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Arghavani H, O'Connor S, Fortier C, Rudkowska I. Lack of change in blood pressure and arterial stiffness after high dairy intake in hyperinsulinemic subjects: a cross-over randomized controlled trial. Appl Physiol Nutr Metab 2024; 49:350-359. [PMID: 37939366 DOI: 10.1139/apnm-2023-0053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
To evaluate the effects of high dairy (HD) (≥4 servings/day), compared to adequate dairy (AD) (2-3 servings/day as per Canada's Food Guide for Healthy Eating (2007)), on blood pressure (BP) and measures of arterial stiffness in hyperinsulinemic subjects. In this cross-over clinical trial, hyperinsulinemic adults were randomized to AD and HD for 6 weeks. Anthropometric, glycemic, and lipid parameters were analyzed and dietary intake was evaluated; BP, carotid-femoral pulse wave velocity, augmentation index, and measures of arterial stiffness were assessed. Twenty-seven participants completed the study. Dairy intake was 2.2 ± 1.2 servings/day during AD. In addition, lower total and low-density lipoprotein (LDL) cholesterol were observed without significant change in BP or arterial stiffness between before and after AD. During HD, the subjects consumed 5.8 ± 1.9 servings/day of dairy products, providing a higher intake of protein, saturated fat, calcium, phosphorus, sodium, and potassium compared to the baseline diet. After the HD, subjects had higher body fat, fasting insulin, homeostatic model assessment for insulin resistance (HOMA-IR) index, and triglycerides without altering BP or arterial stiffness compared to before HD. Overall, adequate or high intake of total dairy did not modify BP or arterial stiffness in hyperinsulinemic adults after 6 weeks.
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Affiliation(s)
- Hana Arghavani
- Endocrinology and Nephrology Axis, CHU de Québec Research Center-Université Laval, Québec, QC, Canada
| | - Sarah O'Connor
- Institut universitaire de cardiologie et pneumologie de Québec (IUCPQ) Research Centre, Québec, QC, Canada
- Faculty of Pharmacy, Université Laval, Québec, QC, Canada
| | - Catherine Fortier
- Endocrinology and Nephrology Axis, CHU de Québec Research Center-Université Laval, Québec, QC, Canada
- Department of Kinesiology, Université Laval, Québec, QC, Canada
| | - Iwona Rudkowska
- Endocrinology and Nephrology Axis, CHU de Québec Research Center-Université Laval, Québec, QC, Canada
- Department of Kinesiology, Université Laval, Québec, QC, Canada
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2
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Theodoridis X, Chourdakis M, Papaemmanouil A, Chaloulakou S, Georgakou AV, Chatzis G, Triantafyllou A. The Effect of Diet on Vascular Aging: A Narrative Review of the Available Literature. Life (Basel) 2024; 14:267. [PMID: 38398776 PMCID: PMC10890697 DOI: 10.3390/life14020267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 01/30/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024] Open
Abstract
Early vascular aging is related to various cardiovascular diseases including hypertension, coronary heart disease, and stroke. Healthful lifestyle practices and interventions, including dietary regimens and consistent aerobic exercise, exert favorable modulation on these processes, thereby diminishing the risk of cardiovascular disease with advancing age. The principal objective of this review was to conduct a comprehensive evaluation and synthesis of the available literature regarding the effectiveness of different diets on vascular health, such as arterial stiffness and endothelial function. To conduct this review, a thorough search of electronic databases including PubMed, Scopus, and Web of Science Core Collection was carried out. Based on the existing evidence, the Mediterranean, Dietary Approaches to Stop Hypertension, and low-calorie diets may have a beneficial effect on vascular health. However, more randomized controlled trials with sufficient sample sizes, longer follow-ups, rigorous methodologies, and, possibly, head-to-head comparisons between the different diets are needed to shed light on this topic.
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Affiliation(s)
- Xenophon Theodoridis
- Laboratory of Hygiene, Social and Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (X.T.); (A.P.); (S.C.); (A.V.G.)
- Third Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, 56403 Thessaloniki, Greece
| | - Michail Chourdakis
- Laboratory of Hygiene, Social and Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (X.T.); (A.P.); (S.C.); (A.V.G.)
| | - Androniki Papaemmanouil
- Laboratory of Hygiene, Social and Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (X.T.); (A.P.); (S.C.); (A.V.G.)
| | - Stavroula Chaloulakou
- Laboratory of Hygiene, Social and Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (X.T.); (A.P.); (S.C.); (A.V.G.)
| | - Athina Vasiliki Georgakou
- Laboratory of Hygiene, Social and Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (X.T.); (A.P.); (S.C.); (A.V.G.)
| | - Georgios Chatzis
- School of Physical Education and Sports Science, Aristotle University of Thessaloniki, 57001 Thessaloniki, Greece;
| | - Areti Triantafyllou
- Third Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, 56403 Thessaloniki, Greece
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3
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Young J, Seeberg KA, Aakre KM, Borgeraas H, Nordstrand N, Wisløff T, Hjelmesæth J, Omland T, Hertel JK. The liver-heart axis in patients with severe obesity: The association between liver fibrosis and chronic myocardial injury may be explained by shared risk factors of cardiovascular disease. Clin Biochem 2024; 123:110688. [PMID: 37995847 DOI: 10.1016/j.clinbiochem.2023.110688] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 11/13/2023] [Accepted: 11/20/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Severe obesity is associated with increased risk of non-alcoholic fatty liver disease and cardiovascular disease. We hypothesized that liver fibrosis as quantified by the Enhanced Liver Fibrosis (ELF) test would be predictive of myocardial injury and fibrosis, expressed by higher concentrations of cardiac troponin T and I measured by high-sensitivity assays (hs-cTnT and hs-cTnI, respectively). MATERIAL AND METHODS We performed cross-sectional analyses of baseline data from 136 patients (mean age 45 years, 38 % male) with severe obesity participating in the non-randomized clinical trial Prevention of Coronary Heart Disease in Morbidly Obese Patients (ClinicalTrials.gov NCT00626964). Associations between ELF scores, hs-cTnT, and hs-cTnI concentrations were assessed using linear regression analysis. RESULTS ELF scores were associated with hs-cTnT in the unadjusted model (B 0.381, 95 % Confidence Interval [CI] 0.247, 0.514), but the association was attenuated upon adjustment for potential confounders (B -0.031, 95 % CI -0.155, 0.093). Similarly, for hs-cTnI, an observed association with ELF scores in the unadjusted model was attenuated upon adjustment for potential confounders ((B 0.432, 95 % CI 0.179, 0.685) and (B 0.069, 95 % CI -0.230, 0.367), respectively). Age, sex, hypertension, and estimated glomerular filtration rate were amongst the shared predictors of ELF score, hs-cTnT, and hs-cTnI that provided the univariable models with the highest R-squared and lowest Akaike Information Criterion values. CONCLUSIONS Contrary to our hypothesis, ELF score did not predict myocardial injury and fibrosis, but we rather demonstrated an association between liver fibrosis and myocardial injury and fibrosis may be explained by shared risk factors of cardiovascular disease.
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Affiliation(s)
- J Young
- K.G. Jebsen Center for Cardiac Biomarkers, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - K A Seeberg
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Endocrinology, Obesity and Nutrition, Vestfold Hospital Trust, Tønsberg, Norway
| | - K M Aakre
- Hormone Laboratory, Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway; Department of Heart Disease, Haukeland University Hospital, Bergen, Norway; Department of Clinical Science, University of Bergen, Bergen, Norway
| | - H Borgeraas
- Department of Endocrinology, Obesity and Nutrition, Vestfold Hospital Trust, Tønsberg, Norway
| | - N Nordstrand
- Department of Cardiology, Oslo University Hospital, Oslo, Norway
| | - T Wisløff
- K.G. Jebsen Center for Cardiac Biomarkers, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - J Hjelmesæth
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Endocrinology, Obesity and Nutrition, Vestfold Hospital Trust, Tønsberg, Norway
| | - T Omland
- K.G. Jebsen Center for Cardiac Biomarkers, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Cardiology, Oslo University Hospital, Oslo, Norway
| | - J K Hertel
- Department of Endocrinology, Obesity and Nutrition, Vestfold Hospital Trust, Tønsberg, Norway
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Perin L, Camboim IG, Schneider CD, Lehnen AM. Weight loss associated with low-energy diets with different glycaemic loads does not improve arterial stiffness: a randomised clinical trial. Br J Nutr 2023; 130:1859-1870. [PMID: 37154243 DOI: 10.1017/s0007114523001022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
We evaluated the effects of two low-energy diets with different glycaemic loads on arterial stiffness in adults with excess weight. This was a 45-day parallel-group, randomised clinical trial including seventy-five participants (20-59 years; BMI 32 kg/m2). They were assigned to two similar low-energy diets (reduction of ∼750 kcal.d-1) with macronutrient composition (55 % carbohydrates, 20 % proteins and 25 % lipids) but different glycaemic loads: high-glycaemic load (HGL 171 g.d-1; n 36) or low-glycaemic load (LGL 67 g.d-1; n 39). We evaluated: arterial stiffness (pulse wave velocity, PWV); augmentation index (AIx@75); reflection coefficient; fasting blood glucose; fasting lipid profile; blood pressure and body composition. We found no improvements in PWV (P = 0·690) and AIx@75 (P = 0·083) in both diet groups, but there was a decrease in the reflection coefficient in the LGL group (P = 0·003) compared with baseline. The LGL diet group showed reductions in body weight (Δ -4·9 kg; P = 0·001), BMI (Δ -1·6 kg/m2; P = 0·001), waist circumference (Δ -3·1 cm; P = 0·001), body fat (Δ -1·8 %; P = 0·034), as well as TAG (Δ -14·7 mg/dl; P = 0·016) and VLDL (Δ -2·8 mg/dl; P = 0·020). The HGL diet group showed a reduction in total cholesterol (Δ -14·6 mg/dl; P = 0·001), LDL (Δ -9·3 mg/dl; P = 0·029) but a reduction in HDL (Δ -3·7 mg/dl; P = 0·002). In conclusion, a 45-day intervention with low-energy HGL or LGL diets in adults with excess weight was not effective to improve arterial stiffness. However, the LGL diet intervention was associated with a reduction of reflection coefficient and improvements in body composition, TAG and VLDL levels.
