underlying mechanisms in obesity associated diseases. Biochim Biophys Acta Mol Basis Dis 2016; 1863:1115-1131. [PMID: 27639834 DOI: 10.1016/j.bbadis.2016.09.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 09/08/2016] [Accepted: 09/08/2016] [Indexed: 02/07/2023]
Abstract
Obesity and its possible association with diseases including diabetes and cardiovascular diseases have been studied for decades for its impact on healthcare. Recent studies clearly indicate the need for developing accurate and reproducible methodologies for assessing body fat content and distribution. Body fat distribution plays a significant role in developing an insight in the underlying mechanisms in which adipose tissue is linked with various diseases. Among imaging technologies including computerized axial tomography (CAT or CT), magnetic resonance imaging (MRI), and magnetic resonance spectroscopy (MRS), MRI and MRS seem to be the best emerging techniques and together are being considered as the gold standard for body fat content and distribution. This paper reviews studies up to the present time involving different methodologies of these two emerging technologies and presents the basic concepts of MRI and MRS with required novel image analysis techniques in accurate, quantitative, and direct assessment of body fat content and distribution. This article is part of a Special Issue entitled: Oxidative Stress and Mitochondrial Quality in Diabetes/Obesity and Critical Illness Spectrum of Diseases - edited by P. Hemachandra Reddy.
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Affiliation(s)
| | | | - Jason E Hill
- Texas Tech University, Lubbock, TX, United States
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How to estimate aortic characteristic impedance from magnetic resonance and applanation tonometry data? J Hypertens 2016; 33:575-82; discussion 583. [PMID: 25629364 DOI: 10.1097/hjh.0000000000000448] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Compare seven previous methods for the estimation of aortic characteristic impedance, which contributes to left ventricle pulsatile load, from phase-contrast cardiovascular magnetic resonance (CMR) and applanation tonometry data. METHODS We studied 77 healthy (43 ± 16 years) individuals and 16 hypertensive (61 ± 9 years) patients, who consecutively underwent ascending aorta CMR and carotid tonometry, resulting in flow and pressure waveforms, respectively. Characteristic impedance was semi-automatically estimated in time domain from these latter waveforms, using seven methods. The methods were based on the following: methods 1-4, magnitudes at specific times; method 5, early-systolic up-slope; method 6, time-derivatives peak; and method 7, pressure-flow loop early-systolic slope. RESULTS Aortic characteristic impedance was significantly increased in hypertensive patients when compared to elderly controls (n = 32) with a similar mean age of (59 ± 8 years) when using methods based on 95% of peak flow, up-slopes, and derivatives peaks (P < 0.05). When considering healthy individuals, impedance indices were significantly correlated to central pulse pressure for all methods (P < 0.005). Finally, characteristic impedance was correlated to the frequency-domain reference values (r > 0.65, P < 0.0001), with a slight superiority for the same three methods as above (r > 0.82, P < 0.0001). CONCLUSIONS This is the first study demonstrating phase-contrast CMR and tonometry usefulness in aortic characteristic impedance temporal estimation. Methods based on 95% of peak flow, as well as those based on derivative peaks and up-slopes, which are fast and independent of curve preprocessing, were slightly superior. They can be easily integrated in a clinical workflow and may help to understand the complementarity of this pulsatile index with other CMR aortic geometry and stiffness measures in the setting of left ventricle-aortic coupling.
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The association of nonalcoholic fatty liver disease with central and peripheral blood pressure in adolescence: findings from a cross-sectional study. J Hypertens 2016; 33:546-52; discussion 553. [PMID: 25426570 PMCID: PMC4318641 DOI: 10.1097/hjh.0000000000000445] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Objectives: We aimed to determine the association of nonalcoholic fatty liver disease (NAFLD) with central and peripheral blood pressure (BP), in a general adolescent population and to examine whether associations are independent of adiposity. Methods: Using cross-sectional data from a subsample (N = 1904) of a UK birth cohort, we assessed markers of NAFLD including ultrasound scan (USS) determined fatty liver, shear velocity (marker of liver fibrosis), alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma-glutamyltransferase (GGT) at a mean age of 17.8 years. These were related to BP [central and peripheral SBP and DBP and mean arterial pressure (MAP)]. Results: Fatty liver was positively associated with central and peripheral SBP, DBP and MAP in models adjusting for age, sex, social class, puberty and alcohol intake. These positive associations were attenuated to the null when fat mass was included. For example, in confounder-adjusted models, not including fat mass, mean central SBP was 3.74 mmHg [95% confidence interval (CI) 1.12 to 6.36] higher in adolescents with USS fatty liver than in those without; with additional adjustment for fat mass, the association attenuated to the null value (−0.37 mmHg; 95% CI –3.09 to 2.36). Similar patterns were found for associations of ALT and GGT with central and peripheral BP. There was no consistent evidence of associations of shear velocity or AST with BP measurements. Fatty liver was not consistently associated with central pulse pressure (PP), peripheral PP and Aix@75. Conclusion: NAFLD is not associated with higher central or peripheral BP in adolescents once confounding by adiposity is taken into account.
