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Matsumoto T, Murase K, Tabara Y, Gozal D, Smith D, Minami T, Tachikawa R, Tanizawa K, Oga T, Nagashima S, Wakamura T, Komenami N, Setoh K, Kawaguchi T, Tsutsumi T, Takahashi Y, Nakayama T, Hirai T, Matsuda F, Chin K. Impact of sleep characteristics and obesity on diabetes and hypertension across genders and menopausal status: the Nagahama study. Sleep 2018; 41:4985386. [DOI: 10.1093/sleep/zsy071] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Indexed: 12/20/2022] Open
Affiliation(s)
- Takeshi Matsumoto
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kimihiko Murase
- Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yasuharu Tabara
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - David Gozal
- Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Chicago, IL
| | - Dale Smith
- Department of Behavioral Sciences, Olivet Nazarene University, Bourbonnais
| | - Takuma Minami
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ryo Tachikawa
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kiminobu Tanizawa
- Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Toru Oga
- Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shunsuke Nagashima
- Nursing Science, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tomoko Wakamura
- Nursing Science, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Naoko Komenami
- Department of Food and Nutrition, Kyoto Women’s University, Kyoto, Japan
| | - Kazuya Setoh
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takahisa Kawaguchi
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takanobu Tsutsumi
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yoshimitsu Takahashi
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
| | - Takeo Nakayama
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
| | - Toyohiro Hirai
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Fumihiko Matsuda
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kazuo Chin
- Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Haley AP, Oleson S, Pasha E, Birdsill A, Kaur S, Thompson J, Tanaka H. Phenotypic heterogeneity of obesity-related brain vulnerability: one-size interventions will not fit all. Ann N Y Acad Sci 2018; 1428:89-102. [PMID: 29741211 DOI: 10.1111/nyas.13673] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 02/10/2018] [Accepted: 02/17/2018] [Indexed: 01/07/2023]
Abstract
Intact memory and problem solving are key to functional independence and quality of life in older age. Considering the unprecedented demographic shift toward a greater number of older adults than children in the United States in the next few decades, it is critically important for older adults to maintain work productivity and functional independence for as long as possible. Implementing early interventions focused on modifiable risk factors for cognitive decline at midlife is a strategy with the highest chance of success at present, bearing in mind the current lack of dementia cures. We present a selective, narrative review of evidence linking nutrition, body composition, vascular health, and brain function in midlife to highlight the phenotypic heterogeneity of obesity-related brain vulnerability and to endorse the development of individually tailored lifestyle modification plans for primary prevention of cognitive decline.
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Affiliation(s)
- Andreana P Haley
- Department of Psychology, The University of Texas at Austin, Austin, Texas.,Imaging Research Center, The University of Texas at Austin, Austin, Texas
| | - Stephanie Oleson
- Department of Psychology, The University of Texas at Austin, Austin, Texas
| | - Evan Pasha
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, Texas
| | - Alex Birdsill
- Department of Psychology, The University of Texas at Austin, Austin, Texas
| | - Sonya Kaur
- Department of Psychology, The University of Texas at Austin, Austin, Texas
| | - Janelle Thompson
- Department of Psychology, The University of Texas at Austin, Austin, Texas
| | - Hirofumi Tanaka
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, Texas
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Prado NJ, Ferder L, Manucha W, Diez ER. Anti-Inflammatory Effects of Melatonin in Obesity and Hypertension. Curr Hypertens Rep 2018; 20:45. [PMID: 29744660 DOI: 10.1007/s11906-018-0842-6] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE OF REVIEW Here, we review the known relations between hypertension and obesity to inflammation and postulate the endogenous protective effect of melatonin and its potential as a therapeutic agent. We will describe the multiple effects of melatonin on blood pressure, adiposity, body weight, and focus on mitochondrial-related anti-inflammatory and antioxidant protective effects. RECENT FINDINGS Hypertension and obesity are usually associated with systemic and tissular inflammation. The progressive affection of target-organs involves multiple mediators of inflammation, most of them redundant, which make anti-inflammatory strategies ineffective. Melatonin reduces blood pressure, body weight, and inflammation. The mechanisms of action of this ancient molecule of protection involve multiple levels of action, from subcellular to intercellular. Mitochondria is a key inflammatory element in vascular and adipose tissue and a potential pharmacological target. Melatonin protects against mitochondrial dysfunction. Melatonin reduces blood pressure and adipose tissue dysfunction by multiple anti-inflammatory/antioxidant actions and provides potent protection against mitochondria-mediated injury in hypertension and obesity. This inexpensive and multitarget molecule has great therapeutic potential against both epidemic diseases.
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Affiliation(s)
- Natalia Jorgelina Prado
- Instituto de Medicina y Biología Experimental de Cuyo (IMBECU), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Mendoza, Argentina
| | - León Ferder
- Pediatric Department Nephrology Division, Miller School of Medicine, University of Miami, Florida, USA
| | - Walter Manucha
- Instituto de Medicina y Biología Experimental de Cuyo (IMBECU), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Mendoza, Argentina.,Área de Farmacología, Facultad de Ciencias Médicas, Universidad Nacional de Cuyo, Mendoza, Argentina
| | - Emiliano Raúl Diez
- Instituto de Medicina y Biología Experimental de Cuyo (IMBECU), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Mendoza, Argentina. .,Instituto de Fisiología, Facultad de Ciencias Médicas, Universidad Nacional de Cuyo, Centro Universitario, CP 5500, Mendoza, Argentina.
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Werneck AO, Oyeyemi AL, Gerage AM, Cyrino ES, Szwarcwald CL, Sardinha LB, Silva DR. Does leisure-time physical activity attenuate or eliminate the positive association between obesity and high blood pressure? J Clin Hypertens (Greenwich) 2018; 20:959-966. [PMID: 29693793 PMCID: PMC8030866 DOI: 10.1111/jch.13292] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 02/24/2018] [Accepted: 03/11/2018] [Indexed: 11/28/2022]
Abstract
We examine the joint association of weight status and leisure-time physical activity on high blood pressure in a nationally representative sample of adults and older adults in Brazil. This was a national cross-sectional survey conducted in Brazil in 2013 (Brazilian Health Survey). The sample consisted of 59 402 participants (56% women, aged 18 to 100 years). Outcome was objectively assessed blood pressure. Body mass index (BMI) was objectively measured, while self-reported information on leisure-time physical activity, TV viewing, chronological age, race, educational status, tobacco smoking, sodium consumption, and hypertension medication was obtained using questionnaires. Logistic regression analysis with adjusted odds ratio was conducted to test the joint association of BMI and leisure-time physical activity categories on high blood pressure. Overall, compared to normal weight (NW) and physically active group, the NW/inactive (OR = 1.28; 1.04 to 1.58), overweight/active (OR = 1.38; 1.08 to 1.78), overweight/inactive (OR = 1.89; 1.53 to 2.33), obese/active (OR = 2.19; 1.59 to 3.01) and obese/inactive (OR = 2.54; 2.05 to 3.15) groups were 28% to 254% more likely to have high blood pressure. The attenuation and high blood pressure was greater for women and adults than for men and older adults. Thus, leisure-time physical inactivity and being overweight and obesity were associated with high blood pressure in Brazilian population. Engaging in sufficient level of physical activity during leisure could attenuate, but not eliminate, the negative influence of obesity on high blood pressure in Brazilian adults and older adults.
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Affiliation(s)
- André O Werneck
- Study and Research Group in Metabolism, Nutrition, and Exercise (GEPEMENE)State University of LondrinaLondrinaBrazil
| | - Adewale L Oyeyemi
- Department of PhysiotherapyCollege of Medical SciencesUniversity of MaiduguriMaiduguriBorno StateNigeria
| | - Aline M Gerage
- Department of Physical EducationFederal University of Santa Catarina – UFSCFlorianópolisBrazil
| | - Edilson S Cyrino
- Study and Research Group in Metabolism, Nutrition, and Exercise (GEPEMENE)State University of LondrinaLondrinaBrazil
| | | | - Luís B Sardinha
- Exercise and Health LaboratoryCIPERFaculdade de Motricidade HumanaUniversidade de LisboaLisboaPortugal
| | - Danilo R Silva
- Department of Physical EducationFederal University of Sergipe – UFSSão CristóvãoBrazil
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55
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Simas BB, Nunes EA, Crestani CC, Speretta GF. Cardiovascular and metabolic consequences of the association between chronic stress and high-fat diet in rats. Stress 2018; 21:247-256. [PMID: 29429380 DOI: 10.1080/10253890.2018.1437413] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Obesity and chronic stress are considered independent risk factors for the development of cardiovascular diseases and changes in autonomic system activity. However, the cardiovascular consequences induced by the association between high-fat diet (HFD) and chronic stress are not fully understood. We hypothesized that the association between HFD and exposure to a chronic variable stress (CVS) protocol for four weeks might exacerbate the cardiovascular and metabolic disturbances in rats when compared to these factors singly. To test this hypothesis, male Wistar rats were divided into four groups: control-standard chow diet (SD; n = 8); control-HFD (n = 8); CVS-SD (n = 8); and CVS-HFD (n = 8). The CVS consisted of repeated exposure of the rats to different inescapable and unpredictable stressors (restraint tress; damp sawdust, cold, swim stress and light cycle inversion). We evaluated cardiovascular function, autonomic activity, dietary intake, adiposity and metabolism. The HFD increased body weight, adiposity and blood glucose concentration (∼15%) in both control and CVS rats. The CVS-HFD rats showed decreased insulin sensitivity (25%) compared to CVS-SD rats. The control-HFD and CVS-HFD rats presented increased intrinsic heart rate (HR) values (∼8%). CVS increased cardiac sympathetic activity (∼65%) in both SD- and HFD-fed rats. The HFD increased basal HR (∼10%). Blood pressure and baroreflex analyzes showed no differences among the experimental groups. In conclusion, the present data indicate absence of interaction on autonomic imbalance evoked by either CVS or HFD. Additionally, HFD increased HR and evoked metabolic disruptions which are independent of stress exposure.
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Affiliation(s)
- Bruna B Simas
- a Department of Physiological Sciences, Biological Sciences Centre , Federal University of Santa Catarina (UFSC) , Florianópolis , Brazil
| | - Everson A Nunes
- a Department of Physiological Sciences, Biological Sciences Centre , Federal University of Santa Catarina (UFSC) , Florianópolis , Brazil
| | - Carlos C Crestani
- b Laboratory of Pharmacology , São Paulo State University (UNESP), School of Pharmaceutical Sciences , Araraquara , Brazil
| | - Guilherme F Speretta
- a Department of Physiological Sciences, Biological Sciences Centre , Federal University of Santa Catarina (UFSC) , Florianópolis , Brazil
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Wang H, Chen Y, Sun G, Jia P, Qian H, Sun Y. Validity of cardiometabolic index, lipid accumulation product, and body adiposity index in predicting the risk of hypertension in Chinese population. Postgrad Med 2018; 130:325-333. [PMID: 29478365 DOI: 10.1080/00325481.2018.1444901] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVES Adiposity, defined by higher cardiometabolic index (CMI), lipid accumulation product (LAP), and body adiposity index (BAI), has conferred increased metabolic risk. However, the incremental utility of CMI, LAP, and BAI in association with prevalent hypertension has not been well described in a population-based setting. We hypothesized that CMI, LAP, and BAI would provide important insight into hypertension risk. METHODS Blood pressure (BP), fasting lipid profiles, and anthropometric parameters were recorded in a cross-sectional study of 11,400 participants (mean age, 54 years; 53% women) from China. Logistic regression models were used to assess associations of CMI, LAP, and BAI with prevalent hypertension. BAI was evaluated according to hip (cm)/[height (m)1.5]-18; LAP was calculated separately for men [(WC-65) × TG] and women [(WC-58) × TG]; and CMI was defined by TG/HDL-C × waist-to-height ratio. RESULTS CMI, LAP, and BAI were independently correlated with higher SBP and DBP, with nonstandardized (B) coefficients ranging from 1.827 to 4.590 mmHg and 1.475 to 2.210 mmHg (all P < 0.001). After adjustment for hypertension risk factors and potential confounders, CMI, LAP, and BAI, modeled as continuous measures, carried hypertension odds (95% CI) of 1.356 (1.259-1.459), 1.631 (1.501-1.771), and 1.555 (1.454-1.662) in women, respectively, per SD increment. In men, each SD increase in CMI, LAP, and BAI experienced a 31%, 65%, and 53% higher hypertension risk, respectively. Moreover, among women, the odds ratio (95% CI) for hypertension were 2.318 (1.956-2.745), 3.548 (2.985-4.217), and 3.004 (2.537-3.557) in the 4th quartile vs the first quartile of CMI, LAP, and BAI, respectively. For men, the corresponding figures were 2.200 (1.838-2.635), 3.892 (3.238-4.677), and 3.288 (2.754-3.927), respectively. CONCLUSION Measurements of CMI, LAP, and BAI provide a more complete understanding of hypertension risk related to variation in body fat distribution and pinpoint hypertensive participants in great risk of cardiovascular disease in the future.
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Affiliation(s)
- Haoyu Wang
- a Department of Cardiology , The First Hospital of China Medical University , Shenyang , Liaoning, People's Republic of China
| | - Yintao Chen
- a Department of Cardiology , The First Hospital of China Medical University , Shenyang , Liaoning, People's Republic of China
| | - Guozhe Sun
- a Department of Cardiology , The First Hospital of China Medical University , Shenyang , Liaoning, People's Republic of China
| | - Pengyu Jia
- a Department of Cardiology , The First Hospital of China Medical University , Shenyang , Liaoning, People's Republic of China
| | - Hao Qian
- a Department of Cardiology , The First Hospital of China Medical University , Shenyang , Liaoning, People's Republic of China
| | - Yingxian Sun
- a Department of Cardiology , The First Hospital of China Medical University , Shenyang , Liaoning, People's Republic of China
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Nepali S, Kim DK, Lee HY, Ki HH, Kim BR, Hwang SW, Park M, Kim DK, Lee YM. Euphorbia supina extract results in inhibition of high‑fat‑diet‑induced obesity in mice. Int J Mol Med 2018; 41:2952-2960. [PMID: 29484428 DOI: 10.3892/ijmm.2018.3495] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 01/10/2018] [Indexed: 11/05/2022] Open
Abstract
The present study was undertaken to investigate the anti‑obesity effect of a 50% ethanol extract of Euphorbia supina (ESEE) in high‑fat‑diet (HFD)‑induced obese C57BL/6J mice. Mice were fed a HFD with or without ESEE (2, 10, or 50 mg/kg) or with Garcinia cambogia (positive control) for 6 weeks. ESEE supplementation significantly reduced body, epididymal white adipose tissue (eWAT), and organ weights (P<0.05). ESEE also reduced hepatic steatosis and improved serum lipid profiles. In addition, ESEE significantly reduced serum leptin levels and increased adiponectin levels, and significantly downregulated the mRNA and protein levels of proliferator‑activated receptor γ (PPARγ) and CCAAT/enhancer‑binding protein alpha (C/EPBα) in eWAT and liver tissues (all P<0.05). These results suggested that ESEE supplementation protects against HFD‑induced obesity by downregulating PPARγ and C/EPBα, and that ESEE may be beneficial for the prevention and treatment of obesity and associated diseases.