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Affiliation(s)
- Lisiane Perin
- Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Porto Alegre, Rio Grande Grande do Sul, Brasil
| | - Isadora G Camboim
- Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Porto Alegre, Rio Grande Grande do Sul, Brasil
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande Grande do Sul, Brasil
| | - Cláudia D Schneider
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande Grande do Sul, Brasil
| | - Alexandre M Lehnen
- Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Porto Alegre, Rio Grande Grande do Sul, Brasil
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Paquin A, Werlang A, Coutinho T. The EVA (Early Vascular Aging) Study: Association of Central Obesity With Worse Arterial Health After Preeclampsia. J Am Heart Assoc 2023; 12:e031136. [PMID: 37929708 PMCID: PMC10727383 DOI: 10.1161/jaha.123.031136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 10/05/2023] [Indexed: 11/07/2023]
Abstract
Background Women with preeclampsia have a higher risk of cardiovascular disease. This is partly explained by the worse arterial health after preeclampsia. Central obesity (CO) is a risk factor for both preeclampsia and cardiovascular disease. Whether CO contributes to further worsening of arterial health after preeclampsia remains unclear. Our objective was to evaluate the effect of CO and previous preeclampsia on arterial hemodynamics. Methods and Results We studied 40 women with previous preeclampsia (<6 years) and 40 age-matched controls with previous normotensive pregnancy in the same timeframe. We estimated arterial hemodynamics with validated techniques combining applanation tonometry and echocardiography. CO was defined as a waist-to-hip ratio ≥0.85. Differences in arterial hemodynamics across the 3 groups (preeclampsia with CO, preeclampsia without CO, and controls) were assessed with multivariable linear regression models adjusted for potential confounders. Twenty-six (65%) of the participants with preeclampsia had CO compared with 18 (45%) controls. Mean waist-to-hip ratio in patients with preeclampsia with CO, those with preeclampsia and no CO, and controls was 0.94±0.05, 0.80±0.04, and 0.83±0.07, respectively. In multivariable analyses, women with preeclampsia and CO had higher central blood pressure, arterial stiffness (carotid-femoral pulse wave velocity), steady arterial load (systemic vascular resistance), and wave reflections (reflected pressure wave amplitude, augmentation index) compared with controls (P<0.05 for each). Fewer hemodynamic domains were altered in the preeclampsia with no CO group, with higher central diastolic blood pressure, systemic vascular resistance, and wave reflections than controls (P<0.05). Conclusions Women with previous preeclampsia who also experience CO have the greatest alterations in arterial health and hemodynamics. Patients with preeclampsia with CO may represent a higher-risk subgroup who could be targeted for risk stratification and primary prevention of cardiovascular disease.
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Affiliation(s)
- Amélie Paquin
- Division of CardiologyUniversity of Ottawa Heart InstituteOttawaONCanada
- Canadian Women’s Heart Health CentreUniversity of Ottawa Heart InstituteOttawaONCanada
| | - Ana Werlang
- Department of Obstetrics and GynecologyThe Ottawa HospitalOttawaONCanada
| | - Thais Coutinho
- Division of CardiologyUniversity of Ottawa Heart InstituteOttawaONCanada
- Canadian Women’s Heart Health CentreUniversity of Ottawa Heart InstituteOttawaONCanada
- Department of Cardiovascular MedicineMayo ClinicRochesterMN
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Hu Y, Huan J, Wang X, Lin L, Li Y, Zhang L, Li Y. Association of estimated carotid-femoral pulse wave velocity with frailty in middle-aged and older adults with cardiometabolic disease. Aging Clin Exp Res 2023; 35:2425-2436. [PMID: 37698768 DOI: 10.1007/s40520-023-02556-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 08/30/2023] [Indexed: 09/13/2023]
Abstract
PURPOSE The prevalence of frailty in individuals with cardiometabolic disease (CMD) has become a growing concern in public health. The purpose of this study was to investigate the association between estimated pulse wave velocity (ePWV) and frailty in middle-aged and older adults with CMD. METHODS We analyzed data from 23,313 non-institutionalized adults with CMD from the National Health and Nutrition Examination Survey 2003-2018. Frailty status was determined using the frailty index, and logistic regression models were used to assess the association of ePWV with frailty risk. Multivariable logistic regression and propensity-score matching (PSM) were used to adjust for potential confounders. The restricted cubic spline regression model was used to evaluate the non-linear association between ePWV and frailty risk. RESULTS After adjusting for potential confounding factors, we found that each one m/s increase in ePWV was associated with a 15% higher risk of frailty (odds ratio [OR] = 1.15, 95% confidence interval [CI] 1.12 to 1.18, P < 0.001). After PSM, the association remained significant (OR = 1.05, 95% CI 1.03 to 1.08, P < 0.001). The logistic models with restricted cubic splines showed a non-linear dose-response association, with the risk of frailty increasing more rapidly when ePWV exceeded 9.5 m/s. CONCLUSIONS The findings of this study suggest that a higher level of ePWV is associated with an increased risk of frailty in middle-aged and older adults with CMD, and may serve as a viable alternative to directly measured cfPWV.
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Affiliation(s)
- Yuanlong Hu
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Lixia District, Jinan, Shandong, China
- Shandong Province Engineering Laboratory of Traditional Chinese Medicine Precise Diagnosis and Treatment of Cardiovascular Disease, Shandong University of Traditional Chinese Medicine, Lixia District, Jinan, Shandong, China
| | - Jiaming Huan
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Lixia District, Jinan, Shandong, China
- Shandong Province Engineering Laboratory of Traditional Chinese Medicine Precise Diagnosis and Treatment of Cardiovascular Disease, Shandong University of Traditional Chinese Medicine, Lixia District, Jinan, Shandong, China
| | - Xiaojie Wang
- Faculty of Chinese Medicine, Macau University of Science and Technology, Taipa, Macau, China
| | - Lin Lin
- Shandong Province Engineering Laboratory of Traditional Chinese Medicine Precise Diagnosis and Treatment of Cardiovascular Disease, Shandong University of Traditional Chinese Medicine, Lixia District, Jinan, Shandong, China
- Innovative Institute of Chinese Medicine and Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yuan Li
- Experimental Center, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
- Key Laboratory of Traditional Chinese Medicine Classical Theory, Ministry of Education, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
- Shandong Provincial Key Laboratory of Traditional Chinese Medicine for Basic Research, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Lei Zhang
- Shandong Province Engineering Laboratory of Traditional Chinese Medicine Precise Diagnosis and Treatment of Cardiovascular Disease, Shandong University of Traditional Chinese Medicine, Lixia District, Jinan, Shandong, China
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yunlun Li
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Lixia District, Jinan, Shandong, China.
- Shandong Province Engineering Laboratory of Traditional Chinese Medicine Precise Diagnosis and Treatment of Cardiovascular Disease, Shandong University of Traditional Chinese Medicine, Lixia District, Jinan, Shandong, China.
- Department of Cardiovascular, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Lixia District, Jinan, Shandong, China.
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7
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Swift DL, McGee JE, Grammer EE, Huff AC, Clunan MC, Hursey N, Brown TT, Osborne BG, Houmard JA, Carels RA, Pories WJ, Matarese LE. The effect of exercise training level on arterial stiffness after clinically significant weight loss. Clin Obes 2023; 13:e12584. [PMID: 36843503 PMCID: PMC11036368 DOI: 10.1111/cob.12584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 01/13/2023] [Accepted: 02/04/2023] [Indexed: 02/28/2023]
Abstract
Arterial stiffness is improved by weight loss. However, no data exist on the impact of aerobic exercise levels on arterial stiffness during weight maintenance. Adults who were overweight or with obesity (N = 39) participated in a 10-week weight loss program. Participants who achieved ≥7% weight loss were randomized to aerobic training at the minimum physical activity guidelines (PA-REC, 550 MET min/week) or weight maintenance guidelines (WM-REC, 970 MET min/week) for 18 additional weeks. Arterial stiffness (carotid-to-femoral pulse wave velocity [cfPWV], augmentation index normalized for 75 beats/min [AIX75]) and blood pressure [aortic and brachial]) were assessed at baseline, the end of the weight loss phase (week 10), and follow-up (week 28). There was a reduction in cfPWV in participants who met the weight loss goal (-0.34 m/s, p = .02) and approached significance for the entire sample (p = .051). Similarly, there were reductions in AIX75, brachial blood pressure, and aortic blood pressure (p < .05) in the full sample. In the weight maintenance phase, no differences were observed between the PA-REC and the WM-REC groups for change in arterial stiffness or blood pressure (p > .05). However, changes in cfPWV were independently associated with changes in LDL (r2 : 0.45, p = .004) and exercise intensity (r2 : 0.17, p = .033). Aerobic exercise level at the minimum physical activity guidelines or weight maintenance guidelines does not affect the change in PWV or the change in cfPWV after clinically significant weight loss. However, interventions which limit increases in LDL cholesterol and promote high-intensity aerobic exercise may prevent increases in stiffness during weight maintenance.
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Affiliation(s)
- Damon L. Swift
- Department of Kinesiology, East Carolina University, Greenville, North Carolina, USA
- Human Performance Laboratory, East Carolina University, Greenville, North Carolina, USA
| | - Joshua E. McGee
- Department of Kinesiology, East Carolina University, Greenville, North Carolina, USA
- Human Performance Laboratory, East Carolina University, Greenville, North Carolina, USA
| | - Emily E. Grammer
- Department of Kinesiology, East Carolina University, Greenville, North Carolina, USA
- Human Performance Laboratory, East Carolina University, Greenville, North Carolina, USA
| | - Anna C. Huff
- Department of Kinesiology, East Carolina University, Greenville, North Carolina, USA
- Human Performance Laboratory, East Carolina University, Greenville, North Carolina, USA
| | - Marie C. Clunan
- Department of Kinesiology, East Carolina University, Greenville, North Carolina, USA
- Human Performance Laboratory, East Carolina University, Greenville, North Carolina, USA
| | - Nicole Hursey
- Department of Kinesiology, East Carolina University, Greenville, North Carolina, USA
- Human Performance Laboratory, East Carolina University, Greenville, North Carolina, USA
| | - Taylor T. Brown
- Department of Kinesiology, East Carolina University, Greenville, North Carolina, USA
- Human Performance Laboratory, East Carolina University, Greenville, North Carolina, USA
| | | | - Joseph A. Houmard
- Department of Kinesiology, East Carolina University, Greenville, North Carolina, USA
- Human Performance Laboratory, East Carolina University, Greenville, North Carolina, USA
| | - Robert A. Carels
- Department of Psychology, East Carolina University, Greenville, North Carolina, USA
| | - Walter J. Pories
- Department of Surgery, East Carolina University, Greenville, North Carolina, USA
| | - Laura E. Matarese
- Department of Internal Medicine, East Carolina University, Greenville, North Carolina, USA
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Li A, Yan J, Zhao Y, Yu Z, Tian S, Khan AH, Zhu Y, Wu A, Zhang C, Tian XL. Vascular Aging: Assessment and Intervention. Clin Interv Aging 2023; 18:1373-1395. [PMID: 37609042 PMCID: PMC10441648 DOI: 10.2147/cia.s423373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 08/06/2023] [Indexed: 08/24/2023] Open
Abstract
Vascular aging represents a collection of structural and functional changes in a blood vessel with advancing age, including increased stiffness, vascular wall remodeling, loss of angiogenic ability, and endothelium-dependent vasodilation dysfunction. These age-related alterations may occur earlier in those who are at risk for or have cardiovascular diseases, therefore, are defined as early or premature vascular aging. Vascular aging contributes independently to cardio-cerebral vascular diseases (CCVDs). Thus, early diagnosis and interventions targeting vascular aging are of paramount importance in the delay or prevention of CCVDs. Here, we review the direct assessment of vascular aging by examining parameters that reflect changes in structure, function, or their compliance with age including arterial wall thickness and lumen diameter, endothelium-dependent vasodilation, arterial stiffness as well as indirect assessment through pathological studies of biomarkers including endothelial progenitor cell, lymphocytic telomeres, advanced glycation end-products, and C-reactive protein. Further, we evaluate how different types of interventions including lifestyle mediation, such as caloric restriction and salt intake, and treatments for hypertension, diabetes, and hyperlipidemia affect age-related vascular changes. As a single parameter or intervention targets only a certain vascular physiological change, it is recommended to use multiple parameters to evaluate and design intervention approaches accordingly to prevent systemic vascular aging in clinical practices or population-based studies.
