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Joint scientific statement of the European Association for the Study of Obesity and the European Society of Hypertension. J Hypertens 2015; 33:425-34. [DOI: 10.1097/hjh.0000000000000473] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Nethononda RM, Lewandowski AJ, Stewart R, Kylinterias I, Whitworth P, Francis J, Leeson P, Watkins H, Neubauer S, Rider OJ. Gender specific patterns of age-related decline in aortic stiffness: a cardiovascular magnetic resonance study including normal ranges. J Cardiovasc Magn Reson 2015; 17:20. [PMID: 25827408 PMCID: PMC4332729 DOI: 10.1186/s12968-015-0126-0] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 01/26/2015] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Young females exhibit lower cardiovascular event rates that young men, a pattern which is lost, or even reversed with advancing age. As aortic stiffness is a powerful risk factor for cardiovascular events, a gender difference with advancing age could provide a plausible explanation for this pattern. METHODS 777 subjects (♀n = 408, ♂n = 369) across a wide range of age (21-85 years) underwent cardiovascular magnetic resonance to assess aortic pulse wave velocity (PWV) and, in addition, aortic distensibility at three levels; 1) ascending aorta (Ao) and 2) proximal descending aorta (PDA) at the level of the pulmonary artery and 3) the abdominal aorta (DDA). RESULTS There was a strong negative correlation between increasing age and regional aortic distensibility (Ao♀R-0.84, ♂R-0.80, PDA♀R-0.82, ♂R-0.77, DDA♀R-0.80, ♂R-0.71 all p < 0.001) and a strong positive correlation with PWV, (♀R0.53, ♂R 0.63 both p < 0.001). Even after adjustment for mean arterial pressure, body mass index, heart rate, smoking and diabetes, females exhibited a steeper decrease in all distensibility measures in response to increasing age (Ao♀-1.3 vs ♂-1.1 mmHg-1, PDA ♀-1.2 vs ♂-1.0 mmHg, DDA ♀-1.8 vs ♂-1.4 mmHg-1 per 10 years increase in age all p < 0.001). No gender difference in PWV increase with age was observed (p = 0.11). CONCLUSION Although advancing age is accompanied by increased aortic stiffness in both males and females, a significant sex difference in the rate of change exists, with females showing a steeper decline in aortic elasticity. As aortic stiffness is strongly related to cardiovascular events our observations may explain the increase in cardiovascular event rates that accompanies the menopausal age in women.
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Affiliation(s)
- Richard M Nethononda
- />Chris Hani Baragwanath Hospital, Soweto & University of Witwatersrand, Johannesburg, RSA
| | - Adam J Lewandowski
- />Oxford Cardiovascular Clinical Research Facility, University of Oxford, Oxford, UK
| | - Ross Stewart
- />University Oxford Centre for Clinical Magnetic Resonance Research, Radcliffe Division of Medicine, Department of cardiovascular Medicine, Oxford, UK
| | | | - Polly Whitworth
- />University Oxford Centre for Clinical Magnetic Resonance Research, Radcliffe Division of Medicine, Department of cardiovascular Medicine, Oxford, UK
| | - Jane Francis
- />University Oxford Centre for Clinical Magnetic Resonance Research, Radcliffe Division of Medicine, Department of cardiovascular Medicine, Oxford, UK
| | - Paul Leeson
- />Oxford Cardiovascular Clinical Research Facility, University of Oxford, Oxford, UK
| | - Hugh Watkins
- />University Oxford Centre for Clinical Magnetic Resonance Research, Radcliffe Division of Medicine, Department of cardiovascular Medicine, Oxford, UK
| | - Stefan Neubauer
- />University Oxford Centre for Clinical Magnetic Resonance Research, Radcliffe Division of Medicine, Department of cardiovascular Medicine, Oxford, UK
| | - Oliver J Rider
- />University Oxford Centre for Clinical Magnetic Resonance Research, Radcliffe Division of Medicine, Department of cardiovascular Medicine, Oxford, UK
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Weight reduction and aortic stiffness in obese children and adolescents: a 1-year follow-up study. J Hum Hypertens 2015; 29:535-40. [PMID: 25589213 DOI: 10.1038/jhh.2014.127] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Revised: 10/22/2014] [Accepted: 11/21/2014] [Indexed: 11/08/2022]
Abstract
Little is known about the effect of weight reduction on aortic stiffness and especially so in the young. The present study investigates whether weight reduction influences aortic stiffness in obese children and adolescents. Carotid-femoral pulse wave velocity (cfPWV) and augmentation index at heart rate 75 (AIx@HR75) were measured in 72 obese patients aged 10-18 years at baseline and after 1-year of lifestyle intervention (follow-up). We found that although the degree of obesity decreased (Δbody mass index z-score: -0.24±0.45, P<0.0001), cfPWV was higher at follow-up (ΔcfPWV: 0.27±0.47 m s(-1), P<0.0001), which was explained by the increase in age (β=0.12 ms(-1) per year, 95% confidence interval (CI) 0.07-0.17, P<0.0001) and partly by changes in mean arterial pressure and heart rate. Changes in cfPWV were not related to changes in obesity measures. No significant change was found in AIx@HR75 (ΔAIx@HR75: 2.10±9.73%, P=0.072), but changes in AIx@HR75 were related to changes in abdominal fat (Δwaist/height ratio: β=50.3, 95% CI 6.7-94.0, P=0.02) and changes in total body fat percent by dual energy X-ray absorptiometry scan (Δtotal body fat (%): β=0.7, 95% CI 0.1-1.3, P=0.02) when adjusted for gender and relevant baseline confounders. In conclusion, no clear effect of weight reduction was found on aortic stiffness, although changes in AIx@HR75 were associated with changes in both abdominal fat and total body fat percent. The higher cfPWV at follow-up was related to the older age.
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Rider OJ, Lewis AJ, Lewandowski AJ, Ntusi N, Nethononda R, Petersen SE, Francis JM, Pitcher A, Banerjee R, Leeson P, Neubauer S. Obese Subjects Show Sex-Specific Differences in Right Ventricular Hypertrophy. Circ Cardiovasc Imaging 2015; 8:CIRCIMAGING.114.002454. [DOI: 10.1161/circimaging.114.002454] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Oliver J. Rider
- From the Oxford Centre for Clinical Magnetic Resonance Research (O.J.R., A.J.M.L., N.N., R. N., J.M.F., A.P., R.B., S.N.) and Oxford Clinical Cardiovascular Research Facility (A.J.L., P.L.), Department of Cardiovascular Medicine, University of Oxford, Oxford, United Kingdom; and William Harvey Research Institute, Queen Mary, University of London, London, United Kingdom (S.E.P.)
| | - Andrew J.M. Lewis
- From the Oxford Centre for Clinical Magnetic Resonance Research (O.J.R., A.J.M.L., N.N., R. N., J.M.F., A.P., R.B., S.N.) and Oxford Clinical Cardiovascular Research Facility (A.J.L., P.L.), Department of Cardiovascular Medicine, University of Oxford, Oxford, United Kingdom; and William Harvey Research Institute, Queen Mary, University of London, London, United Kingdom (S.E.P.)
| | - Adam J. Lewandowski
- From the Oxford Centre for Clinical Magnetic Resonance Research (O.J.R., A.J.M.L., N.N., R. N., J.M.F., A.P., R.B., S.N.) and Oxford Clinical Cardiovascular Research Facility (A.J.L., P.L.), Department of Cardiovascular Medicine, University of Oxford, Oxford, United Kingdom; and William Harvey Research Institute, Queen Mary, University of London, London, United Kingdom (S.E.P.)
| | - Ntobeko Ntusi
- From the Oxford Centre for Clinical Magnetic Resonance Research (O.J.R., A.J.M.L., N.N., R. N., J.M.F., A.P., R.B., S.N.) and Oxford Clinical Cardiovascular Research Facility (A.J.L., P.L.), Department of Cardiovascular Medicine, University of Oxford, Oxford, United Kingdom; and William Harvey Research Institute, Queen Mary, University of London, London, United Kingdom (S.E.P.)
| | - Richard Nethononda
- From the Oxford Centre for Clinical Magnetic Resonance Research (O.J.R., A.J.M.L., N.N., R. N., J.M.F., A.P., R.B., S.N.) and Oxford Clinical Cardiovascular Research Facility (A.J.L., P.L.), Department of Cardiovascular Medicine, University of Oxford, Oxford, United Kingdom; and William Harvey Research Institute, Queen Mary, University of London, London, United Kingdom (S.E.P.)
| | - Steffen E. Petersen
- From the Oxford Centre for Clinical Magnetic Resonance Research (O.J.R., A.J.M.L., N.N., R. N., J.M.F., A.P., R.B., S.N.) and Oxford Clinical Cardiovascular Research Facility (A.J.L., P.L.), Department of Cardiovascular Medicine, University of Oxford, Oxford, United Kingdom; and William Harvey Research Institute, Queen Mary, University of London, London, United Kingdom (S.E.P.)
| | - Jane M. Francis
- From the Oxford Centre for Clinical Magnetic Resonance Research (O.J.R., A.J.M.L., N.N., R. N., J.M.F., A.P., R.B., S.N.) and Oxford Clinical Cardiovascular Research Facility (A.J.L., P.L.), Department of Cardiovascular Medicine, University of Oxford, Oxford, United Kingdom; and William Harvey Research Institute, Queen Mary, University of London, London, United Kingdom (S.E.P.)
| | - Alex Pitcher
- From the Oxford Centre for Clinical Magnetic Resonance Research (O.J.R., A.J.M.L., N.N., R. N., J.M.F., A.P., R.B., S.N.) and Oxford Clinical Cardiovascular Research Facility (A.J.L., P.L.), Department of Cardiovascular Medicine, University of Oxford, Oxford, United Kingdom; and William Harvey Research Institute, Queen Mary, University of London, London, United Kingdom (S.E.P.)
| | - Rajarshi Banerjee
- From the Oxford Centre for Clinical Magnetic Resonance Research (O.J.R., A.J.M.L., N.N., R. N., J.M.F., A.P., R.B., S.N.) and Oxford Clinical Cardiovascular Research Facility (A.J.L., P.L.), Department of Cardiovascular Medicine, University of Oxford, Oxford, United Kingdom; and William Harvey Research Institute, Queen Mary, University of London, London, United Kingdom (S.E.P.)
| | - Paul Leeson
- From the Oxford Centre for Clinical Magnetic Resonance Research (O.J.R., A.J.M.L., N.N., R. N., J.M.F., A.P., R.B., S.N.) and Oxford Clinical Cardiovascular Research Facility (A.J.L., P.L.), Department of Cardiovascular Medicine, University of Oxford, Oxford, United Kingdom; and William Harvey Research Institute, Queen Mary, University of London, London, United Kingdom (S.E.P.)
| | - Stefan Neubauer
- From the Oxford Centre for Clinical Magnetic Resonance Research (O.J.R., A.J.M.L., N.N., R. N., J.M.F., A.P., R.B., S.N.) and Oxford Clinical Cardiovascular Research Facility (A.J.L., P.L.), Department of Cardiovascular Medicine, University of Oxford, Oxford, United Kingdom; and William Harvey Research Institute, Queen Mary, University of London, London, United Kingdom (S.E.P.)