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Affiliation(s)
- Sarmila Nepali
- Department of Immunology and Institute of Medical Sciences, Medical School, Chonbuk National University, Jeonju, Jeollabuk 54907, Republic of Korea
| | - Do-Kuk Kim
- Department of Oriental Pharmacy, College of Pharmacy and Wonkwang‑Oriental Medicines Research Institute, Wonkwang University, Iksan, Jeollabuk 54538, Republic of Korea
| | - Hoon-Yeon Lee
- Department of Oriental Pharmacy, College of Pharmacy and Wonkwang‑Oriental Medicines Research Institute, Wonkwang University, Iksan, Jeollabuk 54538, Republic of Korea
| | - Hyeon-Hui Ki
- Department of Immunology and Institute of Medical Sciences, Medical School, Chonbuk National University, Jeonju, Jeollabuk 54907, Republic of Korea
| | - Bo-Ram Kim
- Department of Oriental Pharmacy, College of Pharmacy and Wonkwang‑Oriental Medicines Research Institute, Wonkwang University, Iksan, Jeollabuk 54538, Republic of Korea
| | - Sung-Woo Hwang
- Department of Oriental Pharmacy, College of Pharmacy and Wonkwang‑Oriental Medicines Research Institute, Wonkwang University, Iksan, Jeollabuk 54538, Republic of Korea
| | - Min Park
- Department of Oriental Pharmacy, College of Pharmacy and Wonkwang‑Oriental Medicines Research Institute, Wonkwang University, Iksan, Jeollabuk 54538, Republic of Korea
| | - Dae-Ki Kim
- Department of Immunology and Institute of Medical Sciences, Medical School, Chonbuk National University, Jeonju, Jeollabuk 54907, Republic of Korea
| | - Young-Mi Lee
- Department of Oriental Pharmacy, College of Pharmacy and Wonkwang‑Oriental Medicines Research Institute, Wonkwang University, Iksan, Jeollabuk 54538, Republic of Korea
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Taing KY, Farkouh ME, Moineddin R, Tu JV, Jha P. Comparative associations between anthropometric and bioelectric impedance analysis derived adiposity measures with blood pressure and hypertension in India: a cross-sectional analysis. BMC OBESITY 2017; 4:37. [PMID: 29214029 PMCID: PMC5709937 DOI: 10.1186/s40608-017-0173-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 11/10/2017] [Indexed: 11/10/2022]
Abstract
Background The utility of bioelectrical impedance analysis (BIA) derived adiposity measures as compared to anthropometric measures for the assessment of adiposity-related health risk is not clear. We aimed to clarify the relationships of BIA and anthropometric derived adipose measures with blood pressure and hypertension, and to compare the discriminative ability of the respective measures for hypertension. Methods We used baseline data collected between 2015 and 2016 from the Indian Study on Health of Adults (ISHA), an ongoing population based cohort study in India (N = 5990; age 30–69 years). We examined and compared the associations and discriminative ability between anthropometric (body mass index, waist circumference, hip circumference, waist-hip ratio, waist-height ratio) and BIA (whole body and trunk fat percentage) derived adiposity measures with blood pressure components (systolic pressure, diastolic pressure, pulse pressure, mean arterial pressure, mid-blood pressure) and hypertension. Results Regardless of whether the adiposity measure was derived from BIA or anthropometry, all were strongly and positively associated with blood pressure and hypertension. For both men and women, the magnitude of association of BIA measures with blood pressure and hypertension were comparable to those of anthropometric measures. Further, the ability of BIA derived adiposity measures to distinguish between those with and without hypertension was similar to the discriminative ability of anthropometric measures. Conclusions As compared to simple anthropometric measures, BIA derived estimates of adiposity provide no apparent advantage in the assessment of blood pressure and hypertension. The observed similarities between adiposity measures suggest that simple anthropometrics may be sufficient to assess adiposity and adiposity-related risks.
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Affiliation(s)
- Kevin Y Taing
- Centre for Global Health Research, St. Michael's Hospital, Toronto, ON Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON Canada
| | - Michael E Farkouh
- Peter Munk Cardiac Centre, University Health Network, Toronto, ON Canada.,The Heart and Stroke Richard Lewar Centre of Excellence in Cardiovascular Research, University of Toronto, Toronto, ON Canada
| | - Rahim Moineddin
- Department of Family and Community Medicine, University of Toronto, Toronto, ON Canada.,Institute for Clinical Evaluative Sciences, Toronto, ON Canada
| | - Jack V Tu
- Institute for Clinical Evaluative Sciences, Toronto, ON Canada.,Schulich Heart Centre, Sunnybrook Health Sciences Centre, Toronto, ON Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON Canada
| | - Prabhat Jha
- Centre for Global Health Research, St. Michael's Hospital, Toronto, ON Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON Canada
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Morel S, Kwak B, Rohner-Jeanrenaud F, Steffens S, Molica F. Adipokines at the crossroad between obesity and cardiovascular disease. Thromb Haemost 2017; 113:553-66. [DOI: 10.1160/th14-06-0513] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Accepted: 09/18/2014] [Indexed: 12/31/2022]
Abstract
SummaryObesity, and especially excessive visceral adipose tissue accumulation, is considered as a low-grade inflammatory state that is responsible for adipocyte dysfunction and associated metabolic disorders. Adipose tissue displays endocrine functions by releasing pro- or antiinflammatory bioactive molecules named adipokines. An altered expression of these molecules, provoked by obesity or adipocyte dysregulation, contributes to major metabolic diseases such as insulin resistance and type 2 diabetes mellitus that are important risk factors for cardiovascular disease. However, obesity is also characterised by the expansion of perivascular adipose tissue that acts locally via diffusion of adipokines into the vascular wall. Local inflammation within blood vessels induced by adipokines contributes to the onset of endothelial dysfunction, atherosclerosis and thrombosis, but also to vascular remodelling and hypertension. A fast expansion of obesity is expected in the near future, which will rapidly increase the incidence of these cardiovascular diseases. The focus of this review is to summarise the link between metabolic and cardiovascular disease and discuss current treatment approaches, limitations and future perspectives for more targeted therapies.
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Boateng GO, Adams EA, Odei Boateng M, Luginaah IN, Taabazuing MM. Obesity and the burden of health risks among the elderly in Ghana: A population study. PLoS One 2017; 12:e0186947. [PMID: 29117264 PMCID: PMC5695605 DOI: 10.1371/journal.pone.0186947] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Accepted: 10/10/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The causes and health risks associated with obesity in young people have been extensively documented, but elderly obesity is less well understood, especially in sub-Saharan Africa. This study examines the relationship between obesity and the risk of chronic diseases, cognitive impairment, and functional disability among the elderly in Ghana. It highlights the social and cultural dimensions of elderly obesity and discusses the implications of related health risks using a socio-ecological model. METHODOLOGY We used data from wave 1 of the Ghana Study on Global Ageing and Adult Health (SAGE) survey-2007/8, with a restricted sample of 2,091 for those 65 years and older. Using random effects multinomial, ordered, and binary logit models, we examined the relationship between obesity and the risk of stage 1 and stage 2 hypertension, arthritis, difficulties with recall and learning new tasks, and deficiencies with activities of daily living and instrumental activities of daily living. FINDINGS Elderly Ghanaians who were overweight and obese had a higher risk of stage 1 and stage 2 hypertension, and were more likely to be diagnosed with arthritis and report severe deficiencies with instrumental activities of daily living. Those who were underweight were 1.71 times more likely to report severe difficulties with activities of daily living. A sub analysis using waist circumference as a measure of body fat showed elderly females with abdominal adiposity were relatively more likely to have stage 2 hypertension. CONCLUSIONS These findings call for urgent policy initiatives geared towards reducing obesity among working adults given the potentially detrimental consequences in late adulthood. Future research should explore the gendered pathways leading to health disadvantages among Ghanaian women in late adulthood.
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Affiliation(s)
- Godfred O. Boateng
- Department of Anthropology & Global Health, Northwestern University, Evanston, Illinois, United States of America
| | - Ellis A. Adams
- Global Studies Institute, Georgia State University, Atlanta, Georgia, United States of America
- Department of Geosciences, Georgia State University, Atlanta, Georgia, United States of America
| | - Mavis Odei Boateng
- Department of Social Work, University of Windsor, Windsor, Ontario, Canada
| | - Isaac N. Luginaah
- Department of Geography, Western University, London, Ontario, Canada
| | - Mary-Margaret Taabazuing
- Department of Medicine, Division of Geriatric Medicine, Western University, London, Ontario, Canada
- Department of Medicine, London Health Sciences Centre, Victoria Campus, London, Ontario, Canada
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Schrover IM, Dorresteijn JAN, Smits JE, Danser AHJ, Visseren FLJ, Spiering W. Identifying treatment response to antihypertensives in patients with obesity-related hypertension. Clin Hypertens 2017; 23:20. [PMID: 29085669 PMCID: PMC5654008 DOI: 10.1186/s40885-017-0077-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 09/18/2017] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND In patients with obesity-related hypertension (ORH), reaction to antihypertensive medication is likely influenced by patientcharacteristics. METHODS Effects of aliskiren, moxonidine and hydrochlorothiazide on 24-h blood pressure (BP) were compared to placebo. Linear mixed effect models were used to analyze the effect of patient characteristics on BP levels and treatment response. RESULTS Systolic BP response to aliskiren was higher in patients with a BMI > 30.7 kg/m2 compared to patients with a BMI ≤ 30.7 kg/m2 (-21 mmHg versus -4 mmHg). In patients with a hsCRP > 1.8 mg/L the systolic BP response to aliskiren was higher than in patients with a low hsCRP (-15 mmHg versus -7 mmHg). Hydrochlorothiazide (HCTZ) treatment effect on systolic BP was -13 mmHg when heart rate > 71 beats/min compared to -3 mmHg when heart rate was ≤ 71 beats/min. CONCLUSION In patients with ORH, BP response to aliskiren is positively related to BMI and hsCRP. Systolic BP response to HCTZ is positively related to heart rate and negatively to renin levels. TRIAL REGISTRATION NCT01138423. Registered June 4th, 2010.
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Affiliation(s)
- Ilse M Schrover
- Department of Vascular Medicine, University Medical Center Utrecht, P.O. Box 85500, 3584 GA Utrecht, The Netherlands
| | - Jannick A N Dorresteijn
- Department of Vascular Medicine, University Medical Center Utrecht, P.O. Box 85500, 3584 GA Utrecht, The Netherlands
| | - Jodine E Smits
- Department of Vascular Medicine, University Medical Center Utrecht, P.O. Box 85500, 3584 GA Utrecht, The Netherlands
| | - A H Jan Danser
- Division of Pharmacology and Vascular Medicine, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Frank L J Visseren
- Department of Vascular Medicine, University Medical Center Utrecht, P.O. Box 85500, 3584 GA Utrecht, The Netherlands
| | - Wilko Spiering
- Department of Vascular Medicine, University Medical Center Utrecht, P.O. Box 85500, 3584 GA Utrecht, The Netherlands
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Phillips BE, Williams JP, Greenhaff PL, Smith K, Atherton PJ. Physiological adaptations to resistance exercise as a function of age. JCI Insight 2017; 2:95581. [PMID: 28878131 PMCID: PMC5621901 DOI: 10.1172/jci.insight.95581] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 08/03/2017] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The impact of resistance exercise training (RE-T) across the life span is poorly defined. METHODS To resolve this, we recruited three distinct age cohorts of young (18-28 years; n = 11), middle-aged (45-55 years; n = 20), and older (nonsarcopenic; 65-75 years; n = 17) individuals to a cross-sectional intervention study. All subjects participated in 20 weeks of fully supervised whole-body progressive RE-T, undergoing assessment of body composition, muscle and vascular function, and metabolic health biomarkers before and after RE-T. Individuals also received stable isotope tracer infusions to ascertain muscle protein synthesis (MPS). RESULTS There was an age-related increase in adiposity, but only young and middle-age groups demonstrated reductions following RE-T. Increases in blood pressure with age were attenuated by RE-T in middle-aged, but not older, individuals, while age-related increases in leg vascular conductance were unaffected by RE-T. The index of insulin sensitivity was reduced by RE-T in older age. Despite being matched at baseline, only younger individuals increased muscle mass in response to RE-T, and there existed a negative correlation between age and muscle growth; in contrast, increases in mechanical quality were preserved across ages. Acute increases in MPS (upon feeding plus acute RE-T) were enhanced only in younger individuals, perhaps explaining greater hypertrophy. CONCLUSION Our data indicate that RE-T offsets some, but not all, negative characteristics of ageing - some of which are apparent in midlife. FUNDING Biotechnology and Biological Sciences Research Council (BB/C516779/1).
