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Escobar S, Peçanha D, Duque M, Duque A, Crahim V, De Lorenzo A, Tibiriçá E. Evaluation of systemic endothelial-dependent and endothelial-independent microvascular reactivity in metabolically healthy obesity: An observational study. Microvasc Res 2023:104553. [PMID: 37230166 DOI: 10.1016/j.mvr.2023.104553] [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: 01/05/2023] [Revised: 05/18/2023] [Accepted: 05/19/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND Metabolically healthy obesity (MHO), a phenotype of obesity considered to be of lower cardiovascular risk, is still a controversial concept. This study aimed to investigate the presence of subclinical systemic microvascular dysfunction in individuals with MHO. METHODS This was a cross-sectional study in which 112 volunteers were allocated into three groups: metabolically healthy normal weight (MHNW), MHO, or metabolically unhealthy obesity (MUO). Obesity was defined as a body mass index (BMI) ≥ 30 kg/m2. MHO was defined as the absence of any component of metabolic syndrome, except waist circumference. Microvascular reactivity was evaluated using cutaneous laser speckle contrast imaging. RESULTS Mean age was 33.2 ± 7.66 years. The median BMI in the MHNW, MHO and MUO groups was 23.6, 32.8, and 35.8 kg/m2, respectively. Baseline microvascular conductance values were lower in the MUO group (0.25 ± 0.08 APU/mmHg) than in MHO (0.30 ± 0.10 APU/mmHg) and MHNW groups (0.33 ± 0.12 APU/mmHg) (P = 0.0008). There were no significant differences regarding endothelial-dependent (acetylcholine stimulation or postocclusive reactive hyperemia) or endothelial-independent (sodium nitroprusside stimulation) microvascular reactivity among the groups. CONCLUSIONS Individuals with MUO had lower baseline systemic microvascular flow than those with MHNW or MHO, but endothelium-dependent or endothelium-independent microvascular reactivity were not changed in any of the groups. The relatively young age of the study population, the low frequency of class III obesity, or the strict definition of MHO (absence of any metabolic syndrome criteria) might account for the lack of difference of microvascular reactivity among MHNW, MHO or MUO.
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Affiliation(s)
- Silas Escobar
- National Institute of Cardiology, Rio de Janeiro, Brazil
| | | | - Maíra Duque
- National Institute of Cardiology, Rio de Janeiro, Brazil
| | - Alice Duque
- National Institute of Cardiology, Rio de Janeiro, Brazil
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Obesity blunts cephalic-phase microvascular responses to food. Physiol Behav 2020; 225:113087. [PMID: 32707159 DOI: 10.1016/j.physbeh.2020.113087] [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: 11/28/2019] [Revised: 07/09/2020] [Accepted: 07/17/2020] [Indexed: 11/22/2022]
Abstract
Neurally mediated anticipatory responses, also named cephalic-phase responses, and microcirculatory regulation are two important mechanisms to maintain metabolic homeostasis. Altered cephalic-phase responses in obesity and its metabolic consequences have been proposed. There is, however, a lack of studies focusing on in vivo assessment of the microcirculation during this phase in patients with obesity. In this randomized controlled trial, we selected patients with obesity and healthy subjects after clinical and laboratory assessments. Those with obesity were randomized into two groups: experimental (cephalic-phase microvascular response stimulation - CP group, n = 13) and controls (n = 14). Healthy subjects (n = 17) were also included to form a CP control group. Skin microvascular assessment was used as a model of systemic microcirculation. Resting functional capillary density (FCD) and peak FCD during post-occlusive reactive hyperemia (PORH) were measured by dorsal finger videocapillaroscopy and expressed mainly capillary recruitment capacity. Resting red blood cell velocity (RBCV), peak RBCV during PORH (RBCVmax), and time taken to reach RBCVmax (TRBCVmax) were assessed by dynamic nailfold videocapillaroscopy and expressed the microhemodynamics. Patients with obesity (with or without stimulus) failed to show an increase on FCD during PORH post-stimulus (p = 0.221 and p = 0.307, respectively) depicting lack of capillary recruitment. In contrast, healthy subjects presented an increase in this microvascular outcome (p = 0.004). Changes in all variables of microhemodynamics occurred in both CP groups (healthy and those with obesity). During CP, we originally demonstrated an absence of capillary recruitment in subjects with obesity. These findings might contribute to the literature of microvascular impairment and metabolic conditions.
