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Saxton SN, Toms LK, Aldous RG, Withers SB, Ohanian J, Heagerty AM. Restoring Perivascular Adipose Tissue Function in Obesity Using Exercise. Cardiovasc Drugs Ther 2021; 35:1291-1304. [PMID: 33687595 PMCID: PMC8578065 DOI: 10.1007/s10557-020-07136-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/21/2020] [Indexed: 12/24/2022]
Abstract
Purpose Perivascular adipose tissue (PVAT) exerts an anti-contractile effect which is vital in regulating vascular tone. This effect is mediated via sympathetic nervous stimulation of PVAT by a mechanism which involves noradrenaline uptake through organic cation transporter 3 (OCT3) and β3-adrenoceptor-mediated adiponectin release. In obesity, autonomic dysfunction occurs, which may result in a loss of PVAT function and subsequent vascular disease. Accordingly, we have investigated abnormalities in obese PVAT, and the potential for exercise in restoring function. Methods Vascular contractility to electrical field stimulation (EFS) was assessed ex vivo in the presence of pharmacological tools in ±PVAT vessels from obese and exercised obese mice. Immunohistochemistry was used to detect changes in expression of β3-adrenoceptors, OCT3 and tumour necrosis factor-α (TNFα) in PVAT. Results High fat feeding induced hypertension, hyperglycaemia, and hyperinsulinaemia, which was reversed using exercise, independent of weight loss. Obesity induced a loss of the PVAT anti-contractile effect, which could not be restored via β3-adrenoceptor activation. Moreover, adiponectin no longer exerts vasodilation. Additionally, exercise reversed PVAT dysfunction in obesity by reducing inflammation of PVAT and increasing β3-adrenoceptor and OCT3 expression, which were downregulated in obesity. Furthermore, the vasodilator effects of adiponectin were restored. Conclusion Loss of neutrally mediated PVAT anti-contractile function in obesity will contribute to the development of hypertension and type II diabetes. Exercise training will restore function and treat the vascular complications of obesity. Supplementary Information The online version contains supplementary material available at 10.1007/s10557-020-07136-0.
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Affiliation(s)
- Sophie N Saxton
- Division of Cardiovascular Sciences, University of Manchester, Manchester, UK
- The Lydia Becker Institute of Immunology & Inflammation, University of Manchester, Manchester, UK
| | - Lauren K Toms
- Division of Cardiovascular Sciences, University of Manchester, Manchester, UK
| | | | - Sarah B Withers
- Division of Cardiovascular Sciences, University of Manchester, Manchester, UK
- The Lydia Becker Institute of Immunology & Inflammation, University of Manchester, Manchester, UK
- School of Science, Engineering and Environment, University of Salford, Salford, UK
| | - Jacqueline Ohanian
- Division of Cardiovascular Sciences, University of Manchester, Manchester, UK
| | - Anthony M Heagerty
- Division of Cardiovascular Sciences, University of Manchester, Manchester, UK.
- The Lydia Becker Institute of Immunology & Inflammation, University of Manchester, Manchester, UK.
- Division of Cardiovascular Sciences, Manchester Academic Health Science Centre, Core Technology Facility (3rd floor), 46 Grafton Street, Manchester, M13 9NT, UK.
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DeBoer MD, Filipp SL, Gurka MJ. Use of a Metabolic Syndrome Severity Z Score to Track Risk During Treatment of Prediabetes: An Analysis of the Diabetes Prevention Program. Diabetes Care 2018; 41:2421-2430. [PMID: 30275282 PMCID: PMC6196828 DOI: 10.2337/dc18-1079] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 08/10/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE We assessed whether changes in metabolic syndrome (MetS) severity during the treatment of prediabetes are associated with reduced risk of type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). RESEARCH DESIGN AND METHODS We analyzed data from the Diabetes Prevention Program (DPP) for 2,476 adults in 1996-1999 with prediabetes randomized to receive treatment with lifestyle modification, metformin, or placebo for 2-3 years and followed through 2014 for T2DM and CVD outcomes. We calculated effect sizes from baseline in a MetS severity z score (MetS-Z) and the individual MetS components, and assessed relationships between 1-year effect size and incident T2DM and CVD using hazard ratios (HRs) and mediation analysis. RESULTS Baseline MetS-Z and its components were associated with risk of incident T2DM and CVD. During year 1 of intervention, MetS-Z and its components decreased most with lifestyle modification, followed by treatment with metformin and placebo. Risk of T2DM within 1-5 years was most strongly associated with 1-year changes in MetS-Z and waist circumference (both HRs for a 1 SD increase = 1.80), whereas the risk of CVD was associated with a 1-year change in MetS-Z, glucose, and systolic blood pressure. In mediation analyses, the effect of lifestyle modification on T2DM risk was mediated by 1-year changes in MetS-Z, waist circumference, glucose, and triglycerides, whereas the effect of metformin was mediated by MetS-Z and glucose. CONCLUSIONS Changes in these risk indicators of MetS severity during intervention in the DPP reflect altered disease risk and may help in tracking earlier responses to treatment and in motivating patients.