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Affiliation(s)
- Ao Li
- Queen Mary School, Nanchang University, Nanchang, Jiangxi, 330031, People’s Republic of China
- Aging and Vascular Diseases, Human Aging Research Institute (HARI) and School of Life Science, Nanchang University, and Jiangxi Key Laboratory of Human Aging, Nanchang, Jiangxi, 330031, People’s Republic of China
| | - Jinhua Yan
- Department of Geriatrics, Institute of Gerontology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Ya Zhao
- Aging and Vascular Diseases, Human Aging Research Institute (HARI) and School of Life Science, Nanchang University, and Jiangxi Key Laboratory of Human Aging, Nanchang, Jiangxi, 330031, People’s Republic of China
| | - Zhenping Yu
- Institute of Translational Medicine, School of Life Science, Nanchang University, and Jiangxi Key Laboratory of Human Aging, Nanchang, Jiangxi, 330031, People’s Republic of China
| | - Shane Tian
- Department of Biochemistry/Chemistry, Ohio State University, Columbus, OH, USA
| | - Abdul Haseeb Khan
- Aging and Vascular Diseases, Human Aging Research Institute (HARI) and School of Life Science, Nanchang University, and Jiangxi Key Laboratory of Human Aging, Nanchang, Jiangxi, 330031, People’s Republic of China
| | - Yuanzheng Zhu
- Aging and Vascular Diseases, Human Aging Research Institute (HARI) and School of Life Science, Nanchang University, and Jiangxi Key Laboratory of Human Aging, Nanchang, Jiangxi, 330031, People’s Republic of China
| | - Andong Wu
- Aging and Vascular Diseases, Human Aging Research Institute (HARI) and School of Life Science, Nanchang University, and Jiangxi Key Laboratory of Human Aging, Nanchang, Jiangxi, 330031, People’s Republic of China
| | - Cuntai Zhang
- Department of Geriatrics, Institute of Gerontology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Xiao-Li Tian
- Aging and Vascular Diseases, Human Aging Research Institute (HARI) and School of Life Science, Nanchang University, and Jiangxi Key Laboratory of Human Aging, Nanchang, Jiangxi, 330031, People’s Republic of China
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9
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Berk KA, Borgeraas H, Narverud I, Mulder MT, Øyri LKL, Verhoeven AJM, Småstuen MC, Bogsrud MP, Omland T, Hertel JK, Gjevestad E, Nordstrand N, Holven KB, Hjelmesæth J. Differential effects of bariatric surgery and lifestyle interventions on plasma levels of Lp(a) and fatty acids. Lipids Health Dis 2022; 21:145. [PMID: 36577984 PMCID: PMC9795629 DOI: 10.1186/s12944-022-01756-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 12/13/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Limited evidence suggests that surgical and non-surgical obesity treatment differentially influence plasma Lipoprotein (a) [Lp(a)] levels. Further, a novel association between plasma arachidonic acid and Lp(a) has recently been shown, suggesting that fatty acids are a possible target to influence Lp(a). Here, the effects of bariatric surgery and lifestyle interventions on plasma levels of Lp(a) were compared, and it was examined whether the effects were mediated by changes in plasma fatty acid (FA) levels. METHODS The study includes two independent trials of patients with overweight or obesity. Trial 1: Two-armed intervention study including 82 patients who underwent a 7-week low energy diet (LED), followed by Roux-en-Y gastric bypass and 52-week follow-up (surgery-group), and 77 patients who underwent a 59-week energy restricted diet- and exercise-program (lifestyle-group). Trial 2: A clinical study including 134 patients who underwent a 20-week very-LED/LED (lifestyle-cohort). RESULTS In the surgery-group, Lp(a) levels [median (interquartile range)] tended to increase in the pre-surgical LED-phase [17(7-68)-21(7-81)nmol/L, P = 0.05], but decreased by 48% after surgery [21(7-81)-11(7-56)nmol/L, P < 0.001]. In the lifestyle-group and lifestyle-cohort, Lp(a) increased by 36%[14(7-77)-19(7-94)nmol/L, P < 0.001] and 14%[50(14-160)-57(19-208)nmol/L, P < 0.001], respectively. Changes in Lp(a) were independent of weight loss. Plasma levels of total saturated FAs remained unchanged after surgery, but decreased after lifestyle interventions. Arachidonic acid and total n-3 FAs decreased after surgery, but increased after lifestyle interventions. Plasma FAs did not mediate the effects on Lp(a). CONCLUSION Bariatric surgery reduced, whereas lifestyle interventions increased plasma Lp(a), independent of weight loss. The interventions differentially influenced changes in plasma FAs, but these changes did not mediate changes in Lp(a). TRIAL REGISTRATION Trial 1: Clinicaltrials.gov NCT00626964. Trial 2: Netherlands Trial Register NL2140 (NTR2264).
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Affiliation(s)
- Kirsten A. Berk
- grid.5645.2000000040459992XDepartment of Internal Medicine, Division of Pharmacology and Vascular Medicine, Erasmus Medical Center, Rotterdam, the Netherlands ,grid.5645.2000000040459992XDepartment of Internal Medicine, Division of Dietetics, Erasmus Medical Center, Rotterdam, The Netherlands, Erasmus University MC, Rotterdam, The Netherlands
| | - Heidi Borgeraas
- grid.417292.b0000 0004 0627 3659Morbid Obesity Center, Vestfold Hospital Trust, Tønsberg, Norway
| | - Ingunn Narverud
- grid.55325.340000 0004 0389 8485Norwegian National Advisory Unit On Familial Hypercholesterolemia, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Monique T. Mulder
- grid.5645.2000000040459992XDepartment of Internal Medicine, Division of Pharmacology and Vascular Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Linn K. L. Øyri
- grid.5510.10000 0004 1936 8921Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Adrie J. M. Verhoeven
- grid.5645.2000000040459992XDepartment of Internal Medicine, Division of Pharmacology and Vascular Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Milada Cvancarova Småstuen
- grid.417292.b0000 0004 0627 3659Morbid Obesity Center, Vestfold Hospital Trust, Tønsberg, Norway ,grid.412414.60000 0000 9151 4445Department of Nutrition and Management, Oslo Metropolitan University, Oslo, Norway
| | - Martin P. Bogsrud
- grid.55325.340000 0004 0389 8485Unit for Cardiac and Cardiovascular Genetics, Oslo University Hospital, Oslo, Norway
| | - Torbjørn Omland
- grid.411279.80000 0000 9637 455XDepartment of Cardiology, Akershus University Hospital, Lørenskog, Norway ,grid.5510.10000 0004 1936 8921K.G. Jebsen Center of Cardiac Biomarkers, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Jens Kristoffer Hertel
- grid.417292.b0000 0004 0627 3659Morbid Obesity Center, Vestfold Hospital Trust, Tønsberg, Norway
| | - Espen Gjevestad
- grid.417292.b0000 0004 0627 3659Morbid Obesity Center, Vestfold Hospital Trust, Tønsberg, Norway ,grid.417292.b0000 0004 0627 3659Division of Physical Medicine and Rehabilitation, Vestfold Hospital Trust, Stavern, Norway ,grid.446099.60000 0004 0448 0013Norwegian Police University College, Stavern, Norway
| | - Njord Nordstrand
- grid.411279.80000 0000 9637 455XDepartment of Cardiology, Akershus University Hospital, Lørenskog, Norway
| | - Kirsten B. Holven
- grid.55325.340000 0004 0389 8485Norwegian National Advisory Unit On Familial Hypercholesterolemia, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway ,grid.5510.10000 0004 1936 8921Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Jøran Hjelmesæth
- grid.417292.b0000 0004 0627 3659Morbid Obesity Center, Vestfold Hospital Trust, Tønsberg, Norway ,grid.5510.10000 0004 1936 8921Department of Endocrinology, Morbid Obesity and Preventive Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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10
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Khalafi M, Azali Alamdari K, Symonds ME, Rohani H, Sakhaei MH. A comparison of the impact of exercise training with dietary intervention versus dietary intervention alone on insulin resistance and glucose regulation in individual with overweight or obesity: a systemic review and meta-analysis. Crit Rev Food Sci Nutr 2022; 63:9349-9363. [PMID: 35442133 DOI: 10.1080/10408398.2022.2064424] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE Obesity is associated with the development of insulin resistance (IR) and type 2 diabetes for which exercise training (Ex) and dietary interventions (DI) are effective interventions that can improve IR. We therefore performed a systematic meta-analysis to compare the effect of Ex + DI compared with DI on IR and glucose homeostasis. METHODS PubMed and Cochrane Library were conducted up to May 2021. Meta-analyses were conducted to compare the effect of Ex + DI compared with DI on fasting glucose and insulin, IR and body weight. Standardized mean differences (SMDs), weighted mean differences (WMD) and 95% confidence intervals (95% CIs) were computed using random or fixed effect models. RESULTS Fifty studies involving 2864 participants with overweight or obesity were included in the meta-analysis. Ex + DI caused a larger decrease in fasting glucose (p = 0.001, 62 trials) and IR (p = 0.01, 29 trials) when compared with DI alone. There was no significant evidence, however, for a greater effect of Ex + DI on fasting insulin (p = 0.07, 48 trials) and body weight (p = 0.12, 58 trials), compared with DI alone. CONCLUSION Our results suggest that a combination of Ex and DI may be more effective than DI alone at improving IR and fasting glucose in individuals with overweight and obesity.