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Sousa‐Sá E, Zhang Z, Pereira JR, Wright IM, Okely AD, Santos R. Systematic review on retinal microvasculature, physical activity, sedentary behaviour and adiposity in children and adolescents. Acta Paediatr 2020; 109:1956-1973. [PMID: 31998981 DOI: 10.1111/apa.15204] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 01/16/2020] [Accepted: 01/28/2020] [Indexed: 12/14/2022]
Abstract
AIM As retinal microvasculature (RMV) can be assessed non-invasively, it presents an opportunity to examine the health and disease of the human microcirculation, as RMV alterations have been recognised as one of the earliest signs of cardiovascular risk. This review summarises current literature on the associations between physical activity (PA), sedentary behaviour (SB) and/or adiposity and RMV in children and adolescents aged 0-18 years. METHODS Six databases were searched (MEDLINE, Scopus, Web of Science, ScienceDirect, PsycINFO and CINAHL), through to December 11, 2019. English, Portuguese, French, Spanish or Dutch were the languages searched. Meta-analyses were performed using the meta-analyst software. RESULTS A total of 6796 studies were screened, and 26 studies were included, representing 24 448 participants, from 12 different countries. Studies reporting results on weight status were twenty-three, PA was assessed in six studies, and SB was assessed in three studies. Four studies examined weight status and PA/SB. Meta-analysis was performed for two studies and showed that children with obesity have smaller retinal arterioles (-2.38 µm difference, 95% CI 0.62, 4.15 µm) and larger retinal venules (2.74 µm difference, 95% CI -4.78, -0.72 µm) than children without obesity. CONCLUSION Results showed that adiposity was associated with microvascular alterations in children and adolescents. Increased adiposity, lack of PA and high levels of SB were negatively correlated with vessel width parameters.
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Affiliation(s)
- Eduarda Sousa‐Sá
- Early Start University of Wollongong Wollongong NSW Australia
- Illawarra Health and Medical Research Institute Wollongong NSW Australia
| | - Zhiguang Zhang
- Early Start University of Wollongong Wollongong NSW Australia
| | - João R. Pereira
- Early Start University of Wollongong Wollongong NSW Australia
- Research Unit for Sport and Physical Activity University of Coimbra Coimbra Portugal
| | - Ian M. Wright
- Illawarra Health and Medical Research Institute Wollongong NSW Australia
| | - Anthony D. Okely
- Early Start University of Wollongong Wollongong NSW Australia
- Illawarra Health and Medical Research Institute Wollongong NSW Australia
| | - Rute Santos
- Early Start University of Wollongong Wollongong NSW Australia
- Research Centre in Physical Activity, Health and Leisure University of Porto Porto Portugal
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Wang CH, Chang WT, Huang CH, Tsai MS, Lu TC, Chou E, Wu YW, Chen WJ. Associations between Central Obesity and Outcomes of Adult In-hospital Cardiac Arrest: A Retrospective Cohort Study. Sci Rep 2020; 10:4604. [PMID: 32165678 PMCID: PMC7067829 DOI: 10.1038/s41598-020-61426-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 02/24/2020] [Indexed: 01/15/2023] Open
Abstract
To investigate the association between central obesity and outcomes following in-hospital cardiac arrest (IHCA). A single-centred retrospective study was conducted. Adult patients that experienced IHCA during 2006-2015 were screened. Body mass index (BMI) was calculated at hospital admission. Central obesity-related anthropometric parameters were measured by analysing computed tomography images. A total of 648 patients were included, with mean BMI of 23.0 kg/m2. The proportions of BMI-defined obesity in this cohort were underweight (13.1%), normal weight (41.4%), overweight (31.5%) and obesity (14.0%). The mean waist circumference was 85.9 cm with mean waist-to-height ratio (WHtR) of 0.53. The mean sagittal abdominal diameter was 21.2 cm with mean anterior and posterior abdominal subcutaneous adipose tissue (SAT) depths of 1.6 and 2.0 cm, respectively. Multivariate logistic regression analyses indicated BMI of 11.7-23.3 kg/m2 (odds ratio [OR]: 2.53, 95% confidence interval [CI]: 1.10-5.85; p-value = 0.03), WHtR of 0.49-0.59 (OR: 3.45, 95% CI: 1.56-7.65; p-value = 0.002) and anterior abdominal SAT depth <1.9 cm (OR: 2.84, 95% CI: 1.05-7.74; p-value = 0.04) were positively associated with the favourable neurological outcome. Central obesity was associated with poor IHCA outcomes, after adjusting for the effects of BMI.
