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Ramos TDA, Medeiros CCM, Figueiroa JN, de Carvalho DF, Gusmão TME, Alves JGB. Effects of exergaming on the microcirculation of adolescents with overweight or obesity-a clinical trial efficacy. Appl Physiol Nutr Metab 2023; 48:379-385. [PMID: 36919852 DOI: 10.1139/apnm-2022-0335] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
To assess the effect of exergaming on the microcirculation function of adolescents with overweight or obesity, this non-randomized clinical trial efficacy was conducted with 61 adolescents aged between 10 and 16 years. The intervention group (n = 31) performed exergaming three times per week for 8 weeks. Both groups received guidelines for a healthy diet and staying physically active. Microcirculation was assessed using a laser Doppler flowmetry (LDF) at baseline and after intervention. Primary outcomes derived from LDF assessment included resting flow, maximum flow, maximum/resting flow ratio, area under hyperemia, and post-occlusive reactive hyperemia (PORH). Secondary outcomes were body mass index and systemic blood pressure. Unpaired Student's t test compared intergroup analyses, and paired Student's t test compared intragroup analyses. The significance was set at 5%. Statistical analysis intergroup and intragroup was done by fitting a two-way mixed effects model. Microcirculation was similar between groups. Maximum flow (109.0 ± 38.3 versus 124.6 ± 43.0, P = 0.022), area under hyperemia (1614 ± 472 versus. 1755 ± 461, P = 0.023), and PORH (2.18 ± 0.49 versus 2.01 ± 0.52, P = 0.031) were statistically different after intervention. Body mass index decreased in intervention (24.5 ± 3.8-24.1 ± 4.0 kg/m2, P = 0.002) and control (25.2 ± 3.2-25.1 ± 3.3 kg/m2, P = 0.031) groups. Systolic blood pressure decreased significantly in the intervention group (110 ± 10-106 ± 9 mm Hg; P = 0.041) but not diastolic blood pressure (66.0 ± 7-68.8 ± 8 mm Hg; P = 0.089). Exergaming for 8 weeks led to improvements in the microcirculation function in adolescents with overweighed or obesity. Clinical trials: NTC03532659.
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Affiliation(s)
- Thacira Dantas Almeida Ramos
- Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Department of Integral Medicine, Postgraduate Program in Integral Medicine, Recife, PE, Brazil.,UniFacisa, Departament of Medicine, Campina Grande, PB, Brazil
| | | | - José Natal Figueiroa
- Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Department of Integral Medicine, Postgraduate Program in Integral Medicine, Recife, PE, Brazil
| | | | - Tatianne Moura Estrela Gusmão
- Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Department of Integral Medicine, Postgraduate Program in Integral Medicine, Recife, PE, Brazil.,UniFacisa, Departament of Medicine, Campina Grande, PB, Brazil
| | - João Guilherme Bezerra Alves
- Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Department of Integral Medicine, Postgraduate Program in Integral Medicine, Recife, PE, Brazil
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Vág J, Nagy TL, Mikecs B. Sex-related differences in endothelium-dependent vasodilation of human gingiva. BMC Oral Health 2022; 22:177. [PMID: 35562729 PMCID: PMC9107103 DOI: 10.1186/s12903-022-02186-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 04/14/2022] [Indexed: 11/10/2022] Open
Abstract
Background Sex hormones influence circulation, periodontitis, and wound healing. The aim of the study was to compare the endothelium-dependent and independent vasodilation in human gingiva in men and women. Methods Gingival blood flow was evaluated in twelve male and twelve female subjects with healthy gingiva and no systemic conditions after acetylcholine or nitric oxide donor (NitroPOHL). Agonists were administered into the gingival sulcus at the right secondary incisor (test site). Regional gingival blood flow (GBF) was imaged by Laser Speckle Contrast Imager from the marginal gingiva to the mucogingival junction in four consecutive regions (coronal, midway1, midway2 and apical). Blood flow was expressed in Laser Speckle Perfusion Unit (LSPU). The absolute maximal blood flow change (Dmax), the area under the blood flow curve (AUC), and the time to peak (TTP) were calculated.