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Affiliation(s)
- Mousa Khalafi
- Department of Physical Education and Sport Sciences, Faculty of Humanities, University of Kashan, Kashan, Iran
| | | | - Michael E Symonds
- The Early Life Research Unit, Division of Child Health, Obstetrics and Gynaecology, and Nottingham Digestive Disease Centre and Biomedical Research Centre, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Hadi Rohani
- Department of Exercise Physiology, Sport Sciences Research Institute, Tehran, Iran
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11
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Schutten JC, Joris PJ, Groendijk I, Eelderink C, Groothof D, van der Veen Y, Westerhuis R, Goorman F, Danel RM, de Borst MH, Bakker SJL. Effects of Magnesium Citrate, Magnesium Oxide, and Magnesium Sulfate Supplementation on Arterial Stiffness: A Randomized, Double-Blind, Placebo-Controlled Intervention Trial. J Am Heart Assoc 2022; 11:e021783. [PMID: 35253448 PMCID: PMC9075273 DOI: 10.1161/jaha.121.021783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/21/2021] [Indexed: 11/16/2022]
Abstract
Background Magnesium supplements may have beneficial effects on arterial stiffness. Yet, to our knowledge, no head-to-head comparison between various magnesium formulations in terms of effects on arterial stiffness has been performed. We assessed the effects of magnesium citrate supplementation on arterial stiffness and blood pressure and explored whether other formulations of magnesium have similar effects. Methods and Results In this randomized trial, subjects who were overweight and slightly obese received either magnesium citrate, magnesium oxide, magnesium sulfate, or placebo for 24 weeks. The total daily dose of magnesium was 450 mg/d. The primary outcome was carotid-to-femoral pulse wave velocity, which is the gold standard method for measuring arterial stiffness. Secondary outcomes included blood pressure and plasma and urine magnesium. Overall, 164 participants (mean±SD age, 63.2±6.8 years; 104 [63.4%] women) were included. In the intention-to-treat analysis, neither magnesium citrate nor the other formulations had an effect on carotid-to-femoral pulse wave velocity or blood pressure at 24 weeks compared with placebo. Magnesium citrate increased plasma (+0.04 mmol/L; 95% CI, +0.02 to +0.06 mmol/L) and urine magnesium (+3.12 mmol/24 h; 95% CI, +2.23 to +4.01 mmol/24 h) compared with placebo. Effects on plasma magnesium were similar among the magnesium supplementation groups, but magnesium citrate led to a more pronounced increase in 24-hour urinary magnesium excretion than magnesium oxide or magnesium sulfate. One serious adverse event was reported, which was considered unrelated to the study treatment. Conclusions Oral magnesium citrate supplementation for 24 weeks did not significantly change arterial stiffness or blood pressure. Magnesium oxide and magnesium sulfate had similar nonsignificant effects. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT03632590.
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Affiliation(s)
- Joëlle C. Schutten
- Division of NephrologyDepartment of Internal MedicineUniversity Medical Center GroningenUniversity of GroningenThe Netherlands
| | - Peter J. Joris
- Department of Nutrition and Movement SciencesNUTRIM School of Nutrition and Translational Research in MetabolismMaastricht University Medical CenterMaastrichtThe Netherlands
| | - Iris Groendijk
- Division of NephrologyDepartment of Internal MedicineUniversity Medical Center GroningenUniversity of GroningenThe Netherlands
| | - Coby Eelderink
- Division of NephrologyDepartment of Internal MedicineUniversity Medical Center GroningenUniversity of GroningenThe Netherlands
| | - Dion Groothof
- Division of NephrologyDepartment of Internal MedicineUniversity Medical Center GroningenUniversity of GroningenThe Netherlands
| | - Yvonne van der Veen
- Division of NephrologyDepartment of Internal MedicineUniversity Medical Center GroningenUniversity of GroningenThe Netherlands
| | | | | | | | - Martin H. de Borst
- Division of NephrologyDepartment of Internal MedicineUniversity Medical Center GroningenUniversity of GroningenThe Netherlands
| | - Stephan J. L. Bakker
- Division of NephrologyDepartment of Internal MedicineUniversity Medical Center GroningenUniversity of GroningenThe Netherlands
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12
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Miyaoka Y, Okada T, Tomiyama H, Morikawa A, Rinno S, Kato M, Tsujimoto R, Suzuki R, China R, Nagai M, Nagaoka Y, Nagao T, Kanno Y. Structural changes in renal arterioles are closely associated with central hemodynamic parameters in patients with renal disease. Hypertens Res 2021; 44:1113-1121. [PMID: 33859396 DOI: 10.1038/s41440-021-00656-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 03/10/2021] [Indexed: 02/06/2023]
Abstract
Although central hemodynamics are known to be closely associated with microvascular damage, their association with lesions in the small renal arteries has not yet been fully clarified. We focused on arterioles in renal biopsy specimens and analyzed whether their structural changes were associated with noninvasive vascular function parameters, including central blood pressure (BP) and brachial-ankle pulse wave velocity (baPWV). Forty-four nondiabetic patients (18-50 years of age) with preserved renal function underwent renal biopsy. Wall thickening of arterioles was analyzed based on the media/diameter ratio, and hyalinosis was analyzed by semiquantitative grading. Associations of these indexes (arteriolar wall remodeling grade index (RG index) and arteriolar hyalinosis index (Hyl index)) with clinical variables were analyzed. Multiple regression analyses demonstrated that the RG index was significantly associated with central systolic BP (β = 0.97, p = 0.009), serum cystatin C-based estimated glomerular filtration rate (β = -0.36, p = 0.04), and high-density lipoprotein cholesterol levels (β = -0.37, p = 0.02). The Hyl index was significantly associated with baPWV (β = 0.75, p = 0.01). Our results indicate that aortic stiffness and abnormal central hemodynamics are closely associated with renal microvascular damage in young to middle-aged, nondiabetic kidney disease patients with preserved renal function.
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Affiliation(s)
| | - Tomonari Okada
- Department of Nephrology, Tokyo Medical University, Tokyo, Japan
| | | | - Atsuko Morikawa
- Department of Nephrology, Tokyo Medical University, Tokyo, Japan
| | - Sho Rinno
- Department of Nephrology, Tokyo Medical University, Tokyo, Japan
| | - Miho Kato
- Department of Nephrology, Tokyo Medical University, Tokyo, Japan
| | - Ryuji Tsujimoto
- Department of Nephrology, Tokyo Medical University, Tokyo, Japan
| | - Rie Suzuki
- Department of Nephrology, Tokyo Medical University, Tokyo, Japan
| | - Rieko China
- Department of Nephrology, Tokyo Medical University, Tokyo, Japan
| | - Miho Nagai
- Department of Nephrology, Tokyo Medical University, Tokyo, Japan
| | - Yume Nagaoka
- Department of Nephrology, Tokyo Medical University, Tokyo, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| | - Yoshihiko Kanno
- Department of Nephrology, Tokyo Medical University, Tokyo, Japan
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13
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Wang Y, Armijos RX, Xun P, Weigel MM. Dietary Inflammatory Index and Cardiometabolic Risk in Ecuadorian Women. Nutrients 2021; 13:nu13082640. [PMID: 34444800 PMCID: PMC8400965 DOI: 10.3390/nu13082640] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 07/27/2021] [Accepted: 07/27/2021] [Indexed: 12/15/2022] Open
Abstract
Low-grade systemic inflammation is implicated in metabolic syndrome (MetS) and cardiometabolic diseases. Diet is hypothesized to be an important low-grade inflammation modifier. However, few studies have examined the association of dietary inflammation with MetS and cardiometabolic risk in Latin American populations and their findings are inconsistent. Our cross-sectional study examined the association of dietary inflammatory potential with MetS and cardiometabolic risk components in 276 urban Ecuadorian women. Dietary inflammation was evaluated using an energy-adjusted Dietary Inflammatory Index (E-DII), divided into quartiles (Q). E-DII scores ranged from −4.89 (most anti-inflammatory) to 4.45 (most pro-inflammatory). Participants in the most pro-inflammatory (Q4) compared to the least inflammatory E-DII quartile (Q1) had a 4.4 increased adjusted odds for MetS (95% C.I. = 2.0, 9.63; p < 0.001). Every one-unit increase in E-DII was associated with a 1.4 increase in MetS (95% CI = 1.22, 1.52; p < 0.001). In other adjusted models, the most pro-inflammatory E-DII quartile (Q4) was positively associated with total blood cholesterol and triglycerides (p < 0.001), LDL-c (p = 0.007), diastolic blood pressure (p< 0.002), mean arterial pressure (p < 0.006), waist circumference (p < 0.008), and Framingham risk score (p < 0.001). However, the previously identified associations with pulse wave velocity and BMI were no longer evident in the models. These findings suggest that more pro-inflammatory diets may contribute to poorer cardiometabolic health. Promoting healthier diets with a lower inflammatory potential may help to prevent or slow development of cardiometabolic disorders.
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Affiliation(s)
- Yankun Wang
- Department of Environmental & Occupational Health, Indiana University-Bloomington School of Public Health, Bloomington, IN 47405, USA; (Y.W.); (R.X.A.)
- Global Environmental Health Research Laboratory, Indiana University-Bloomington School of Public Health, Bloomington, IN 47405, USA
| | - Rodrigo X. Armijos
- Department of Environmental & Occupational Health, Indiana University-Bloomington School of Public Health, Bloomington, IN 47405, USA; (Y.W.); (R.X.A.)
- Global Environmental Health Research Laboratory, Indiana University-Bloomington School of Public Health, Bloomington, IN 47405, USA
- Center for Latin American & Caribbean Studies, Indiana University-Bloomington, Bloomington, IN 47405, USA
| | - Pengcheng Xun
- Department of Epidemiology and Biostatistics, Indiana University-Bloomington School of Public Health, Bloomington, IN 47405, USA;
- Atara Biotherapeutics, Thousand Oaks, CA 91320, USA
| | - Mary Margaret Weigel
- Department of Environmental & Occupational Health, Indiana University-Bloomington School of Public Health, Bloomington, IN 47405, USA; (Y.W.); (R.X.A.)
- Global Environmental Health Research Laboratory, Indiana University-Bloomington School of Public Health, Bloomington, IN 47405, USA
- Center for Latin American & Caribbean Studies, Indiana University-Bloomington, Bloomington, IN 47405, USA
- Correspondence: ; Tel.: +812-856-4930
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14
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Heiston EM, Gilbertson NM, Eichner NZM, Malin SK. A Low-Calorie Diet with or without Exercise Reduces Postprandial Aortic Waveform in Females with Obesity. Med Sci Sports Exerc 2021; 53:796-803. [PMID: 32925495 DOI: 10.1249/mss.0000000000002515] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE Arterial stiffness is considered a predictor of cardiovascular disease. Females have higher values of arterial stiffness than males, suggesting a greater risk of heart-related complications. Although a low-calorie diet (LCD) reduces fasting arterial stiffness, in part through weight loss, it is unknown if interval exercise (INT) adds to the benefit of LCD on fasting and postprandial arterial stiffness in females with obesity. METHODS Twenty-five females (47 ± 2.6 yr, 37.6 ± 1.3 kg·m-2) were randomized to 13 d of LCD (n = 12; mixed meals of ~1200 kcal·d-1) or LCD + INT (n = 13; 60 min·d-1 of supervised 3-min intervals at 90% HRpeak and 50% HRpeak). Arterial stiffness (augmentation index [AIx] and carotid-femoral pulse wave velocity [cfPWV]) and blood biochemistries were measured during a 75-g oral glucose tolerance test before and after the intervention to determine fasting and postprandial arterial stiffness as well as insulin sensitivity (simple index of insulin sensitivity [SIIS]) and inflammation (C-reactive protein, interleukin 8, and tumor necrosis factor alpha). RESULTS Although LCD + INT increased V˙O2peak and HDL compared with LCD (P = 0.04 and P < 0.01, respectively), both interventions decreased body fat, LDL, total cholesterol, and triglycerides (all P < 0.01) and increased SIIS (P = 0.03). Despite no effect on fasting AIx (P = 0.27), LCD and LCD + INT decreased AIx60min (-7.4% ± 4.3% vs -7.0% ± 5.0%, P = 0.04) and tAUC120min (-663 ± 263 vs -457 ± 406, P = 0.03). There were no changes in fasting cfPWV (P = 0.91) or cfPWV120min (P = 0.62). Increased SIIS and decreased interleukin 8 were associated with reduced fasting AIx (r = -0.44, P = 0.03, and r = 0.40, P = 0.055), whereas decreased C-reactive protein correlated with reduced postprandial AIx60min (r = 0.43, P = 0.04). CONCLUSION Independent of exercise, 13 d of LCD reduces postprandial AIx in females with obesity. Insulin sensitivity and inflammation correlated with improved arterial stiffness, suggesting unique mechanisms regulate fasted versus postprandial arterial stiffness.