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Abstract
BACKGROUND Obesity is an important risk factor for cardiovascular disease and has become a major concern in healthcare due to its high prevalence worldwide. The aim of the present study was to investigate the impact of BMI on central blood pressure (BP) and pulse wave velocity (PWV) in normotensive and hypertensive patients. PATIENTS AND METHODS Normotensive and hypertensive adult patients who attended the outpatient clinic of cardiovascular risk were included. Peripheral BP was obtained in the brachial artery by using an oscillometric device (OMRON M-6). Central aortic BP waveform was reconstructed from the radial artery pressure waveforms (SphygmoCor, AtCor Medical, Sydney, Australia) and central BP was calculated. Carotid-femoral PWV was measured by an automatic device (Complior, Artech, France). RESULTS We examined a total of 351 patients [50.7% women; 77 patients normal-weight (BMI < 25 kg/m)], 274 patients overweight or obese (BMI ≥25 kg/m). Central SBP showed a positive association with male sex and mean BP, but a negative association with overweight/obesity. PWV was positively associated with age, male sex, central BP, peripheral BP and BP treatment, whereas BMI of at least 25 kg/m led to a decrease in PWV in patients with the same central SBP levels. Likewise, PWV was lower in the overweight/obese group compared to the normal-weight group at the same central SBP. CONCLUSION Overweight and obesity tend to have lower central SBP as compared to lean patients, mainly in women. Further research is required to assess the interaction between body weight and vascular dynamics and their clinical implications.
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Gando Y, Murakami H, Kawakami R, Yamamoto K, Kawano H, Tanaka N, Sawada SS, Miyatake N, Miyachi M. Cardiorespiratory Fitness Suppresses Age-Related Arterial Stiffening in Healthy Adults: A 2-Year Longitudinal Observational Study. J Clin Hypertens (Greenwich) 2016; 18:292-8. [PMID: 26663866 PMCID: PMC8031982 DOI: 10.1111/jch.12753] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 09/09/2015] [Accepted: 09/22/2015] [Indexed: 11/29/2022]
Abstract
Cardiorespiratory fitness is negatively associated with arterial stiffness, although it is unclear whether it is associated with prospective arterial stiffness changes. The authors examined cardiorespiratory fitness and arterial stiffness progression in a 2-year follow-up study of 470 healthy men and women aged 26 to 69 years. Peak oxygen uptake (V˙O2peak) was measured at baseline using a graded cycle exercise test. Arterial stiffness was assessed using brachial-ankle pulse wave velocity (baPWV) at baseline and after 2 years. Two-year changes in baPWV were significantly higher in patients in the lowest V˙O2peak tertile (28.8±7.6 cm/s) compared with those in the highest V˙O2peak tertile (-1.4±7.5 cm/s) (P=.024) and were inversely correlated with V˙O2peak (r=-.112, P=.015). Stepwise multiple regression analysis revealed that age, glucose, baPWV, V˙O2peak, and sex were independent correlates of 2-year changes in baPWV, suggesting that higher cardiorespiratory fitness is associated with age-related arterial stiffening suppression.