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Affiliation(s)
| | | | - Paul L. Greenhaff
- School of Life Sciences, Medical Research Council Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Nottingham, Nottingham and Derby, United Kingdom
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Brown AJ, Lang C, McCrimmon R, Struthers A. Does dapagliflozin regress left ventricular hypertrophy in patients with type 2 diabetes? A prospective, double-blind, randomised, placebo-controlled study. BMC Cardiovasc Disord 2017; 17:229. [PMID: 28835229 PMCID: PMC5569551 DOI: 10.1186/s12872-017-0663-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 08/16/2017] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Patients with diabetes have a two to fourfold increased risk for development of and death from cardiovascular disease [CVD]. The current oral hypoglycaemic agents result in limited reduction in this cardiovascular risk. Sodium glucose linked co-transporter type 2 [SGLT2] inhibitors are a relatively new class of antidiabetic agent that have been shown to have potential cardiovascular benefits. In support of this, the EMPA-REG trial showed a striking 38% and 35% reduction in cardiovascular mortality and heart failure [HF] hospitalisation respectively. The exact mechanism (s) responsible for these effects remain (s) unclear. One potential mechanism is regression of Left ventricular hypertrophy (LVH). METHODS The DAPA-LVH trial is a prospective, double-blind, randomised, placebo-controlled 'proof of concept' single-centre study that has been ongoing since January 2017. It is designed specifically to assess whether the SGLT2 inhibitor dapagliflozin regresses left ventricular [LV] mass in patients with diabetes and left ventricular hypertrophy [LVH]. We are utilising cardiac and abdominal magnetic resonance imaging [MRI] and ambulatory blood pressure monitoring to quantify the cardiovascular and systemic effects of dapagliflozin 10 mg once daily against standard care over a 1 year observation period. The primary endpoint is to detect the changes in LV mass. The secondary outcomes are to assess the changes in, LV volumes, blood pressure, weight, visceral and subcutaneous fat. DISCUSSION This trial will be able to determine if SGLT2 inhibitor therapy reduces LV mass in patient with diabetes and LVH thereby strengthening their position as oral hypoglycaemic agents with cardioprotective benefits. TRIAL REGISTRATION Clinical Trials.gov: NCT02956811 . Registered November 2016.
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MESH Headings
- Administration, Oral
- Benzhydryl Compounds/administration & dosage
- Benzhydryl Compounds/adverse effects
- Blood Pressure Monitoring, Ambulatory
- Clinical Protocols
- Diabetes Mellitus, Type 2/complications
- Diabetes Mellitus, Type 2/diagnosis
- Diabetes Mellitus, Type 2/drug therapy
- Diabetic Cardiomyopathies/diagnostic imaging
- Diabetic Cardiomyopathies/etiology
- Diabetic Cardiomyopathies/physiopathology
- Diabetic Cardiomyopathies/prevention & control
- Disease Progression
- Double-Blind Method
- Glucosides/administration & dosage
- Glucosides/adverse effects
- Humans
- Hypertrophy, Left Ventricular/diagnostic imaging
- Hypertrophy, Left Ventricular/etiology
- Hypertrophy, Left Ventricular/physiopathology
- Hypertrophy, Left Ventricular/prevention & control
- Hypoglycemic Agents/administration & dosage
- Hypoglycemic Agents/adverse effects
- Magnetic Resonance Imaging
- Proof of Concept Study
- Prospective Studies
- Research Design
- Risk Factors
- Scotland
- Time Factors
- Treatment Outcome
- Ventricular Function, Left/drug effects
- Ventricular Remodeling/drug effects
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Affiliation(s)
- Alexander J.M. Brown
- Cardiovascular Medicine, Division of Molecular and Clinical Medicine, Medical Research Institute, Ninewells Hospital and Medical School, Mailbox 2, Dundee, DD1 9SY UK
| | - Chim Lang
- Cardiology, Division of Molecular and Clinical Medicine, Medical Research Institute, Ninewells Hospital and Medical School, Mailbox 2, Dundee, DD1 9SY UK
| | - Rory McCrimmon
- Experimental Diabetes and Metabolism, Division of Molecular and Clinical Medicine, School of Medicine, Level 5, Ninewells Hospital and Medical School, Mailbox 12, Dundee, DD1 9SY UK
| | - Allan Struthers
- Cardiovascular Medicine and Therapeutics, Division of Molecular and Clinical Medicine, Medical Research Institute, Ninewells Hospital and Medical School, Mailbox 2, Dundee, DD1 9SY UK
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Zhao H, Han L, Chang D, Ye Y, Shen J, Daniel CR, Gu J, Chow WH, Wu X. Social-demographics, health behaviors, and telomere length in the Mexican American Mano a Mano Cohort. Oncotarget 2017; 8:96553-96567. [PMID: 29228552 PMCID: PMC5722504 DOI: 10.18632/oncotarget.19903] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 07/26/2017] [Indexed: 12/12/2022] Open
Abstract
In the current study, we examined cross-sectional associations among social-demographics, lifestyle behaviors, and relative telomere length (RTL) in peripheral blood leukocytes, as well as longitudinal relationships among major chronic diseases, weight gain, and RTL, among 12,792 Mexican Americans aged 20 to 85 years in the Mano-A-Mano, the Mexican American Cohort. As expected, RTL was inversely correlated with age (ρ=-0.15, ρ<0.001). In the multivariate analysis, we found that RTL was positively correlated with levels of education (ρ=0.021), self-insurance (ρ=0.041), body mass index (BMI) (ρ<0.001), and sleeping time per day (ρ for trend<0.001), and RTL was inversely correlated with sitting time per day (ρ for trend =0.001). In longitudinal analysis, we found that longer RTL was modestly but positively associated with increased risks of overall cancer (adjusted hazard ratio (adj.HR)=1.05, 95% conference interval (95%CI)=1.02-1.09). In quartile analysis, 4th quartile (longest RTL) was associated with 1.53-fold increased risk of overall cancer (adj.HR=1.53, 95%CI=1.11-2.10), compared to 1st quartile (shortest RTL). RTL was reversely associated with the risk of type-2 diabetes (adj.HR=0.89, 95%CI=0.82-0.94). In quartile analysis, 4th quartile (longest RTL) was associated with 48% decreased risk of typle-2 diabetes (adj.HR=0.52, 95%CI=0.32-0.70), compared to 1st quartile (shortest RTL). In addition, longer RTL was a positive predictor of at least 10% weight gain (adj.HR=1.03, 95%CI=1.00-1.05). In summary, our results in Mexican Americans support the notion that telomere length is a biological mechanism by which social demographics and health behaviors “get under the skin” to affect health.
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Affiliation(s)
- Hua Zhao
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lixia Han
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - David Chang
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Yuanqing Ye
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jie Shen
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Carrie R Daniel
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jian Gu
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Wong-Ho Chow
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Xifeng Wu
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Sakamuri SSVP, Watts R, Takawale A, Wang X, Hernandez-Anzaldo S, Bahitham W, Fernandez-Patron C, Lehner R, Kassiri Z. Absence of Tissue Inhibitor of Metalloproteinase-4 (TIMP4) ameliorates high fat diet-induced obesity in mice due to defective lipid absorption. Sci Rep 2017; 7:6210. [PMID: 28740132 PMCID: PMC5524827 DOI: 10.1038/s41598-017-05951-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 06/07/2017] [Indexed: 01/09/2023] Open
Abstract
Tissue inhibitor of metalloproteases (TIMPs) are inhibitors of matrix metalloproteinases (MMPs) that regulate tissue extracellular matrix (ECM) turnover. TIMP4 is highly expressed in adipose tissue, its levels are further elevated following high-fat diet, but its role in obesity is unknown. Eight-week old wild-type (WT) and Timp4-knockout (Timp4 -/-) mice received chow or high fat diet (HFD) for twelve weeks. Timp4 -/- mice exhibited a higher food intake but lower body fat gain. Adipose tissue of Timp4 -/- -HFD mice showed reduced hypertrophy and fibrosis compared to WT-HFD mice. Timp4 -/- -HFD mice were also protected from HFD-induced liver and skeletal muscle triglyceride accumulation and dyslipidemia. Timp4 -/--HFD mice exhibited reduced basic metabolic rate and energy expenditure, but increased respiratory exchange ratio. Increased free fatty acid excretion was detected in Timp4 -/--HFD compared to WT-HFD mice. CD36 protein, the major fatty acid transporter in the small intestine, increased with HFD in WT but not in Timp4 -/- mice, despite a similar rise in Cd36 mRNA in both genotypes. Consistently, HFD increased enterocyte lipid content only in WT but not in Timp4 -/- mice. Our study reveals that absence of TIMP4 can impair lipid absorption and the high fat diet-induced obesity in mice possibly by regulating the proteolytic processing of CD36 protein in the intestinal enterocytes.
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Affiliation(s)
- Siva S V P Sakamuri
- Department of Physiology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Russell Watts
- Group on Molecular and Cell Biology of Lipids, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Abhijit Takawale
- Department of Physiology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Xiuhua Wang
- Department of Physiology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Samuel Hernandez-Anzaldo
- Department of Biochemistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Wesam Bahitham
- Group on Molecular and Cell Biology of Lipids, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Carlos Fernandez-Patron
- Department of Biochemistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Richard Lehner
- Group on Molecular and Cell Biology of Lipids, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Zamaneh Kassiri
- Department of Physiology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
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Cândido FG, Valente FX, Grześkowiak ŁM, Moreira APB, Rocha DMUP, Alfenas RDCG. Impact of dietary fat on gut microbiota and low-grade systemic inflammation: mechanisms and clinical implications on obesity. Int J Food Sci Nutr 2017; 69:125-143. [PMID: 28675945 DOI: 10.1080/09637486.2017.1343286] [Citation(s) in RCA: 155] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Dietary fat strongly affects human health by modulating gut microbiota composition and low-grade systemic inflammation. High-fat diets have been implicated in reduced gut microbiota richness, increased Firmicutes to Bacteroidetes ratio, and several changes at family, genus and species levels. Saturated (SFA), monounsaturated (MUFA), polyunsaturated (PUFA) and conjugated linolenic fatty acids share important pathways of immune system activation/inhibition with gut microbes, modulating obesogenic and proinflammatory profiles. Mechanisms that link dietary fat, gut microbiota and obesity are mediated by increased intestinal permeability, systemic endotoxemia, and the activity of the endocannabinoid system. Although the probiotic therapy could be a complementary strategy to improve gut microbiota composition, it did not show permanent effects to treat fat-induced dysbiosis. Based upon evidence to date, we believe that high-fat diets and SFA consumption should be avoided, and MUFA and omega-3 PUFA intake should be encouraged in order to regulate gut microbiota and inflammation, promoting body weight/fat control.
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Affiliation(s)
- Flávia Galvão Cândido
- a Departamento de Nutrição e Saúde , Universidade Federal de Viçosa , Viçosa , Brazil
| | - Flávia Xavier Valente
- a Departamento de Nutrição e Saúde , Universidade Federal de Viçosa , Viçosa , Brazil
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67
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Shin S, Kim JM, Sung S, Kim HS. Prevalence and Associated Characteristics of Metabolically Healthy Obese Phenotypes in a Community Dwelling Population. J Obes Metab Syndr 2017; 26:130-137. [PMID: 31089507 PMCID: PMC6484908 DOI: 10.7570/jomes.2017.26.2.130] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 10/02/2016] [Accepted: 12/08/2016] [Indexed: 01/08/2023] Open
Abstract
Background Recent research has focused on overweight and obese individuals with healthy metabolic profiles. Metabolically healthy and obese (MHO) individuals may have unique characteristics, compared to metabolically unhealthy obese (MUO) individuals. The purpose of this study was to evaluate the prevalence and clinical characteristics of both MHO and metabolically unhealthy normal-weight (MUNW) phenotypes in a community dwelling population. Methods Data from women (n=1,916) and men (n=867) aged 20 to 73 years who participated in the Health Examination of Nowon Health Care Center were analyzed. Subjects were categorized according to the presence, absence, or combination of metabolic syndrome and Asian-specific body mass index (BMI) criteria for overweight and obesity. Results The proportions of metabolic healthy individuals in the overweight and obese categories were 67% (overweight) and 39% (obese), respectively. The prevalence rate of the MUNW was 12% of normal weight individuals. Within the overweight and obese categories, MHO individuals tended to be younger compared with their MUO counterparts. High waist circumference (WC) and low high-density lipoprotein cholesterol (HDL-C)levels were two of the most common metabolic risk factors observed in the metabolically unhealthy group. Conclusion The prevalence of both MHO and MUNW phenotypes is relatively high in this community-dwelling population. There is an urgent need for the implementation of lifestyle intervention, consisting of regular exercise and healthy eating in the Nowon Health Care Center.
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Affiliation(s)
- Sohee Shin
- School of Exercise and Sport Science, University of Ulsan, Ulsan, Korea
| | | | - Soonchang Sung
- Department of Sports Science, Seoul National University of Science and Technology, Seoul, Korea
| | - Hyun-Soo Kim
- Department of Sports Science, Seoul National University of Science and Technology, Seoul, Korea
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68
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Schütten MTJ, Houben AJHM, de Leeuw PW, Stehouwer CDA. The Link Between Adipose Tissue Renin-Angiotensin-Aldosterone System Signaling and Obesity-Associated Hypertension. Physiology (Bethesda) 2017; 32:197-209. [PMID: 28404736 DOI: 10.1152/physiol.00037.2016] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 02/20/2017] [Accepted: 02/21/2017] [Indexed: 11/22/2022] Open
Abstract
Obese individuals frequently develop hypertension, which is for an important part attributable to renin-angiotensin-aldosterone system (RAAS) overactivity. This review summarizes preclinical and clinical evidence on the involvement of dysfunctional adipose tissue in RAAS activation and on the renal, central, and vascular mechanisms linking RAAS components to obesity-associated hypertension.