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Affiliation(s)
- Emily M Heiston
- Department of Kinesiology, University of Virginia, Charlottesville, VA
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15
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Improvement of Arterial Stiffness One Month after Bariatric Surgery and Potential Mechanisms. J Clin Med 2021; 10:jcm10040691. [PMID: 33578924 PMCID: PMC7916665 DOI: 10.3390/jcm10040691] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/23/2021] [Accepted: 02/04/2021] [Indexed: 12/17/2022] Open
Abstract
Arterial stiffness (AS) is an independent predictor of cardiovascular risk. We aimed to analyze changes (Δ) in AS 1-month post-bariatric surgery (BS) and search for possible pathophysiological mechanisms. Patients with severe obesity (43% hypertensives) were prospectively evaluated before and 1-month post-BS, with AS assessed by pulse-wave velocity (PWV), augmentation index (AIx@75) and pulse pressure (PP). Ambulatory 24 h blood pressure (BP), anthropometric data, renin-angiotensin-aldosterone system (RAAS) components and several adipokines and inflammatory markers were also analyzed. Overall reduction in body weight was mean (interquartile range (IQR)) = 11.0% (9.6–13.1). A decrease in PWV, AIx@75 and PP was observed 1-month post-BS (all, p < 0.01). There were also significant Δ in BP, RAAS components, adipokines and inflammatory biomarkers. Multiple linear regression adjusted models showed that Δaldosterone was an independent variable (B coeff.95%CI) for final PWV (B = −0.003, −0.005 to 0.000; p = 0.022). Angiotensin-converting enzyme (ACE)/ACE2 and ACE were independent variables for final AIx@75 (B = 0.036, 0.005 to 0.066; p = 0.024) and PP (B = 0.010, 0.003 to 0.017; p = 0.01), respectively. There was no correlation between ΔAS and anthropometric changes nor with Δ of adipokines or inflammatory markers except high-sensitivity C-reactive protein (hs-CRP). Patients with PWV below median decreased PWV (mean, 95%CI = −0.18, −0.25 to −0.10; p < 0.001) and both AIx@75 and PP at 1-month, but not those with PWV above median. In conclusion, there is an improvement in AS 1-month post-BS that correlates with ΔBP and Δrenin-angiotensin-aldosterone components. The benefit is reduced in those with higher PWV.
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16
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Aakre KM, Omland T, Nordstrand N, Gjevestad ES, Holven KB, Lyngbakken MN, Hjelmesæth J. Gastric bypass surgery is associated with reduced subclinical myocardial injury and greater activation of the cardiac natriuretic peptide system than lifestyle intervention. Clin Biochem 2020; 86:36-44. [PMID: 32986994 DOI: 10.1016/j.clinbiochem.2020.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 09/09/2020] [Accepted: 09/19/2020] [Indexed: 12/18/2022]
Abstract
AIMS Morbid obesity is a risk factor for cardiovascular disease. The relative effects of Roux-en-Y gastric bypass surgery (GBS) and intensive lifestyle intervention (ILI) on subclinical myocardial injury, the activity of the cardiac natriuretic system, and systemic inflammation remain unclear. METHODS In a 59-week non-randomized clinical trial that included 131 patients with morbid obesity, we compared the effects ofGBS and ILI on concentrations of cardiac troponin T (cTnT) and I (cTnI), N-terminal pro-B-type natriuretic peptide (NT-proBNP) and C-reactive protein (CRP). RESULTS In the GBS and ILI group, median body mass index (BMI) was reduced by 14.4 kg/m2 versus 3.9 kg/m2, respectively (p value < 0.001). Cardiac troponins decreased after GBS, p = 0.014 (cTnT) and p = 0.065 (cTnI) and increased significantly in those treated with ILI (p values ≤ 0.021) (between-group differences for deltas: p ≤ 0.003). NT-proBNP increased in both groups, but significantly more in the GBS than in the ILI group (between-group differences for deltas: p = 0.008). CRP decreased significantly within the GBS and the ILI group, with this change significantly greater in the GBS group (between-group differences for deltas p < 0.001). The dominating mediator of the biomarker changes was weight loss. Prior coronary artery disease and diabetes were predictive of the magnitude of the changes in cTnI and NT-proBNP, respectively. CONCLUSION Compared to ILI, GBS was associated with reduced subclinical myocardial injury and systemic inflammation, and enhancement of the cardiac natriuretic peptide system. The biomarker changes were predominantly mediated by weight loss.
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Affiliation(s)
- Kristin M Aakre
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway; Department of Clinical Science, University of Bergen, Bergen, Norway; Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Torbjørn Omland
- Department of Cardiology, Division of Medicine, Akershus University Hospital, Lørenskog, Norway; Cardiovascular Research Group, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Njord Nordstrand
- Morbid Obesity Center, Vestfold Hospital Trust, Tønsberg, Norway
| | | | - Kirsten B Holven
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway; Norwegian National Advisory Unit on Familial Hypercholesterolemia, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Magnus N Lyngbakken
- Department of Cardiology, Division of Medicine, Akershus University Hospital, Lørenskog, Norway; Cardiovascular Research Group, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Jøran Hjelmesæth
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway; Department of Endocrinology, Morbid Obesity and Preventive Medicine, Institute of Clinical Medicine, University of Oslo, Norway
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17
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Gilbertson NM, Eichner NZM, Khurshid M, Rexrode EA, Kranz S, Weltman A, Hallowell PT, Malin SK. Impact of Pre-operative Aerobic Exercise on Cardiometabolic Health and Quality of Life in Patients Undergoing Bariatric Surgery. Front Physiol 2020; 11:1018. [PMID: 32982777 PMCID: PMC7479188 DOI: 10.3389/fphys.2020.01018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 07/24/2020] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE Examine the effect of aerobic exercise (EX) combined with standard medical care (SC) (EX + SC) compared to SC alone on cardiometabolic health and quality of life in relation to surgical outcomes. METHODS Patients receiving bariatric surgery were match-paired to 30 days of pre-operative SC (n = 7, 1 male, 39.0 ± 5.3 years, body mass index 46.4 ± 3.0 kg/m2; low calorie diet) or EX + SC (n = 7, 0 males, 45.6 ± 4.8 years, body mass index 43.9 ± 4.2 kg/m2; walking 30 min/day, 5 days/week, 65-85% HR peak ). Body mass, waist circumference, cardiorespiratory fitness (VO2peak), high sensitivity C-reactive protein (hs-CRP), cytokeratin 18 (CK18), weight related quality of life (QoL), and a 120 min mixed meal tolerance test (MMTT) was performed to assess arterial stiffness via augmentation index normalized to a heart rate of 75 beats per minute (AIx@75), whole-body insulin sensitivity, and glucose total area under the curve (tAUC) pre- and post-intervention (∼2 days prior to surgery). Length of hospital stay (admission to discharge) was recorded. RESULTS EX + SC had a greater effect for decreased intake of total calories (P = 0.14; ES = 0.86) compared to SC, but no change in body weight or waist circumference was observed in either group. EX + SC had a greater effect for increased VO2peak (P = 0.24; ES = 0.91) and decreased hs-CRP (P = 0.31; ES = 0.69) compared to SC. EX + SC reduced circulating CK18 (P = 0.05; ES = 3.05) and improved QoL (P = 0.02) compared to SC. Although EX + SC had no statistical effect on arterial stiffness compared to SC, we observed a modest effect size for AIx@75 tAUC (P = 0.36; ES = 0.52). EX + SC had a significantly shorter length of hospital stay (P = 0.05; ES = 1.38) than SC, and a shorter length of hospital stay was associated with decreased sugar intake (r = 0.55, P = 0.04). Decreased AIx@75 tAUC significantly correlated with improved whole-body insulin sensitivity (r = -0.59, P = 0.03) and glucose tAUC (r = 0.57, P = 0.04). CONCLUSION EX with SC for 30 days prior to bariatric surgery may be important for cardiometabolic health, quality of life, and surgical outcomes in the bariatric patient.
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Affiliation(s)
- Nicole M. Gilbertson
- Department of Kinesiology, University of Virginia, Charlottesville, VA, United States
| | - Natalie Z. M. Eichner
- Department of Kinesiology, University of Virginia, Charlottesville, VA, United States
| | - Mahnoor Khurshid
- Department of Kinesiology, University of Virginia, Charlottesville, VA, United States
| | - Elizabeth A. Rexrode
- Department of Surgery, University of Virginia, Charlottesville, VA, United States
| | - Sibylle Kranz
- Department of Kinesiology, University of Virginia, Charlottesville, VA, United States
| | - Arthur Weltman
- Department of Kinesiology, University of Virginia, Charlottesville, VA, United States
- Department of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Peter T. Hallowell
- Department of Surgery, University of Virginia, Charlottesville, VA, United States
| | - Steven K. Malin
- Department of Kinesiology, University of Virginia, Charlottesville, VA, United States
- Department of Medicine, University of Virginia, Charlottesville, VA, United States
- Robert M. Berne Cardiovascular Research Center, University of Virginia, Charlottesville, VA, United States
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18
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Wei J, Palta P, Meyer ML, Kucharska-Newton A, Pence BW, Aiello AE, Power MC, Walker KA, Sharrett AR, Tanaka H, Jack CR, Mosley TH, Reid RI, Reyes DA, Heiss G. Aortic Stiffness and White Matter Microstructural Integrity Assessed by Diffusion Tensor Imaging: The ARIC-NCS. J Am Heart Assoc 2020; 9:e014868. [PMID: 32157957 PMCID: PMC7335527 DOI: 10.1161/jaha.119.014868] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Background Changes in white matter microstructural integrity are detectable before appearance of white matter lesions on magnetic resonance imaging as a manifestation of cerebral small‐vessel disease. The information relating poor white matter microstructural integrity to aortic stiffness, a hallmark of aging, is limited. We aimed to examine the association between aortic stiffness and white matter microstructural integrity among older adults. Methods and Results We conducted a cross‐sectional study to examine the association between aortic stiffness and white matter microstructural integrity among 1484 men and women (mean age, 76 years) at the 2011 to 2013 examination of the ARIC‐NCS (Atherosclerosis Risk in Communities Neurocognitive Study). Aortic stiffness was measured as carotid‐femoral pulse wave velocity. Cerebral white matter microstructural integrity was measured as fractional anisotropy and mean diffusivity using diffusion tensor imaging. Multivariable linear regression was used to examine the associations of carotid‐femoral pulse wave velocity with fractional anisotropy and mean diffusivity of the overall cerebrum and at regions of interest. Each 1‐m/s higher carotid‐femoral pulse wave velocity was associated with lower overall fractional anisotropy (β=−0.03; 95% CI, −0.05 to −0.02) and higher overall mean diffusivity (β=0.03; 95% CI, 0.02–0.04). High carotid‐femoral pulse wave velocity (upper 25th percentile) was associated with lower fractional anisotropy (β=−0.40; 95% CI, −0.61 to −0.20) and higher overall mean diffusivity (β=0.27; 95% CI, 0.10–0.43). Similar associations were observed at individual regions of interest. Conclusions High aortic stiffness is associated with low cerebral white matter microstructural integrity among older adults. Aortic stiffness may serve as a target for the prevention of poor cerebral white matter microstructural integrity.