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Affiliation(s)
- Chih-Hung Wang
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Emergency Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Wei-Tien Chang
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Emergency Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chien-Hua Huang
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Emergency Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Min-Shan Tsai
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Emergency Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Tsung-Chien Lu
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Emergency Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Eric Chou
- Department of Emergency Medicine, Baylor Scott & White All Saints Medical Center, Fort Worth, Texas, USA
| | - Yen-Wen Wu
- Departments of Internal Medicine and Nuclear Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Nuclear Medicine and Cardiology Division of Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- National Yang-Ming University School of Medicine, Taipei, Taiwan
| | - Wen-Jone Chen
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan.
- Department of Emergency Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
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Maranhão PA, de Souza MDGC, Panazzolo DG, Nogueira Neto JF, Bouskela E, Kraemer-Aguiar LG. Metabolic Changes Induced by High-Fat Meal Evoke Different Microvascular Responses in Accordance with Adiposity Status. BIOMED RESEARCH INTERNATIONAL 2018; 2018:5046508. [PMID: 30515403 PMCID: PMC6236900 DOI: 10.1155/2018/5046508] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 10/08/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND Frequently, ingestion of lipids exceeds our daily requirements and constantly exposes humans to circulating lipid overload which may lead to endothelial dysfunction (ED), the earliest marker of atherosclerosis. Nailfold videocapillaroscopy (NVC) technique can detect ED on microcirculation. Using NVC, we aimed to demonstrate if metabolic alterations evoked by high-fat meals can act differently on microvascular endothelial reactivity in lean and women with obesity. METHODS Women, aged between 19 and 40 years, were allocated to control group (CG) and with obesity group (OBG) and were subjected to blood analysis for determination of glucose, total cholesterol (TC), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-c) and high-density lipoprotein cholesterol (HDL-c) and NVC evaluation at fasting and 30, 60, 120, and 180-min after high-fat meal ingestion. NVC technique evaluated microvascular reactivity through the following variables: red blood cell velocity (RBCV) at rest and after 1-min ischemia (maximal red blood cell velocity, RBCVmax) and time taken to reach it (TRBCVmax). A P value ≤0.05 was considered significant. RESULTS High-fat meal promoted a two-phase response in both groups: one until 60-min, associated with glucose and insulin levels, and the other after 120-min, associated with TG levels. Significant differences between groups were observed concerning insulin and HDL-c concentrations only at fasting and TC, TG, and LDL-c levels in all-time points. Regarding microvascular reactivity, RBCV, RBCVmax, and TRBCVmax were significantly different in OBG at 30-min compared to baseline. RBCVmax and TRBCVmax were significantly different in CG at 30-min and 60-min comparing to fasting. In all-time points, OBG presented RBCV, RBCVmax , and TRBCVmax significantly different in comparison to CG. CONCLUSION High-fat meal worsened ED on microcirculation in women with obesity and induced impairment of endothelial function in lean ones, reinforcing the association between high-fat meal and atherosclerosis.
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Affiliation(s)
- Priscila Alves Maranhão
- Laboratory for Clinical and Experimental Research on Vascular Biology (BioVasc), Biomedical Center, State University of Rio de Janeiro, Rio de Janeiro, RJ 20550-013, Brazil
| | - Maria das Graças Coelho de Souza
- Laboratory for Clinical and Experimental Research on Vascular Biology (BioVasc), Biomedical Center, State University of Rio de Janeiro, Rio de Janeiro, RJ 20550-013, Brazil
| | - Diogo Guarnieri Panazzolo