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Gjevestad E, Hjelmesaeth J, Sandbu R, Nordstrand N. Effects of intensive lifestyle intervention and gastric bypass on aortic stiffness: a 1-year nonrandomized clinical study. Obesity (Silver Spring) 2015; 23:37-45. [PMID: 25174845 DOI: 10.1002/oby.20880] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2014] [Accepted: 08/10/2014] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To compare the long-term effects of Roux-en-Y gastric bypass (GBS) and intensive lifestyle intervention (ILI) on aortic stiffness. METHODS Nonrandomized clinical trial. Aortic stiffness was assessed by carotid-femoral pulse wave velocity (cf PWV) using high-fidelity applanation tonometry. RESULTS A total of 159 treatment-seeking morbidly obese patients were included, 82 (54 females) in the GBS-group and 77 (48 females) in the ILI-group. Participants in the GBS-group were younger (42.0 ± 9.9 vs. 46.4 ± 10.5 years), heavier (BMI 45.7 ± 5.3 vs. 42.0 ± 4.9 kg/m(2) ), and had lower systolic pressure (137 ± 19 vs. 145 ± 18 mm Hg) and pulse pressure (57 ± 16 vs. 65 ± 17 mm Hg), all P ≤ 0.006. Mean (SD) cf PWV at baseline was 8.6 ± 1.7 m/s in the GBS-group and 8.6 ± 1.9 m/s in the ILI-group, P = 0.959. At follow-up, mean (95% CI) weight loss was larger in the GBS-group than in the ILI-group -43.3 (-46.0 to -40.7) vs. -12.1 (-14.6 to -9.6) kg, P < 0.001. The mean change in cf PWV was -0.02 (-0.31 to 0.27) m/s in the GBS-group and 0.03 (-0.28 to 0.33) m/s in the ILI-group, both P ≥ 0.412; adjusted between-group difference (ANCOVA) 0.05 (-0.40 to 0.49) m/s, P = 0.836. The adjusted regression analysis showed that weight loss was associated with increased cf PWV in the GBS-group. CONCLUSIONS GBS and ILI had no significant long-term effects on aortic stiffness in treatment-seeking morbidly obese individuals.
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Affiliation(s)
- Espen Gjevestad
- Morbid Obesity Center, Vestfold Hospital Trust, Tønsberg, Norway; Clinic Physical Medicine and Rehabilitation, Vestfold Hospital Trust, Stavern, Norway
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Petersen KS, Blanch N, Keogh JB, Clifton PM. Effect of Weight Loss on Pulse Wave Velocity. Arterioscler Thromb Vasc Biol 2015; 35:243-52. [DOI: 10.1161/atvbaha.114.304798] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Kristina S. Petersen
- From the School of Pharmacy and Medical Science, University of South Australia, Adelaide, Australia
| | - Natalie Blanch
- From the School of Pharmacy and Medical Science, University of South Australia, Adelaide, Australia
| | - Jennifer B. Keogh
- From the School of Pharmacy and Medical Science, University of South Australia, Adelaide, Australia
| | - Peter M. Clifton
- From the School of Pharmacy and Medical Science, University of South Australia, Adelaide, Australia
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57
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Hribal ML, Fiorentino TV, Sesti G. Role of C reactive protein (CRP) in leptin resistance. Curr Pharm Des 2014; 20:609-15. [PMID: 23688010 PMCID: PMC4155811 DOI: 10.2174/13816128113199990016] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Accepted: 05/13/2013] [Indexed: 01/23/2023]
Abstract
Increased plasma levels of both leptin and C reactive protein (CRP) have been reported in a number of conditions, including obesity, and have been linked to cardiovascular pathophysiological processes and increased cardiovascular risk; interestingly these two biomarkers appear to be able to reciprocally regulate their bioavailability, through complex mechanisms that have not been completely clarified yet. Here we first review clinical evidence suggesting not only that the circulatory levels of CRP and leptin show an independent correlation, but also that assessing them in tandem may result in an increased ability to predict cardiovascular disease. We summarize also molecular studies showing that leptin is able to promote CRP production from hepatocytes and endothelial cells in vitro and discuss the studies addressing the possibility that in vivo leptin administration may be able to modulate plasma CRP levels. Furthermore, we describe two studies demonstrating that CRP directly binds leptin in extra-cellular settings, thus impairing its biological actions. Finally we report genetic evidence that common variations at the leptin receptor locus are associated with CRP blood levels. Overall, the data reviewed here show that the chronic elevation of CRP observed in obese subjects may worsen leptin resistance, contributing to the pathogenesis of cardiovascular disease, and highlight a potential link between conditions, such as leptin resistance and endothelial dysfunction, that may be amenable of pharmacological treatment targeted to the disruption of leptin-CRP interaction.
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Affiliation(s)
| | | | - Giorgio Sesti
- Department of Medical and Surgical Sciences, University of Catanzaro Magna Graecia, Viale Europa, località Germaneto 88100 Catanzaro, Italy.
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Megias-Rangil I, Merino J, Ferré R, Plana N, Heras M, Cabré A, Bonada A, Rabassa A, Masana L. Subclinical atherosclerosis determinants in morbid obesity. Nutr Metab Cardiovasc Dis 2014; 24:963-968. [PMID: 24907020 DOI: 10.1016/j.numecd.2014.04.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Revised: 03/31/2014] [Accepted: 04/20/2014] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND AIMS Obesity is associated with increased cardiovascular risk. However, the impact of morbid obesity on vascular structure and function is not well understood. This study was designed to appraise subclinical atherosclerosis markers, including carotid intima media thickness (cIMT), endothelial function, and arterial wall stiffness, and their determinants, in morbidly obese patients. METHODS AND RESULTS In this cross-sectional study 194 overweight and obese patients were distributed in morbid-obese patients (MOP, n = 110), obese (OP, n = 84) and overweight patients (OwP, n = 33) groups. Demography, anthropometry, clinical and standard biochemical data were recorded. cIMT, endothelial function, defined as the small artery reactivity index (saRHI), and artery wall rigidity, studied by the augmentation index, were determined. More than 50% of the MOP, OP and OwP had a cIMT above the 75th percentile per age and gender. No differences in cIMT or saRHI were observed, although overweight and obese patients (OOP) had higher arterial rigidity compared with the morbid-obese patients. In a multivariate regression test, while cholesterol was the main determinant of cIMT in overweight and obese patients, glucose metabolism was the determinant in MOP. CONCLUSION More than half of the population have a cIMT above general population ranges. OwP, OP and MOP have similar cIMT and saRHI. However, OOP have greater arterial wall rigidity. Dysglycemia is the main factor associated with subclinical atherosclerosis in MOP.
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Affiliation(s)
- I Megias-Rangil
- Dietetics and Nutrition Unit, Sant Joan University Hospital, Avinguda Josep Laporte Num 1, 43204 Reus, Spain.
| | - J Merino
- Vascular Medicine and Metabolism Unit, Lipids and Atherosclerosis Research Unit, Sant Joan University Hospital, Rovira i Virgili University, IISPV, CIBERDEM. Reus, Spain
| | - R Ferré
- Vascular Medicine and Metabolism Unit, Lipids and Atherosclerosis Research Unit, Sant Joan University Hospital, Rovira i Virgili University, IISPV, CIBERDEM. Reus, Spain
| | - N Plana
- Vascular Medicine and Metabolism Unit, Lipids and Atherosclerosis Research Unit, Sant Joan University Hospital, Rovira i Virgili University, IISPV, CIBERDEM. Reus, Spain
| | - M Heras
- Vascular Medicine and Metabolism Unit, Lipids and Atherosclerosis Research Unit, Sant Joan University Hospital, Rovira i Virgili University, IISPV, CIBERDEM. Reus, Spain
| | - A Cabré
- Vascular Medicine and Metabolism Unit, Lipids and Atherosclerosis Research Unit, Sant Joan University Hospital, Rovira i Virgili University, IISPV, CIBERDEM. Reus, Spain
| | - A Bonada
- Vascular Medicine and Metabolism Unit, Lipids and Atherosclerosis Research Unit, Sant Joan University Hospital, Rovira i Virgili University, IISPV, CIBERDEM. Reus, Spain
| | - A Rabassa
- Vascular Medicine and Metabolism Unit, Lipids and Atherosclerosis Research Unit, Sant Joan University Hospital, Rovira i Virgili University, IISPV, CIBERDEM. Reus, Spain
| | - L Masana
- Vascular Medicine and Metabolism Unit, Lipids and Atherosclerosis Research Unit, Sant Joan University Hospital, Rovira i Virgili University, IISPV, CIBERDEM. Reus, Spain
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Canepa M, AlGhatrif M, Pestelli G, Kankaria R, Makrogiannis S, Strait JB, Brunelli C, Lakatta EG, Ferrucci L. Impact of central obesity on the estimation of carotid-femoral pulse wave velocity. Am J Hypertens 2014; 27:1209-17. [PMID: 24637912 DOI: 10.1093/ajh/hpu038] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Studies have found that central obesity is associated with higher carotid-femoral pulse wave velocity (PWV). However, traveled distance (TD) measured over the body surface can be substantially overestimated with wider waist circumference (WC). We sought to investigate whether central obesity biases the estimation of PWV and whether this bias explains the association between PWV and different measures of adiposity. METHODS Seven hundred eleven participants (49.5% men) from the Baltimore Longitudinal Study of Aging with PWV, anthropometrics, and quantification of different fat depots by computed tomography and dual x-ray absorptiometry were included. TD and relative PWV were estimated with a tape measure over the body surface or linear distances taken from radiological images, unaffected by obesity. RESULTS A significant association was found between wider WC and a greater difference between the 2 TD measurements and their respective PWV in both sexes (r ≥ 0.34; P < 0.001). This overestimation bias appeared to be generally higher in women than men (0.27 m/sec for each unit increase in WC; P < 0.0001). When TD estimated over the body surface was used to calculate PWV, greater WC, total body fat, subcutaneous fat, and visceral fat were all associated with higher PWV (P < 0.05 for all). However, when PWV was calculated using TD estimated from radiological images or body height, only the association with visceral fat held significant. CONCLUSIONS When TD is measured over the body surface, the role of obesity on PWV is substantially overestimated. After accounting for this bias, PWV was still independently associated with visceral fat but not with other measures of adiposity, confirming its contribution to arterial stiffening.