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Affiliation(s)
- Jingkai Wei
- Department of Epidemiology Gillings School of Global Public Health University of North Carolina at Chapel Hill Chapel Hill NC
| | - Priya Palta
- School of Medicine Columbia University New York NY.,Department of Epidemiology Mailman School of Public Health Columbia University New York NY
| | - Michelle L Meyer
- Department of Emergency Medicine School of Medicine University of North Carolina at Chapel Hill Chapel Hill NC
| | - Anna Kucharska-Newton
- Department of Epidemiology Gillings School of Global Public Health University of North Carolina at Chapel Hill Chapel Hill NC.,Department of Epidemiology College of Public Health University of Kentucky Lexington KY
| | - Brian W Pence
- Department of Epidemiology Gillings School of Global Public Health University of North Carolina at Chapel Hill Chapel Hill NC
| | - Allison E Aiello
- Department of Epidemiology Gillings School of Global Public Health University of North Carolina at Chapel Hill Chapel Hill NC
| | - Melinda C Power
- Department of Epidemiology and Biostatistics Milken Institute School of Public Health Washington DC
| | - Keenan A Walker
- Department of Neurology Johns Hopkins University Baltimore MD
| | - A Richey Sharrett
- Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore MD
| | - Hirofumi Tanaka
- Department of Kinesiology and Health Education University of Texas at Austin TX
| | | | | | - Robert I Reid
- Department of Information Technology Mayo Clinic Rochester MN
| | | | - Gerardo Heiss
- Department of Epidemiology Gillings School of Global Public Health University of North Carolina at Chapel Hill Chapel Hill NC
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19
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García-Prieto CF, Gil-Ortega M, Plaza A, Manzano-Lista FJ, González-Blázquez R, Alcalá M, Rodríguez-Rodríguez P, Viana M, Aránguez I, Gollasch M, Somoza B, Fernández-Alfonso MS. Caloric restriction induces H 2O 2 formation as a trigger of AMPK-eNOS-NO pathway in obese rats: Role for CAMKII. Free Radic Biol Med 2019; 139:35-45. [PMID: 31100477 DOI: 10.1016/j.freeradbiomed.2019.05.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 05/13/2019] [Accepted: 05/13/2019] [Indexed: 02/06/2023]
Abstract
Caloric restriction (CR) improves endothelial function through the upregulation of adenosine monophosphate-activated protein kinase (AMPK) and endothelial nitric oxide synthase (eNOS). Moreover, hydrogen peroxide (H2O2) is upregulated in yeast subjected to CR. Our aim was to assess if mild short-term CR increases vascular H2O2 formation as a link with AMPK and eNOS activation. Twelve-week old Zucker obese (fa/fa) and control Zucker lean male rats were fed a standard chow either ad libitum (AL, n=10) or with a 20% CR (CR, n=10) for two weeks. CR significantly improved relaxation to ACh in fa/fa rats because of an enhanced endogenous production of H2O2 in aortic rings (H2O2 levels fa/faAL=0.5 ± 0.05 nmol/mg vs. H2O2 levels fa/faCR=0.76 ± 0.07 nmol/mg protein; p<0.05). Expression of mitochondrial superoxide dismutase (Mn-SOD) and total SOD activity were increased in aorta from fa/fa animals after CR. In cultured aortic endothelial cells, serum deprivation or 2-deoxy-d-glucose induced a significant increase in: i) superoxide anion and H2O2 levels, ii) p-AMPK/AMPK and p-eNOS/eNOS expression and iii) nitric oxide levels. This effect was reduced by catalase and strongly inhibited by Ca2+/calmodulin-dependent kinase II (CamkII) silencing. In conclusion, we propose that mild short-term CR might be a trigger of mechanisms aimed at protecting the vascular wall by the increase of H2O2, which then activates AMPK and nitric oxide release, thus improving endothelium-dependent relaxation. In addition, we demonstrate that CAMKII plays a key role in mediating CR-induced AMPK activation through H2O2 increase.
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Affiliation(s)
- Concha F García-Prieto
- Departamento de Ciencias Farmacéuticas y de La Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, 28925, Madrid, Spain
| | - Marta Gil-Ortega
- Departamento de Ciencias Farmacéuticas y de La Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, 28925, Madrid, Spain
| | - Adrián Plaza
- Departamento de Ciencias Farmacéuticas y de La Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, 28925, Madrid, Spain
| | - F J Manzano-Lista
- Instituto Pluridisciplinar and Departamento de Farmacología, Facultad de Farmacia, Universidad Complutense, Madrid, Spain
| | - Raquel González-Blázquez
- Departamento de Ciencias Farmacéuticas y de La Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, 28925, Madrid, Spain
| | - Martín Alcalá
- Departamento de Química y Bioquímica, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, 28925, Madrid, Spain
| | | | - Marta Viana
- Departamento de Química y Bioquímica, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, 28925, Madrid, Spain
| | - Isabel Aránguez
- Instituto Pluridisciplinar and Departamento de Bioquímica y Biología Molecular, Facultad de Farmacia, Universidad Complutense, Madrid, Spain
| | - Maik Gollasch
- Experimental and Clinical Research Center, Charité - University Medicine Berlin and the Max Delbrück Center for Molecular Medicine Berlin, Germany
| | - Beatriz Somoza
- Departamento de Ciencias Farmacéuticas y de La Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, 28925, Madrid, Spain
| | - María S Fernández-Alfonso
- Instituto Pluridisciplinar and Departamento de Farmacología, Facultad de Farmacia, Universidad Complutense, Madrid, Spain.
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20
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Syed-Abdul MM, Hu Q, Jacome-Sosa M, Padilla J, Manrique-Acevedo C, Heimowitz C, Parks EJ. Effect of carbohydrate restriction-induced weight loss on aortic pulse wave velocity in overweight men and women. Appl Physiol Nutr Metab 2018; 43:1247-1256. [DOI: 10.1139/apnm-2018-0113] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Increased aortic stiffness, measured by carotid-to-femoral pulse wave velocity (PWV), is an independent predictor of cardiovascular disease, and past data have shown that low-fat and low-energy diets, fed for 8–24 weeks, lower PWV. The purpose of this study was to determine whether a reduction in PWV would be achieved by dietary carbohydrate (CHO) restriction, shown to bring about weight loss over a shorter timeframe. Men (n = 10, age: 41.8 ± 10.2 years, BMI: 34.2 ± 3.0 kg/m2 (mean ± SD)) and women (n = 10, age: 38.6 ± 6.1 years, BMI: 33.5 ± 3.8 kg/m2) with characteristics of insulin resistance and the metabolic syndrome consumed a structured, CHO-restricted diet for 4 weeks (energy deficit, 645 kcal/day). For the whole group, subjects lost 5.4% ± 0.5% (P < 0.001) of body weight and experienced significant reductions in blood pressure (6%–8%), plasma insulin (34%), and triglycerides (34%). PWV was reduced by 6% ± 2% (7.1 ± 0.2 m/s to 6.7 ± 0.2 m/s, P = 0.008) and surprisingly, in women, it fell significantly (from 7.2 ± 0.3 m/s to 6.3 ± 0.3 m/s, P = 0.028), while no changes were observed in men (7.2 ± 0.3 vs. 7.0 ± 0.3 m/s, P = 0.144). This is the first study to demonstrate that weight loss can improve PWV in as little as 4 weeks and that dietary CHO restriction may be an effective treatment for reducing aortic stiffness in women. Future studies are needed to establish the mechanisms by which dietary CHO restriction may confer more cardiovascular benefits to women than to men.
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Affiliation(s)
- Majid M. Syed-Abdul
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO 65211, USA
| | - Qiong Hu
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO 65211, USA
| | - Miriam Jacome-Sosa
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO 65211, USA
| | - Jaume Padilla
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO 65211, USA
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO 65211, USA
- Department of Child Health, School of Medicine, University of Missouri, Columbia, MO 65212, USA
| | - Camila Manrique-Acevedo
- Division of Endocrinology, School of Medicine, University of Missouri, Columbia, MO 65212, USA
| | | | - Elizabeth J. Parks
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO 65211, USA
- Department of Child Health, School of Medicine, University of Missouri, Columbia, MO 65212, USA
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21
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Abstract
BACKGROUND Beyond the essential but somewhat artificial conditions that typify formal clinical studies, real-world evidence (RWE) of weight loss program effectiveness is paramount for an accurate assessment of such programs and refinement of best practices. OBJECTIVES To evaluate the current state of RWE studies and publications on weight loss, identify the range of weight loss components being used in RWE programs, and to provide a general overview of the consistency or lack of consistency with regard to measuring and reporting outcomes. METHODS A structured search of PubMed was performed to identify relevant English-language publications from 2006 to December 2017 that reported real-world studies of weight loss among adults. Duplicates, non-relevant publications, articles on weight loss surgery, pediatric studies, randomized controlled trials, studies with self-reported weight loss, no objective weight measures, or that failed to include weight loss results were excluded. RESULTS This review included 62 RWE publications. Forty-nine studies included dietary intervention, 37 included exercise, 29 included motivational counseling, and 5 contained some patients who had pharmacologic treatment as part of their weight loss regimen. The numbers of participants per study ranged from 10 to more than 3 million. The interventions reported in the publications included diet, exercise, counseling to promote diet and/or exercise, motivational counseling, and pharmacotherapy, and various combinations of these. CONCLUSIONS Despite general acceptance that weight loss programs are capable of facilitating successful outcomes, this review revealed substantial inconsistency in the design and reporting of such programs, making it very difficult to draw conclusions about the comparative merits of different real-world weight loss strategies/components. In addition, there was a marked lack of congruence with current weight loss management guidelines, and notably few studies incorporating anti-obesity medications. There clearly is a need for greater rigor and standardization among designing and reporting RWE weight-loss studies.