- Laboratory for Clinical and Experimental Research on Vascular Biology (BioVasc), Biomedical Center, State University of Rio de Janeiro, Rio de Janeiro, RJ 20550-013, Brazil
| | - José Firmino Nogueira Neto
- Lipids Laboratory (Lablip), Policlínica Piquet Carneiro, State University of Rio de Janeiro, Rio de Janeiro, RJ 20550-003, Brazil
| | - Eliete Bouskela
- Laboratory for Clinical and Experimental Research on Vascular Biology (BioVasc), Biomedical Center, State University of Rio de Janeiro, Rio de Janeiro, RJ 20550-013, Brazil
| | - Luiz Guilherme Kraemer-Aguiar
- Laboratory for Clinical and Experimental Research on Vascular Biology (BioVasc), Biomedical Center, State University of Rio de Janeiro, Rio de Janeiro, RJ 20550-013, Brazil
- Obesity Unit, Policlínica Piquet Carneiro, Department of Internal Medicine, Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, RJ 20550-030, Brazil
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Bastos da Cunha C, Sicuro F, Maranhão PA, Borges MA, Cyrino FZ, Gazolla FM, Madeira IR, Bordallo MAN, Bouskela E, Kraemer-Aguiar LG. Microcirculation, Adiposity, and Traditional and Emerging Cardiovascular Risk Factors in Prepubertal Children. J Endocr Soc 2017; 1:908-917. [PMID: 29264541 PMCID: PMC5686770 DOI: 10.1210/js.2017-00130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 06/06/2017] [Indexed: 01/12/2023] Open
Abstract
PURPOSE Previous studies have shown that microvascular dysfunction (MD) is associated with a number of cardiovascular risk factors, including obesity. Few studies have assessed microvascular reactivity in children, and in most of these, results were confounded by the effects of puberty. Our aim was to establish whether MD is already present in obese prepubertal children. METHODS This cross-sectional study included 52 obese, 18 overweight, and 28 eutrophic children, with a mean ± standard deviation age of 7.44 ± 1.22 years. We evaluated cardiovascular risk factors and nutritive microvascular function by using nailfold dynamic videocapillaroscopy and determined functional capillary density (FCD), red blood cell velocity at resting conditions (RBCV) and at peak (RBCVmax), and time to reach peak velocity during the post-occlusive reactive hyperemic response following 1 minute ischemia. RESULTS On univariate analysis, differences in microvascular reactivity were not observed among the groups. Obese and overweight children had significantly higher scores than eutrophic children for the following parameters: body mass index, waist circumference, waist-to-height ratio, mean arterial pressure, homeostasis model assessment for insulin resistance, levels of insulin, leptin, glucose, triglycerides, total cholesterol, uric acid, and C-reactive protein. Multivariate analysis demonstrated the association between metabolic, anthropometric, and microvascular variables, stratified according to the degree of adiposity and body fat distribution. CONCLUSIONS Univariate analysis did not show any difference in microvascular reactivity between groups but, by testing these variables by multivariate means, we noticed a common and direct variation between cardiovascular/metabolic risk factors and microvascular reactivity occurring early in life.
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Affiliation(s)
- Carolina Bastos da Cunha
- Endocrinology, Department of Internal Medicine, Faculty of Medical Sciences, State University of Rio Janeiro, Rio de Janeiro, Brazil 20550-170
| | - Fernando Sicuro
- Clinical and Experimental Research Laboratory on Vascular Biology (BioVasc), Biomedical Center, State University of Rio de Janeiro, Rio de Janeiro, Brazil 20550-013
| | - Priscila Alves Maranhão
- Department of Information Sciences and Health Decision (CIDES) of the Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
| | - Marcos Antonio Borges
- Endocrinology, Department of Internal Medicine, Faculty of Medical Sciences, State University of Rio Janeiro, Rio de Janeiro, Brazil 20550-170
| | - Fátima Z. Cyrino
- Clinical and Experimental Research Laboratory on Vascular Biology (BioVasc), Biomedical Center, State University of Rio de Janeiro, Rio de Janeiro, Brazil 20550-013
| | - Fernanda Mussi Gazolla
- Endocrinology, Department of Internal Medicine, Faculty of Medical Sciences, State University of Rio Janeiro, Rio de Janeiro, Brazil 20550-170
| | - Isabel Rey Madeira
- Endocrinology, Department of Internal Medicine, Faculty of Medical Sciences, State University of Rio Janeiro, Rio de Janeiro, Brazil 20550-170