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Affiliation(s)
| | - Majd AlGhatrif
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute of Aging, National Institutes of Health, Baltimore, Maryland; Laboratory of Cardiovascular Sciences, Human Cardiovascular Studies Unit, National Institute of Aging, National Institutes of Health, Baltimore, Maryland; Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland.
| | - Gabriele Pestelli
- Department of Internal Medicine, University of Genova, Genova, Italy
| | - Rohan Kankaria
- Laboratory of Cardiovascular Sciences, Human Cardiovascular Studies Unit, National Institute of Aging, National Institutes of Health, Baltimore, Maryland
| | - Sokratis Makrogiannis
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute of Aging, National Institutes of Health, Baltimore, Maryland
| | - James B Strait
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute of Aging, National Institutes of Health, Baltimore, Maryland; Laboratory of Cardiovascular Sciences, Human Cardiovascular Studies Unit, National Institute of Aging, National Institutes of Health, Baltimore, Maryland
| | - Claudio Brunelli
- Department of Internal Medicine, University of Genova, Genova, Italy
| | - Edward G Lakatta
- Laboratory of Cardiovascular Sciences, Human Cardiovascular Studies Unit, National Institute of Aging, National Institutes of Health, Baltimore, Maryland
| | - Luigi Ferrucci
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute of Aging, National Institutes of Health, Baltimore, Maryland
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Rider OJ, Asaad M, Ntusi N, Wainwright E, Clutton G, Hancock G, Banerjee R, Pitcher A, Samaras K, Clarke K, Neubauer S, Dorrell L, Holloway CJ. HIV is an independent predictor of aortic stiffness. J Cardiovasc Magn Reson 2014; 16:57. [PMID: 25187084 PMCID: PMC4422254 DOI: 10.1186/s12968-014-0057-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 07/16/2014] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Patients with treated Human Immunodeficiency Virus-1 (HIV) infection are at increased risk of cardiovascular events. Traditionally much of this risk has been attributed to metabolic and anthropometric abnormalities associated with HIV, which are similar to the metabolic syndrome (MS), an established risk factor for cardiovascular mortality. It remains unclear whether treated HIV infection is itself associated with increased risk, via increase vascular stiffness. METHODS 226 subjects (90 with HIV) were divided into 4 groups based on HIV and MS status: 1) HIV-ve/MS-ve, 2) HIV-ve/MS + ve, 3) HIV + ve/MS-ve and 4)HIV + ve/MS + ve. CMR was used to determine aortic pulse wave velocity (PWV) and regional aortic distensibility (AD). RESULTS PWV was 11% higher and regional AD up to 14% lower in the HIV + ve/MS-ve group when compared to HIV-ve/MS-ve (p < 0.01 all analyses). PWV and AD in the HIV + ve/MS-ve group was similar to that observed in the HIV-ve/MS + ve group (p > 0.99 all analyses). The HIV + ve/MS + ve group had 32% higher PWV and 30-34% lower AD than the HIV-ve/MS-ve group (all p < 0.001), and 19% higher PWV and up to 31% lower AD than HIV + ve/MS-ve subjects (all p < 0.05). On multivariable regression, age, systolic blood pressure and treated HIV infection were all independent predictors of both PWV and regional AD. CONCLUSION Across multiple measures, treated HIV infection is associated with increased aortic stiffness and is also an independent predictor of both PWV and regional AD. The magnitude of the effect of treated HIV and MS are similar, with additive detrimental effects on central vascular elasticity.
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Affiliation(s)
- Oliver J Rider
- Department of Physiology, Anatomy and Genetics, University of Oxford, Parks Road, Oxford, OX1 3PT, UK.
- Department of Cardiovascular Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research, (OCMR), John Radcliffe Hospital, Oxford, OX3 9DU, UK.
| | - Mina Asaad
- Department of Physiology, Anatomy and Genetics, University of Oxford, Parks Road, Oxford, OX1 3PT, UK.
- Department of Cardiovascular Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research, (OCMR), John Radcliffe Hospital, Oxford, OX3 9DU, UK.
| | - Ntobeko Ntusi
- Department of Cardiovascular Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research, (OCMR), John Radcliffe Hospital, Oxford, OX3 9DU, UK.
| | - Emma Wainwright
- Oxford NIHR Biomedical Research Centre, University of Oxford, Oxford, UK.
| | - Genevieve Clutton
- Oxford NIHR Biomedical Research Centre, University of Oxford, Oxford, UK.
| | - Gemma Hancock
- Oxford NIHR Biomedical Research Centre, University of Oxford, Oxford, UK.
| | - Rajarshi Banerjee
- Department of Physiology, Anatomy and Genetics, University of Oxford, Parks Road, Oxford, OX1 3PT, UK.
| | - Alex Pitcher
- Department of Cardiovascular Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research, (OCMR), John Radcliffe Hospital, Oxford, OX3 9DU, UK.
| | | | - Kieran Clarke
- Department of Physiology, Anatomy and Genetics, University of Oxford, Parks Road, Oxford, OX1 3PT, UK.
| | - Stefan Neubauer
- Department of Cardiovascular Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research, (OCMR), John Radcliffe Hospital, Oxford, OX3 9DU, UK.
- Oxford NIHR Biomedical Research Centre, University of Oxford, Oxford, UK.
| | - Lucy Dorrell
- Oxford NIHR Biomedical Research Centre, University of Oxford, Oxford, UK.
| | - Cameron J Holloway
- Department of Physiology, Anatomy and Genetics, University of Oxford, Parks Road, Oxford, OX1 3PT, UK.
- Department of Cardiovascular Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research, (OCMR), John Radcliffe Hospital, Oxford, OX3 9DU, UK.
- St Vincent's Hospital, Sydney, Australia.
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Khan JN, Wilmot EG, Leggate M, Singh A, Yates T, Nimmo M, Khunti K, Horsfield MA, Biglands J, Clarysse P, Croisille P, Davies M, McCann GP. Subclinical diastolic dysfunction in young adults with Type 2 diabetes mellitus: a multiparametric contrast-enhanced cardiovascular magnetic resonance pilot study assessing potential mechanisms. Eur Heart J Cardiovasc Imaging 2014; 15:1263-9. [PMID: 24970723 DOI: 10.1093/ehjci/jeu121] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
AIMS To assess the cardiac, vascular, anthropometric, and biochemical determinants of subclinical diastolic dysfunction in younger adults with Type 2 diabetes mellitus (T2DM) using multiparametric contrast-enhanced cardiovascular magnetic resonance (CMR) imaging. METHODS AND RESULTS Twenty adults <40 years with T2DM [mean age 31.8(6.6) years, T2DM duration 4.7(4.0) years] and 20 age and sex-matched controls [10 obese non-diabetic controls and 10 lean controls (LC)] were studied. Cardiac volumes and function, circumferential strain and peak early diastolic strain rate (PEDSR), myocardial perfusion reserve, aortic stiffness (distensibility, pulse-wave velocity), focal fibrosis on late gadolinium enhancement, and pre- and post-contrast T1 mapping for contrast agent partition coefficient (subset, n = 26) were determined by CMR. In the T2DM cohort, mean aortic distensibility correlated with PEDSR (r = 0.564, P = 0.023) and diabetes duration correlated inversely with PEDSR (r = -0.534, P = 0.015) on univariate analysis. There was a close association between PEDSR and peak systolic strain (r = -0.580, P = 0.007). CONCLUSION In young adults with T2DM, diabetes duration and aortic distensibility were associated with diastolic dysfunction. Interventional studies are required to assess whether cardiac dysfunction can be reversed in this phenotype of patients.
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Affiliation(s)
- Jamal Nasir Khan
- Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK The NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK
| | - Emma Gwyn Wilmot
- Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK The NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK Diabetes Research Unit, University of Leicester, Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK The NIHR Leicester Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK
| | - Melanie Leggate
- The NIHR Leicester Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, Leicester, UK
| | - Anvesha Singh
- Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK The NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK
| | - Thomas Yates
- Diabetes Research Unit, University of Leicester, Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK The NIHR Leicester Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK
| | - Myra Nimmo
- The NIHR Leicester Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, Leicester, UK
| | - Kamlesh Khunti
- Diabetes Research Unit, University of Leicester, Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK The NIHR Leicester Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK
| | - Mark A Horsfield
- Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK The NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK
| | - John Biglands
- Cardiovascular Research Department, Leeds General Infirmary, Leeds, West Yorkshire, UK
| | | | | | - Melanie Davies
- Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK The NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK Diabetes Research Unit, University of Leicester, Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK The NIHR Leicester Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK
| | - Gerry Patrick McCann
- Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK The NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK
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Hawkins M, Gabriel KP, Cooper J, Storti KL, Sutton-Tyrrell K, Kriska A. The impact of change in physical activity on change in arterial stiffness in overweight or obese sedentary young adults. Vasc Med 2014; 19:257-263. [PMID: 24879662 DOI: 10.1177/1358863x14536630] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Arterial stiffness is associated with cardiovascular events and mortality. Lifestyle factors such as physical activity (PA) may reduce arterial stiffness. The purpose of this study is to determine the impact of change in PA on 1-year change in arterial stiffness in 274 overweight/obese sedentary young adults. The Slow Adverse Vascular Effects of excess weight (SAVE) trial was a study evaluating the relationships between weight loss, dietary sodium, and vascular health. PA was measured with the ActiGraph AM7164 accelerometer. Intensity of activity was determined using established cut-points. Arterial stiffness was assessed by brachial-ankle pulse wave velocity (baPWV) using an automated device. Analysis of covariance compared changes in total accelerometer counts, minutes/day in light-intensity PA (LPA), moderate-to-vigorous PA (MVPA), and sedentary time, by categories of change in baPWV. Models were adjusted for time since baseline visit, age, sex, race, homeostatis model of assessment of insulin resistance, mean arterial pressure, heart rate, and weight change. Total accelerometer counts and time spent in MVPA increased from baseline to 12 months while time spent in LPA significantly decreased. Mean baPWV was similar at each time point. Those who showed decreased baPWV also showed an increase in total accelerometer counts per day and time spent in MVPA in the fully adjusted models (p<0.001). Changes in sedentary time and time spent in LPA were not associated with changes in baPWV. These results indicate that even modest increases in MVPA can reduce arterial stiffness, a risk factor for future cardiovascular events.
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Affiliation(s)
- Marquis Hawkins
- Division of Biostatistics & Epidemiology, Department of Public Health, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA
| | - Kelley P Gabriel
- Division of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Jennifer Cooper
- Nationwide Children's Hospital Research Institute, Columbus, OH, USA
| | - Kristi L Storti
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kim Sutton-Tyrrell
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA Co-author is deceased
| | - Andrea Kriska
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
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63
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Collier SR, Sandberg K, Moody AM, Frechette V, Curry CD, Ji H, Gowdar R, Chaudhuri D, Meucci M. Reduction of plasma aldosterone and arterial stiffness in obese pre- and stage1 hypertensive subjects after aerobic exercise. J Hum Hypertens 2014; 29:53-7. [PMID: 24785976 DOI: 10.1038/jhh.2014.33] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Revised: 02/25/2014] [Accepted: 02/28/2014] [Indexed: 01/21/2023]
Abstract
Obesity-related hypertension is associated with increased activity of the renin-angiotensin-aldosterone system (RAAS), increasing arterial stiffness. Aerobic exercise decreases pulse wave velocity (PWV), therefore a treatment option for hypertension and obesity. Assess RAAS activity and PWV before and after 4 weeks of aerobic training in unmedicated, pre-to-stage-1 hypertensives. Ten obese subjects (52±3.2 years, body mass index=33.5±1.4) performed 30 min of aerobic exercise on a treadmill 3 days per week at 65% of peak oxygen consumption (VO2peak). Descriptive characteristics, systolic and diastolic blood pressure (SBP and DBP), PWV, and a blood draw was performed at baseline, following the 4-week control and training interventions. No differences in descriptive characteristics during the control period were observed, however, a significant decrease in plasma aldosterone (ALDO) (255.4±75 to 215.8±66 pg ml(-1), P=0.001), SBP (140±12 to 136±10.4 mm Hg; P=0.02), DBP (89±4.2 to 85±6.3 mm Hg; P=0.03) and central PWV (11.2±0.6 to 9.8±0.8 m s(-1); P=0.04) was shown pre-to-post exercise training. Four weeks of moderate-intensity aerobic training in obese, hypertensives decreases plasma ALDO independently of body weight and is significantly correlated to decreases in PWV reductions.