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Affiliation(s)
- Yuko Gando
- Department of Health Promotion and ExerciseNational Institutes of Biomedical Innovation, Health and NutritionTokyoJapan
| | - Haruka Murakami
- Department of Health Promotion and ExerciseNational Institutes of Biomedical Innovation, Health and NutritionTokyoJapan
| | - Ryoko Kawakami
- Department of Health Promotion and ExerciseNational Institutes of Biomedical Innovation, Health and NutritionTokyoJapan
- Faculty of Sport SciencesWaseda UniversitySaitamaJapan
| | - Kenta Yamamoto
- Department of Health Promotion and ExerciseNational Institutes of Biomedical Innovation, Health and NutritionTokyoJapan
- Faculty of Pharmaceutical SciencesTeikyo Heisei UniversityTokyoJapan
| | - Hiroshi Kawano
- Department of Health Promotion and ExerciseNational Institutes of Biomedical Innovation, Health and NutritionTokyoJapan
- Faculty of LettersKokushikan UniversityTokyoJapan
| | - Noriko Tanaka
- Department of Health Promotion and ExerciseNational Institutes of Biomedical Innovation, Health and NutritionTokyoJapan
- Research Center of Health, Physical Fitness and SportsNagoya UniversityNagoyaJapan
| | - Susumu S. Sawada
- Department of Health Promotion and ExerciseNational Institutes of Biomedical Innovation, Health and NutritionTokyoJapan
| | - Nobuyuki Miyatake
- Department of HygieneFaculty of MedicineKagawa UniversityMikiKagawaJapan
| | - Motohiko Miyachi
- Department of Health Promotion and ExerciseNational Institutes of Biomedical Innovation, Health and NutritionTokyoJapan
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Dawes TJW, Gandhi A, de Marvao A, Buzaco R, Tokarczuk P, Quinlan M, Durighel G, Diamond T, Monje Garcia L, de Cesare A, Cook SA, O'Regan DP. Pulmonary Artery Stiffness Is Independently Associated with Right Ventricular Mass and Function: A Cardiac MR Imaging Study. Radiology 2016; 280:398-404. [PMID: 26909648 DOI: 10.1148/radiol.2016151527] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Purpose To determine the relationship between pulmonary artery (PA) stiffness and both right ventricular (RV) mass and function with cardiac magnetic resonance (MR) imaging. Materials and Methods The study was approved by the local research ethics committee, and all participants gave written informed consent. Cardiac MR imaging was performed at 1.5 T in 156 healthy volunteers (63% women; age range, 19-61 years; mean age, 36.1 years). High-temporal-resolution phase-contrast imaging was performed in the main and right PAs. Pulmonary pulse wave velocity (PWV) was determined by the interval between arterial systolic upslopes. RV function was assessed with feature tracking to derive peak systolic strain and strain rate, as well as peak early-diastolic strain rate. RV volumes, ejection fraction (RVEF), and mass were measured from the cine images. The association of pulmonary PWV with RV function and mass was quantified with univariate linear regression. Interstudy repeatability was assessed with intraclass correlation. Results The repeatability coefficient for pulmonary PWV was 0.96. Increases in pulmonary PWV and RVEF were associated with increases in age (r = 0.32, P < .001 and r = 0.18, P = .025, respectively). After adjusting for age (P = .090), body surface area (P = .073), and sex (P = .005), pulmonary PWV demonstrated an independent positive association with RVEF (r = 0.34, P = .026). Significant associations were also seen with RV mass (r = 0.41, P = .004), RV radial strain (r = 0.38, P = .022), and strain rate (r = 0.35, P = .002), and independent negative associations were seen with radial (r = 0.27, P = .003), longitudinal (r = 0.40, P = .007), and circumferential (r = 0.31, P = .005) peak early-diastolic strain rate with the same covariates. Conclusion Pulmonary PWV is reliably assessed with cardiac MR imaging. In subjects with no known cardiovascular disease, increasing PA stiffness is associated with increasing age and is also moderately associated with both RV mass and function after controlling for age, body surface area, and sex. (©) RSNA, 2016 Online supplemental material is available for this article.
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Affiliation(s)
- Timothy J W Dawes
- From the Medical Research Council Clinical Sciences Centre, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, W12 0HS, England (T.J.W.D., A.d.M., R.B., P.T., M.Q., G.D., T.D., L.M.G., S.A.C., D.P.O'R.); Department of Cardiology, Imperial College NHS Healthcare Trust, London, England (A.G.); and Sorbonne Universités, UPMC Univ Paris 06, INSERM UMR_S 1146, CNRS UMR 7371, Lib, Paris, France (A.d.C.)
| | - Ajay Gandhi
- From the Medical Research Council Clinical Sciences Centre, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, W12 0HS, England (T.J.W.D., A.d.M., R.B., P.T., M.Q., G.D., T.D., L.M.G., S.A.C., D.P.O'R.); Department of Cardiology, Imperial College NHS Healthcare Trust, London, England (A.G.); and Sorbonne Universités, UPMC Univ Paris 06, INSERM UMR_S 1146, CNRS UMR 7371, Lib, Paris, France (A.d.C.)