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Affiliation(s)
- Mark D DeBoer
- Department of Pediatrics, University of Virginia, Charlottesville, VA
| | - Stephanie L Filipp
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL
| | - Matthew J Gurka
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL
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Gurka MJ, Filipp SL, Musani SK, Sims M, DeBoer MD. Use of BMI as the marker of adiposity in a metabolic syndrome severity score: Derivation and validation in predicting long-term disease outcomes. Metabolism 2018; 83:68-74. [PMID: 29410278 PMCID: PMC5960618 DOI: 10.1016/j.metabol.2018.01.015] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 12/14/2017] [Accepted: 01/17/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Estimates of adiposity in evaluating the metabolic syndrome (MetS) have traditionally utilized measures of waist circumference (WC), whereas body mass index (BMI) is more commonly used clinically. Our objective was to determine if a MetS severity Z-score employing BMI as its measure of adiposity (MetS-Z-BMI) would perform similarly to a WC-based score (MetS-Z-WC) in predicting future disease. METHODS To formulate the MetS-Z-BMI, we performed confirmatory factor analysis on a sex- and race/ethnicity-specific basis on MetS-related data for 6870 adult participants of the National Health and Nutrition Survey 1999-2010. We then validated this score and compared it to MetS-Z-WC in assessing correlations with future coronary heart disease (CHD) and Type 2 diabetes mellitus (T2DM) using Cox proportional hazard analysis of 13,094 participants of the Atherosclerosis Risk in Communities study and Jackson Heart Study. RESULTS Loading factors, which represent the relative contribution of each component to the latent MetS factor, were lower for BMI than for WC in formulating the two respective scores (MetS-Z-BMI and MetS-Z-WC). Nevertheless, MetS-Z-BMI and MetS-Z-WC exhibited similar hazard ratios (HR) toward future disease. For each one standard-deviation-unit increase in MetS-Z-BMI, HR for CHD was 1.76 (95% confidence interval [CI]: 1.65, 1.88) and HR for T2DM was 3.39 (CI 3.16, 3.63) (both p < 0.0001). There were no meaningful differences between the MetS-Z-WC and MetS-Z-BMI scores in their associations with future CHD and T2DM. CONCLUSIONS A MetS severity Z-score utilizing BMI as its measure of adiposity operated similarly to a WC-based score in predicting future CHD and T2DM, suggesting overall similarity in MetS-based risk as estimated by both measures of adiposity. This indicates potential clinical usefulness of MetS-Z-BMI in assessing and following MetS-related risk over time.
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Affiliation(s)
- Matthew J Gurka
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida 32608, United States.
| | - Stephanie L Filipp
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida 32608, United States
| | - Solomon K Musani
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39213, United States
| | - Mario Sims
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39213, United States
| | - Mark D DeBoer
- Department of Pediatrics, Division of Pediatric Endocrinology, PO Box 800386, University of Virginia, Charlottesville, Virginia 22908, United States
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Vilmi-Kerälä T, Koivistoinen T, Palomäki O, Uotila J, Palomäki A. Arterial stiffness in fertile women with metabolic syndrome. Ann Med 2017; 49:636-643. [PMID: 28590772 DOI: 10.1080/07853890.2017.1339907] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION Although metabolic syndrome (MetS) is evidently associated with the risk of cardiovascular disease (CVD), recently its use has been questioned. We studied the utility of MetS diagnosis when estimating individual CVD risk. METHODS We compared 27 fertile women with MetS and 27 counterparts without the syndrome, matched pairwise according to well-known risk factors of CVD. Pulse wave velocity (PWV) and central blood pressure (cBP) were determined noninvasively via a SphygmoCor device. Arterial compliance was measured noninvasively with an HDI/PulseWaveTMCR-2000 arterial tonometer. RESULTS PWV (7.1 ± 2.5 versus 6.5 ± 1.1 m/s, p = .037), and both systolic (120.9 ± 12.2 versus 111.5 ± 16.0 mmHg, p = .031) and diastolic cBP (81.3 ± 8.5 versus 74.1 ± 11.2 mmHg, p = .035) were higher in the MetS group. Systemic arterial compliance values were lower in both large (15.1 ± 8.0 versus 16.1 ± 4.4 mL/mmHg × 10, p = .034) and small arteries (7.1 ± 2.5 versus 9.3 ± 3.2 mL/mmHg ×100, p = .010) in women with MetS. CONCLUSIONS Fertile women with MetS had increased arterial stiffness, as measured by three different methods. Our results highlight the utility of MetS when revealing increased individual CVD risks in fertile-aged women. Key messages Women with MetS have increased arterial stiffness when measured by different methods. MetS is a useful clinical tool to assess increased cardiovascular risk, particularly among fertile-aged women.