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Affiliation(s)
- S R Collier
- Vascular Biology and Autonomic Studies Laboratory, Department of Health Leisure and Exercise Science, Appalachian State University, Boone, NC, USA
| | - K Sandberg
- Center for the Study of Sex Differences in Health, Aging and Disease, Department of Medicine, Georgetown University Medical Center, Washington DC, USA
| | - A M Moody
- Vascular Biology and Autonomic Studies Laboratory, Department of Health Leisure and Exercise Science, Appalachian State University, Boone, NC, USA
| | - V Frechette
- Department of Medicine, Upstate Medical University, Syracuse, NY, USA
| | - C D Curry
- Vascular Biology and Autonomic Studies Laboratory, Department of Health Leisure and Exercise Science, Appalachian State University, Boone, NC, USA
| | - H Ji
- Center for the Study of Sex Differences in Health, Aging and Disease, Department of Medicine, Georgetown University Medical Center, Washington DC, USA
| | - R Gowdar
- Department of Medicine, Upstate Medical University, Syracuse, NY, USA
| | - D Chaudhuri
- Department of Medicine, Upstate Medical University, Syracuse, NY, USA
| | - M Meucci
- Department of Movement, University of Rome 'Foro Italico', Human and Health Sciences, Rome, Italy
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Davis AE, Lewandowski AJ, Holloway CJ, Ntusi NAB, Banerjee R, Nethononda R, Pitcher A, Francis JM, Myerson SG, Leeson P, Donovan T, Neubauer S, Rider OJ. Observational study of regional aortic size referenced to body size: production of a cardiovascular magnetic resonance nomogram. J Cardiovasc Magn Reson 2014; 16:9. [PMID: 24447690 PMCID: PMC3899403 DOI: 10.1186/1532-429x-16-9] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Accepted: 01/14/2014] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Cardiovascular magnetic resonance (CMR) is regarded as the gold standard for clinical assessment of the aorta, but normal dimensions are usually referenced to echocardiographic and computed tomography data and no large CMR normal reference range exists. As a result we aimed to 1) produce a normal CMR reference range of aortic diameters and 2) investigate the relationship between regional aortic size and body surface area (BSA) in a large group of healthy subjects with no vascular risk factors. METHODS 447 subjects (208 male, aged 19-70 years) without identifiable cardiac risk factors (BMI range 15.7-52.6 kg/m2) underwent CMR at 1.5 T to determine aortic diameter at three levels: the ascending aorta (Ao) and proximal descending aorta (PDA) at the level of the pulmonary artery, and the abdominal aorta (DDA), at a level 12 cm distal to the PDA. In addition, 201 of these subjects had aortic root imaging, allowing for measurements at the level of the aortic valve annulus (AV), aortic sinuses and sinotubular junction (STJ). RESULTS Normal diameters (mean ±2 SD) were; AV annulus male(♂) 24.4 ± 5.4, female (♀) 21.0 ± 3.6 mm, aortic sinus♂ 32.4 ± 7.7, ♀27.6 ± 5.8 mm, ST-junction ♂25.0 ± 7.4, ♀21.8 ± 5.4 mm, Ao ♂26.7 ± 7.7, ♀25.5 ± 7.4 mm, PDA ♂20.6 ± 5.6, +18.9 ± 4.0 mm, DDA ♂17.6 ± 5.1, ♀16.4 ± 4.0 mm. Aortic root and thoracic aortic diameters increased at all levels measured with BSA. No gender difference was seen in the degree of dilatation with increasing BSA (p>0.5 for all analyses). CONCLUSION Across both genders, increasing body size is characterized by a modest degree of aortic dilatation, even in the absence of traditional cardiovascular risk factors.
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Affiliation(s)
- Anne E Davis
- Radcliffe Department of Medicine, Division of Cardiovascular Medicine, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - Adam J Lewandowski
- Oxford Clinical Cardiovascular Research Facility, University of Oxford, Oxford, UK
| | - Cameron J Holloway
- St. Vincent’s Hospital and the Victor Chang Cardiac Research Institute, Sydney, Australia
| | - Ntobeko AB Ntusi
- Radcliffe Department of Medicine, Division of Cardiovascular Medicine, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - Rajarshi Banerjee
- Radcliffe Department of Medicine, Division of Cardiovascular Medicine, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - Richard Nethononda
- Radcliffe Department of Medicine, Division of Cardiovascular Medicine, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - Alex Pitcher
- Radcliffe Department of Medicine, Division of Cardiovascular Medicine, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - Jane M Francis
- Radcliffe Department of Medicine, Division of Cardiovascular Medicine, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - Saul G Myerson
- Radcliffe Department of Medicine, Division of Cardiovascular Medicine, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - Paul Leeson
- Oxford Clinical Cardiovascular Research Facility, University of Oxford, Oxford, UK
| | - Tim Donovan
- University of Cumbria Health and Medical Sciences, Lancaster, UK
| | - Stefan Neubauer
- Radcliffe Department of Medicine, Division of Cardiovascular Medicine, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - Oliver J Rider
- Radcliffe Department of Medicine, Division of Cardiovascular Medicine, John Radcliffe Hospital, Oxford OX3 9DU, UK
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65
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Rider OJ, Lewis AJ, Neubauer S. Structural and Metabolic Effects of Obesity on the Myocardium and the Aorta. Obes Facts 2014; 7:329-338. [PMID: 25342107 PMCID: PMC5644846 DOI: 10.1159/000368429] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Accepted: 11/08/2013] [Indexed: 12/12/2022] Open
Abstract
Obesity per se is a recognized risk factor for cardiovascular disease exerting independent adverse effects on the cardiovascular system. Despite this well documented link, the mechanisms by which obesity modulates cardiovascular risk are not well understood. Obesity is linked to a wide variety of cardiac changes, from subclinical diastolic dysfunction to end stage systolic heart failure. In addition, obesity causes changes in cardiac metabolism that make ATP production and utilization less efficient producing functional consequences that are linked to the increased rate of heart failure in this population. This review focuses on the cardiovascular structural and metabolic remodelling that occurs in obesity with and without co-morbidities and the potential links to increased mortality in this population. © 2014 S. Karger GmbH, Freiburg.
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Affiliation(s)
- Oliver J. Rider
- *Dr. Oliver J Rider, University of Oxford Centre for Clinical Magnetic Resonance Research, Level 0, John Radcliffe Hospital, Oxford OX3 9DU (UK),
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66
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Fu S, Luo L, Ye P, Liu Y, Zhu B, Zheng J, Bai Y, Bai J. Overall and abdominal obesity indicators had different association with central arterial stiffness and hemodynamics independent of age, sex, blood pressure, glucose, and lipids in Chinese community-dwelling adults. Clin Interv Aging 2013; 8:1579-84. [PMID: 24348027 PMCID: PMC3848376 DOI: 10.2147/cia.s54352] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objective Limited large sample studies have specially compared overall and abdominal obesity in relation to central arterial stiffness and hemodynamics in community-dwelling adults, especially in the People’s Republic of China. This study aimed to compare the relationship between an overall obesity indicator (body mass index [BMI]), an abdominal obesity index (waist circumference [WC]), and central arterial stiffness and hemodynamics, independent of age, sex, blood pressure, glucose, and lipids, in Chinese community-dwelling adults. Methods For 2,624 adults in this study, anthropometric indices, such as BMI and WC, were measured. Central arterial stiffness was assessed by carotid-femoral pulse wave velocity (cfPWV). Central hemodynamics was represented by central pulse pressure (cPP). Results Both overall and abdominally obese adults were older, with significantly higher cfPWV, cPP, peripheral pulse pressure (pPP), fasting blood glucose (FBG), and low-density lipoprotein-cholesterol (LDL-C), and significantly lower high-density lipoprotein-cholesterol (HDL-C). After adjusting for age and sex, both the overall and abdominally obese individuals had independently higher pPP, FBG, and LDL-C levels, and lower HDL-C level. The overall obese individuals had independently higher cPP, but not cfPWV, after adjusting for age and sex, while the abdominally obese individuals had independently higher cfPWV, but not cPP. After adjusting for age, sex, pPP, FBG, LDL-C, and HDL-C, WC, but not BMI, was independently correlated with cfPWV, and BMI, but not WC, was independently associated with cPP. Age, sex, pPP, FBG, and HDL-C levels have independent association with cfPWV. Age, sex, pPP, but not FBG and HDL-C levels, have independent association with cPP. Conclusion The abdominal obesity index (WC), rather than the overall obesity indicator (BMI), was related to central arterial stiffness, independent of age, sex, blood pressure, glucose and lipids, while the overall obesity indicator (BMI), rather than the abdominal obesity indicator (WC), was independently correlated with central hemodynamics. Age, sex, and blood pressure were independently associated with central arterial stiffness and hemodynamics, but blood glucose and lipids were independently associated with central arterial stiffness, rather than hemodynamics.
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Affiliation(s)
- Shihui Fu
- Department of Geriatric Cardiology, Beijing, People's Republic of China
| | - Leiming Luo
- Department of Geriatric Cardiology, Beijing, People's Republic of China
| | - Ping Ye
- Department of Geriatric Cardiology, Beijing, People's Republic of China
| | - Yuan Liu
- Department of Geriatric Cardiology, Beijing, People's Republic of China
| | - Bing Zhu
- Department of Geriatric Cardiology, Beijing, People's Republic of China
| | - Jin Zheng
- Department of Geriatric Cardiology, Beijing, People's Republic of China
| | - Yongyi Bai
- Department of Geriatric Cardiology, Beijing, People's Republic of China
| | - Jie Bai
- Department of Clinical Biochemistry, Chinese People's liberation Army General Hospital, Beijing, People's Republic of China
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67
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Improvement in cardiovascular indices after Roux-en-Y gastric bypass or sleeve gastrectomy for morbid obesity. Obes Surg 2013; 23:31-8. [PMID: 22923313 DOI: 10.1007/s11695-012-0743-8] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Morbidly obese patients display cardiac abnormalities which are partially reversed after weight loss. The aim of the present study was to assess the potential difference in cardiovascular disease indices between patients who underwent either gastric bypass surgery or sleeve gastrectomy. METHODS Thirty-seven morbidly obese patients who underwent either Roux-en-Y gastric bypass (RYGB) (n = 14) or SG (n = 23) were examined before, 3 and 6 months after surgery. Indices of cardiac autonomic nervous system activity were evaluated, namely baroreflex sensitivity (BRS) and heart rate variability (HRV). A complete echocardiographic study was performed in a subgroup of 17 patients (RYGB 8, SG 9) preoperatively and 6 months after surgery, evaluating epicardial fat thickness, aortic distensibility, left ventricular (LV) Tei index, left atrium diameter, ejection fraction, and LV mass. RESULTS All subjects experienced significant (p < 0.001) and similar weight loss independently of the type of operation. BRS and HRV indices improved significantly and to the same degree after surgery in both groups. In the echocardiographic study, all parameters improved significantly at 6 months in comparison with the baseline values. In addition, the RYGB group displayed significantly greater reduction in epicardial fat thickness (p = 0.007) and also tended to have a better LV performance as expressed by the lower values of the Tei index (p = 0.06) compared to the SG group 6 months after surgery. CONCLUSIONS Both RYGB and SG exert comparable effects on weight loss and improvement of cardiovascular parameters. RYGB displays a more beneficial influence on epicardial fat thickness and left ventricular performance than SG.
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68
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Corden B, Keenan NG, de Marvao AS, Dawes TJ, DeCesare A, Diamond T, Durighel G, Hughes AD, Cook SA, O’Regan DP. Body Fat Is Associated With Reduced Aortic Stiffness Until Middle Age. Hypertension 2013; 61:1322-7. [DOI: 10.1161/hypertensionaha.113.01177] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Obesity is a major risk factor for cardiometabolic disease, but the effect of body composition on vascular aging and arterial stiffness remains uncertain. We investigated relationships among body composition, blood pressure, age, and aortic pulse wave velocity in healthy individuals. Pulse wave velocity in the thoracic aorta, an indicator of central arterial stiffness, was measured in 221 volunteers (range, 18–72 years; mean, 40.3±13 years) who had no history of cardiovascular disease using cardiovascular MRI. In univariate analyses, age (
r
=0.78;
P
<0.001) and blood pressure (
r
=0.41;
P
<0.001) showed a strong positive association with pulse wave velocity. In multivariate analysis, after adjustment for age, sex, and mean arterial blood pressure, elevated body fat% was associated with reduced aortic stiffness until the age of 50 years, thereafter adiposity had an increasingly positive association with aortic stiffness (β=0.16;
P
<0.001). Body fat% was positively associated with cardiac output when age, sex, height, and absolute lean mass were adjusted for (β=0.23;
P
=0.002). These findings suggest that the cardiovascular system of young adults may be capable of adapting to the state of obesity and that an adverse association between body fat and aortic stiffness is only apparent in later life.