Results Males had higher baseline GBF than females (257 ± 18.2 vs. 225 ± 18.8 LSPU, p < 0.001). Acetylcholine and NitroPOHL significantly increased the GBF in all test regions. The Dmax after the acetylcholine was reduced apically compared to the coronal (90 ± 13 LSPU vs. 117 ± 7 LSPU, p < 0.01), but it was similar after NitroPOHL (78 ± 9 LSPU vs. 86 ± 6 LSPU, p = 0.398) in both sexes. The Dmax and AUC were higher, and the TTP was smaller in men in most regions after acetylcholine but not after NitroPOHL. Conclusion In the human gingiva, the endothelium-independent vasodilation propagates without attenuation in the line of the vascular supply in both sexes. At the same time, the endothelium-dependent ascending vasodilation attenuates similarly in men and women. However, men had more pronounced endothelium-dependent vasodilation than women. Therefore, it might contribute to the increased severity of periodontal disease in men. Trial registration The study was registered with ClinicalTrials.gov on 09.06.2021 (NCT04918563).
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Affiliation(s)
- János Vág
- Department of Conservative Dentistry, Faculty of Dentistry, Semmelweis University, Szentkirályi utca 47, Budapest, 1088, Hungary.
| | - Tamás László Nagy
- Department of Conservative Dentistry, Faculty of Dentistry, Semmelweis University, Szentkirályi utca 47, Budapest, 1088, Hungary
| | - Barbara Mikecs
- Department of Conservative Dentistry, Faculty of Dentistry, Semmelweis University, Szentkirályi utca 47, Budapest, 1088, Hungary
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Antioxidants and Oxidative Stress in Children: Influence of Puberty and Metabolically Unhealthy Status. Antioxidants (Basel) 2020; 9:antiox9070618. [PMID: 32679739 PMCID: PMC7402162 DOI: 10.3390/antiox9070618] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 07/01/2020] [Accepted: 07/13/2020] [Indexed: 02/07/2023] Open
Abstract
Oxidative stress could help explain the relationship between childhood obesity and a metabolically unhealthy (MU) status. Moreover, puberty could also influence this relationship, since it entails physiological cardiometabolic changes. We aimed to evaluate plasma antioxidants and oxidative stress biomarkers in MU and metabolically healthy (MH) prepubertal and pubertal children and their associations with pro-inflammatory and endothelial damage biomarkers, taking puberty into account. A total of 1444 Spanish children aged 3-17 years (48.9% males, 66% prepubertal, 47.1% with obesity) were recruited. Blood pressure, anthropometric and biochemical parameters were measured, and children were categorized as having a MU or MH status according to risk factors. Retinol, carotenes, tocopherols, total antioxidant capacity (TAC), oxidized low-density lipoprotein and selected pro-inflammatory and endothelial damage biomarkers were analyzed. General linear models adjusted for age, sex, recruitment center and body mass index, partial correlations and stepwise linear regressions were performed. Lower carotenes and tocopherols levels were found in MU than in MH children. Plasma TAC was lower in prepubertal and higher in pubertal children with obesity compared to normal-weight children. Antioxidants and oxidative stress biomarkers showed novel associations with several pro-inflammatory and endothelial damage biomarkers, with pubertal differences, supporting the importance of considering both the antioxidant and oxidative stress status and puberty in the prevention of metabolic diseases in childhood.
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Radman M, McGuire J, Zimmerman J. Childhood Obesity, Endothelial Cell Activation, and Critical Illness. Front Pediatr 2020; 8:441. [PMID: 32850554 PMCID: PMC7419464 DOI: 10.3389/fped.2020.00441] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 06/25/2020] [Indexed: 12/13/2022] Open
Abstract
Pediatric obesity is increasing in prevalence and is frequently an antecedent to adult obesity and adult obesity-associated morbidities such as atherosclerosis, type II diabetes, and chronic metabolic syndrome. Endothelial cell activation, one aspect of inflammation, is present in the early stages of atherosclerosis, often prior to the onset of symptoms. Endothelial activation is a pathological condition in which vasoconstricting, pro-thrombotic, and proliferative mediators predominate protective vasodilating, anti-thrombogenic, and anti-mitogenic mediators. Many studies report poor outcomes among obese children with systemic endothelial activation. Likewise, the link between childhood obesity and poor outcomes in critical illness is well-established. However, the link between obesity and severity of endothelial activation specifically in the setting of critical illness is largely unstudied. Although endothelial cell activation is believed to worsen disease in critically ill children, the nature and extent of this response is poorly understood due to the difficulty in measuring endothelial cell dysfunction and destruction. Based on the data available for the obese, asymptomatic population and the obese, critically ill population, the authors posit that obesity, and obesity-associated chronic inflammation, including oxidative stress and insulin resistance, may contribute to endothelial activation and associated worse outcomes among critically ill children. A research agenda to examine this hypothesis is suggested.