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Affiliation(s)
- Tiina Vilmi-Kerälä
- a Faculty of Medicine and Life Sciences , University of Tampere , Tampere , Finland.,b Department of Obstetrics and Gynecology , Tampere University Hospital , Tampere , Finland
| | - Teemu Koivistoinen
- c Department of Emergency Medicine , Kanta-Häme Central Hospital , Hämeenlinna , Finland
| | - Outi Palomäki
- b Department of Obstetrics and Gynecology , Tampere University Hospital , Tampere , Finland
| | - Jukka Uotila
- a Faculty of Medicine and Life Sciences , University of Tampere , Tampere , Finland.,b Department of Obstetrics and Gynecology , Tampere University Hospital , Tampere , Finland
| | - Ari Palomäki
- a Faculty of Medicine and Life Sciences , University of Tampere , Tampere , Finland.,c Department of Emergency Medicine , Kanta-Häme Central Hospital , Hämeenlinna , Finland.,d Cardiometabolic Unit , Linnan Klinikka , Hämeenlinna , Finland
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Brudecki J, Chrzanowska M. Anthropometric indicators as predictors of the risk of metabolic syndrome in adult working men. ANTHROPOLOGICAL REVIEW 2015. [DOI: 10.1515/anre-2015-0005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Measurement of body weight, height, waist and hip circumference is a standard procedure that allows to better define the risk of metabolic syndrome.
The aim of the study is to determine the usefulness of anthropometric indicators such as BMI, WC (waist circumference), WHR, WHtR and percentage of body fat to predict the metabolic cardiovascular risk in the adult male population of Krakow, as well as an attempt to determine the metabolic cardiovascular risk with the original anthropometric risk index.
The study included 405 men from the population working in the T. Sendzimir Steelworks in Kraków at the age of 30-69 years. Anthropometric measurements: body height measured to the nearest mm, circuits (waist, hips) measured to the nearest centimetre, the percentage of fat (the type of electronic scales Tanita BF 300) measured according to the standard protocol by the same technician and biomedical indicators assessing the functional status of organism, total cholesterol, HDL, LDL, triglycerides, glucose and blood pressure measured with a mercury manometer.
As a measure of goodness of fit for the indices of risk (and their components), the AUC method was used for the ROC curves to evaluate the sensitivity and specificity of the diagnostic test.
The results show that significant in predicting the risk of metabolic syndrome are not only standard anthropometric measurements specified in the standards of WHO, EGIR, NCEP and IDF. In addition, it is important to take into account the amount of fat and calculate the cumulative risk index based on all relevant measurements and indicators.
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Affiliation(s)
- Janusz Brudecki
- Faculty of Physical Education and Sport, Department of Anthropology, University of Physical Education in Kraków
| | - Maria Chrzanowska
- Faculty of Physical Education and Sport, Department of Anthropology, University of Physical Education in Kraków
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Zhou X, Han D, Xu R, Li S, Wu H, Qu C, Wang F, Wang X, Zhao Y. A model of metabolic syndrome and related diseases with intestinal endotoxemia in rats fed a high fat and high sucrose diet. PLoS One 2014; 9:e115148. [PMID: 25502558 PMCID: PMC4263741 DOI: 10.1371/journal.pone.0115148] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Accepted: 11/19/2014] [Indexed: 12/17/2022] Open
Abstract
AIM We sought develop and characterize a diet-induced model of metabolic syndrome and its related diseases. METHODS The experimental animals (Spague-Dawley rats) were randomly divided into two groups, and each group was fed a different feed for 48 weeks as follows: 1) standard control diet (SC), and 2) a high sucrose and high fat diet (HSHF). The blood, small intestine, liver, pancreas, and adipose tissues were sampled for analysis and characterization. RESULTS Typical metabolic syndrome (MS), non-alcoholic fatty liver disease (NAFLD), and type II diabetes (T2DM) were common in the HSHF group after a 48 week feeding period. The rats fed HSHF exhibited signs of obesity, dyslipidemia, hyperglycaemia, glucose intolerance, and insulin resistance (IR). At the same time, these animals had significantly increased levels of circulating LPS, TNFα, and IL-6 and increased ALP in their intestinal tissue homogenates. These animals also showed a significant reduction in the expression of occluding protein. The HSHF rats showed fatty degeneration, inflammation, fibrosis, cirrhosis, and lipid accumulation when their liver pathologies were examined. The HSHF rats also displayed increased islet diameters from 12 to 24 weeks, while reduced islet diameters occurred from 36 to 48 weeks with inflammatory cell infiltration and islet fat deposition. The morphometry of adipocytes in HSHF rats showed hypertrophy and inflammatory cell infiltration. HSHF CD68 analysis showed macrophage infiltration and significant increases in fat and pancreas size. HSHF Tunel analysis showed significant increases in liver and pancreas cell apoptosis. CONCLUSIONS This work demonstrated the following: 1) a characteristic rat model of metabolic syndrome (MS) can be induced by a high sucrose and high fat diet, 2) this model can be used to research metabolic syndrome and its related diseases, such as NAFLD and T2DM, and 3) intestinal endotoxemia (IETM) may play an important role in the pathogenesis of MS and related diseases, such as NAFLD and T2DM.