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Affiliation(s)
- Ben Corden
- From the Robert Steiner MRI Unit, MRC Clinical Sciences Centre, Imperial College London, London, United Kingdom (B.C., A.S.M.d.M., T.J.W.D., T.D., G.D., S.A.C., D.P.O.R.); Department of Cardiology, Imperial College Healthcare NHS Trust, London, United Kingdom (N.G.K.); Institut National de la Santé et de la Recherche Médicale (INSERM), Paris, France (A.D.); International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom (A.D.H.)
| | - Niall G. Keenan
- From the Robert Steiner MRI Unit, MRC Clinical Sciences Centre, Imperial College London, London, United Kingdom (B.C., A.S.M.d.M., T.J.W.D., T.D., G.D., S.A.C., D.P.O.R.); Department of Cardiology, Imperial College Healthcare NHS Trust, London, United Kingdom (N.G.K.); Institut National de la Santé et de la Recherche Médicale (INSERM), Paris, France (A.D.); International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom (A.D.H.)
| | - Antonio S.M. de Marvao
- From the Robert Steiner MRI Unit, MRC Clinical Sciences Centre, Imperial College London, London, United Kingdom (B.C., A.S.M.d.M., T.J.W.D., T.D., G.D., S.A.C., D.P.O.R.); Department of Cardiology, Imperial College Healthcare NHS Trust, London, United Kingdom (N.G.K.); Institut National de la Santé et de la Recherche Médicale (INSERM), Paris, France (A.D.); International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom (A.D.H.)
| | - Timothy J.W. Dawes
- From the Robert Steiner MRI Unit, MRC Clinical Sciences Centre, Imperial College London, London, United Kingdom (B.C., A.S.M.d.M., T.J.W.D., T.D., G.D., S.A.C., D.P.O.R.); Department of Cardiology, Imperial College Healthcare NHS Trust, London, United Kingdom (N.G.K.); Institut National de la Santé et de la Recherche Médicale (INSERM), Paris, France (A.D.); International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom (A.D.H.)
| | - Alain DeCesare
- From the Robert Steiner MRI Unit, MRC Clinical Sciences Centre, Imperial College London, London, United Kingdom (B.C., A.S.M.d.M., T.J.W.D., T.D., G.D., S.A.C., D.P.O.R.); Department of Cardiology, Imperial College Healthcare NHS Trust, London, United Kingdom (N.G.K.); Institut National de la Santé et de la Recherche Médicale (INSERM), Paris, France (A.D.); International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom (A.D.H.)
| | - Tamara Diamond
- From the Robert Steiner MRI Unit, MRC Clinical Sciences Centre, Imperial College London, London, United Kingdom (B.C., A.S.M.d.M., T.J.W.D., T.D., G.D., S.A.C., D.P.O.R.); Department of Cardiology, Imperial College Healthcare NHS Trust, London, United Kingdom (N.G.K.); Institut National de la Santé et de la Recherche Médicale (INSERM), Paris, France (A.D.); International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom (A.D.H.)
| | - Giuliana Durighel
- From the Robert Steiner MRI Unit, MRC Clinical Sciences Centre, Imperial College London, London, United Kingdom (B.C., A.S.M.d.M., T.J.W.D., T.D., G.D., S.A.C., D.P.O.R.); Department of Cardiology, Imperial College Healthcare NHS Trust, London, United Kingdom (N.G.K.); Institut National de la Santé et de la Recherche Médicale (INSERM), Paris, France (A.D.); International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom (A.D.H.)
| | - Alun D. Hughes
- From the Robert Steiner MRI Unit, MRC Clinical Sciences Centre, Imperial College London, London, United Kingdom (B.C., A.S.M.d.M., T.J.W.D., T.D., G.D., S.A.C., D.P.O.R.); Department of Cardiology, Imperial College Healthcare NHS Trust, London, United Kingdom (N.G.K.); Institut National de la Santé et de la Recherche Médicale (INSERM), Paris, France (A.D.); International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom (A.D.H.)
| | - Stuart A. Cook
- From the Robert Steiner MRI Unit, MRC Clinical Sciences Centre, Imperial College London, London, United Kingdom (B.C., A.S.M.d.M., T.J.W.D., T.D., G.D., S.A.C., D.P.O.R.); Department of Cardiology, Imperial College Healthcare NHS Trust, London, United Kingdom (N.G.K.); Institut National de la Santé et de la Recherche Médicale (INSERM), Paris, France (A.D.); International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom (A.D.H.)
| | - Declan P. O’Regan
- From the Robert Steiner MRI Unit, MRC Clinical Sciences Centre, Imperial College London, London, United Kingdom (B.C., A.S.M.d.M., T.J.W.D., T.D., G.D., S.A.C., D.P.O.R.); Department of Cardiology, Imperial College Healthcare NHS Trust, London, United Kingdom (N.G.K.); Institut National de la Santé et de la Recherche Médicale (INSERM), Paris, France (A.D.); International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom (A.D.H.)
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69
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Metabolic parameters associated with arterial stiffness in older adults with Type 2 diabetes. J Hypertens 2013; 31:1010-7. [DOI: 10.1097/hjh.0b013e32835f7ecf] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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70
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Chen JY, Tsai PJ, Tai HC, Tsai RL, Chang YT, Wang MC, Chiou YW, Yeh ML, Tang MJ, Lam CF, Shiesh SC, Li YH, Tsai WC, Chou CH, Lin LJ, Wu HL, Tsai YS. Increased Aortic Stiffness and Attenuated Lysyl Oxidase Activity in Obesity. Arterioscler Thromb Vasc Biol 2013; 33:839-46. [DOI: 10.1161/atvbaha.112.300036] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective—
One potential mechanism through which obesity exerts adverse effects on the vascular system is by increasing aortic stiffness, a change known to be predictive of increased cardiovascular mortality. The aim of this study was to investigate the pathophysiology that links obesity to aortic stiffening.
Approach and Results—
Obese (
ob/ob
) mice were used to examine physical, morphological, and molecular changes in the aorta in response to obesity.
ob/ob
mice had increased aortic pulse wave velocity and tissue rigidity.
ob/ob
aorta exhibited decreases of lysyl oxidase (LOX) activity and cross-linked elastin, and increases of elastin fragmentation and elastolytic activity. The aortas of
ob/ob
mice were surrounded by a significant amount of proinflammatory and pro-oxidative perivascular adipose tissue. In vitro studies revealed that the conditioned medium from differentiated adipocytes or the perivascular adipose tissue of
ob/ob
mice attenuated LOX activity. Furthermore, inhibition of LOX in wild-type lean mice caused elastin fragmentation and induced a significant increase in pulse wave velocity. Finally, we found that obese humans had stiffer arteries and lower serum LOX levels than do normal-weight humans.
Conclusion—
Our results demonstrated that obesity resulted in aortic stiffening in both humans and mice, and established a causal relationship between LOX downregulation and aortic stiffening in obesity.
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Affiliation(s)
- Ju-Yi Chen
- From the Institute of Clinical Medicine (J.-Y.C., H.-C.T., R.-L.T., Y.-T.C., M.-C.W., Y.-S.T.), Cardiovascular Research Center (J.-Y.C., H.-C.T., Y.-H.L., H.-L.W.), Department of Medical Laboratory Science and Biotechnology (P.-J.T., S.-C.S.), Institute of Biomedical Engineering (Y.-W.C., M.-L.Y.), Department of Physiology (M.-J.T.), Department of Anesthesiology (C.-F.L.), Institute of Clinical Pharmacy and Pharmaceutical Sciences (L.-J.L.), and Department of Biochemistry and Molecular Biology (H.-L
| | - Pei-Jane Tsai
- From the Institute of Clinical Medicine (J.-Y.C., H.-C.T., R.-L.T., Y.-T.C., M.-C.W., Y.-S.T.), Cardiovascular Research Center (J.-Y.C., H.-C.T., Y.-H.L., H.-L.W.), Department of Medical Laboratory Science and Biotechnology (P.-J.T., S.-C.S.), Institute of Biomedical Engineering (Y.-W.C., M.-L.Y.), Department of Physiology (M.-J.T.), Department of Anesthesiology (C.-F.L.), Institute of Clinical Pharmacy and Pharmaceutical Sciences (L.-J.L.), and Department of Biochemistry and Molecular Biology (H.-L
| | - Haw-Chih Tai
- From the Institute of Clinical Medicine (J.-Y.C., H.-C.T., R.-L.T., Y.-T.C., M.-C.W., Y.-S.T.), Cardiovascular Research Center (J.-Y.C., H.-C.T., Y.-H.L., H.-L.W.), Department of Medical Laboratory Science and Biotechnology (P.-J.T., S.-C.S.), Institute of Biomedical Engineering (Y.-W.C., M.-L.Y.), Department of Physiology (M.-J.T.), Department of Anesthesiology (C.-F.L.), Institute of Clinical Pharmacy and Pharmaceutical Sciences (L.-J.L.), and Department of Biochemistry and Molecular Biology (H.-L
| | - Ruei-Lan Tsai
- From the Institute of Clinical Medicine (J.-Y.C., H.-C.T., R.-L.T., Y.-T.C., M.-C.W., Y.-S.T.), Cardiovascular Research Center (J.-Y.C., H.-C.T., Y.-H.L., H.-L.W.), Department of Medical Laboratory Science and Biotechnology (P.-J.T., S.-C.S.), Institute of Biomedical Engineering (Y.-W.C., M.-L.Y.), Department of Physiology (M.-J.T.), Department of Anesthesiology (C.-F.L.), Institute of Clinical Pharmacy and Pharmaceutical Sciences (L.-J.L.), and Department of Biochemistry and Molecular Biology (H.-L
| | - Yu-Tzu Chang
- From the Institute of Clinical Medicine (J.-Y.C., H.-C.T., R.-L.T., Y.-T.C., M.-C.W., Y.-S.T.), Cardiovascular Research Center (J.-Y.C., H.-C.T., Y.-H.L., H.-L.W.), Department of Medical Laboratory Science and Biotechnology (P.-J.T., S.-C.S.), Institute of Biomedical Engineering (Y.-W.C., M.-L.Y.), Department of Physiology (M.-J.T.), Department of Anesthesiology (C.-F.L.), Institute of Clinical Pharmacy and Pharmaceutical Sciences (L.-J.L.), and Department of Biochemistry and Molecular Biology (H.-L
| | - Mei-Chung Wang
- From the Institute of Clinical Medicine (J.-Y.C., H.-C.T., R.-L.T., Y.-T.C., M.-C.W., Y.-S.T.), Cardiovascular Research Center (J.-Y.C., H.-C.T., Y.-H.L., H.-L.W.), Department of Medical Laboratory Science and Biotechnology (P.-J.T., S.-C.S.), Institute of Biomedical Engineering (Y.-W.C., M.-L.Y.), Department of Physiology (M.-J.T.), Department of Anesthesiology (C.-F.L.), Institute of Clinical Pharmacy and Pharmaceutical Sciences (L.-J.L.), and Department of Biochemistry and Molecular Biology (H.-L
| | - Yu-Wei Chiou