| | - Maria Alice Neves Bordallo
- Endocrinology, Department of Internal Medicine, Faculty of Medical Sciences, State University of Rio Janeiro, Rio de Janeiro, Brazil 20550-170
| | - Eliete Bouskela
- Clinical and Experimental Research Laboratory on Vascular Biology (BioVasc), Biomedical Center, State University of Rio de Janeiro, Rio de Janeiro, Brazil 20550-013
| | - Luiz Guilherme Kraemer-Aguiar
- Endocrinology, Department of Internal Medicine, Faculty of Medical Sciences, State University of Rio Janeiro, Rio de Janeiro, Brazil 20550-170
- Clinical and Experimental Research Laboratory on Vascular Biology (BioVasc), Biomedical Center, State University of Rio de Janeiro, Rio de Janeiro, Brazil 20550-013
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das Graças Coelho de Souza M, Kraemer-Aguiar LG, Bouskela E. Inflammation-induced microvascular dysfunction in obesity – A translational approach. Clin Hemorheol Microcirc 2017; 64:645-654. [DOI: 10.3233/ch-168018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Maria das Graças Coelho de Souza
- Laboratório de Pesquisas Clínicas e Experimentais em Biologia Vascular, Centro Biomédico, Universidade do Estado do Rio de Janeiro, RJ, Brazil
| | - Luiz Guilherme Kraemer-Aguiar
- Laboratório de Pesquisas Clínicas e Experimentais em Biologia Vascular, Centro Biomédico, Universidade do Estado do Rio de Janeiro, RJ, Brazil
- Ambulatório de Obesidade, Policlínica Piquet Carneiro, Departamento de Medicina Interna, Faculdade de Ciências Médicas, Centro Biomédico, Universidade do Estado do Rio de Janeiro, RJ, Brazil
| | - Eliete Bouskela
- Laboratório de Pesquisas Clínicas e Experimentais em Biologia Vascular, Centro Biomédico, Universidade do Estado do Rio de Janeiro, RJ, Brazil
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Dynamic nailfold videocapillaroscopy may be used for early detection of microvascular dysfunction in obesity. Microvasc Res 2016; 106:31-5. [DOI: 10.1016/j.mvr.2016.03.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 02/21/2016] [Accepted: 03/07/2016] [Indexed: 01/10/2023]
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Vasconcellos F, Seabra A, Cunha F, Montenegro R, Penha J, Bouskela E, Nogueira Neto JF, Collett-Solberg P, Farinatti P. Health markers in obese adolescents improved by a 12-week recreational soccer program: a randomised controlled trial. J Sports Sci 2015. [PMID: 26208409 DOI: 10.1080/02640414.2015.1064150] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The effects of a recreational soccer program (RSP) upon body composition, heart rate variability (HRV), biochemical markers, cardio-respiratory fitness, and endothelial function in obese adolescents were investigated. A randomised controlled clinical trial was conducted with 30 adolescents aged 12-17 years and body mass index (BMI) >2 standard deviations of WHO reference values, which were assigned to RSP (n = 10, 2 girls) and obese control (n = 10, 4 girls) groups. The 12-week RSP included 60-min sessions performed 3 times/week. BMI, waist circumference, blood pressure, blood glucose, lipid profile, insulin, C-reactive protein, HRV, and maximal oxygen consumption (VO2peak) were evaluated following standardised procedures. Body composition was determined by dual-energy X-ray absorptiometry and endothelial function by venous occlusion plethysmography. After intervention, RSP exhibited significant reductions in BMI (-0.7 ± 0.2 kg · m(-2)), waist circumference (-8.2 ± 1.4 cm), %body fat (-2.2 ± 0.4%), systolic blood pressure (-5.0 ± 2.3 mmHg), total cholesterol (-16.2 ± 5.8 mg · dL(-1)), triglycerides (-20.5 ± 12.9 mg · dL(-1)), C-reactive protein (-0.06 ± 0.01 mg · dL(-1)), insulin resistance (HOMA-IR, -1.4 ± 0.6), and sympathetic activity (LF, -13.9 ± 6.6 un) vs. controls (P < 0.05). Significant increase was observed in parasympathetic activity (HF, 13.9 ± 6.6 un), VO2peak (7.9 ± 2.8 ml · kg(-1) · min(-1)), and high-density lipoprotein cholesterol (11.0 ± 6.3 mg · dL(-1)) (P < 0.05). Vascular conductance (19.5 ± 8.1 ml · min(-1) · 100 ml, P = 0.005) increased and vascular resistance (-5.9 ± 2.4 ml · min(-1) · 100 ml, P = 0.041) decreased in RSP, but not in controls. A 12-week recreational soccer intervention was effective to improve biochemical, cardiovascular, and fitness health markers in obese adolescents.