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Affiliation(s)
- Craig Primack
- a Department of Obesity Medicine , Scottsdale Weight Loss , Scottsdale , AZ , USA
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22
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Effect of physical activity on pulse wave velocity in elderly subjects with normal glucose, prediabetes or Type 2 Diabetes. Sci Rep 2018; 8:8045. [PMID: 29795274 PMCID: PMC5966452 DOI: 10.1038/s41598-018-25755-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 04/30/2018] [Indexed: 01/26/2023] Open
Abstract
Carotid-femoral pulse wave velocity ((cf)PWV) is a measure of arterial stiffness, predicting cardiovascular disease. We hypothesized that the amount of physical activity (PA) is correlated with reduced arterial stiffness in Type 2 diabetic (T2D) subjects. 570 subjects from the 1945 Oulu birth cohort were included in the analysis. (cf)PWV was determined by a non-invasive applanation tonometry. Oral glucose tolerance test was performed and LDL and HDL cholesterol analyzed. PA was registered daily with a wrist-worn acceleration meter for two weeks. (cf)PWV values in subjects with impaired glucose metabolism (IGM) and T2D were higher than in normal glycemic subjects (P < 0.001). PA, fasting and 2 h glucose and HbA1c correlated significantly with (cf)PWV, but HDL or LDL cholesterol did not. The 2 h glucose, heart rate and alcohol consumption in T2D subjects had independent effects on (cf)PWV in multiple regression analysis. T2D and IGM were significantly associated to (cf)PWV. Interestingly, lipids did not have an additional effect on (cf)PWV. Subjects walking more than 10 000 steps/day had 0.2 m/s lower (cf)PWV than those walking less than 6000 steps/day. Presence of T2D, elevated heart rate and alcohol consumption in males were associated with increased aortic stiffening in elderly subjects.
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23
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Yan K, Zhu H, Xu J, Pan H, Li N, Wang L, Yang H, Liu M, Gong F. Lotus Leaf Aqueous Extract Reduces Visceral Fat Mass and Ameliorates Insulin Resistance in HFD-Induced Obese Rats by Regulating PPARγ2 Expression. Front Pharmacol 2017; 8:409. [PMID: 28690544 PMCID: PMC5481353 DOI: 10.3389/fphar.2017.00409] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 06/09/2017] [Indexed: 12/18/2022] Open
Abstract
Objectives: Lotus leaf is a kind of traditional Chinese medicine. We aimed to explore the effects of lotus leaf aqueous extract (LLAE) on peroxisome proliferative activated receptor γ2 (PPARγ2) expression in preadipocytes and adipocytes and further investigate its effects on high fat diet (HFD)-induced obese rats. Methods: pGL3-Enhancer-PPARγ2 (625 bp)-Luc plasmid, a luciferase reporter gene expression plasmid containing PPARγ2 promoter, was stably transfected into 3T3-L1 preadipocytes. PPARγ2 promoter activities were determined by assaying the luciferase activities. Then PPARγ2 promoter activities in preadipocytes and PPARγ2 mRNA levels in human subcutaneous adipocytes were measured after the administration with LLAE. Additionally, the effects of LLAE on body weight, fat mass, glucose and lipid metabolism and the expression of PPARγ2, insulin receptor substrate 1 and glucose transporter 4 (GLUT4) in visceral adipose tissue (VAT) were measured in HFD-induced obese rats treated with low or high dose [0.5 or 3.0 g crude drug/(kg.d)] LLAE for 6 weeks. Results: Ten μg/ml LLAE significantly increased the luciferase activities in 3T3-L1 cells and the stimulatory action reached 2.51 folds of controls when LLAE was 1000 μg/ml (P < 0.01). After treating 3T3-L1 cells with 100 μg/ml LLAE, the stimulatory role peaked at 32 h where it was 2.58 folds of controls (P < 0.01). Besides, 100 μg/ml LLAE significantly increased PPARγ2 mRNA levels in human adipocytes to 1.91 folds of controls (P < 0.01). In HFD-induced obese rats, administration with both low and high dose LLAE notably reduced visceral fat mass by 45.5 and 58.4%, respectively, and significantly decreased fasting serum insulin levels (P < 0.05). The high dose LLAE also significantly decreased homeostasis model assessment of insulin resistance in obese rats (P < 0.05). Furthermore, the mRNA levels of PPARγ2 and GLUT4 in VAT of obese rats were significantly increased when compared with control rats, and were notably suppressed by LLAE intervention for 6 weeks (P < 0.05). Conclusion: LLAE significantly reduces visceral fat mass and ameliorates insulin resistance in HFD-induced obese rats. These beneficial effects of LLAE may associate with its role in stimulating PPARγ2 expression in preadipocytes and subcutaneous adipocytes and suppressing PPARγ2 and GLUT4 expression in VAT.
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Affiliation(s)
- Kemin Yan
- Key Laboratory of Endocrinology of National Health and Family Planning Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical CollegeBeijing, China
| | - Huijuan Zhu
- Key Laboratory of Endocrinology of National Health and Family Planning Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical CollegeBeijing, China
| | - Jian Xu
- Key Laboratory of Endocrinology of National Health and Family Planning Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical CollegeBeijing, China.,Department of Endocrinology, Beijing Tian Tan Hospital, Capital Medical UniversityBeijing, China
| | - Hui Pan
- Key Laboratory of Endocrinology of National Health and Family Planning Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical CollegeBeijing, China
| | - Naishi Li
- Key Laboratory of Endocrinology of National Health and Family Planning Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical CollegeBeijing, China
| | - Linjie Wang
- Key Laboratory of Endocrinology of National Health and Family Planning Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical CollegeBeijing, China
| | - Hongbo Yang
- Key Laboratory of Endocrinology of National Health and Family Planning Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical CollegeBeijing, China
| | - Meijuan Liu
- Key Laboratory of Endocrinology of National Health and Family Planning Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical CollegeBeijing, China
| | - FengYing Gong
- Key Laboratory of Endocrinology of National Health and Family Planning Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical CollegeBeijing, China
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Crosstalk between Vitamins A, B12, D, K, C, and E Status and Arterial Stiffness. DISEASE MARKERS 2017; 2017:8784971. [PMID: 28167849 PMCID: PMC5266829 DOI: 10.1155/2017/8784971] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Accepted: 12/14/2016] [Indexed: 02/07/2023]
Abstract
Arterial stiffness is associated with cardiovascular risk, morbidity, and mortality. The present paper reviews the main vitamins related to arterial stiffness and enabling destiffening, their mechanisms of action, providing a brief description of the latest studies in the area, and their implications for primary cardiovascular prevention, clinical practice, and therapy. Despite inconsistent evidence for destiffening induced by vitamin supplementation in several randomized clinical trials, positive results were obtained in specific populations. The main mechanisms are related to antiatherogenic effects, improvement of endothelial function (vitamins A, C, D, and E) and metabolic profile (vitamins A, B12, C, D, and K), inhibition of the renin-angiotensin-aldosterone system (vitamin D), anti-inflammatory (vitamins A, D, E, and K) and antioxidant effects (vitamins A, C, and E), decrease of homocysteine level (vitamin B12), and reversing calcification of arteries (vitamin K). Vitamins A, B12, C, D, E, and K status is important in evaluating cardiovascular risk, and vitamin supplementation may be an effective, individualized, and inexpensive destiffening therapy.
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25
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Jansen A, Lyche JL, Polder A, Aaseth J, Skaug MA. Increased blood levels of persistent organic pollutants (POP) in obese individuals after weight loss-A review. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2017; 20:22-37. [PMID: 28051929 DOI: 10.1080/10937404.2016.1246391] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Lipophilic persistent organic pollutants (POP) are stored in adipose tissue. Following rapid weight loss such as when induced by bariatric surgery, an increased release of potential harmful lipophilic compounds into the blood circulation may occur. Weight reduction is recommended for overweight and obese individuals in order to decrease risk of weight-related health problems. However, in cases of significant weight reduction POP become mobilized chemicals and consequently may adversely affect health, including endocrine disruption. The objective of the present investigation was to estimate quantitatively the level of mobilization of POP following weight loss over time. According to literature search criteria, 17 studies were identified with 2061 participants. Data from 5 of the studies with 270 participants were used to assess the change in blood levels of POP in percent per kilogram weight loss. Weight loss in the included studies varied from 4.4 to 64.8 kg. In all studies, the majority of POP concentrations in blood were found to rise following weight reduction. Blood concentrations following weight reduction were elevated by 2-4% per kilogram weight loss for most POP examined. The increased POP levels were still elevated 12 mo after intervention. Most research in this field, including animal studies, is carried out on a single compound or group of selected compounds, not taking the "cocktail effect" into consideration. This does not reflect the true range of POP to which humans are actually exposed. Few chronic investigations have been published and, in particular, few studies were available that compared the increase in POP concentrations with clinical consequences as individuals lost weight. These limitations call for caution in interpreting results. The benefits of losing weight still far outweigh the potential adverse health risks. However, further studies are recommended to determine the clinical significance of increased blood levels of POPs following rapid and excessive weight loss, particularly for women attending weight reduction treatment before pregnancy.
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Affiliation(s)
- Aina Jansen
- a Center for Morbid Obesity , Department of Surgery, Innlandet Hospital Trust , Gjøvik , Norway
- b Department of Food Safety and Infection Biology , Norwegian University of Life Sciences (NMBU) , Campus Adamstuen, Oslo , Norway
| | - Jan L Lyche
- b Department of Food Safety and Infection Biology , Norwegian University of Life Sciences (NMBU) , Campus Adamstuen, Oslo , Norway
| | - Anuschka Polder
- b Department of Food Safety and Infection Biology , Norwegian University of Life Sciences (NMBU) , Campus Adamstuen, Oslo , Norway
| | - Jan Aaseth
- c Innlandet Hospital Trust , Kongsvinger Hospital Division , Kongsvinger , Norway
- d Faculty of Public Health , Hedmark University of Applied Sciences , Elverum , Norway
| | - Marit Aralt Skaug
- d Faculty of Public Health , Hedmark University of Applied Sciences , Elverum , Norway
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26
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Di Pino A, Currenti W, Urbano F, Mantegna C, Purrazzo G, Piro S, Purrello F, Rabuazzo AM. Low advanced glycation end product diet improves the lipid and inflammatory profiles of prediabetic subjects. J Clin Lipidol 2016; 10:1098-108. [DOI: 10.1016/j.jacl.2016.07.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 07/02/2016] [Accepted: 07/02/2016] [Indexed: 01/12/2023]
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27
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Effect of weight loss induced by energy restriction on measures of arterial compliance: A systematic review and meta-analysis. Atherosclerosis 2016; 247:7-20. [DOI: 10.1016/j.atherosclerosis.2016.01.042] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Revised: 01/13/2016] [Accepted: 01/26/2016] [Indexed: 12/16/2022]
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28
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Management of Moderate Hypertriglyceridemia in Childhood and Adolescence. CURRENT CARDIOVASCULAR RISK REPORTS 2016. [DOI: 10.1007/s12170-016-0484-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Samson R, Jaiswal A, Ennezat PV, Cassidy M, Le Jemtel TH. Clinical Phenotypes in Heart Failure With Preserved Ejection Fraction. J Am Heart Assoc 2016; 5:e002477. [PMID: 26811159 PMCID: PMC4859363 DOI: 10.1161/jaha.115.002477] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Rohan Samson
- Tulane University Heart and Vascular InstituteTulane University School of MedicineNew OrleansLA
| | - Abhishek Jaiswal
- Tulane University Heart and Vascular InstituteTulane University School of MedicineNew OrleansLA
| | - Pierre V. Ennezat
- Department of CardiologyCentre Hospitalier Universitaire de GrenobleGrenoble Cedex 09France
| | - Mark Cassidy
- Tulane University Heart and Vascular InstituteTulane University School of MedicineNew OrleansLA
| | - Thierry H. Le Jemtel
- Tulane University Heart and Vascular InstituteTulane University School of MedicineNew OrleansLA
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Petersen K, Blanch N, Keogh J, Clifton P. Weight Loss, Dietary Intake and Pulse Wave Velocity. Pulse (Basel) 2015; 3:134-40. [PMID: 26587462 DOI: 10.1159/000435792] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
We have recently conducted a meta-analysis to determine the effect of weight loss achieved by an energy-restricted diet with or without exercise, anti-obesity drugs or bariatric surgery on pulse wave velocity (PWV) measured at all arterial segments. Twenty studies, including 1,259 participants, showed that modest weight loss (8% of the initial body weight) caused a reduction in PWV measured at all arterial segments. However, due to the poor methodological design of the included studies, the results of this meta-analysis can only be regarded as hypothesis generating and highlight the need for further research in this area. In the future, well-designed randomised controlled trials are required to determine the effect of diet-induced weight loss on PWV and the mechanisms involved. In addition, there is observational evidence that dietary components such as fruit, vegetables, dairy foods, sodium, potassium and fatty acids may be associated with PWV, although evidence from well-designed intervention trials is lacking. In the future, the effect of concurrently improving dietary quality and achieving weight loss should be assessed in randomised controlled trials.