- From the Institute of Clinical Medicine (J.-Y.C., H.-C.T., R.-L.T., Y.-T.C., M.-C.W., Y.-S.T.), Cardiovascular Research Center (J.-Y.C., H.-C.T., Y.-H.L., H.-L.W.), Department of Medical Laboratory Science and Biotechnology (P.-J.T., S.-C.S.), Institute of Biomedical Engineering (Y.-W.C., M.-L.Y.), Department of Physiology (M.-J.T.), Department of Anesthesiology (C.-F.L.), Institute of Clinical Pharmacy and Pharmaceutical Sciences (L.-J.L.), and Department of Biochemistry and Molecular Biology (H.-L
| | - Ming-Long Yeh
- From the Institute of Clinical Medicine (J.-Y.C., H.-C.T., R.-L.T., Y.-T.C., M.-C.W., Y.-S.T.), Cardiovascular Research Center (J.-Y.C., H.-C.T., Y.-H.L., H.-L.W.), Department of Medical Laboratory Science and Biotechnology (P.-J.T., S.-C.S.), Institute of Biomedical Engineering (Y.-W.C., M.-L.Y.), Department of Physiology (M.-J.T.), Department of Anesthesiology (C.-F.L.), Institute of Clinical Pharmacy and Pharmaceutical Sciences (L.-J.L.), and Department of Biochemistry and Molecular Biology (H.-L
| | - Ming-Jer Tang
- From the Institute of Clinical Medicine (J.-Y.C., H.-C.T., R.-L.T., Y.-T.C., M.-C.W., Y.-S.T.), Cardiovascular Research Center (J.-Y.C., H.-C.T., Y.-H.L., H.-L.W.), Department of Medical Laboratory Science and Biotechnology (P.-J.T., S.-C.S.), Institute of Biomedical Engineering (Y.-W.C., M.-L.Y.), Department of Physiology (M.-J.T.), Department of Anesthesiology (C.-F.L.), Institute of Clinical Pharmacy and Pharmaceutical Sciences (L.-J.L.), and Department of Biochemistry and Molecular Biology (H.-L
| | - Chen-Fuh Lam
- From the Institute of Clinical Medicine (J.-Y.C., H.-C.T., R.-L.T., Y.-T.C., M.-C.W., Y.-S.T.), Cardiovascular Research Center (J.-Y.C., H.-C.T., Y.-H.L., H.-L.W.), Department of Medical Laboratory Science and Biotechnology (P.-J.T., S.-C.S.), Institute of Biomedical Engineering (Y.-W.C., M.-L.Y.), Department of Physiology (M.-J.T.), Department of Anesthesiology (C.-F.L.), Institute of Clinical Pharmacy and Pharmaceutical Sciences (L.-J.L.), and Department of Biochemistry and Molecular Biology (H.-L
| | - Shu-Chu Shiesh
- From the Institute of Clinical Medicine (J.-Y.C., H.-C.T., R.-L.T., Y.-T.C., M.-C.W., Y.-S.T.), Cardiovascular Research Center (J.-Y.C., H.-C.T., Y.-H.L., H.-L.W.), Department of Medical Laboratory Science and Biotechnology (P.-J.T., S.-C.S.), Institute of Biomedical Engineering (Y.-W.C., M.-L.Y.), Department of Physiology (M.-J.T.), Department of Anesthesiology (C.-F.L.), Institute of Clinical Pharmacy and Pharmaceutical Sciences (L.-J.L.), and Department of Biochemistry and Molecular Biology (H.-L
| | - Yi-Heng Li
- From the Institute of Clinical Medicine (J.-Y.C., H.-C.T., R.-L.T., Y.-T.C., M.-C.W., Y.-S.T.), Cardiovascular Research Center (J.-Y.C., H.-C.T., Y.-H.L., H.-L.W.), Department of Medical Laboratory Science and Biotechnology (P.-J.T., S.-C.S.), Institute of Biomedical Engineering (Y.-W.C., M.-L.Y.), Department of Physiology (M.-J.T.), Department of Anesthesiology (C.-F.L.), Institute of Clinical Pharmacy and Pharmaceutical Sciences (L.-J.L.), and Department of Biochemistry and Molecular Biology (H.-L
| | - Wei-Chuan Tsai
- From the Institute of Clinical Medicine (J.-Y.C., H.-C.T., R.-L.T., Y.-T.C., M.-C.W., Y.-S.T.), Cardiovascular Research Center (J.-Y.C., H.-C.T., Y.-H.L., H.-L.W.), Department of Medical Laboratory Science and Biotechnology (P.-J.T., S.-C.S.), Institute of Biomedical Engineering (Y.-W.C., M.-L.Y.), Department of Physiology (M.-J.T.), Department of Anesthesiology (C.-F.L.), Institute of Clinical Pharmacy and Pharmaceutical Sciences (L.-J.L.), and Department of Biochemistry and Molecular Biology (H.-L
| | - Chang-Hua Chou
- From the Institute of Clinical Medicine (J.-Y.C., H.-C.T., R.-L.T., Y.-T.C., M.-C.W., Y.-S.T.), Cardiovascular Research Center (J.-Y.C., H.-C.T., Y.-H.L., H.-L.W.), Department of Medical Laboratory Science and Biotechnology (P.-J.T., S.-C.S.), Institute of Biomedical Engineering (Y.-W.C., M.-L.Y.), Department of Physiology (M.-J.T.), Department of Anesthesiology (C.-F.L.), Institute of Clinical Pharmacy and Pharmaceutical Sciences (L.-J.L.), and Department of Biochemistry and Molecular Biology (H.-L
| | - Li-Jen Lin
- From the Institute of Clinical Medicine (J.-Y.C., H.-C.T., R.-L.T., Y.-T.C., M.-C.W., Y.-S.T.), Cardiovascular Research Center (J.-Y.C., H.-C.T., Y.-H.L., H.-L.W.), Department of Medical Laboratory Science and Biotechnology (P.-J.T., S.-C.S.), Institute of Biomedical Engineering (Y.-W.C., M.-L.Y.), Department of Physiology (M.-J.T.), Department of Anesthesiology (C.-F.L.), Institute of Clinical Pharmacy and Pharmaceutical Sciences (L.-J.L.), and Department of Biochemistry and Molecular Biology (H.-L
| | - Hua-Lin Wu
- From the Institute of Clinical Medicine (J.-Y.C., H.-C.T., R.-L.T., Y.-T.C., M.-C.W., Y.-S.T.), Cardiovascular Research Center (J.-Y.C., H.-C.T., Y.-H.L., H.-L.W.), Department of Medical Laboratory Science and Biotechnology (P.-J.T., S.-C.S.), Institute of Biomedical Engineering (Y.-W.C., M.-L.Y.), Department of Physiology (M.-J.T.), Department of Anesthesiology (C.-F.L.), Institute of Clinical Pharmacy and Pharmaceutical Sciences (L.-J.L.), and Department of Biochemistry and Molecular Biology (H.-L
| | - Yau-Sheng Tsai
- From the Institute of Clinical Medicine (J.-Y.C., H.-C.T., R.-L.T., Y.-T.C., M.-C.W., Y.-S.T.), Cardiovascular Research Center (J.-Y.C., H.-C.T., Y.-H.L., H.-L.W.), Department of Medical Laboratory Science and Biotechnology (P.-J.T., S.-C.S.), Institute of Biomedical Engineering (Y.-W.C., M.-L.Y.), Department of Physiology (M.-J.T.), Department of Anesthesiology (C.-F.L.), Institute of Clinical Pharmacy and Pharmaceutical Sciences (L.-J.L.), and Department of Biochemistry and Molecular Biology (H.-L
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Figueroa A, Vicil F, Sanchez-Gonzalez MA, Wong A, Ormsbee MJ, Hooshmand S, Daggy B. Effects of diet and/or low-intensity resistance exercise training on arterial stiffness, adiposity, and lean mass in obese postmenopausal women. Am J Hypertens 2013; 26:416-23. [PMID: 23382493 DOI: 10.1093/ajh/hps050] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Obesity and aging are associated with increased arterial stiffness as indicated by an increased pulse-wave velocity (PWV). We evaluated the independent and combined effects on PWV and body composition of a hypocaloric diet and low-intensity resistance exercise training (LIRET) with slow movement. METHODS Forty-one postmenopausal women (mean age, 54±6 years; body mass index (BMI), 33.8±0.5kg/m(2)) were randomly assigned to LIRET (n = 14), diet (n = 13), or diet + LIRET (n = 14) for 12 weeks. The women's PWV, mean arterial pressure (MAP), body composition by dual-en ergy x-ray absorptiometry (DXA), and plasma adipokine and insulin levels were measured before and after the interventions. RESULTS Body weight (P = 0.0001), trunk-fat mass (FM, P = 0.0001), and the serum concentration of leptin (P = 0.02 and P = 0.004) decreased similarly with diet and diet + LIRET, but not with LIRET alone. Leg lean mass (LM) decreased (P = 0.02) with diet, but did not change with diet + LIRET or with LIRET alone. Leg muscle strength increased similarly with LIRET (P = 0.001) and diet + LIRET (P = 0.0001), but did not change with diet alone. Brachial-ankle PWV (baPWV) decreased with diet (P = 0.04) and diet + LIRET (P = 0.01), whereas femoral-ankle PWV (legPWV) decreased only with diet (P = 0.01). Mean arterial pressure (MAP) decreased after LIRET (P = 0.03), diet (P = 0.04), and diet + LIRET (P = 0.004). Carotid-femoral PWV, serum adiponectin concentration, and insulin were not significantly affected by the interventions examined in the study. The reductions in baPWV and legPWV were correlated with one another (r = 0.73, P = 0.0001), and the reductions in legPWV and trunk FM were also correlated with one another (r = 0.36, P = 0.03). CONCLUSIONS A hypocaloric diet decreases baPWV mainly by reducing legPWV, and this reduction is related to the loss of truncal fat. Although LIRET alone does not affect PWV or body composition, LIRET combined with diet improves baPWV and muscle strength while preventing loss of lean body mass in obese postmenopausal women.
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Affiliation(s)
- Arturo Figueroa
- Department of Nutrition, Food and Exercise Sciences, The Florida State University, Tallahassee, FL, USA.
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72
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Goto K, Shioda K, Uchida S. Effect of 2 days of intensive resistance training on appetite-related hormone and anabolic hormone responses. Clin Physiol Funct Imaging 2012; 33:131-6. [PMID: 23383691 DOI: 10.1111/cpf.12005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2012] [Accepted: 09/18/2012] [Indexed: 01/31/2023]
Abstract
This study was designed to determine endocrine responses during 2 days of strenuous resistance training. Ten healthy men performed resistance training twice a day for two successive days to induce acute fatigue (excessive physical stress). The resistance training consisted of four exercises for the lower body in the morning and seven exercises for the upper body in the afternoon. Maximal isometric and isokinetic strengths were measured from day 1 (before the training period) to day 3 (after the training period). Fasting blood samples were taken on days 1-3. Maximal isometric and isokinetic strengths significantly decreased with two successive days of training (P<0·05), with significant increases in serum creatine phosphokinase and myoglobin concentrations (P<0·05). Significant reductions in the fasting concentrations of serum insulin-like growth factor-1, free testosterone, insulin and high-molecular-weight adiponectin were observed on day 3 (P<0·05), whereas there were no changes in the serum cortisol concentration or the free testosterone/cortisol ratio. Plasma active ghrelin and serum leptin concentrations decreased by -20·7 ± 2·8% and -29·6 ± 4·1%, respectively (P<0·05). Two days strenuous resistance training significantly affects the profiles of anabolic hormone and endocrine regulators of appetite and energy balance, such as ghrelin and leptin. The present findings suggest that decreased ghrelin and leptin concentrations might reflect excessive physical stress and may be early signs of accumulated fatigue.