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Affiliation(s)
- Monica T J Schütten
- Department of Internal Medicine and Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Alfons J H M Houben
- Department of Internal Medicine and Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Peter W de Leeuw
- Department of Internal Medicine and Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Coen D A Stehouwer
- Department of Internal Medicine and Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands
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69
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Landgraf K, Schuster S, Meusel A, Garten A, Riemer T, Schleinitz D, Kiess W, Körner A. Short-term overfeeding of zebrafish with normal or high-fat diet as a model for the development of metabolically healthy versus unhealthy obesity. BMC PHYSIOLOGY 2017; 17:4. [PMID: 28327129 PMCID: PMC5361797 DOI: 10.1186/s12899-017-0031-x] [Citation(s) in RCA: 105] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 03/14/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Obese individuals differ in their risk of developing metabolic and cardiovascular complications depending on fat distribution (subcutaneous versus visceral) and adipose tissue (AT) phenotype (hyperplasic versus hypertrophic). However, the exact mechanisms which determine whether an obese individual is metabolically healthy or unhealthy are not clear, and analyses of the underlying pathomechanisms are limited by the lack of suitable in vivo models in which metabolically healthy versus metabolically unhealthy AT accumulation can be specifically induced. In the current study, we aimed to establish a protocol for the use of zebrafish as a model for obesity-related metabolically healthy versus metabolically unhealthy AT accumulation. METHODS We overfed adult male zebrafish of the AB strain with normal fat diet (NFD) or high fat diet (HFD) for 8 weeks and compared parameters related to obesity, i.e. body weight, body mass index, condition index and body fat percentage, to control zebrafish fed under physiological conditions. In addition, we investigated the presence of early obesity-related metabolic alterations by quantifying blood glucose levels, plasma triglyceride and cholesterol levels, and by assessing ectopic lipid accumulation in the liver of zebrafish. Finally, we determined gene expression levels of marker genes related to lipid metabolism, inflammation and fibrosis in visceral AT and liver. RESULTS We show that 8-weeks overfeeding with either NFD or HFD leads to a significant increase in body weight and AT mass compared to controls. In contrast to NFD-overfed zebrafish, HFD-overfed zebrafish additionally present metabolic alterations, e.g. hyperglycemia and ectopic lipid accumulation in the liver, and a metabolically unhealthy AT phenotype with adipocyte hypertrophy especially in the visceral AT depot, which is accompanied by changes in the expression of marker genes for lipid metabolism, inflammation and fibrosis. CONCLUSIONS In summary, we have established a method for the specific induction of metabolically distinct obesity phenotypes in zebrafish. Our results indicate that zebrafish represents an attractive model to study regulatory mechanisms involved in the determination of AT phenotype during development of metabolically healthy versus metabolically unhealthy obesity.
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Affiliation(s)
- Kathrin Landgraf
- Center for Pediatric Research Leipzig (CPL), University Hospital for Children & Adolescents, University of Leipzig, Liebigstraße 21, 04103, Leipzig, Germany. .,Integrated Research and Treatment Center (IFB) Adiposity Diseases, University of Leipzig, Leipzig, Germany.
| | - Susanne Schuster
- Center for Pediatric Research Leipzig (CPL), University Hospital for Children & Adolescents, University of Leipzig, Liebigstraße 21, 04103, Leipzig, Germany
| | - Andrej Meusel
- Institute of Medical Physics and Biophysics, University of Leipzig, Leipzig, Germany
| | - Antje Garten
- Center for Pediatric Research Leipzig (CPL), University Hospital for Children & Adolescents, University of Leipzig, Liebigstraße 21, 04103, Leipzig, Germany
| | - Thomas Riemer
- Institute of Medical Physics and Biophysics, University of Leipzig, Leipzig, Germany
| | - Dorit Schleinitz
- Integrated Research and Treatment Center (IFB) Adiposity Diseases, University of Leipzig, Leipzig, Germany
| | - Wieland Kiess
- Center for Pediatric Research Leipzig (CPL), University Hospital for Children & Adolescents, University of Leipzig, Liebigstraße 21, 04103, Leipzig, Germany
| | - Antje Körner
- Center for Pediatric Research Leipzig (CPL), University Hospital for Children & Adolescents, University of Leipzig, Liebigstraße 21, 04103, Leipzig, Germany.,Integrated Research and Treatment Center (IFB) Adiposity Diseases, University of Leipzig, Leipzig, Germany
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Gnatiuc L, Alegre-Díaz J, Halsey J, Herrington WG, López-Cervantes M, Lewington S, Collins R, Tapia-Conyer R, Peto R, Emberson JR, Kuri-Morales P. Adiposity and Blood Pressure in 110 000 Mexican Adults. Hypertension 2017; 69:608-614. [PMID: 28223471 PMCID: PMC5344187 DOI: 10.1161/hypertensionaha.116.08791] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 12/05/2016] [Accepted: 01/27/2017] [Indexed: 02/07/2023]
Abstract
Previous studies have reached differing conclusions about the importance of general versus central markers of adiposity to blood pressure, leading to suggestions that population-specific adiposity thresholds may be needed. We examined the relevance of adiposity to blood pressure among 111 911 men and women who, when recruited into the Mexico City Prospective Study, were aged 35 to 89 years, had no chronic disease, and were not taking antihypertensives. Linear regression was used to estimate the effects on systolic and diastolic blood pressure of 2 markers of general adiposity (body mass index and height-adjusted weight) and 4 markers of central adiposity (waist circumference, hip circumference, waist:hip ratio, and waist:height ratio), adjusted for relevant confounders. Mean (SD) adiposity levels were: body mass index (28.7±4.5 kg/m2), height-adjusted weight (70.2±11.2 kg), waist circumference (93.3±10.6 cm), hip circumference (104.0±9.0 cm), waist:hip ratio (0.90±0.06), and waist:height ratio (0.60±0.07). Associations with blood pressure were linear with no threshold levels below which lower general or central adiposity was not associated with lower blood pressure. On average, each 1 SD higher measured adiposity marker was associated with a 3 mm Hg higher systolic blood pressure and 2 mm Hg higher diastolic blood pressure (SEs <0.1 mm Hg), but for the waist:hip ratio, associations were only approximately half as strong. General adiposity associations were independent of central adiposity, but central adiposity associations were substantially reduced by adjustment for general adiposity. Findings were similar for men and women. In Mexican adults, often overweight or obese, markers of general adiposity were stronger independent predictors of blood pressure than measured markers of central adiposity, with no threshold effects.
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Affiliation(s)
- Louisa Gnatiuc
- From the Clinical Trial Service Unit and Epidemiological Studies Unit (L.G., J.H., W.G.H., S.L., R.C., R.P., J.R.E.) and Medical Research Council Population Health Research Unit (S.L., J.R.E.), Nuffield Department of Population Health, University of Oxford, United Kingdom; and School of Medicine, National Autonomous University of Mexico (Universidad Nacional Autónoma de México) (J.A.-D., M.L.-C., R.T.-C., P.K.-M.)
| | - Jesus Alegre-Díaz
- From the Clinical Trial Service Unit and Epidemiological Studies Unit (L.G., J.H., W.G.H., S.L., R.C., R.P., J.R.E.) and Medical Research Council Population Health Research Unit (S.L., J.R.E.), Nuffield Department of Population Health, University of Oxford, United Kingdom; and School of Medicine, National Autonomous University of Mexico (Universidad Nacional Autónoma de México) (J.A.-D., M.L.-C., R.T.-C., P.K.-M.).
| | - Jim Halsey
- From the Clinical Trial Service Unit and Epidemiological Studies Unit (L.G., J.H., W.G.H., S.L., R.C., R.P., J.R.E.) and Medical Research Council Population Health Research Unit (S.L., J.R.E.), Nuffield Department of Population Health, University of Oxford, United Kingdom; and School of Medicine, National Autonomous University of Mexico (Universidad Nacional Autónoma de México) (J.A.-D., M.L.-C., R.T.-C., P.K.-M.)
| | - William G Herrington
- From the Clinical Trial Service Unit and Epidemiological Studies Unit (L.G., J.H., W.G.H., S.L., R.C., R.P., J.R.E.) and Medical Research Council Population Health Research Unit (S.L., J.R.E.), Nuffield Department of Population Health, University of Oxford, United Kingdom; and School of Medicine, National Autonomous University of Mexico (Universidad Nacional Autónoma de México) (J.A.-D., M.L.-C., R.T.-C., P.K.-M.)
| | - Malaquías López-Cervantes
- From the Clinical Trial Service Unit and Epidemiological Studies Unit (L.G., J.H., W.G.H., S.L., R.C., R.P., J.R.E.) and Medical Research Council Population Health Research Unit (S.L., J.R.E.), Nuffield Department of Population Health, University of Oxford, United Kingdom; and School of Medicine, National Autonomous University of Mexico (Universidad Nacional Autónoma de México) (J.A.-D., M.L.-C., R.T.-C., P.K.-M.)
| | - Sarah Lewington
- From the Clinical Trial Service Unit and Epidemiological Studies Unit (L.G., J.H., W.G.H., S.L., R.C., R.P., J.R.E.) and Medical Research Council Population Health Research Unit (S.L., J.R.E.), Nuffield Department of Population Health, University of Oxford, United Kingdom; and School of Medicine, National Autonomous University of Mexico (Universidad Nacional Autónoma de México) (J.A.-D., M.L.-C., R.T.-C., P.K.-M.)
| | - Rory Collins
- From the Clinical Trial Service Unit and Epidemiological Studies Unit (L.G., J.H., W.G.H., S.L., R.C., R.P., J.R.E.) and Medical Research Council Population Health Research Unit (S.L., J.R.E.), Nuffield Department of Population Health, University of Oxford, United Kingdom; and School of Medicine, National Autonomous University of Mexico (Universidad Nacional Autónoma de México) (J.A.-D., M.L.-C., R.T.-C., P.K.-M.)
| | - Roberto Tapia-Conyer
- From the Clinical Trial Service Unit and Epidemiological Studies Unit (L.G., J.H., W.G.H., S.L., R.C., R.P., J.R.E.) and Medical Research Council Population Health Research Unit (S.L., J.R.E.), Nuffield Department of Population Health, University of Oxford, United Kingdom; and School of Medicine, National Autonomous University of Mexico (Universidad Nacional Autónoma de México) (J.A.-D., M.L.-C., R.T.-C., P.K.-M.)
| | - Richard Peto
- From the Clinical Trial Service Unit and Epidemiological Studies Unit (L.G., J.H., W.G.H., S.L., R.C., R.P., J.R.E.) and Medical Research Council Population Health Research Unit (S.L., J.R.E.), Nuffield Department of Population Health, University of Oxford, United Kingdom; and School of Medicine, National Autonomous University of Mexico (Universidad Nacional Autónoma de México) (J.A.-D., M.L.-C., R.T.-C., P.K.-M.)
| | - Jonathan R Emberson
- From the Clinical Trial Service Unit and Epidemiological Studies Unit (L.G., J.H., W.G.H., S.L., R.C., R.P., J.R.E.) and Medical Research Council Population Health Research Unit (S.L., J.R.E.), Nuffield Department of Population Health, University of Oxford, United Kingdom; and School of Medicine, National Autonomous University of Mexico (Universidad Nacional Autónoma de México) (J.A.-D., M.L.-C., R.T.-C., P.K.-M.).
| | - Pablo Kuri-Morales
- From the Clinical Trial Service Unit and Epidemiological Studies Unit (L.G., J.H., W.G.H., S.L., R.C., R.P., J.R.E.) and Medical Research Council Population Health Research Unit (S.L., J.R.E.), Nuffield Department of Population Health, University of Oxford, United Kingdom; and School of Medicine, National Autonomous University of Mexico (Universidad Nacional Autónoma de México) (J.A.-D., M.L.-C., R.T.-C., P.K.-M.)
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71
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Hu Z, Chen M, Wu J, Song Q, Yan C, Du X, Wang Z. Improved control of hypertension following laparoscopic fundoplication for gastroesophageal reflux disease. Front Med 2017; 11:68-73. [PMID: 28213877 DOI: 10.1007/s11684-016-0490-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 09/01/2016] [Indexed: 01/05/2023]
Abstract
This study aims to determine whether successful laparoscopic fundoplication for gastroesophageal reflux disease (GERD) can improve the control of hypertension. We conducted an observational study of GERD patients with hypertension. The esophageal and gastroesophageal symptoms of these patients were successfully treated with laparoscopic fundoplication, as measured by the reduced GERD symptoms and proton pump inhibitor consumption. A hypertension control scale was used to classify the use of antihypertensive medications and the quality of blood pressure control before and after anti-reflux surgery.Wilcoxon signed-ranks test was used for the statistical analyses. Seventy GERD patients were included in the analysis and followed up for a mean period of 3.5 ± 1.4 years. Prior to surgery, all participating patients were taking at least one class of antihypertensive medication, and 56 patients (80%) had intermittently high blood pressure. After surgery, the mean number of antihypertensive medication classes per patient was significantly reduced from 1.61 ± 0.77 pre-procedure to 1.27 ± 0.88 post-procedure (P < 0.001). The blood pressure of 48 of the 56 cases (86%) with preoperative intermittent high blood pressure returned to normal post procedure. A total of 50 patients (71%) recorded improvements on the hypertension control scale, with the overall mean score decreasing from 3.1 ± 1.0 preprocedure to 1.4 ± 1.0 post-procedure (P < 0.001). Therefore, successful laparoscopic fundoplication may result in better blood pressure control in some hypertensive GERD patients. This result suggests a possible connection between gastroesophageal reflux and hypertension.
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Affiliation(s)
- Zhiwei Hu
- Department of Gastroesophageal Reflux Disease, PLA Rocket Force General Hospital, Beijing, 100088, China
| | - Meiping Chen
- Department of Gastroesophageal Reflux Disease, PLA Rocket Force General Hospital, Beijing, 100088, China
| | - Jimin Wu
- Department of Gastroesophageal Reflux Disease, PLA Rocket Force General Hospital, Beijing, 100088, China
| | - Qing Song
- Department of Gastroesophageal Reflux Disease, PLA Rocket Force General Hospital, Beijing, 100088, China
| | - Chao Yan
- Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Xing Du
- Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Zhonggao Wang
- Department of Gastroesophageal Reflux Disease, PLA Rocket Force General Hospital, Beijing, 100088, China. .,Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.
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72
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Preventive effect of Eucommia leaf extract on aortic media hypertrophy in Wistar-Kyoto rats fed a high-fat diet. Hypertens Res 2017; 40:546-551. [DOI: 10.1038/hr.2016.189] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 11/05/2016] [Accepted: 11/20/2016] [Indexed: 12/27/2022]
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Abstract
Obesity and hypertension have both been on the rise in children. Each is associated with increased cardiovascular disease risk and both track into adulthood, increasing the prevalence of heart disease and related morbidity and mortality. All children should be screened for hypertension, but children with comorbid obesity may not only particularly benefit from the screening but may also prove the most challenging to screen. Increased arm circumference and conical arm shape are particularly problematic when attempting to obtain an accurate blood pressure (BP) measurement. This review focuses on the unique aspects of hypertension evaluation and management in the child with comorbid obesity. Specific traditional and non-traditional risk factors that may contribute to elevated BP in children with obesity are highlighted. Current proposed pathophysiologic mechanisms by which obesity may contribute to elevated BP and hypertension is reviewed, with focus on the role of the sympathetic nervous system and the renin-angiotensin-aldosterone system. This review also presents a targeted treatment approach to children with obesity-related hypertension, providing evidence for the recommended therapeutic lifestyle change that should form the basis of any antihypertensive treatment plan in this population of at-risk children. Advantages of specific pharmacologic agents in the treatment of obesity-related hypertension are also reviewed.