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Affiliation(s)
- Kristina Petersen
- Division of Health Sciences, School of Pharmacy and Medical Science, University of South Australia, Adelaide, S.A., Australia
| | - Natalie Blanch
- Division of Health Sciences, School of Pharmacy and Medical Science, University of South Australia, Adelaide, S.A., Australia
| | - Jennifer Keogh
- Division of Health Sciences, School of Pharmacy and Medical Science, University of South Australia, Adelaide, S.A., Australia
| | - Peter Clifton
- Division of Health Sciences, School of Pharmacy and Medical Science, University of South Australia, Adelaide, S.A., Australia
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Kavey REW. Combined dyslipidemia in childhood. J Clin Lipidol 2015; 9:S41-56. [PMID: 26343211 DOI: 10.1016/j.jacl.2015.06.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Revised: 05/21/2015] [Accepted: 06/05/2015] [Indexed: 01/19/2023]
Abstract
Combined dyslipidemia (CD) is now the predominant dyslipidemic pattern in childhood, characterized by moderate-to-severe elevation in triglycerides and non-high-density lipoprotein cholesterol (non-HDL-C), minimal elevation in low-density lipoprotein cholesterol (LDL-C), and reduced HDL-C. Nuclear magnetic resonance spectroscopy shows that the CD pattern is represented at the lipid subpopulation level as an increase in small, dense LDL and in overall LDL particle number plus a reduction in total HDL-C and large HDL particles, a highly atherogenic pattern. In youth, CD occurs almost exclusively with obesity and is highly prevalent, seen in more than 40% of obese adolescents. CD in childhood predicts pathologic evidence of atherosclerosis and vascular dysfunction in adolescence and young adulthood, and early clinical cardiovascular events in adult life. There is a tight connection between CD, visceral adiposity, insulin resistance, nonalcoholic fatty liver disease, and the metabolic syndrome, suggesting an integrated pathophysiological response to excessive weight gain. Weight loss, changes in dietary composition, and increases in physical activity have all been shown to improve CD significantly in children and adolescents in short-term studies. Most importantly, even small amounts of weight loss are associated with significant decreases in triglyceride levels and increases in HDL-C levels with improvement in lipid subpopulations. Diet change focused on limitation of simple carbohydrate intake with specific elimination of all sugar-sweetened beverages is very effective. Evidence-based recommendations for initiating diet and activity change are provided. Rarely, drug therapy is needed, and the evidence for drug treatment of CD in childhood is reviewed.
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Affiliation(s)
- Rae-Ellen W Kavey
- Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, USA.
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Moh MC, Sum CF, Lam BCC, Ng XW, Su C, Tavintharan S, Yeoh LY, Wong MDS, Lee SBM, Tang WE, Lim SC. Evaluation of body adiposity index as a predictor of aortic stiffness in multi-ethnic Asian population with type 2 diabetes. Diab Vasc Dis Res 2015; 12:111-8. [PMID: 25491287 DOI: 10.1177/1479164114554609] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Cardiovascular disease is the leading cause of morbidity and mortality in type 2 diabetes mellitus. We evaluated the predictive ability of the recently developed body adiposity index for aortic stiffness, an intermediate endpoint of cardiovascular disease, in a cross-sectional multi-ethnic Asian type 2 diabetes mellitus cohort (N = 1408). AS was estimated using carotid-femoral pulse wave velocity measured by applanation tonometry. Body adiposity index was computed as hip circumference/(height)(1.5) - 18. Compared to body mass index, waist circumference and visceral fat area, body adiposity index displayed the weakest association with pulse wave velocity (r = 0.077, 0.096, 0.134 and 0.058, respectively; all p < 0.05). Interestingly, the relationship between measurements of obesity and pulse wave velocity was ethnic dependent - body mass index, body adiposity index, waist circumference and visceral fat area consistently predicted pulse wave velocity only in Indians but not others. In multi-variable analysis, body mass index was a significant determinant of pulse wave velocity in all ethnicities. In conclusion, body adiposity index is a weak predictor of aortic stiffness (when compared with body mass index) in Asians with type 2 diabetes mellitus.
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Affiliation(s)
- Mei Chung Moh
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
| | | | | | - Xiao Wei Ng
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
| | - Chang Su
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
| | | | - Lee Ying Yeoh
- Department of Medicine, Khoo Teck Puat Hospital, Singapore
| | | | | | - Wern Ee Tang
- National Healthcare Group Polyclinics, Singapore
| | - Su Chi Lim
- Diabetes Centre, Khoo Teck Puat Hospital, Singapore
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33
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Joint scientific statement of the European Association for the Study of Obesity and the European Society of Hypertension. J Hypertens 2015; 33:425-34. [DOI: 10.1097/hjh.0000000000000473] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Gjevestad E, Hjelmesaeth J, Sandbu R, Nordstrand N. Effects of intensive lifestyle intervention and gastric bypass on aortic stiffness: a 1-year nonrandomized clinical study. Obesity (Silver Spring) 2015; 23:37-45. [PMID: 25174845 DOI: 10.1002/oby.20880] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2014] [Accepted: 08/10/2014] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To compare the long-term effects of Roux-en-Y gastric bypass (GBS) and intensive lifestyle intervention (ILI) on aortic stiffness. METHODS Nonrandomized clinical trial. Aortic stiffness was assessed by carotid-femoral pulse wave velocity (cf PWV) using high-fidelity applanation tonometry. RESULTS A total of 159 treatment-seeking morbidly obese patients were included, 82 (54 females) in the GBS-group and 77 (48 females) in the ILI-group. Participants in the GBS-group were younger (42.0 ± 9.9 vs. 46.4 ± 10.5 years), heavier (BMI 45.7 ± 5.3 vs. 42.0 ± 4.9 kg/m(2) ), and had lower systolic pressure (137 ± 19 vs. 145 ± 18 mm Hg) and pulse pressure (57 ± 16 vs. 65 ± 17 mm Hg), all P ≤ 0.006. Mean (SD) cf PWV at baseline was 8.6 ± 1.7 m/s in the GBS-group and 8.6 ± 1.9 m/s in the ILI-group, P = 0.959. At follow-up, mean (95% CI) weight loss was larger in the GBS-group than in the ILI-group -43.3 (-46.0 to -40.7) vs. -12.1 (-14.6 to -9.6) kg, P < 0.001. The mean change in cf PWV was -0.02 (-0.31 to 0.27) m/s in the GBS-group and 0.03 (-0.28 to 0.33) m/s in the ILI-group, both P ≥ 0.412; adjusted between-group difference (ANCOVA) 0.05 (-0.40 to 0.49) m/s, P = 0.836. The adjusted regression analysis showed that weight loss was associated with increased cf PWV in the GBS-group. CONCLUSIONS GBS and ILI had no significant long-term effects on aortic stiffness in treatment-seeking morbidly obese individuals.
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Affiliation(s)
- Espen Gjevestad
- Morbid Obesity Center, Vestfold Hospital Trust, Tønsberg, Norway; Clinic Physical Medicine and Rehabilitation, Vestfold Hospital Trust, Stavern, Norway
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35
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Petersen KS, Blanch N, Keogh JB, Clifton PM. Effect of Weight Loss on Pulse Wave Velocity. Arterioscler Thromb Vasc Biol 2015; 35:243-52. [DOI: 10.1161/atvbaha.114.304798] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Kristina S. Petersen
- From the School of Pharmacy and Medical Science, University of South Australia, Adelaide, Australia
| | - Natalie Blanch
- From the School of Pharmacy and Medical Science, University of South Australia, Adelaide, Australia
| | - Jennifer B. Keogh
- From the School of Pharmacy and Medical Science, University of South Australia, Adelaide, Australia
| | - Peter M. Clifton
- From the School of Pharmacy and Medical Science, University of South Australia, Adelaide, Australia
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36
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Hawkins M, Gabriel KP, Cooper J, Storti KL, Sutton-Tyrrell K, Kriska A. The impact of change in physical activity on change in arterial stiffness in overweight or obese sedentary young adults. Vasc Med 2014; 19:257-263. [PMID: 24879662 DOI: 10.1177/1358863x14536630] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Arterial stiffness is associated with cardiovascular events and mortality. Lifestyle factors such as physical activity (PA) may reduce arterial stiffness. The purpose of this study is to determine the impact of change in PA on 1-year change in arterial stiffness in 274 overweight/obese sedentary young adults. The Slow Adverse Vascular Effects of excess weight (SAVE) trial was a study evaluating the relationships between weight loss, dietary sodium, and vascular health. PA was measured with the ActiGraph AM7164 accelerometer. Intensity of activity was determined using established cut-points. Arterial stiffness was assessed by brachial-ankle pulse wave velocity (baPWV) using an automated device. Analysis of covariance compared changes in total accelerometer counts, minutes/day in light-intensity PA (LPA), moderate-to-vigorous PA (MVPA), and sedentary time, by categories of change in baPWV. Models were adjusted for time since baseline visit, age, sex, race, homeostatis model of assessment of insulin resistance, mean arterial pressure, heart rate, and weight change. Total accelerometer counts and time spent in MVPA increased from baseline to 12 months while time spent in LPA significantly decreased. Mean baPWV was similar at each time point. Those who showed decreased baPWV also showed an increase in total accelerometer counts per day and time spent in MVPA in the fully adjusted models (p<0.001). Changes in sedentary time and time spent in LPA were not associated with changes in baPWV. These results indicate that even modest increases in MVPA can reduce arterial stiffness, a risk factor for future cardiovascular events.
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Affiliation(s)
- Marquis Hawkins
- Division of Biostatistics & Epidemiology, Department of Public Health, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA
| | - Kelley P Gabriel
- Division of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Jennifer Cooper
- Nationwide Children's Hospital Research Institute, Columbus, OH, USA
| | - Kristi L Storti
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kim Sutton-Tyrrell
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA Co-author is deceased
| | - Andrea Kriska
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
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