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Affiliation(s)
- Monique Radman
- Seattle Children's Hospital, Pediatric Critical Care, University of Washington, Seattle, WA, United States
| | - John McGuire
- Seattle Children's Hospital, Pediatric Critical Care, University of Washington, Seattle, WA, United States
| | - Jerry Zimmerman
- Seattle Children's Hospital, Pediatric Critical Care, University of Washington, Seattle, WA, United States
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Pediatric Hypertension: Impact on the Heart, Brain, Kidney, and Retina. CURRENT CARDIOVASCULAR RISK REPORTS 2018. [DOI: 10.1007/s12170-018-0577-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Hedvall Kallerman P, Hagman E, Edstedt Bonamy AK, Zemack H, Marcus C, Norman M, Westerståhl M. Obese children without comorbidities have impaired microvascular endothelial function. Acta Paediatr 2014; 103:411-7. [PMID: 24372596 DOI: 10.1111/apa.12549] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Revised: 12/04/2013] [Accepted: 12/18/2013] [Indexed: 01/18/2023]
Abstract
AIM The aim was to test acetylcholine-induced endothelium-dependent vasodilatation in obese children without comorbidities, compared with normal weight controls, and to analyse associations between vasodilatation and other potential risk factors. METHODS Endothelium-dependent vasodilatation was induced by transdermal iontophoresis of acetylcholine in 54 obese children (8.3-18.2 years old, 41% girls) and 44 normal weight controls (7.5-20.2 years old, 82% girls), and the subsequent change in perfusion was measured with laser Doppler flowmetry. In a subgroup of the obese children, associations between acetylcholine-induced vasodilatation and blood lipids, glucose/insulin metabolism, inflammation, 24-h ambulatory blood pressure (ABP), cardiovascular fitness and duration of obesity were evaluated. RESULTS We found a lower endothelium-dependent vasodilatory response to acetylcholine in the obese children than the controls (p < 0.001). The peak perfusion response was 33% lower in obese children (p = 0.001). There was a trend towards lower vasodilatation in obese children with higher levels of triglycerides (p = 0.07). Children with the shortest duration of obesity exhibited the lowest vasodilatation (p = 0.03). No associations were found between 24-h ABP, cardiovascular fitness, inflammation and glucose/insulin metabolism. CONCLUSION Obese children without comorbidities have significantly impaired microvascular endothelial function. The children who had been obese for a longer time seemed less affected.
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Affiliation(s)
- P Hedvall Kallerman
- Divisions of Pediatrics; Department of Clinical Science, Intervention and Technology; Karolinska Institutet; Stockholm Sweden
| | - E Hagman
- Divisions of Pediatrics; Department of Clinical Science, Intervention and Technology; Karolinska Institutet; Stockholm Sweden
| | - A-K Edstedt Bonamy
- Department of Women's and Children's Health; Karolinska Institutet; Stockholm Sweden
| | - H Zemack
- Divisions of Pediatrics; Department of Clinical Science, Intervention and Technology; Karolinska Institutet; Stockholm Sweden
| | - C Marcus
- Divisions of Pediatrics; Department of Clinical Science, Intervention and Technology; Karolinska Institutet; Stockholm Sweden
- National Childhood Obesity Center; Karolinska University Hospital Huddinge; Stockholm Sweden
| | - M Norman
- Divisions of Pediatrics; Department of Clinical Science, Intervention and Technology; Karolinska Institutet; Stockholm Sweden
| | - M Westerståhl
- Divisions of Pediatrics; Department of Clinical Science, Intervention and Technology; Karolinska Institutet; Stockholm Sweden
- Division of Clinical Physiology; Department of Laboratory Medicine; Karolinska Institutet; Stockholm Sweden
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Matsuo Y, Oberbach A, Till H, Inge TH, Wabitsch M, Moss A, Jehmlich N, Völker U, Müller U, Siegfried W, Kanesawa N, Kurabayashi M, Schuler G, Linke A, Adams V. Impaired HDL function in obese adolescents: impact of lifestyle intervention and bariatric surgery. Obesity (Silver Spring) 2013; 21:E687-95. [PMID: 23804534 DOI: 10.1002/oby.20538] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Revised: 04/12/2013] [Accepted: 06/03/2013] [Indexed: 12/15/2022]
Abstract