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Affiliation(s)
- Tammy M Brady
- Division of Pediatric Nephrology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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74
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Taing KY, Farkouh ME, Moineddin R, Tu JV, Jha P. Age and sex-specific associations of anthropometric measures of adiposity with blood pressure and hypertension in India: a cross-sectional study. BMC Cardiovasc Disord 2016; 16:247. [PMID: 27905876 PMCID: PMC5134088 DOI: 10.1186/s12872-016-0424-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 11/25/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A determinant of blood pressure is adiposity; however, there are uncertainties surrounding whether general or central adiposity is the more important determinant of blood pressure. Further, inconsistent results exist for the relationships of anthropometric measures with blood pressure and hypertension, and whether these relationships differ substantially by age and sex is unclear. We aimed to elucidate the associations of anthropometric measures of general and central adiposity with blood pressure and hypertension, and determine the effect of age and sex on these relationships. METHODS We used cross-sectional data from the Centre for Global Health Research health check-up survey conducted during 2006-2007 of the general population in India (n = 7 601; age 18-59 years). We examined the associations of anthropometric measures (body mass index, waist circumference, hip circumference, waist-hip ratio, waist-height ratio) with blood pressure components (systolic pressure, diastolic pressure, pulse pressure, mean arterial pressure, mid-blood pressure) and hypertension within four (18-29 years, 30-39 years, 40-49 years, 50-59 years) age groups, by sex. We adjusted all analyses for education and location, with further adjustments, variously, for either a measure of central (waist circumference) or general (body mass index) adiposity. RESULTS On average, every 5 kg/m2 greater body mass index or 10 cm wider waist circumference was associated with a 5 and 4 mmHg higher systolic blood pressure, respectively. When considered separately, each anthropometric measure was strongly and positively associated with most blood pressure components in all age groups, and for both sexes. However, with few exceptions, when considered jointly (body mass index adjusted for waist circumference), the associations of body mass index with blood pressure components and hypertension were greatly diminished for both sexes, and particularly in the ≥30 years age groups. By contrast, further adjustment of waist circumference for body mass index did not materially alter the associations of waist circumference with blood pressure components and hypertension. CONCLUSIONS Our findings indicate that central adiposity, as assessed with anthropometric measures, may be a more important determinant of blood pressure and hypertension than general adiposity for adults in India.
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Affiliation(s)
- Kevin Y Taing
- Centre for Global Health Research, St. Michael's Hospital, Toronto, ON, Canada. .,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
| | - Michael E Farkouh
- Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada.,The Heart and Stroke Richard Lewar Centre of Excellence in Cardiovascular Research, University of Toronto, Toronto, ON, Canada
| | - Rahim Moineddin
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.,Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
| | - Jack V Tu
- Schulich Heart Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Prabhat Jha
- Centre for Global Health Research, St. Michael's Hospital, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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76
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Bussey CE, Withers SB, Aldous RG, Edwards G, Heagerty AM. Obesity-Related Perivascular Adipose Tissue Damage Is Reversed by Sustained Weight Loss in the Rat. Arterioscler Thromb Vasc Biol 2016; 36:1377-85. [DOI: 10.1161/atvbaha.116.307210] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 04/26/2016] [Indexed: 11/16/2022]
Affiliation(s)
- Charlotte E. Bussey
- From the Institute of Cardiovascular Sciences (C.E.B., S.B.W., R.G.A., A.M.H.), and Faculty of Life Sciences (G.E.), University of Manchester, Manchester, United Kingdom
| | - Sarah B. Withers
- From the Institute of Cardiovascular Sciences (C.E.B., S.B.W., R.G.A., A.M.H.), and Faculty of Life Sciences (G.E.), University of Manchester, Manchester, United Kingdom
| | - Robert G. Aldous
- From the Institute of Cardiovascular Sciences (C.E.B., S.B.W., R.G.A., A.M.H.), and Faculty of Life Sciences (G.E.), University of Manchester, Manchester, United Kingdom
| | - Gillian Edwards
- From the Institute of Cardiovascular Sciences (C.E.B., S.B.W., R.G.A., A.M.H.), and Faculty of Life Sciences (G.E.), University of Manchester, Manchester, United Kingdom
| | - Anthony M. Heagerty
- From the Institute of Cardiovascular Sciences (C.E.B., S.B.W., R.G.A., A.M.H.), and Faculty of Life Sciences (G.E.), University of Manchester, Manchester, United Kingdom
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77
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Gu N, You L, Shi C, Yang L, Pang L, Cui X, Ji C, Zheng W, Guo X. Expression of miR-199a-3p in human adipocytes is regulated by free fatty acids and adipokines. Mol Med Rep 2016; 14:1180-6. [PMID: 27279151 PMCID: PMC4940088 DOI: 10.3892/mmr.2016.5379] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 05/17/2016] [Indexed: 01/14/2023] Open
Abstract
Obesity is associated with a notable risk for disease, including risk of cardiovascular disorders, type 2 diabetes mellitus (T2DM) and hypertension. Adipose tissue modulates the metabolism by releasing free fatty acids (FFAs) and adipokines, including leptin, resistin, tumor necrosis factor-α (TNF-α) and interleukin 6 (IL-6). Altered secretion patterns of FFAs and adipokines have been demonstrated to result in obesity-associated insulin resistance (IR) and inflammatory responses. MicroRNA-199a-3p (miR)-199a-3p expression is significantly induced in differentiated human adipose-derived mesenchymal stem cells and indicates the association with T2DM. However, the association between miR-199a-3p levels in adipocytes and obesity-associated IR, as well as inflammatory responses remains to be elucidated. The present study observed an elevation of miR-199a-3p expression level in mature human adipocytes (visceral) compared with pre-adipocytes. In addition, miR-199a-3p expression was higher in visceral adipose deposits from obese subjects. FFA, TNF-α, IL-6 and leptin significantly induced miR-199a-3p expression in mature human adipocytes, while resistin had the opposite effect. miR-199a-3p may represent a factor in the modulation of obesity-associated IR and inflammatory responses.
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Affiliation(s)
- Nan Gu
- Nanjing Maternity and Child Health Care Institute, Nanjing Maternity and Child Health Care Hospital Affiliated With Nanjing Medical University, Nanjing, Jiangsu 210004, P.R. China
| | - Lianghui You
- Nanjing Maternity and Child Health Care Institute, Nanjing Maternity and Child Health Care Hospital Affiliated With Nanjing Medical University, Nanjing, Jiangsu 210004, P.R. China
| | - Chunmei Shi
- Nanjing Maternity and Child Health Care Institute, Nanjing Maternity and Child Health Care Hospital Affiliated With Nanjing Medical University, Nanjing, Jiangsu 210004, P.R. China
| | - Lei Yang
- Nanjing Maternity and Child Health Care Institute, Nanjing Maternity and Child Health Care Hospital Affiliated With Nanjing Medical University, Nanjing, Jiangsu 210004, P.R. China
| | - Lingxia Pang
- Nanjing Maternity and Child Health Care Institute, Nanjing Maternity and Child Health Care Hospital Affiliated With Nanjing Medical University, Nanjing, Jiangsu 210004, P.R. China
| | - Xianwei Cui
- Nanjing Maternity and Child Health Care Institute, Nanjing Maternity and Child Health Care Hospital Affiliated With Nanjing Medical University, Nanjing, Jiangsu 210004, P.R. China
| | - Chenbo Ji
- Nanjing Maternity and Child Health Care Institute, Nanjing Maternity and Child Health Care Hospital Affiliated With Nanjing Medical University, Nanjing, Jiangsu 210004, P.R. China
| | - Wen Zheng
- Maternity and Child Health Hospital of Yancheng, Yancheng, Jiangsu 224002, P.R. China
| | - Xirong Guo
- Nanjing Maternity and Child Health Care Institute, Nanjing Maternity and Child Health Care Hospital Affiliated With Nanjing Medical University, Nanjing, Jiangsu 210004, P.R. China
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78
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Movahed MR, Lee JZ, Lim WY, Hashemzadeh M, Hashemzadeh M. Strong independent association between obesity and essential hypertension. Clin Obes 2016; 6:189-92. [PMID: 27166134 DOI: 10.1111/cob.12139] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2015] [Revised: 01/17/2016] [Accepted: 01/21/2016] [Indexed: 01/13/2023]
Abstract
Obesity and hypertension (HTN) are major risk factors for cardiovascular disease. Association between obesity and HTN has not been studied in a large populations following adjustment for comorbidities. The goal of this study was to evaluate any association between obesity and HTN after adjusting for baseline characteristics. We used ICD-9 codes for obesity and HTN from the Nationwide Inpatient Sample (NIS) databases. Two randomly selected years, 1992 and 2002, were chosen from the databases as two independent samples. We used uni- and multivariable analysis to study any correlation between obesity and HTN. The 1992 database contained a total of 6,195,744 patients. HTN was present in 37.2 % of patients with obesity versus 12% of the control group (OR: 4.36, CI 4.30-4.42, P < 0.001). The 2002 database contained a total of 7,153,982 patients. HTN was present in 50.7% of patients with obesity versus 25.6% of the control group (OR: 2.98, CI 2.96-3.00, P < 0.001). Using multivariable analysis adjusting for gender, hyperlipidaemia, age, smoking, type 2 diabetes and chronic renal failure, obesity remained correlated with HTN in both years (1992: OR 2.69, CI 2.67-2.72, P < 0.001; 2002: OR 2.98, CI 2.96-3.00, P < 0.001). The presence of obesity was found to be strongly and independently associated with HTN. The cause of this correlation is not known warranting further investigation.
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Affiliation(s)
- M R Movahed
- CareMore HealthCare, Tucson, AZ, USA
- School of Medicine, University of Arizona, Tucson, AZ, USA
| | - J Z Lee
- School of Medicine, University of Arizona, Tucson, AZ, USA
| | - W Y Lim
- Hurley Medical Center, Flint, MI, USA
| | - M Hashemzadeh
- School of Medicine, University of Arizona, Tucson, AZ, USA
- PIMA College, Tucson, AZ, USA
| | - M Hashemzadeh
- Long Beach VA Health Care System, Long Beach, CA, USA
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Feldman RD, Ding Q, Hussain Y, Limbird LE, Pickering JG, Gros R. Aldosterone mediates metastatic spread of renal cancer
via
the G protein‐coupled estrogen receptor (GPER). FASEB J 2016; 30:2086-96. [DOI: 10.1096/fj.15-275552] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 11/09/2015] [Indexed: 01/20/2023]
Affiliation(s)
- Ross D. Feldman
- Discipline of MedicineMemorial University of NewfoundlandSt. John'sNewfoundland and LabradorCanada
- Molecular Medicine Group, Robarts Research InstituteLondonOntarioCanada
| | - Qingming Ding
- Discipline of MedicineMemorial University of NewfoundlandSt. John'sNewfoundland and LabradorCanada
- Molecular Medicine Group, Robarts Research InstituteLondonOntarioCanada
| | - Yasin Hussain
- Molecular Medicine Group, Robarts Research InstituteLondonOntarioCanada
| | - Lee E. Limbird
- Department of Life and Physical SciencesFisk UniversityNashvilleTennesseeUSA
| | | | - Robert Gros
- Molecular Medicine Group, Robarts Research InstituteLondonOntarioCanada
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Mohan M, McSwiggan S, Baig F, Rutherford L, Lang CC. Metformin and its effects on myocardial dimension and left ventricular hypertrophy in normotensive patients with coronary heart disease (the MET-REMODEL study): rationale and design of the MET-REMODEL study. Cardiovasc Ther 2015; 33:1-8. [PMID: 25545400 DOI: 10.1111/1755-5922.12101] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Left ventricular hypertrophy (LVH) is a common and independent risk factor for cardiovascular events in patients with coronary artery disease (CAD). Controlling blood pressure is the standard approach to the management of LVH, but this is only partially effective as LVH also persists in normotensive patients. Apart from blood pressure (BP), other main risk factors associated with LVH are insulin resistance (IR) and central obesity. The diabetic medication, Metformin, reduces IR and aids weight loss and may therefore regress LVH. The MET REMODEL study will investigate the ability of Metformin to regress LVH in 64 patients with CAD. The MET-REMODEL trial is a single-center, phase IV, double blind, randomized, placebo-controlled trial to investigate the efficacy of Metformin in regression of the independent cardiac risk factor of LVH in patients with CAD who are insulin resistant. A minimum of 64 adults with a history of CAD with LVH and IR will be randomized into two groups to receive, either Metformin XL or placebo. The primary endpoint of this trial is to investigate any change in left ventricular mass index. Secondary endpoints include changes to insulin resistance measured using fasting insulin resistance index (FIRI), obesity, LV size, and function and improvement in endothelial function. A positive result will assist clinicians to identify a new mechanism for LVH regression by administering Metformin XL. This may also lead to investigating the mortality benefit of Metformin in patients with CAD and LVH.
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Affiliation(s)
- Mohapradeep Mohan
- Division of Cardiovascular & Diabetes Medicine, Ninewells Hospital & Medical School, Dundee, Angus, UK
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81
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Navarro E, Funtikova AN, Fíto M, Schröder H. Can metabolically healthy obesity be explained by diet, genetics, and inflammation? Mol Nutr Food Res 2015; 59:75-93. [PMID: 25418549 DOI: 10.1002/mnfr.201400521] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 11/18/2014] [Accepted: 11/18/2014] [Indexed: 12/20/2022]
Abstract
A substantial proportion of obese individuals do not present cardiometabolic complications such as diabetes, hypertension, or dyslipidemia. Some, but not all, prospective studies observe similar risk of cardiovascular events and all-cause mortality among individuals with this so-called "metabolically healthy obese" (MHO) phenotype, compared to the metabolically healthy normal weight or metabolically healthy non-obese phenotypes. Compared to the metabolically unhealthy obese (MUO) phenotype, MHO is often characterized by a more favorable inflammatory profile, less visceral fat, less infiltration of macrophages into adipose tissue, and smaller adipocyte cell size. Tipping the inflammation balance in adipose tissue might be particularly important for metabolic health in the obese. While the potential role of genetic predisposition or lifestyle factors such as diet in the MHO phenotype is yet to be clarified, it is well known that diet affects inflammation profile and contributes to the functionality of adipose tissue. This review will discuss genetic predisposition and the molecular mechanisms underlying the potential effect of food on the development of the metabolic phenotype characteristic of obesity.