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Affiliation(s)
- Kazushige Goto
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsushi, Shiga, Japan.
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73
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Rider OJ, Lewandowski A, Nethononda R, Petersen SE, Francis JM, Pitcher A, Holloway CJ, Dass S, Banerjee R, Byrne JP, Leeson P, Neubauer S. Gender-specific differences in left ventricular remodelling in obesity: insights from cardiovascular magnetic resonance imaging. Eur Heart J 2012; 34:292-9. [PMID: 23053174 DOI: 10.1093/eurheartj/ehs341] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
AIMS As obesity-related cardiovascular mortality, although elevated when compared with normal weight, is lower in females than in males at every body mass index (BMI) level, we aimed to investigate gender-specific differences in left ventricular (LV) hypertrophy in obesity, which themselves have been shown to have varying prognostic value. METHOD AND RESULTS In total, 741 subjects (female, n = 399) without identifiable cardiovascular risk factors (BMI 15.7-59.2 kg/m(2)) underwent cardiovascular magnetic resonance (1.5 T) to determine LV mass, end-diastolic volume (EDV, mL), and LV mass/volume ratio (LVM/VR). Across both sexes, there was a strong positive correlation between BMI and LV mass (male r = 0.44, female r = 0.57, both P < 0.001), with males showing a greater LV hypertrophic response (male +2.3 vs. female +1.6 g per BMI point increase, P = 0.001). Concentric hypertrophy was present in both sexes and LVM/VR positively correlated to BMI (male r = 0.45, female r = 0.29, both P < 0.001) on linear regression analysis. However, the degree of concentric hypertrophy was greater in males (male +0.13 vs. female +0.06 LVM/VR increase per BMI point increase, P = 0.001). On the other hand, females showed a greater LV cavity dilatory response (female +1.1 vs. male +0.3 mL per BMI point increase, P < 0.001). Indeed, in contrast to females, where BMI and LV-EDV were positively correlated (r = 0.38, P < 0.001), BMI did not correlate with EDV in men (r = 0.03, P = 0.62). CONCLUSION In the absence of traditional cardiovascular risk factors, obese men show predominantly concentric hypertrophy, whereas obese women exhibit both eccentric and concentric hypertrophy. As concentric hypertrophy is more strongly related to cardiovascular mortality than eccentric hypertrophy, our observations may explain the observed gender difference in obesity-related mortality.
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Affiliation(s)
- Oliver J Rider
- Department of Cardiovascular Medicine, University of Oxford, UK.
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74
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Does chronic kidney disease modify the association between body mass index and cardiovascular disease risk factors. J Nephrol 2012; 25:317-24. [PMID: 21725923 DOI: 10.5301/jn.2011.8454] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2011] [Indexed: 11/20/2022]
Abstract
BACKGROUND Excess weight is paradoxically associated with better cardiovascular disease (CVD) outcomes and mortality in end-stage renal disease (ESRD) patients treated with hemodialysis. This association has been observed in chronic kidney disease (CKD) as well. One potential explanation for this inverse relationship is that the usual positive correlation between severity of CVD risk factors and higher body mass index (BMI) is reversed in CKD. To test this hypothesis, we determined the relationship between BMI and CVD risk factors in patients with and without CKD. METHODS This was a cross-sectional study of the nationally representative US National Health and Nutrition Examination Survey (NHANES) 1999-2006. CKD was defined as glomerular filtration rate <60 ml/min per 1.73 m2. Covariates were age, race/ethnicity, sex and use of relevant prescription medications. Outcome variables were total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, systolic blood pressure (SBP), diastolic blood pressure (DBP), C-reactive protein (CRP) and fasting glucose (FG). RESULTS There were 1,895 and 32,431 patients with and without CKD, respectively. Those with CKD were older and had higher BMI. The shapes of the association between BMI and total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, SBP, CRP and FG were similar in those with or without CKD. In a sensitivity analysis excluding patients taking relevant prescription medications, our results did not differ substantially. CONCLUSIONS CKD did not alter the shapes of the association between higher BMI and CVD risk factors. Inverse associations between BMI and CVD risk factors are unlikely to explain why CKD patients with higher BMI may have better outcomes.
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75
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Cooper JN, Buchanich JM, Youk A, Brooks MM, Barinas-Mitchell E, Conroy MB, Sutton-Tyrrell K. Reductions in arterial stiffness with weight loss in overweight and obese young adults: potential mechanisms. Atherosclerosis 2012; 223:485-90. [PMID: 22703865 PMCID: PMC3411893 DOI: 10.1016/j.atherosclerosis.2012.05.022] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2012] [Revised: 03/20/2012] [Accepted: 05/22/2012] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Arterial stiffness decreases with weight loss in overweight/obese young adults. We aimed to determine the mechanisms by which this occurs. METHODS We evaluated carotid-femoral pulse wave velocity (cfPWV) and brachial-ankle pulse wave velocity (baPWV) in 344 young adults (23% male, BMI 25-40 kg/m(2)) at baseline, 6, and 12 months in a behavioral weight loss intervention. Linear mixed models were used to evaluate associations between weight loss and arterial stiffness and to examine whether improvements in obesity-related factors explained these associations. RESULTS At 6 months (7% mean weight loss), there was a significant median decrease of 47.5 cm/s in cfPWV (p < 0.0001) and a mean decrease of 11.7 cm/s in baPWV (p = 0.049). At 12 months (6% mean weight loss), only cfPWV remained reduced. In models adjusting for changes in mean arterial pressure and obesity-related factors, changes in BMI (p = 0.01) and common carotid artery diameter (p = 0.003) were positively associated with change in cfPWV. Reductions in heart rate (p < 0.0001) and C-reactive protein (p = 0.02) were associated with reduced baPWV and accounted for the association between weight loss and reduced baPWV. CONCLUSIONS Weight loss is associated with reduced cfPWV independently of changes in established hemodynamic and cardiometabolic risk factors, but its association with reduced baPWV is explained by concurrent reductions in heart rate and inflammation.
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Affiliation(s)
- Jennifer N. Cooper
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto St., Pittsburgh, PA, USA 15261
- Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto St., Pittsburgh, PA, USA 15261
| | - Jeanine M. Buchanich
- Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto St., Pittsburgh, PA, USA 15261
| | - Ada Youk
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto St., Pittsburgh, PA, USA 15261
- Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto St., Pittsburgh, PA, USA 15261
| | - Maria Mori Brooks
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto St., Pittsburgh, PA, USA 15261
- Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto St., Pittsburgh, PA, USA 15261
| | - Emma Barinas-Mitchell
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto St., Pittsburgh, PA, USA 15261
| | - Molly B. Conroy
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto St., Pittsburgh, PA, USA 15261
- Division of General Internal Medicine, University of Pittsburgh, UPMC Montefiore Hospital, Suite W933, Pittsburgh, PA, USA 15213
| | - Kim Sutton-Tyrrell
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto St., Pittsburgh, PA, USA 15261
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Pucci G, Battista F, Schillaci G. Aerobic physical exercise and arterial de-stiffening: a recipe for vascular rejuvenation? Hypertens Res 2012; 35:964-6. [PMID: 22786568 DOI: 10.1038/hr.2012.107] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Giacomo Pucci
- Unit of Internal Medicine, Department of Clinical and Experimental Medicine, University of Perugia, S. Maria Hospital, Terni, Italy
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77
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van der Meer RW, Lamb HJ, Smit JWA, de Roos A. MR Imaging Evaluation of Cardiovascular Risk in Metabolic Syndrome. Radiology 2012; 264:21-37. [DOI: 10.1148/radiol.12110772] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Poudyal H, Panchal SK, Ward LC, Waanders J, Brown L. Chronic high-carbohydrate, high-fat feeding in rats induces reversible metabolic, cardiovascular, and liver changes. Am J Physiol Endocrinol Metab 2012; 302:E1472-82. [PMID: 22436699 DOI: 10.1152/ajpendo.00102.2012] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Age-related physiological changes develop at the same time as the increase in metabolic syndrome in humans after young adulthood. There is a paucity of data in models mimicking chronic diet-induced changes in human middle age and interventions to reverse these changes. This study measured the changes during chronic consumption of a high-carbohydrate (as cornstarch), low-fat (C) diet and a high-carbohydrate (as fructose and sucrose), high-fat (H) diet in rats for 32 wk. C diet feeding induced changes without metabolic syndrome, such as disproportionate increases in total body lean and fat mass, reduced bone mineral content, cardiovascular remodeling with increased systolic blood pressure, left ventricular and arterial stiffness, and increased plasma markers of liver injury. H diet feeding induced visceral adiposity with reduced lean mass, increased lipid infiltration in the skeletal muscle, impaired glucose and insulin tolerance, cardiovascular remodeling, hepatic steatosis, and increased infiltration of inflammatory cells in the heart and the liver. Chia seed supplementation for 24 wk attenuated most structural and functional modifications induced by age or H diet, including increased whole body lean mass and lipid redistribution from the abdominal area, and normalized the chronic low-grade inflammation induced by H diet feeding; these effects may be mediated by increased metabolism of anti-inflammatory n-3 fatty acids from chia seed. These results suggest that chronic H diet feeding for 32 wk mimics the diet-induced cardiovascular and metabolic changes in middle age and that chia seed may serve as an alternative dietary strategy in the management of these changes.
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Affiliation(s)
- Hemant Poudyal
- School of Biomedical Sciences, The University of Queensland, Brisbane, Australia
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Budimir D, Jeroncic A, Gunjaca G, Rudan I, Polasek O, Boban M. Sex-specific association of anthropometric measures of body composition with arterial stiffness in a healthy population. Med Sci Monit 2012; 18:CR65-71. [PMID: 22293879 PMCID: PMC3560590 DOI: 10.12659/msm.882457] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background Anthropometric measures of body composition and arterial stiffness are commonly used as indicators of cardiovascular risk. Little is known, however, about the association of the anthropometric measures with arterial stiffness, especially in a healthy, generally non-obese population. Material/Methods In a sample of 352 healthy subjects (200 premenopausal women), 3 arterial stiffness indices were analyzed (pulse wave velocity, augmentation index and central systolic blood pressure) in relation to 5 anthropometric measures of body composition (body mass index – BMI, body fat percentage by skinfold measurements –%BF, waist circumference – WC, waist-hip ratio – WHpR, and waist-height ratio – WHtR). Data were analyzed using correlation and regression analyses, with adjustment for the following confounders: age, blood pressures, height, heart rate, blood lipids and smoking. Results Most correlations between anthropometric measures and arterial stiffness indices were significant and positive in both sex groups (r=0.14–0.40, P<0.05). After adjustment for confounding effects, BMI, WC and WHtR remained significant (but inverse) predictors of arterial stiffness (β from −0.06 to −0.16; P<0.05) in the females, while in the males BMI was the only measure inversely predicting arterial stiffness (β from −0.09 to −0.13; P<0.05). Conclusions Measures of body composition are weak and inverse predictors of arterial stiffness and their influence is sex-dependent. BMI, WC and WHtR were key predictors of arterial stiffness in the females, while BMI was the principal predictor in the males. The associations of anthropometric measures with arterial stiffness are strongly and differently confounded by various factors that have to be taken into account when explaining results of similar studies.