| | - Antonio de Marvao
- From the Medical Research Council Clinical Sciences Centre, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, W12 0HS, England (T.J.W.D., A.d.M., R.B., P.T., M.Q., G.D., T.D., L.M.G., S.A.C., D.P.O'R.); Department of Cardiology, Imperial College NHS Healthcare Trust, London, England (A.G.); and Sorbonne Universités, UPMC Univ Paris 06, INSERM UMR_S 1146, CNRS UMR 7371, Lib, Paris, France (A.d.C.)
| | - Rui Buzaco
- From the Medical Research Council Clinical Sciences Centre, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, W12 0HS, England (T.J.W.D., A.d.M., R.B., P.T., M.Q., G.D., T.D., L.M.G., S.A.C., D.P.O'R.); Department of Cardiology, Imperial College NHS Healthcare Trust, London, England (A.G.); and Sorbonne Universités, UPMC Univ Paris 06, INSERM UMR_S 1146, CNRS UMR 7371, Lib, Paris, France (A.d.C.)
| | - Paweł Tokarczuk
- From the Medical Research Council Clinical Sciences Centre, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, W12 0HS, England (T.J.W.D., A.d.M., R.B., P.T., M.Q., G.D., T.D., L.M.G., S.A.C., D.P.O'R.); Department of Cardiology, Imperial College NHS Healthcare Trust, London, England (A.G.); and Sorbonne Universités, UPMC Univ Paris 06, INSERM UMR_S 1146, CNRS UMR 7371, Lib, Paris, France (A.d.C.)
| | - Marina Quinlan
- From the Medical Research Council Clinical Sciences Centre, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, W12 0HS, England (T.J.W.D., A.d.M., R.B., P.T., M.Q., G.D., T.D., L.M.G., S.A.C., D.P.O'R.); Department of Cardiology, Imperial College NHS Healthcare Trust, London, England (A.G.); and Sorbonne Universités, UPMC Univ Paris 06, INSERM UMR_S 1146, CNRS UMR 7371, Lib, Paris, France (A.d.C.)
| | - Giuliana Durighel
- From the Medical Research Council Clinical Sciences Centre, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, W12 0HS, England (T.J.W.D., A.d.M., R.B., P.T., M.Q., G.D., T.D., L.M.G., S.A.C., D.P.O'R.); Department of Cardiology, Imperial College NHS Healthcare Trust, London, England (A.G.); and Sorbonne Universités, UPMC Univ Paris 06, INSERM UMR_S 1146, CNRS UMR 7371, Lib, Paris, France (A.d.C.)
| | - Tamara Diamond
- From the Medical Research Council Clinical Sciences Centre, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, W12 0HS, England (T.J.W.D., A.d.M., R.B., P.T., M.Q., G.D., T.D., L.M.G., S.A.C., D.P.O'R.); Department of Cardiology, Imperial College NHS Healthcare Trust, London, England (A.G.); and Sorbonne Universités, UPMC Univ Paris 06, INSERM UMR_S 1146, CNRS UMR 7371, Lib, Paris, France (A.d.C.)
| | - Laura Monje Garcia
- From the Medical Research Council Clinical Sciences Centre, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, W12 0HS, England (T.J.W.D., A.d.M., R.B., P.T., M.Q., G.D., T.D., L.M.G., S.A.C., D.P.O'R.); Department of Cardiology, Imperial College NHS Healthcare Trust, London, England (A.G.); and Sorbonne Universités, UPMC Univ Paris 06, INSERM UMR_S 1146, CNRS UMR 7371, Lib, Paris, France (A.d.C.)
| | - Alain de Cesare
- From the Medical Research Council Clinical Sciences Centre, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, W12 0HS, England (T.J.W.D., A.d.M., R.B., P.T., M.Q., G.D., T.D., L.M.G., S.A.C., D.P.O'R.); Department of Cardiology, Imperial College NHS Healthcare Trust, London, England (A.G.); and Sorbonne Universités, UPMC Univ Paris 06, INSERM UMR_S 1146, CNRS UMR 7371, Lib, Paris, France (A.d.C.)
| | - Stuart A Cook
- From the Medical Research Council Clinical Sciences Centre, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, W12 0HS, England (T.J.W.D., A.d.M., R.B., P.T., M.Q., G.D., T.D., L.M.G., S.A.C., D.P.O'R.); Department of Cardiology, Imperial College NHS Healthcare Trust, London, England (A.G.); and Sorbonne Universités, UPMC Univ Paris 06, INSERM UMR_S 1146, CNRS UMR 7371, Lib, Paris, France (A.d.C.)
| | - Declan P O'Regan
- From the Medical Research Council Clinical Sciences Centre, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, W12 0HS, England (T.J.W.D., A.d.M., R.B., P.T., M.Q., G.D., T.D., L.M.G., S.A.C., D.P.O'R.); Department of Cardiology, Imperial College NHS Healthcare Trust, London, England (A.G.); and Sorbonne Universités, UPMC Univ Paris 06, INSERM UMR_S 1146, CNRS UMR 7371, Lib, Paris, France (A.d.C.)