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82
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Gonçalves CG, Glade MJ, Meguid MM. Metabolically healthy obese individuals: Key protective factors. Nutrition 2015; 32:14-20. [PMID: 26440861 DOI: 10.1016/j.nut.2015.07.010] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 07/20/2015] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Obesity is a significant quality of life-impairing health problem affecting industrialized nations. However, despite carrying a large fat mass, some very obese individuals exhibit normal metabolic profiles (metabolically healthy obesity). The physiological factors underlying their protective and favorable metabolic profiles remain poorly defined. METHODS A search of the National Library of Medicine PubMed database was performed using the following keywords: Metabolically healthy obese, metabolically normal obese, insulin resistance, metabolically unhealthy normal weight, and uncomplicated obesity. RESULTS This article reviewed factors associated with severe obesity that lacks complications, and suggests putative activities by which these obese individuals avoid developing the clinical features of metabolic syndrome, or the metabolic complications associated with severe obesity. CONCLUSIONS Despite the knowledge that visceral fat deposition is the seminal factor that ultimately causes insulin resistance (IR) and the detrimental inflammatory and hormonal profile that contributes to increase risk for cardiovascular disease, it remains unknown whether metabolically healthy obesity (MHO) has genetic predisposing factors, and whether MHO ultimately succumbs to IR and the metabolic syndrome, indicating a need for prophylatic bariatric surgery.
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Affiliation(s)
- Carolina G Gonçalves
- Department of Surgery, Positivo University, Curitiba, PR, Brazil 81280 to 330. Surgical Metabolism Laboratory, Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil
| | | | - Michael M Meguid
- Surgical Metabolism and Nutrition Laboratory, Department of Surgery, University Hospital, SUNY Upstate Medical University, Syracuse, NY, USA.
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83
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Endothelial function in hypertensive obese patients: 1 year after surgically induced weight loss. Obes Surg 2015; 24:1581-4. [PMID: 24908247 DOI: 10.1007/s11695-014-1328-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The aim of this study was to describe the effect of surgically induced weight loss on vascular function measured by flow-mediated dilatation (FMD) in hypertensive obese patients. This prospective study included 33 patients (78 % females, mean age 53 (9) years) undergoing bariatric surgery (BS). Before and 12 months postoperatively, the BMI, 24-h ambulatory BP, high-sensitivity C-reactive protein (hs-CRP), leptin, homeostasis model assessment (HOMA IR), and abdominal fat were measured. Endothelial function was assessed by FMD. After BS, the excess body weight loss was 71 %; the 24-h [systolic 18(11)//diastolic 7(7) mmHg] BP values, hs-CRP, leptin, HOMA, and abdominal fat significantly decreased, with no changes in endothelial function. Weight loss achieved by BS was associated with a significant improvement in BP and metabolic and inflammation parameters, but FMD did not improve.
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Ying A, Arima H, Czernichow S, Woodward M, Huxley R, Turnbull F, Perkovic V, Neal B. Effects of blood pressure lowering on cardiovascular risk according to baseline body-mass index: a meta-analysis of randomised trials. Lancet 2015; 385:867-74. [PMID: 25468168 DOI: 10.1016/s0140-6736(14)61171-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND The cardiovascular benefits of blood pressure lowering in obese people compared with people of normal weight might depend on choice of drug. We compared the effects of blood pressure-lowering regimens on cardiovascular risk in groups of patients categorised by baseline body-mass index (BMI). METHODS We used individual patient data from trials included in the Blood Pressure Lowering Treatment Trialists' Collaboration to compare the effects of different classes of blood pressure-lowering regimens for the primary outcome of total major cardiovascular events (stroke, coronary heart disease, heart failure, and cardiovascular death). We used meta-analyses and meta-regressions to assess interactions between treatment and BMI when fitted as either a categorical variable (<25 kg/m(2), 25 to <30 kg/m(2), and ≥30 kg/m(2)) or a continuous variable. FINDINGS Analyses were based on 135,715 individuals from 22 trials who had 14,353 major cardiovascular events. None of the six primary comparisons showed evidence that protection varied by drug class across the three BMI groups (all p for trend >0·20). When analysed as a continuous variable, angiotensin-converting-enzyme inhibitors gave slightly greater protection for each 5 kg/m(2) higher BMI than did calcium antagonists (hazard ratio 0·93, 95% CI 0·89-0·98; p=0·004) or diuretics (0·93, 0·89-0·98; p=0·002). The meta-regressions showed no relation between BMI category and the risk reduction for a given fall in systolic blood pressure. By contrast with a previous report, we noted no relation between BMI and the efficacy of calcium antagonists compared with diuretics. INTERPRETATION We found little evidence that selection of a particular class of blood pressure-lowering drug will lead to substantially different outcomes for individuals who are obese compared with those who are lean. FUNDING None.
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Chen Z, Smith M, Du H, Guo Y, Clarke R, Bian Z, Collins R, Chen J, Qian Y, Wang X, Chen X, Tian X, Wang X, Peto R, Li L. Blood pressure in relation to general and central adiposity among 500 000 adult Chinese men and women. Int J Epidemiol 2015; 44:1305-19. [PMID: 25747585 PMCID: PMC4588860 DOI: 10.1093/ije/dyv012] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2015] [Indexed: 12/22/2022] Open
Abstract
Background: Greater adiposity is associated with higher blood pressure. Substantial uncertainty remains, however, about which measures of adiposity most strongly predict blood pressure and whether these associations differ materially between populations. Methods: We examined cross-sectional data on 500 000 adults recruited from 10 diverse localities across China during 2004–08. Multiple linear regression was used to estimate the effects on systolic blood pressure (SBP) of general adiposity [e.g. body mass index (BMI), body fat percentage, height-adjusted weight] vs central adiposity [e.g. waist circumference (WC), hip circumference (HC), waist-hip ratio (WHR)], before and after adjustment for each other. The main analyses excluded those reported taking any antihypertensive medication, and were adjusted for age, region and education. Results: The overall mean [standard deviation (SD)] BMI was 23.6 (3.3) kg/m2 and mean WC was 80.0 (9.5) cm. The differences in SBP (men/women, mmHg) per 1SD higher general adiposity (height-adjusted weight: 6.6/5.6; BMI: 5.5/4.9; body fat percentage: 5.5/5.0) were greater than for central adiposity (WC: 5.0/4.3; HC: 4.8/4.1; WHR: 3.7/3.2), with a 10 kg/m2 greater BMI being associated on average with 16 (men/women: 17/14) mmHg higher SBP. The associations of blood pressure with measures of general adiposity were not materially altered by adjusting for WC and HC, but those for central adiposity were significantly attenuated after adjusting for BMI (WC: 1.1/0.7; HC: 0.3/−0.2; WHR: 0.6/0.6). Conclusion: In adult Chinese, blood pressure is more strongly associated with general adiposity than with central adiposity, and the associations with BMI were about 50% stronger than those observed in Western populations.
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Affiliation(s)
- Zhengming Chen
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK,
| | - Margaret Smith
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Huaidong Du
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Yu Guo
- Chinese Academy of Medical Sciences, Beijing, China
| | - Robert Clarke
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Zheng Bian
- Chinese Academy of Medical Sciences, Beijing, China
| | - Rory Collins
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Junshi Chen
- China National Centre for Food Safety Risk Assessment, Beijing, China
| | - Yijian Qian
- Tongxiang Centre for Disease Control and Prevention (CDC), Zhejiang, China
| | | | | | | | | | - Richard Peto
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Liming Li
- Chinese Academy of Medical Sciences, Beijing, China, Department of Epidemiology & Biostatistics, Peking University, Beijing, China
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86
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Diletti R, Garcia-Garcia HM, Bourantas C, Van Mieghem NM, van Geuns RJ, Muramatsu T, Zhang YJ, Mauri L, Belardi J, Silber S, Widimsky P, Leon M, Windecker S, Meredith I, Neumann FJ, Yeung AC, Saito S, Liu M, van Leeuwen F, Serruys PW. Impact of body mass index on long-term clinical outcomes after second-generation drug eluting stent implantation: Insights from the international global RESOLUTE program. Catheter Cardiovasc Interv 2015; 85:952-8. [PMID: 25689692 DOI: 10.1002/ccd.25828] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2014] [Accepted: 01/03/2015] [Indexed: 12/25/2022]
Abstract
BACKGROUND An increased body mass index (BMI) is associated with a high risk of cardiovascular disease and reduction in life expectancy. However, several studies reported improved clinical outcomes in obese patients treated for cardiovascular diseases. The aim of the present study is to investigate the impact of BMI on long-term clinical outcomes after implantation of zotarolimus eluting stents. METHODS Individual patient data were pooled from the RESOLUTE Clinical Program comprising five trials worldwide. The study population was sorted according to BMI tertiles and clinical outcomes were evaluated at 2-year follow-up. RESULTS Data from a total of 5,127 patients receiving the R-ZES were included in the present study. BMI tertiles were as follow: I tertile (≤ 25.95 kg/m(2) -Low or normal weight) 1,727 patients; II tertile (>25.95 ≤ 29.74 kg/m(2) -overweight) 1,695 patients, and III tertile (>29.74 kg/m(2) -obese) 1,705 patients. At 2-years follow-up no difference was found for patients with high BMI (III tertile) compared with patients with normal or low BMI (I tertile) in terms of target lesion failure (I-III tertile, HR [95% CI] = 0.89 [0.69, 1.14], P = 0.341; major adverse cardiac events (I-III tertile, HR [95% CI] = 0.90 [0.72, 1.14], P = 0.389; cardiac death (I-III tertile, HR [95% CI] = 1.20 [0.73, 1.99], P = 0.476); myocardial infarction (I-III tertile, HR [95% CI] = 0.86 [0.55, 1.35], P = 0.509; clinically-driven target lesion revascularization (I-III tertile, HR [95% CI] = 0.75 [0.53, 1.08], P = 0.123; definite or probable stent thrombosis (I-III tertile, HR [95% CI] = 0.98 [0.49, 1.99], P = 0.964. CONCLUSIONS In the present study, the patients' body mass index was found to have no impact on long-term clinical outcomes after coronary artery interventions.
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Affiliation(s)
- Roberto Diletti
- Department of Interventional Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands
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87
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Chen X, Du H, Zhang J, Chen X, Luo G, Que X, Zhang N, Bian Z, Guo Y, Li L, Chen Z, Wu X. Adiposity and blood pressure among 55 000 relatively lean rural adults in southwest of China. J Hum Hypertens 2015; 29:522-9. [PMID: 25652532 PMCID: PMC4537884 DOI: 10.1038/jhh.2014.129] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 12/08/2014] [Accepted: 12/10/2014] [Indexed: 11/09/2022]
Abstract
Obesity is a strong determinant of blood pressure. Uncertainty remains, however, about which indices of adiposity most strongly predict blood pressure, particularly among those who were relatively lean, such as those from rural China. We analyzed cross-sectional data on 55 687 (38.3% men) participants aged 30–79 years who were enrolled into the China Kadoorie Biobank from a rural county in southwest of China during 2004–2008. Measured body mass index (BMI) and waist circumference (WC) were related to blood pressure in multivariable linear regression analyses. The overall mean values of BMI, WC, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 23.3 kg m−2, 78.0 cm, 129.2 mm Hg and 77.2 mm Hg, respectively. There was a strongly positive, and apparently linear, relationship of BMI and WC with blood pressure, with 1 s.d. higher BMI associated with 4.3/2.3 mm Hg higher SBP/DBP and 1 s.d. WC associated with 3.8/2.1 mm Hg (P<0.0001). Additional adjustment for WC only slightly attenuated the association of BMI with blood pressure, whereas additional adjustment for BMI almost completely eliminated the association of WC with blood pressure. Our findings suggest that in relatively lean Chinese adults, general adiposity is more strongly assciated with blood pressure than central adiposity.
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Affiliation(s)
- X Chen
- 1] West China School of Public Health, Sichuan University, Sichuan Province, China [2] Sichuan Provincial Center of Disease Prevention and Control, Sichuan Province, China
| | - H Du
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - J Zhang
- West China School of Public Health, Sichuan University, Sichuan Province, China
| | - X Chen
- Pengzhou Center of Disease Prevention and Control, Sichuan Province, China
| | - G Luo
- Pengzhou Center of Disease Prevention and Control, Sichuan Province, China
| | - X Que
- Pengzhou Center of Disease Prevention and Control, Sichuan Province, China
| | - N Zhang
- Sichuan Provincial Center of Disease Prevention and Control, Sichuan Province, China
| | - Z Bian
- Chinese Academy of Medical Sciences, Beijing, China
| | - Y Guo
- Chinese Academy of Medical Sciences, Beijing, China
| | - L Li
- 1] Chinese Academy of Medical Sciences, Beijing, China [2] School of Public Health, Peking University, Beijing, China
| | - Z Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - X Wu
- Sichuan Provincial Center of Disease Prevention and Control, Sichuan Province, China
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88
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Li G, Liu JY, Zhang HX, Li Q, Zhang SW. Exercise training attenuates sympathetic activation and oxidative stress in diet-induced obesity. Physiol Res 2014; 64:355-67. [PMID: 25536322 DOI: 10.33549/physiolres.932851] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
It is known that excessive sympathetic activity and oxidative stress are enhanced in obesity. This study aimed to clarify whether exercise training (ET) attenuates sympathetic activation and oxidative stress in obesity. The obesity was induced by high-fat diet (HFD) for 12 weeks. Male Sprague-Dawley rats were assigned to four groups: regular diet (RD) plus sedentary (RD-S), RD plus ET (RD-ET), HFD plus sedentary (HFD-S), and HFD plus ET (HFD-ET). The rats in RD-ET and HFD-ET groups were trained on a motorized treadmill for 60 min/day, five days/week for 8 weeks. The sympathetic activity was evaluated by the plasma norepinephrine (NE) level. The superoxide anion, malondialdehyde and F2-isoprostanes levels in serum and muscles were measured to evaluate oxidative stress. The ET prevented the increases in the body weight, arterial pressure and white adipose tissue mass in HFD rats. The NE level in plasma and oxidative stress related parameters got lower in HFD-ET group compared with HFD-S group. We have found decreased mRNA and protein levels of toll-like receptor (TLR)-2 and TLR-4 by ET in HFD rats. These findings suggest that ET may be effective for attenuating sympathetic activation and oxidative stress in diet-induced obesity.