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Affiliation(s)
- Fabrício Vasconcellos
- a Research Centre in Education, Innovation, and Intervention in Sports, Sports Faculty , University of Oporto , Oporto , Portugal.,b Laboratory of Physical Activity and Health Promotion, Institute of Physical Education and Sports , University of Rio de Janeiro State , Rio de Janeiro , Brazil
| | - Andre Seabra
- c Research Centre in Physical Activity, Health and Leisure (CIAFEL), Sports Faculty , University of Oporto , Oporto , Portugal
| | - Felipe Cunha
- b Laboratory of Physical Activity and Health Promotion, Institute of Physical Education and Sports , University of Rio de Janeiro State , Rio de Janeiro , Brazil
| | - Rafael Montenegro
- b Laboratory of Physical Activity and Health Promotion, Institute of Physical Education and Sports , University of Rio de Janeiro State , Rio de Janeiro , Brazil
| | - Jociene Penha
- d Laboratory of Clinical and Experimental Research in Vascular Biology, Biomedical Center , University of Rio de Janeiro State , Rio de Janeiro , Brazil
| | - Eliete Bouskela
- d Laboratory of Clinical and Experimental Research in Vascular Biology, Biomedical Center , University of Rio de Janeiro State , Rio de Janeiro , Brazil
| | - José Firmino Nogueira Neto
- e Medical Sciences Graduate Program, Faculty of Medical Sciences , University of Rio de Janeiro State , Rio de Janeiro , Brazil
| | - Paulo Collett-Solberg
- d Laboratory of Clinical and Experimental Research in Vascular Biology, Biomedical Center , University of Rio de Janeiro State , Rio de Janeiro , Brazil
| | - Paulo Farinatti
- b Laboratory of Physical Activity and Health Promotion, Institute of Physical Education and Sports , University of Rio de Janeiro State , Rio de Janeiro , Brazil.,f Physical Activity Sciences Graduate Program , Salgado de Oliveira University , Niteroi , Brazil
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Walther G, Obert P, Dutheil F, Chapier R, Lesourd B, Naughton G, Courteix D, Vinet A. Metabolic syndrome individuals with and without type 2 diabetes mellitus present generalized vascular dysfunction: cross-sectional study. Arterioscler Thromb Vasc Biol 2015; 35:1022-9. [PMID: 25657309 DOI: 10.1161/atvbaha.114.304591] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The first objective of this study was to demonstrate differences within endothelial-dependent and endothelial-independent vasoreactivity in macro- and microcirculation beds among patients with metabolic syndrome (MetS) with and without type 2 diabetes mellitus (T2D) compared with healthy counterparts. The second objective was to determine relationships among the function of macro- and microvascular systems and abdominal adiposity, as well as inflammatory markers in the 3 groups. APPROACH AND RESULTS Cross-sectional analyses of 53 patients with MetS without T2D and 25 with T2D, as well as aged 40 years and sex-matched healthy controls included microvascular (cutaneous blood flow measured with laser Doppler flowmetry in response to iontophoresis of acetylcholine and sodium nitroprusside), and macrovascular reactivity (flow-mediated dilation and nitrate-mediated dilation) along with anthropometric measures, plasma glucose, and insulin and inflammatory markers. Compared with controls, MetS participants showed depressed endothelial function of both micro- and macrocirculation beds. T2D in patients with MetS revealed an exacerbated vascular smooth muscle dysfunction in micro- and macrocirculation compared with MetS without T2D. Indices of micro- and macrocirculation were predominantly inversely related to abdominal fat and inflammatory markers. CONCLUSIONS MetS was associated with endothelial-dependent and endothelial-independent dysfunction, affecting both the macro- and the microvascular systems. Participants with diabetes mellitus demonstrated the most severe smooth muscle dysfunction. The presence of central abdominal fat and systemic inflammation seems implicated in the pathogenesis of vascular dysfunctions in MetS.
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Affiliation(s)
- Guillaume Walther
- From the Avignon University, LAPEC EA4278, Avignon, France (G.W., P.O., A.V.); Blaise Pascal University, Laboratory Metabolic Adaptations to Exercise in Physiological and Pathological Conditions (AME2P, EA3533), Clermont-Ferrand, France (F.D., B.L., D.C.); University Hospital of Clermont-Ferrand (CHU), Clermont-Ferrand, France (F.D., B.L.); Omental-Thermalia Center, Châtelguyon, France (R.C.); and School of Exercise Science, Australian Catholic University, Melbourne, Victoria, Australia (P.O., F.D., G.N., D.C.).
| | - Philippe Obert
- From the Avignon University, LAPEC EA4278, Avignon, France (G.W., P.O., A.V.); Blaise Pascal University, Laboratory Metabolic Adaptations to Exercise in Physiological and Pathological Conditions (AME2P, EA3533), Clermont-Ferrand, France (F.D., B.L., D.C.); University Hospital of Clermont-Ferrand (CHU), Clermont-Ferrand, France (F.D., B.L.); Omental-Thermalia Center, Châtelguyon, France (R.C.); and School of Exercise Science, Australian Catholic University, Melbourne, Victoria, Australia (P.O., F.D., G.N., D.C.)