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Affiliation(s)
- Danijela Budimir
- Department of Pharmacology, University of Split School of Medicine, Split, Croatia
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80
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Comprehensive MRI analysis of early cardiac and vascular remodeling in middle-aged patients with abdominal obesity. J Hypertens 2012; 30:567-73. [DOI: 10.1097/hjh.0b013e32834f6f3f] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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81
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Recio-Rodriguez JI, Gomez-Marcos MA, Patino-Alonso MC, Agudo-Conde C, Rodriguez-Sanchez E, Garcia-Ortiz L. Abdominal obesity vs general obesity for identifying arterial stiffness, subclinical atherosclerosis and wave reflection in healthy, diabetics and hypertensive. BMC Cardiovasc Disord 2012; 12:3. [PMID: 22292502 PMCID: PMC3395841 DOI: 10.1186/1471-2261-12-3] [Citation(s) in RCA: 99] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2011] [Accepted: 02/01/2012] [Indexed: 02/08/2023] Open
Abstract
Background Our aim was to analyze the relationship between abdominal obesity and general obesity, with subclinical atherosclerosis, arterial stiffness and wave reflection in healthy, diabetics and hypertensive subjects. Methods A cross-sectional descriptive study was made of 305 individuals (diabetics 32.8%, hypertensive subjects 37.0% and healthy individuals 30.2%). Measurements: Body mass index (BMI), waist circumference (WC), body fat percentage (BFP) and waist/height ratio (WHtR). Arterial stiffness was assessed according to pulse wave velocity (PWV), intima-media thickness of the common carotid artery (C-IMT), augmentation index (central and peripheral), ankle-brachial index (ABI), and central and peripheral pulse pressure. Results WC and WHtR showed a positive correlation to PWV and C-IMT in the studied groups. After adjusting for age, gender, high sensitivity c-reactive protein, serum glucose and the presence of diabetes, hypertension, smoking, dyslipidemia, antidiabetic drugs, lipid-lowering drugs, and atherosclerotic plaques, it was seen that for every 0.1 point increase in WHtR, and for every cm increase in WC, the PWV increased 0.041 and 0.029 m/sec, and C-IMT increased 0.001 mm and 0.001 mm, respectively. Conclusions The measures of abdominal obesity (WHtR and WC) correlates better than BMI and BFP with arterial stiffness evaluated by PWV, and with subclinical atherosclerosis evaluated by C-IMT, independently of the presence of diabetes or hypertension. Trial Registration Clinical Trials.gov Identifier: NCT01325064
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Affiliation(s)
- Jose I Recio-Rodriguez
- Primary Care Research Unit, La Alamedilla Health Center, SACYL, REDIAPP, Salamanca, Spain.
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82
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Barton M, Baretella O, Meyer MR. Obesity and risk of vascular disease: importance of endothelium-dependent vasoconstriction. Br J Pharmacol 2012; 165:591-602. [PMID: 21557734 PMCID: PMC3315033 DOI: 10.1111/j.1476-5381.2011.01472.x] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2011] [Revised: 04/04/2011] [Accepted: 04/25/2011] [Indexed: 12/11/2022] Open
Abstract
UNLABELLED Obesity has become a serious global health issue affecting both adults and children. Recent devolopments in world demographics and declining health status of the world's population indicate that the prevalence of obesity will continue to increase in the next decades. As a disease, obesity has deleterious effects on metabolic homeostasis, and affects numerous organ systems including heart, kidney and the vascular system. Thus, obesity is now regarded as an independent risk factor for atherosclerosis-related diseases such as coronary artery disease, myocardial infarction and stroke. In the arterial system, endothelial cells are both the source and target of factors contributing to atherosclerosis. Endothelial vasoactive factors regulate vascular homeostasis under physiological conditions and maintain basal vascular tone. Obesity results in an imbalance between endothelium-derived vasoactive factors favouring vasoconstriction, cell growth and inflammatory activation. Abnormal regulation of these factors due to endothelial cell dysfunction is both a consequence and a cause of vascular disease processes. Finally, because of the similarities of the vascular pathomechanisms activated, obesity can be considered to cause accelerated, 'premature' vascular aging. Here, we will review some of the pathomechanisms involved in obesity-related activation of endothelium-dependent vasoconstriction, the clinical relevance of obesity-associated vascular risk, and therapeutic interventions using 'endothelial therapy' aiming at maintaining or restoring vascular endothelial health. LINKED ARTICLES This article is part of a themed section on Fat and Vascular Responsiveness. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2012.165.issue-3.
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Affiliation(s)
- Matthias Barton
- Molecular Internal Medicine, University of Zurich, Zurich, Switzerland.
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83
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Lewandowski AJ, Lazdam M, Davis E, Kylintireas I, Diesch J, Francis J, Neubauer S, Singhal A, Lucas A, Kelly B, Leeson P. Short-term exposure to exogenous lipids in premature infants and long-term changes in aortic and cardiac function. Arterioscler Thromb Vasc Biol 2011; 31:2125-35. [PMID: 21817105 DOI: 10.1161/atvbaha.111.227298] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Intravenous lipid use is associated with an acute hyperlipidemia, but long-term consequences have not been studied. We investigated whether elevated lipids in humans during the critical period of preterm neonatal life have a long-term impact on aortic and myocardial function relevant to adult disease. METHODS AND RESULTS We followed up 102 subjects born prematurely and now aged 23 to 28 years. Eighteen received intravenous lipids as neonates and were matched to controls with equivalent perinatal characteristics. Global and regional aortic stiffness and left ventricular function were assessed by cardiovascular magnetic resonance. Those who received intravenous lipids had greater aortic stiffness in early adulthood (P=0.0002), with greater stiffness in the abdominal aorta (P=0.012). The relationship was graded according to the elevation in neonatal cholesterol induced by intravenous lipids (P<0.0001) but not other metabolic parameters altered by the infusion. Peak systolic circumferential strain was also reduced in the lipid group (P=0.006), which, again, was proportional to neonatal cholesterol level (P<0.01). CONCLUSIONS Aortic and myocardial function in young adulthood is associated with intralipid exposure during neonatal life for preterm infants, in a graded manner related to the rise in cholesterol. Circulating cholesterol during critical developmental periods may have long-term impacts on the human cardiovascular system.
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Affiliation(s)
- Adam J Lewandowski
- Cardiovascular Clinical Research Facility, Department of Cardiovascular Medicine, University of Oxford, Oxford, United Kingdom
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84
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Schouten F, Twisk JW, de Boer MR, Stehouwer CD, Serné EH, Smulders YM, Ferreira I. Increases in central fat mass and decreases in peripheral fat mass are associated with accelerated arterial stiffening in healthy adults: the Amsterdam Growth and Health Longitudinal Study. Am J Clin Nutr 2011; 94:40-8. [PMID: 21562083 DOI: 10.3945/ajcn.111.013532] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Central fatness is associated with higher arterial stiffness, a mechanism that may explain adiposity-related increases in cardiovascular disease risk. In contrast, peripheral fat and lean masses may counteract such adverse effects, but evidence of this contention, as derived from longitudinal studies at the general population level, is lacking. OBJECTIVE The objective was to investigate the associations between changes in central (ie, trunk) fat mass, peripheral (ie, limbs) fat mass, and lean masses with changes in arterial stiffness. DESIGN A longitudinal study in 277 (145 women) healthy adults was conducted. Body composition (dual-energy X-ray absorptiometry) and arterial stiffness estimates (ultrasound imaging) were measured repeatedly at the ages of 36 and 42 y. RESULTS Changes (per 10 kg) in trunk fat mass were positively associated and changes in peripheral fat mass were inversely associated with carotid Young's elastic modulus (in 10(3) ⋅ kPa) [β = 0.14 (95% CI: 0.02, 0.25) and -0.16 (-0.30, -0.01), respectively] and carotid-femoral pulse wave velocity (in m/s) [β = 1.54 (0.02, 3.07) and -1.46 (-3.48, 0.56), respectively]. Individuals in whom trunk fat increased and peripheral fat decreased over the 6-y follow-up (33% of the study population) had the steepest increases in these stiffness estimates. Notably, these changes were accompanied by minor increases in body weight, which remained within the limits of the normal range throughout. CONCLUSIONS Increases in trunk mass and decreases in peripheral fat mass are associated with accelerated arterial stiffening. These findings emphasize the importance of assessing regional changes in body composition, because it may enable identification of individuals with an unrecognized increased cardiovascular disease risk.
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Affiliation(s)
- Fleur Schouten
- Department of Health Sciences and the EMGO Institute for Health and Care Research, Faculty of Earth and Life Sciences, VU University, Amsterdam, Netherlands, VU University Medical Center, Amsterdam, Netherlands
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85
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Cockcroft JR, Wilkinson IB, Avolio AP, McEniery CM, Butlin M. Weight loss, blood pressure reduction, and aortic stiffness: an old dilemma revisited. Obesity (Silver Spring) 2011; 19:468. [PMID: 21346741 DOI: 10.1038/oby.2010.304] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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86
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Nordstrand N, Gjevestad E, Dinh KN, Hofsø D, Røislien J, Saltvedt E, Os I, Hjelmesæth J. The relationship between various measures of obesity and arterial stiffness in morbidly obese patients. BMC Cardiovasc Disord 2011; 11:7. [PMID: 21284837 PMCID: PMC3042421 DOI: 10.1186/1471-2261-11-7] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2010] [Accepted: 02/01/2011] [Indexed: 02/08/2023] Open
Abstract
Background Obesity is associated with increased risk of cardiovascular disease. Arterial stiffness assessed by carotid femoral pulse wave velocity (PWV) is an independent predictor of cardiovascular morbidity and mortality. We aimed to investigate how various measures of body composition affect arterial stiffness. Methods This is an analysis of cross-sectional baseline data from a controlled clinical trial addressing changes in arterial stiffness after either surgery or lifestyle intervention in a population of morbidly obese patients. High-fidelity applanation tonometry (Millar®, Sphygmocor®) was used to measure pulse wave velocity (PWV). Carotid femoral PWV is a direct measure of arterial stiffness and is considered to be the gold standard method. The Inbody 720 Body Composition Analyzer was used for bioelectrical impedance analysis (BIA). Spearman's correlation, independent samples t-test, chi-square tests, Fisher's exact test and multiple linear regression analyses were used as statistical methods. Results A total of 133 patients (79 women), with a mean (SD) age of 43 (11) years were included in the study. Men had a significantly higher prevalence of obesity related comorbidities and significantly higher PWV, 9.1 (2.0) m/s vs. 8.1 (1.8) m/s, p = 0.003, than women. In the female group, PWV was positively correlated with WC, WHtR, BMI and visceral fat area. In the male group, PWV was negatively correlated with BMI. Multiple linear regression analysis showed that increasing BMI, WC, WHtR, visceral fat area and fat mass were independently associated with higher PWV in women, but not in men, after adjustment for age, hypertension and type 2 diabetes. Conclusion Most measures of general and abdominal obesity were predictors of arterial stiffness in female morbidly obese patients. Trial registration ClinicalTrials.gov Identifier NCT00626964
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Affiliation(s)
- N Nordstrand
- Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway.
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87
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Obesity and aging: determinants of endothelial cell dysfunction and atherosclerosis. Pflugers Arch 2010; 460:825-37. [DOI: 10.1007/s00424-010-0860-y] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2010] [Accepted: 06/17/2010] [Indexed: 02/02/2023]
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