OBJECTIVE HDL regulates endothelial function via stimulation of nitric oxide production. It is documented that endothelial function is impaired in obese adolescents, and improved by lifestyle interventions (LI). DESIGN AND METHODS HDL function in obese adolescents and the impact of LI or Roux-en-Y gastric bypass surgery (RYGB) was assessed. HDL was isolated from 14 adolescents with normal body mass index (HDLcontrol ), 10 obese (HDLobese ) before and after 6 month LI, and five severe obese adolescents before and one year after RYGB. HDL-mediated phosphorylation of endothelial nitric oxide synthase (eNOS)-Ser(1177) , eNOS-Thr(495) , and PKC-ßII was evaluated. In addition the HDL proteome was analyzed. RESULTS HDLobese -mediated eNOS-Ser(1177) phosphorylation was reduced, whereas eNOS-Thr(495) phosphorylation increased significantly when compared to HDLcontrol . No impact of obesity was observed on PKC-ßII phosphorylation. LI and RYGB had no impact on HDL-mediated phosphorylation of eNOS and PKC-ßII. A principle component plot analysis of the HDL particle separated controls and severe obese, whereas the interventions did not trigger sufficient differences to the HDL proteome to permit distinction. CONCLUSION These results demonstrated that HDL-function is impaired in obese adolescents, and that LI or RYGB did not correct this dysfunction. This might be an argument for developing earlier prevention strategies in obese adolescents to avoid HDL dysfunction.
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Affiliation(s)
- Yae Matsuo
- University Leipzig-Heart Center Leipzig, Department of Cardiology, Leipzig, Germany; Takasaki General Medical Center, Division of Cardiology, Takasaki, Japan; Gunma University School of Medicine, Department of Cardiology, Maebashi, Japan
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Montero D, Walther G, Perez-Martin A, Roche E, Vinet A. Endothelial dysfunction, inflammation, and oxidative stress in obese children and adolescents: markers and effect of lifestyle intervention. Obes Rev 2012; 13:441-55. [PMID: 22133012 DOI: 10.1111/j.1467-789x.2011.00956.x] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
With an increasing prevalence, pediatric obesity is often a prelude to adulthood obesity, and represents a major public health issue. Comorbidities are very common and severe in obese adults, justifying the search for earlier markers or risk factors for cardiovascular diseases in obese children. Endothelial dysfunction has been found to be present in the early stages of atherosclerosis, and can be non-invasively assessed with widely accepted and well-standardized techniques at the macrocirculation level. Endothelial dysfunction at the microcirculation level is less documented in obese children. Obesity in children has been repeatedly and independently correlated to endothelial dysfunction, inflammation and oxidative stress markers, although the relationship between these factors remains to be investigated. However, this would not only allow substantial improvements in risk stratification, but also provide essential data regarding the evolution of endothelial dysfunction in childhood obesity, especially during puberty when pro-inflammatory and pro-oxidative changes, with relative insulin resistance, occur. Therapeutic strategies such as lifestyle interventions in early childhood obesity appear all the more necessary, optimally including both exercise and diet because of their known effects on inflammatory and oxidative stress markers, potentially reversing endothelial dysfunction.
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Affiliation(s)
- D Montero
- Pharm-Ecology Cardiovascular Laboratory, Faculty of Sciences, Avignon, France
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Shantsila A, Dwivedi G, Shantsila E, Butt M, Beevers DG, Lip GY. Persistent Macrovascular and Microvascular Dysfunction in Patients With Malignant Hypertension. Hypertension 2011; 57:490-6. [DOI: 10.1161/hypertensionaha.110.166314] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Alena Shantsila
- From the University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, United Kingdom
| | - Girish Dwivedi
- From the University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, United Kingdom
| | - Eduard Shantsila
- From the University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, United Kingdom
| | - Mehmood Butt
- From the University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, United Kingdom
| | - D. Gareth Beevers
- From the University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, United Kingdom
| | - Gregory Y.H. Lip
- From the University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, United Kingdom
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