| | - Frédéric Dutheil
- From the Avignon University, LAPEC EA4278, Avignon, France (G.W., P.O., A.V.); Blaise Pascal University, Laboratory Metabolic Adaptations to Exercise in Physiological and Pathological Conditions (AME2P, EA3533), Clermont-Ferrand, France (F.D., B.L., D.C.); University Hospital of Clermont-Ferrand (CHU), Clermont-Ferrand, France (F.D., B.L.); Omental-Thermalia Center, Châtelguyon, France (R.C.); and School of Exercise Science, Australian Catholic University, Melbourne, Victoria, Australia (P.O., F.D., G.N., D.C.)
| | - Robert Chapier
- From the Avignon University, LAPEC EA4278, Avignon, France (G.W., P.O., A.V.); Blaise Pascal University, Laboratory Metabolic Adaptations to Exercise in Physiological and Pathological Conditions (AME2P, EA3533), Clermont-Ferrand, France (F.D., B.L., D.C.); University Hospital of Clermont-Ferrand (CHU), Clermont-Ferrand, France (F.D., B.L.); Omental-Thermalia Center, Châtelguyon, France (R.C.); and School of Exercise Science, Australian Catholic University, Melbourne, Victoria, Australia (P.O., F.D., G.N., D.C.)
| | - Bruno Lesourd
- From the Avignon University, LAPEC EA4278, Avignon, France (G.W., P.O., A.V.); Blaise Pascal University, Laboratory Metabolic Adaptations to Exercise in Physiological and Pathological Conditions (AME2P, EA3533), Clermont-Ferrand, France (F.D., B.L., D.C.); University Hospital of Clermont-Ferrand (CHU), Clermont-Ferrand, France (F.D., B.L.); Omental-Thermalia Center, Châtelguyon, France (R.C.); and School of Exercise Science, Australian Catholic University, Melbourne, Victoria, Australia (P.O., F.D., G.N., D.C.)
| | - Geraldine Naughton
- From the Avignon University, LAPEC EA4278, Avignon, France (G.W., P.O., A.V.); Blaise Pascal University, Laboratory Metabolic Adaptations to Exercise in Physiological and Pathological Conditions (AME2P, EA3533), Clermont-Ferrand, France (F.D., B.L., D.C.); University Hospital of Clermont-Ferrand (CHU), Clermont-Ferrand, France (F.D., B.L.); Omental-Thermalia Center, Châtelguyon, France (R.C.); and School of Exercise Science, Australian Catholic University, Melbourne, Victoria, Australia (P.O., F.D., G.N., D.C.)
| | - Daniel Courteix
- From the Avignon University, LAPEC EA4278, Avignon, France (G.W., P.O., A.V.); Blaise Pascal University, Laboratory Metabolic Adaptations to Exercise in Physiological and Pathological Conditions (AME2P, EA3533), Clermont-Ferrand, France (F.D., B.L., D.C.); University Hospital of Clermont-Ferrand (CHU), Clermont-Ferrand, France (F.D., B.L.); Omental-Thermalia Center, Châtelguyon, France (R.C.); and School of Exercise Science, Australian Catholic University, Melbourne, Victoria, Australia (P.O., F.D., G.N., D.C.)
| | - Agnès Vinet
- From the Avignon University, LAPEC EA4278, Avignon, France (G.W., P.O., A.V.); Blaise Pascal University, Laboratory Metabolic Adaptations to Exercise in Physiological and Pathological Conditions (AME2P, EA3533), Clermont-Ferrand, France (F.D., B.L., D.C.); University Hospital of Clermont-Ferrand (CHU), Clermont-Ferrand, France (F.D., B.L.); Omental-Thermalia Center, Châtelguyon, France (R.C.); and School of Exercise Science, Australian Catholic University, Melbourne, Victoria, Australia (P.O., F.D., G.N., D.C.)