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Affiliation(s)
- Xin Zhou
- Department of Pathophysiology, Basic Medical Science, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Dewu Han
- Department of Pathophysiology, Basic Medical Science, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
- * E-mail:
| | - Ruiling Xu
- Department of Pathophysiology, Basic Medical Science, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Suhong Li
- Department of Pathology, Shanxi Tumor Hospital, Taiyuan, 030013, Shanxi, China
| | - Huiwen Wu
- Department of Pathophysiology, Basic Medical Science, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
- Science & technology center of Fenyang College, Shanxi Medical University, Fenyang 032200, Shanxi, China
| | - Chongxiao Qu
- Department of Pathology, Shanxi Provincial People's Hospital, Taiyuan, 030012, Shanxi, China
| | - Feng Wang
- Department of Pathophysiology, Basic Medical Science, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Xiangyu Wang
- Department of Oral Medicine, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Yuanchang Zhao
- Department of Pathophysiology, Basic Medical Science, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
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Panchal SK, Brown L. Rodent models for metabolic syndrome research. J Biomed Biotechnol 2010; 2011:351982. [PMID: 21253582 PMCID: PMC3018657 DOI: 10.1155/2011/351982] [Citation(s) in RCA: 236] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2010] [Revised: 12/01/2010] [Accepted: 12/02/2010] [Indexed: 02/07/2023] Open
Abstract
Rodents are widely used to mimic human diseases to improve understanding of the causes and progression of disease symptoms and to test potential therapeutic interventions. Chronic diseases such as obesity, diabetes and hypertension, together known as the metabolic syndrome, are causing increasing morbidity and mortality. To control these diseases, research in rodent models that closely mimic the changes in humans is essential. This review will examine the adequacy of the many rodent models of metabolic syndrome to mimic the causes and progression of the disease in humans. The primary criterion will be whether a rodent model initiates all of the signs, especially obesity, diabetes, hypertension and dysfunction of the heart, blood vessels, liver and kidney, primarily by diet since these are the diet-induced signs in humans with metabolic syndrome. We conclude that the model that comes closest to fulfilling this criterion is the high carbohydrate, high fat-fed male rodent.
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Affiliation(s)
- Sunil K. Panchal
- Department of Biological and Physical Sciences, University of Southern Queensland, Toowoomba, QLD 4350, Australia
| | - Lindsay Brown
- Department of Biological and Physical Sciences, University of Southern Queensland, Toowoomba, QLD 4350, Australia
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Ozer JS, Reagan WJ, Schomaker S, Palandra J, Baratta M, Ramaiah S. Translational Biomarkers of Acute Drug‐Induced Liver Injury: The Current State, Gaps, and Future Opportunities. Biomarkers 2010. [DOI: 10.1002/9780470918562.ch9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Metabolic Syndrome and Risk of Acute Myocardial Infarction. J Am Coll Cardiol 2010; 55:2390-8. [DOI: 10.1016/j.jacc.2009.12.053] [Citation(s) in RCA: 164] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2009] [Revised: 12/14/2009] [Accepted: 12/17/2009] [Indexed: 11/21/2022]
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Ozer JS, Chetty R, Kenna G, Palandra J, Zhang Y, Lanevschi A, Koppiker N, Souberbielle BE, Ramaiah SK. Enhancing the utility of alanine aminotransferase as a reference standard biomarker for drug-induced liver injury. Regul Toxicol Pharmacol 2010; 56:237-46. [DOI: 10.1016/j.yrtph.2009.11.001] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2009] [Revised: 10/28/2009] [Accepted: 11/03/2009] [Indexed: 12/18/2022]
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