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Chen Q, Chiheb S, Fysekidis M, Jaber Y, Brahimi M, Nguyen MT, Millasseau S, Cosson E, Valensi P. Arterial stiffness is elevated in normotensive type 2 diabetic patients with peripheral neuropathy. Nutr Metab Cardiovasc Dis 2015; 25:1041-1049. [PMID: 26474725 DOI: 10.1016/j.numecd.2015.08.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2014] [Revised: 06/19/2015] [Accepted: 08/02/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND AIMS Arterial stiffness, a measure of macrovascular damage predictive of poor cardio-vascular outcomes, is strongly related to age and hypertension (HT). In diabetic patients peripheral neuropathy (PN) has been found to be associated with increased arterial stiffness, which might be due to the concomitant presence of HT. The aim of this study was to examine in type-2 diabetic patients, the relationship between arterial stiffness and presence or absence of PN and HT separately. METHODS AND RESULTS Arterial stiffness was measured with the gold standard carotid-femoral pulse wave velocity (PWV) in 447 type-2 diabetic subjects of whom 66% were hypertensive, 53% had PN, and 40% had both. Patients with PN were older, more often hypertensive and had higher PWV than those free of PN. Patients were separated according to the presence or absence of PN and HT. PWV values above the 90th percentile age- and blood pressure-adjusted reference range (PWV+) were different across these groups (p < 0.005) with the following respective prevalences: 27.2%, 53.4%, 33.3% and 30.6%. Only PWV+ was significantly associated with PN and hypertension in the interaction analysis. CONCLUSION Well controlled hypertensive patients did not have elevated arterial stiffness compared to normotensive patients. This might be due to anti-hypertensive treatment although our study design does not allow us to confirm it. A strong association between PN and arterial stiffness was only present in normotensive patients, suggesting that normotensive type 2 diabetic patients with PN and elevated arterial stiffness should be carefully managed to prevent future macrovascular complications.
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Affiliation(s)
- Q Chen
- Department of Endocrinology-Diabetology-Nutrition, Jean Verdier Hospital, AP-HP, Paris-Nord University, CRNH-IdF, CINFO, Bondy, France; Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shangai, China
| | - S Chiheb
- Department of Endocrinology-Diabetology-Nutrition, Jean Verdier Hospital, AP-HP, Paris-Nord University, CRNH-IdF, CINFO, Bondy, France
| | - M Fysekidis
- Department of Endocrinology-Diabetology-Nutrition, Jean Verdier Hospital, AP-HP, Paris-Nord University, CRNH-IdF, CINFO, Bondy, France
| | - Y Jaber
- Department of Endocrinology-Diabetology-Nutrition, Jean Verdier Hospital, AP-HP, Paris-Nord University, CRNH-IdF, CINFO, Bondy, France
| | - M Brahimi
- Department of Endocrinology-Diabetology-Nutrition, Jean Verdier Hospital, AP-HP, Paris-Nord University, CRNH-IdF, CINFO, Bondy, France
| | - M T Nguyen
- Department of Endocrinology-Diabetology-Nutrition, Jean Verdier Hospital, AP-HP, Paris-Nord University, CRNH-IdF, CINFO, Bondy, France
| | - S Millasseau
- Pulse Wave Consulting, Saint Leu la Foret, France
| | - E Cosson
- Department of Endocrinology-Diabetology-Nutrition, Jean Verdier Hospital, AP-HP, Paris-Nord University, CRNH-IdF, CINFO, Bondy, France; UMR U1153 Inserm/U1125 Inra/Cnam/Univ Paris 13, Research Center in Epidemiology and Biostatistic Sorbonne-Paris-Cité, Bobigny, France
| | - P Valensi
- Department of Endocrinology-Diabetology-Nutrition, Jean Verdier Hospital, AP-HP, Paris-Nord University, CRNH-IdF, CINFO, Bondy, France.
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50
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Carotid–femoral pulse wave velocity assessment by two different methods. J Hypertens 2015; 33:1868-75; discussion 1875. [DOI: 10.1097/hjh.0000000000000631] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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