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Affiliation(s)
- G Li
- Physical Education College, Northeast Normal University, Changchun City, Jilin Province, China.
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89
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Jahangir E, De Schutter A, Lavie CJ. The relationship between obesity and coronary artery disease. Transl Res 2014; 164:336-44. [PMID: 24726461 DOI: 10.1016/j.trsl.2014.03.010] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Revised: 03/07/2014] [Accepted: 03/18/2014] [Indexed: 10/25/2022]
Abstract
Obesity continues to be a growing issue in the United States, with an estimated prevalence of 72 million people. There are major health implications associated with obesity, including its relationship with hypertension, diabetes mellitus type 2, metabolic syndrome, and dyslipidemia, all independent risk factors for coronary artery disease (CAD). Despite the increased risk of developing CAD, in recent years an "obesity paradox" has been described in which moderately obese individuals with established cardiovascular disease, including CAD, appear to have mortality similar to their normal-weight counterparts. This review examines the relationship between obesity and CAD, including the increased risk of hypertension, diabetes mellitus, metabolic syndrome, and dyslipidemia, along with a discussion of the obesity paradox and the benefits of weight reduction.
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Affiliation(s)
- Eiman Jahangir
- John Ochsner Heart and Vascular Institute, Department of Cardiovascular Diseases, Ochsner Clinical School-The University of Queensland School of Medicine, New Orleans, La.
| | - Alban De Schutter
- John Ochsner Heart and Vascular Institute, Department of Cardiovascular Diseases, Ochsner Clinical School-The University of Queensland School of Medicine, New Orleans, La
| | - Carl J Lavie
- John Ochsner Heart and Vascular Institute, Department of Cardiovascular Diseases, Ochsner Clinical School-The University of Queensland School of Medicine, New Orleans, La; Department of Preventive Medicine, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, La
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90
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Abraham NG, Sodhi K, Silvis AM, Vanella L, Favero G, Rezzani R, Lee C, Zeldin DC, Schwartzman ML. CYP2J2 targeting to endothelial cells attenuates adiposity and vascular dysfunction in mice fed a high-fat diet by reprogramming adipocyte phenotype. Hypertension 2014; 64:1352-61. [PMID: 25245389 DOI: 10.1161/hypertensionaha.114.03884] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Obesity is a global epidemic and a common risk factor for endothelial dysfunction and the subsequent development of diabetes mellitus and vascular diseases such as hypertension. Epoxyeicosatrienoic acids (EETs) are cytochrome P450 (CYP)-derived metabolites of arachidonic acid that contribute to vascular protection by stimulating vasodilation and inhibiting inflammation. Heme oxygenase-1 is a stress response protein that plays an important cytoprotective role against oxidative insult in diabetes mellitus and cardiovascular disease. We recently demonstrated interplay between EETs and heme oxygenase-1 in the attenuation of adipogenesis. We examined whether adipocyte dysfunction in mice fed a high-fat diet could be prevented by endothelial-specific targeting of the human CYP epoxygenase, CYP2J2. Tie2-CYP2J2 transgenic mice, fed a high-fat diet, had a reduction in body weight gain, blood glucose, insulin levels, and inflammatory markers. Tie2-CYP2J2 gene targeting restored HF-mediated decreases in vascular heme oxygenase-1, Cyp2C44, soluble epoxide hydrolase, phosphorylated endothelial nitric oxide synthase, phosphorylated protein kinase B, and phosphorylated adenosine monophosphate protein kinase protein expression, thus improving vascular function. These changes translated into decreased inflammation and oxidative stress within adipose tissue and decreased peroxisome proliferator-activated receptor-γ, CCAAT/enhancer binding protein alpha, mesoderm-specific transcript, and adipocyte 2 expression and increased uncoupling protein 1 and uncoupling protein 2 expression, reflecting the effect of vascular EET overproduction on adipogenesis. The current study documents a direct link between endothelial-specific EET production and adipogenesis, further implicating the EET-heme oxygenase-1 crosstalk as an important cytoprotective mechanism in the amelioration of vascular and adipocyte dysfunction resulting from diet-induced obesity.
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Affiliation(s)
- Nader G Abraham
- From the Departments of Medicine and Pharmacology, New York Medical College, Valhalla (N.G.A., M.L.S.); Departments of Medicine and Obstetrics and Gynecology, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV (K.S., A.M.S.); Biochemistry Section and Medicinal Chemistry Section, Department of Drug Sciences, University of Catania, Catania, Italy (L.V.); Department of Clinical and Experimental Sciences, Division of Anatomy and Physiopathology, University of Brescia, Brescia, Italy (G.F., R.R.); Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC (C.L., D.C.Z.).
| | - Komal Sodhi
- From the Departments of Medicine and Pharmacology, New York Medical College, Valhalla (N.G.A., M.L.S.); Departments of Medicine and Obstetrics and Gynecology, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV (K.S., A.M.S.); Biochemistry Section and Medicinal Chemistry Section, Department of Drug Sciences, University of Catania, Catania, Italy (L.V.); Department of Clinical and Experimental Sciences, Division of Anatomy and Physiopathology, University of Brescia, Brescia, Italy (G.F., R.R.); Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC (C.L., D.C.Z.)
| | - Anne M Silvis
- From the Departments of Medicine and Pharmacology, New York Medical College, Valhalla (N.G.A., M.L.S.); Departments of Medicine and Obstetrics and Gynecology, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV (K.S., A.M.S.); Biochemistry Section and Medicinal Chemistry Section, Department of Drug Sciences, University of Catania, Catania, Italy (L.V.); Department of Clinical and Experimental Sciences, Division of Anatomy and Physiopathology, University of Brescia, Brescia, Italy (G.F., R.R.); Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC (C.L., D.C.Z.)
| | - Luca Vanella
- From the Departments of Medicine and Pharmacology, New York Medical College, Valhalla (N.G.A., M.L.S.); Departments of Medicine and Obstetrics and Gynecology, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV (K.S., A.M.S.); Biochemistry Section and Medicinal Chemistry Section, Department of Drug Sciences, University of Catania, Catania, Italy (L.V.); Department of Clinical and Experimental Sciences, Division of Anatomy and Physiopathology, University of Brescia, Brescia, Italy (G.F., R.R.); Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC (C.L., D.C.Z.)
| | - Gaia Favero
- From the Departments of Medicine and Pharmacology, New York Medical College, Valhalla (N.G.A., M.L.S.); Departments of Medicine and Obstetrics and Gynecology, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV (K.S., A.M.S.); Biochemistry Section and Medicinal Chemistry Section, Department of Drug Sciences, University of Catania, Catania, Italy (L.V.); Department of Clinical and Experimental Sciences, Division of Anatomy and Physiopathology, University of Brescia, Brescia, Italy (G.F., R.R.); Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC (C.L., D.C.Z.)
| | - Rita Rezzani
- From the Departments of Medicine and Pharmacology, New York Medical College, Valhalla (N.G.A., M.L.S.); Departments of Medicine and Obstetrics and Gynecology, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV (K.S., A.M.S.); Biochemistry Section and Medicinal Chemistry Section, Department of Drug Sciences, University of Catania, Catania, Italy (L.V.); Department of Clinical and Experimental Sciences, Division of Anatomy and Physiopathology, University of Brescia, Brescia, Italy (G.F., R.R.); Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC (C.L., D.C.Z.)
| | - Craig Lee
- From the Departments of Medicine and Pharmacology, New York Medical College, Valhalla (N.G.A., M.L.S.); Departments of Medicine and Obstetrics and Gynecology, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV (K.S., A.M.S.); Biochemistry Section and Medicinal Chemistry Section, Department of Drug Sciences, University of Catania, Catania, Italy (L.V.); Department of Clinical and Experimental Sciences, Division of Anatomy and Physiopathology, University of Brescia, Brescia, Italy (G.F., R.R.); Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC (C.L., D.C.Z.)
| | - Darryl C Zeldin
- From the Departments of Medicine and Pharmacology, New York Medical College, Valhalla (N.G.A., M.L.S.); Departments of Medicine and Obstetrics and Gynecology, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV (K.S., A.M.S.); Biochemistry Section and Medicinal Chemistry Section, Department of Drug Sciences, University of Catania, Catania, Italy (L.V.); Department of Clinical and Experimental Sciences, Division of Anatomy and Physiopathology, University of Brescia, Brescia, Italy (G.F., R.R.); Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC (C.L., D.C.Z.)
| | - Michal L Schwartzman
- From the Departments of Medicine and Pharmacology, New York Medical College, Valhalla (N.G.A., M.L.S.); Departments of Medicine and Obstetrics and Gynecology, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV (K.S., A.M.S.); Biochemistry Section and Medicinal Chemistry Section, Department of Drug Sciences, University of Catania, Catania, Italy (L.V.); Department of Clinical and Experimental Sciences, Division of Anatomy and Physiopathology, University of Brescia, Brescia, Italy (G.F., R.R.); Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC (C.L., D.C.Z.)
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91
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Antiobesity and Hypolipidemic Activity of Moringa oleifera Leaves against High Fat Diet-Induced Obesity in Rats. ACTA ACUST UNITED AC 2014. [DOI: 10.1155/2014/162914] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In the present study, the methanolic extract of Moringa oleifera leaves (MEMOL) was evaluated for antiobesity activity in rats. The antiobesity potential of MEMOL was studied against high fat diet-induced obesity (HFD) in rats. In this study, chronic administration of HFD in rats produced hypercholesterolemia (116.2 ± 0.27 mg/dL), which led to an increase in the body weight (225 gr), total cholesterol, triglycerides (263.0 ± 4.69 mg/dL), and attenuation in the levels of HDL (34.51 ± 2.20 mg/dL) as well as changes in body temperature of animals. Treatment of obese rats with MEMOL for 49 days resulted in a significant (P<0.001) change in body weight, total cholesterol, triglycerides, and LDL level along with a significant (P<0.001) increase in body temperature as compared to the HFD-induced obesity. MEMOL treated rats also showed a significant decrease in the level of liver biomarkers, organ weight, and blood glucose level. Further, rats treated with MEMOL (200 mg and 400 mg/kg) show reduced atherogenic index (1.7 ± 0.6 and 0.87 ± 0.76). The results indicate that the rats treated with Moringa oleifera (MO) have significantly attenuated the body weight without any change in the feed intake and also elicited significant thermogenic effect and to act as hypolipidemic and thermogenic property in obesity related disorders.
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92
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Santhanam P, Driscoll H. Comparison of Metabolic Parameters Between Obese Normotensive and Obese Hypertensive Individuals-A Study of the NHANES Cross-Sectional Data 2011-2012. J Clin Hypertens (Greenwich) 2014; 16:467. [DOI: 10.1111/jch.12299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Prasanna Santhanam
- Joan C. Edwards School of Medicine; Section of Endocrinology; Marshall University; Huntington WV
| | - Henry Driscoll
- Joan C. Edwards School of Medicine; Section of Endocrinology; Marshall University; Huntington WV
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93
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Abstract
The combination of obesity and hypertension is associated with high morbidity and mortality because it leads to cardiovascular and kidney disease. Potential mechanisms linking obesity to hypertension include dietary factors, metabolic, endothelial and vascular dysfunction, neuroendocrine imbalances, sodium retention, glomerular hyperfiltration, proteinuria, and maladaptive immune and inflammatory responses. Visceral adipose tissue also becomes resistant to insulin and leptin and is the site of altered secretion of molecules and hormones such as adiponectin, leptin, resistin, TNF and IL-6, which exacerbate obesity-associated cardiovascular disease. Accumulating evidence also suggests that the gut microbiome is important for modulating these mechanisms. Uric acid and altered incretin or dipeptidyl peptidase 4 activity further contribute to the development of hypertension in obesity. The pathophysiology of obesity-related hypertension is especially relevant to premenopausal women with obesity and type 2 diabetes mellitus who are at high risk of developing arterial stiffness and endothelial dysfunction. In this Review we discuss the relationship between obesity and hypertension with special emphasis on potential mechanisms and therapeutic targeting that might be used in a clinical setting.
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Affiliation(s)
- Vincent G DeMarco
- Internal Medicine, University of Missouri, Columbia School of Medicine, One Hospital Drive, Columbia, MO 65212, USA
| | - Annayya R Aroor
- Internal Medicine, University of Missouri, Columbia School of Medicine, One Hospital Drive, Columbia, MO 65212, USA
| | - James R Sowers
- Internal Medicine, University of Missouri, Columbia School of Medicine, One Hospital Drive, Columbia, MO 65212, USA
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94
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Flores L, Vidal J, Núñez I, Rueda S, Viaplana J, Esmatjes E. Longitudinal changes of blood pressure after weight loss: factors involved. Surg Obes Relat Dis 2014; 11:215-21. [PMID: 25304830 DOI: 10.1016/j.soard.2014.04.028] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 04/24/2014] [Accepted: 04/28/2014] [Indexed: 12/28/2022]
Abstract
BACKGROUND The combination of obesity and hypertension (HT) places patients at a higher risk for adverse cardiovascular outcomes and raises the need to establish the pathogenic mechanisms of this relationship. The aim of this study was to assess the effects of important weight loss on longitudinal changes in blood pressure (BP) and investigate the pathogenic factors associated with these changes. METHODS We performed a prospective, open-label study including 37 obese hypertensive patients (28 females, mean age 52±8 yr) undergoing BS. Before BS, and at 4 and 12 months postoperatively, the body mass index (BMI), 24-h ambulatory BP, renin-angiotensin-aldosterone system (RAAS: plasma rennin activity, aldosterone, angiotensin II, and angiotensin converting enzyme), sympathetic nervous system (SNS: metanephrines, normetanephrines, and norepinephrine) components, leptin, insulin, and abdominal fat were measured. RESULTS Before BS, HT-duration was 6±6 years, the BMI 45±5 kg/m2 and excess weight (EBW) was 53±12 kg. At 12 months, the excess BMI loss was 14 kg/m2 and the EBW loss was 70 %; HT remission was observed in 70%; 24-h (systolic 19±13/diastolic 7±9 mm Hg), day and night BP levels and aldosterone, norepinephrine, leptin, insulin, subcutaneous and visceral abdominal fat (VAT) significantly decreased (P<.05). Mixed models for repeated measures revealed that HT-duration, baseline BP, BMI, and VAT area were the main variables associated with longitudinal changes in BP. CONCLUSION These results demonstrate that the hypotensive response after weight loss in severely hypertensive obese patients is mainly regulated by HT-duration, baseline BP, BMI and VAT area, independently of suppression of hyperinsulinemia or changes in RAAS and SNS components.
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Affiliation(s)
- Lilliam Flores
- Obesity Unit, Department of Endocrinology and Nutrition, Hospital Clinic, Barcelona, Spain; CIBERDEM: Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, Barcelona, Spain.
| | - Josep Vidal
- Obesity Unit, Department of Endocrinology and Nutrition, Hospital Clinic, Barcelona, Spain; CIBERDEM: Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, Barcelona, Spain; IDIBAPS:Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Isabel Núñez
- Diagnostic Imaging Center, Hospital Clinic, Barcelona, Spain
| | - Sergio Rueda
- Obesity Unit, Department of Endocrinology and Nutrition, Hospital Clinic, Barcelona, Spain
| | - Judith Viaplana
- IDIBAPS:Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Enric Esmatjes
- CIBERDEM: Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, Barcelona, Spain; IDIBAPS:Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain; Diabetes Unit, Department of Endocrinology and Nutrition. Hospital Clinic i Provincial, Barcelona, Spain
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95
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Davies M, Fraser SA, Galic S, Choy SW, Katerelos M, Gleich K, Kemp BE, Mount PF, Power DA. Novel mechanisms of Na+ retention in obesity: phosphorylation of NKCC2 and regulation of SPAK/OSR1 by AMPK. Am J Physiol Renal Physiol 2014; 307:F96-F106. [PMID: 24808538 DOI: 10.1152/ajprenal.00524.2013] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Enhanced tubular reabsorption of salt is important in the pathogenesis of obesity-related hypertension, but the mechanisms remain poorly defined. To identify changes in the regulation of salt transporters in the kidney, C57BL/6 mice were fed a 40% fat diet [high-fat diet (HFD)] or a 12% fat diet (control diet) for 14 wk. Compared with control diet-fed mice, HFD-fed mice had significantly greater elevations in weight, blood pressure, and serum insulin and leptin levels. When we examined Na(+) transporter expression, Na(+)-K(+)-2Cl(-) cotransporter (NKCC2) was unchanged in whole kidney and reduced in the cortex, Na(+)-Cl(-) cotransporter (NCC) and α-epithelial Na(+) channel (ENaC) and γ-ENaC were unchanged, and β-ENaC was reduced. Phosphorylation of NCC was unaltered. Activating phosphorylation of NKCC2 at S126 was increased 2.5-fold. Activation of STE-20/SPS1-related proline-alanine-rich protein kinase (SPAK)/oxidative stress responsive 1 kinase (OSR1) was increased in kidneys from HFD-fed mice, and enhanced phosphorylation of NKCC2 at T96/T101 was evident in the cortex. Increased activity of NKCC2 in vivo was confirmed with diuretic experiments. HFD-fed mice had reduced activating phosphorylation of AMP-activated protein kinase (AMPK) in the renal cortex. In vitro, activation of AMPK led to a reduction in phospho-SPAK/phospho-OSR1 in AMPK(+/+) murine embryonic fibroblasts (MEFs), but no effect was seen in AMPK(-/-) MEFs, indicating an AMPK-mediated effect. Activation of the with no lysine kinase/SPAK/OSR1 pathway with low-NaCl solution invoked a greater elevation in phospho-SPAK/phospho-OSR1 in AMPK(-/-) MEFs than in AMPK(+/+) MEFs, consistent with a negative regulatory effect of AMPK on SPAK/OSR1 phosphorylation. In conclusion, this study identifies increased phosphorylation of NKCC2 on S126 as a hitherto-unrecognized mediator of enhanced Na(+) reabsorption in obesity and identifies a new role for AMPK in regulating the activity of SPAK/OSR1.
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Affiliation(s)
- Matthew Davies
- Kidney Laboratory, Institute for Breathing and Sleep, University of Melbourne, Heidelberg, Victoria, Australia; Department of Nephrology, University of Melbourne, Heidelberg, Victoria, Australia; Department of Medicine, University of Melbourne, Heidelberg, Victoria, Australia; and
| | - Scott A Fraser
- Kidney Laboratory, Institute for Breathing and Sleep, University of Melbourne, Heidelberg, Victoria, Australia
| | - Sandra Galic
- St. Vincent's Institute, Fitzroy, Victoria, Australia
| | - Suet-Wan Choy
- Kidney Laboratory, Institute for Breathing and Sleep, University of Melbourne, Heidelberg, Victoria, Australia; Department of Nephrology, University of Melbourne, Heidelberg, Victoria, Australia; Department of Medicine, University of Melbourne, Heidelberg, Victoria, Australia; and
| | - Marina Katerelos
- Kidney Laboratory, Institute for Breathing and Sleep, University of Melbourne, Heidelberg, Victoria, Australia
| | - Kurt Gleich
- Kidney Laboratory, Institute for Breathing and Sleep, University of Melbourne, Heidelberg, Victoria, Australia
| | - Bruce E Kemp
- St. Vincent's Institute, Fitzroy, Victoria, Australia
| | - Peter F Mount
- Kidney Laboratory, Institute for Breathing and Sleep, University of Melbourne, Heidelberg, Victoria, Australia; Department of Nephrology, University of Melbourne, Heidelberg, Victoria, Australia; Department of Medicine, University of Melbourne, Heidelberg, Victoria, Australia; and
| | - David A Power
- Kidney Laboratory, Institute for Breathing and Sleep, University of Melbourne, Heidelberg, Victoria, Australia; Department of Nephrology, University of Melbourne, Heidelberg, Victoria, Australia; Department of Medicine, University of Melbourne, Heidelberg, Victoria, Australia; and
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96
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Epidemiology of Secondary Hypertension in Children. CURRENT CARDIOVASCULAR RISK REPORTS 2014. [DOI: 10.1007/s12170-014-0388-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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97
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Abstract
The prevalence of both obesity and hypertension are increasing worldwide. Hypertension is a common consequence of obesity. Increased central adiposity is associated with increased aldosterone levels and blood pressure in human beings. A number of small studies have shown an association between obesity-mediated hypertension and mechanisms directly linked to increased levels of aldosterone. These studies have shown a trend toward relatively greater blood pressure reduction using aldosterone-receptor blockers compared with other classes of antihypertensive agents. Other than treatment for weight loss, treatment of hypertension with specific antihypertensive medications that block or reduce aldosterone action are appropriate in obese patients. Further research is needed to understand the exact role of the adipocyte in obesity-mediated hypertension.
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98
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Gidding SS, Palermo RA, DeLoach SS, Keith SW, Falkner B. Associations of cardiac structure with obesity, blood pressure, inflammation, and insulin resistance in African-American adolescents. Pediatr Cardiol 2014; 35:307-14. [PMID: 24096716 PMCID: PMC3946929 DOI: 10.1007/s00246-013-0777-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Accepted: 08/13/2013] [Indexed: 12/30/2022]
Abstract
To determine if obesity, blood pressure (BP), markers of inflammation, and insulin resistance are associated with cardiac structure in African-American adolescents, a cross-sectional study was performed on a cohort oversampled for high BP and obesity. Measurements included the following: anthropometrics, BP, homeostasis model assessment (HOMA) to assess insulin resistance, high-sensitivity C-reactive protein, and plasma adipokines (adiponectin, interleukin-6, plasminogen activator inhibitor-1). Echocardiogram measurements were left-ventricular mass index (LVMI) (g/m(2.7)), LV relative wall thickness (LVRWT), left-atrial diameter index [LADI (mm/m)], and LV diastolic time intervals. LADI (r (2) = 0.25) was associated with body mass index (BMI) systolic BP (SBP) and female sex. LVMI (r (2) = 0.35) variation was associated with BMI SBP, heart rate, age, and male sex. LVRWT (r (2) = 0.05) was associated with HOMA. Tissue diastolic intervals were not associated with any risk factor. Inflammatory markers and adipokines were associated with BMI but were not independently associated with any echocardiographic measures. In African-American adolescents, BMI and SBP, but not inflammatory markers or adipokines, are important correlates of LA size and LVM.
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Affiliation(s)
- Samuel S. Gidding
- Nemours Cardiac Center, Nemours Cardiac Center at A.I. duPont Hospital for Children, Wilmington, Delaware
| | - Robert A. Palermo
- Nemours Cardiac Center, Nemours Cardiac Center at A.I. duPont Hospital for Children, Wilmington, Delaware
| | - Stephanie S. DeLoach
- Department of Internal Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Scott W. Keith
- Division of Biostatistics, Department of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Bonita Falkner
- Division of Nephrology, Thomas Jefferson University, Philadelphia, Pennsylvania
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99
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Lucke-Wold BP, DiPasquale K, Logsdon AF, Nguyen L, Lucke-Wold AN, Turner RC, Huber JD, Rosen CL. Metabolic Syndrome and its Profound Effect on Prevalence of Ischemic Stroke. AMERICAN MEDICAL STUDENT RESEARCH JOURNAL 2014; 1:29-38. [PMID: 27284575 PMCID: PMC4896644 DOI: 10.15422/amsrj.2014.05.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Ischemic stroke represents a leading cause of death worldwide and the leading cause of disability in the United States. Greater than 8% of all deaths are attributed to ischemic stroke. This rate is consistent with the heightened burden of cardiovascular disease deaths. Treatments for acute ischemic stroke remain limited to tissue plasminogen activator and mechanical thrombolysis, both of which require significant medical expertise and can only be applied to a select number of patients based on time of presentation, imaging, and absence of contraindications. Over 1,000 compounds that were successful in treating ischemic stroke in animal models have failed to correlate to success in clinical trials. The search for alternative treatments is ongoing, drawing greater attention to the importance of preclinical models that more accurately represent the clinical population through incorporation of common risk factors. This work reviews the contribution of these commonly observed risk factors in the clinical population highlighting both the pathophysiology as well as current clinical diagnosis and treatment standards. We also highlight future potential therapeutic targets, areas requiring further investigation, and recent changes in best-practice clinical care.
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Affiliation(s)
- Brandon P Lucke-Wold
- Department of Neurosurgery, West Virginia University, School of Medicine, Morgantown, West Virginia; The Center for Neuroscience, West Virginia University, School of Medicine, Morgantown, West Virginia
| | - Kenneth DiPasquale
- The Center for Neuroscience, West Virginia University, School of Medicine, Morgantown, West Virginia; Department of Basic Pharmaceutical Sciences, West Virginia University, School of Pharmacy, Morgantown, West Virginia
| | - Aric F Logsdon
- The Center for Neuroscience, West Virginia University, School of Medicine, Morgantown, West Virginia; Department of Basic Pharmaceutical Sciences, West Virginia University, School of Pharmacy, Morgantown, West Virginia
| | - Linda Nguyen
- Department of Basic Pharmaceutical Sciences, West Virginia University, School of Pharmacy, Morgantown, West Virginia
| | - A Noelle Lucke-Wold
- The Center for Neuroscience, West Virginia University, School of Medicine, Morgantown, West Virginia; West Virginia University, School of Nursing, Morgantown, West Virginia
| | - Ryan C Turner
- Department of Neurosurgery, West Virginia University, School of Medicine, Morgantown, West Virginia; The Center for Neuroscience, West Virginia University, School of Medicine, Morgantown, West Virginia
| | - Jason D Huber
- The Center for Neuroscience, West Virginia University, School of Medicine, Morgantown, West Virginia; Department of Basic Pharmaceutical Sciences, West Virginia University, School of Pharmacy, Morgantown, West Virginia
| | - Charles L Rosen
- Department of Neurosurgery, West Virginia University, School of Medicine, Morgantown, West Virginia; The Center for Neuroscience, West Virginia University, School of Medicine, Morgantown, West Virginia
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100
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Grundy SM, Neeland IJ, Turer AT, Vega GL. Ethnic and gender susceptibility to metabolic risk. Metab Syndr Relat Disord 2013; 12:110-6. [PMID: 24325736 DOI: 10.1089/met.2013.0113] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Aggregation of metabolic risk factors-i.e., elevated plasma triglyceride (TG), reduced high-density lipoprotein cholesterol (HDL-C), elevated blood pressure, and raised plasma glucose-convey increased risk for atherosclerotic cardiovascular disease and type 2 diabetes. METHODS This study was carried out to determine the association of waist girth, ethnicity, and gender with susceptibility for metabolic risk. Included were 1671 adult women (50.7% black) and 1339 men (46.5% black) enrolled in the Dallas Heart Study. Subjects were stratified into three categories by waist girth-low, intermediate, and high, corresponding to BMI ranges of <25 kg/m(2), 25-29.9 kg/m(2), and ≥30 kg/m(2). RESULTS Risk factor prevalence rose progressively through each waist-girth category. However, even among those with high waist-girth, prevalence of three or more risk factors was less than 50%. Several differences among the ethnic groups were noted; for example, Hispanic men had a higher prevalence of elevated TG compared to whites; black men, on the other hand, had a lower frequency of high TG. There were also fewer black men with low HDL-C than in the other groups. Black and Hispanic men had a higher prevalence of elevated glucose and updated homeostasis model assessment of insulin resistance (HOMA2-IR) than whites. More black men had elevated blood pressure than other groups. These differences were less pronounced among ethnic groups of women. CONCLUSION Although ethnic and gender differences in risk factor prevalence may exist, it is notable that the majority of subjects, even when obese, did not have elevated risk factors. This finding points to the need to focus largely on subjects with metabolic risk factors when implementing therapeutic interventions.
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Affiliation(s)
- Scott M Grundy
- 1 Center for Human Nutrition and Department of Clinical Nutrition, University of Texas Southwestern Medical Center , Dallas, Texas
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