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Lira-Junior R, Figueredo CM, Bouskela E, Fischer RG. Severe Chronic Periodontitis Is Associated With Endothelial and Microvascular Dysfunctions: A Pilot Study. J Periodontol 2014; 85:1648-57. [DOI: 10.1902/jop.2014.140189] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Leão LMCSM, Maranhão PA, Oliveira V, Villela NR, Bordallo MAN, Borges MA, Bouskela E, Kraemer-Aguiar LG. Nonobese Young Females with Polycystic Ovary Syndrome have Nutritive Microvascular Dysfunction: A Pilot Study. Endocr Pract 2014; 20:1281-9. [PMID: 25100380 DOI: 10.4158/ep14130.or] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To investigate nutritive microvascular function in young nonobese females with polycystic ovary syndrome (PCOS) and to correlate microvascular reactivity with sex steroids, inflammatory markers, and metabolic variables. METHODS Fourteen nonobese females with PCOS (24.6 ± 2.7 years, body mass index [BMI] 23.7 ± 3.1 kg/m2) and 13 age- and BMI-matched controls (22.8 ± 2.3 years, 22.5 ± 3.4kg/m2) underwent anthropometric, hormonal, and microvascular evaluations. The main outcome measures were capillary density, red blood cell velocity (RBCV) at resting and peak during postocclusive reactive hyperemia (RBCVmax), and time taken to reach RBCVmax (TRBCVmax). RESULTS Subjects with PCOS had lower RBCV and higher TRBCVmax compared to controls, respectively (0.237 [0.220-0.324] vs. 0.362 [0.297-0.382] mm/s, P<.01) and (5 [5-6] vs. 4 [3-5] s, P<.05]. The free androgen index (FAI) and sex hormone-binding globulin (SHBG) level were different between groups. FAI correlated to RBCVmax (ρ = -0.49, P<.05) and to TRBCVmax (ρ = 0.41, P<.05). SHBG correlated with RBCVmax (ρ = 0.52, P<.01) while estradiol (E2) levels correlated with RBCV (ρ = 0.80, P<.001) and RBCVmax (ρ = 0.46, P<.05). CONCLUSION Microvascular dysfunction characterized by reduced RBCVmax and prolonged TRBCVmax was present in young, nonobese PCOS subjects. FAI was associated with observed impairments, suggesting a possible common mechanism linking sex hormones and microvascular dysfunction.
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Affiliation(s)
| | - Priscila Alves Maranhão
- Clinical and Experimental Research Laboratory on Vascular Biology (BioVasc), Biomedical Center, State University of Rio de Janeiro, Brazil
| | - Viviane Oliveira
- Endocrinology Department of Internal Medicine, Medical Sciences Faculty, State University of Rio de Janeiro, Brazil
| | - Nivaldo Ribeiro Villela
- Clinical and Experimental Research Laboratory on Vascular Biology (BioVasc), Biomedical Center, State University of Rio de Janeiro, Brazil Anesthesiology Department of Surgery, Medical Sciences Faculty, State University of Rio de Janeiro, Brazil
| | - Maria Alice Neves Bordallo
- Endocrinology Department of Internal Medicine, Medical Sciences Faculty, State University of Rio de Janeiro, Brazil
| | - Marcos Antonio Borges
- Endocrinology Department of Internal Medicine, Medical Sciences Faculty, State University of Rio de Janeiro, Brazil
| | - Eliete Bouskela
- Anesthesiology Department of Surgery, Medical Sciences Faculty, State University of Rio de Janeiro, Brazil
| | - Luiz Guilherme Kraemer-Aguiar
- Endocrinology Department of Internal Medicine, Medical Sciences Faculty, State University of Rio de Janeiro, Brazil Clinical and Experimental Research Laboratory on Vascular Biology (BioVasc), Biomedical Center, State University of Rio de Janeiro, Brazil
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13
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Siegrist M, Hanssen H, Neidig M, Fuchs M, Lechner F, Stetten M, Blume K, Lammel C, Haller B, Vogeser M, Parhofer KG, Halle M. Association of leptin and insulin with childhood obesity and retinal vessel diameters. Int J Obes (Lond) 2013; 38:1241-7. [PMID: 24301134 DOI: 10.1038/ijo.2013.226] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 11/16/2013] [Accepted: 11/26/2013] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Childhood obesity is associated with an impaired retinal microcirculation. The aim of the study was to investigate the association between specific obesity-related biomarkers, physical fitness and retinal vessel diameters in school children. DESIGN AND SUBJECTS We studied 381 children aged 10-11 years (body mass index (BMI): 19.3±3.7 kg m(-2)) in a school-based setting. MEASUREMENTS Anthropometric measurements and blood sampling were conducted using standard protocols for children. The serum biomarkers leptin, adiponectin, insulin as well as interleukin-6 (IL-6) were analyzed. Physical fitness was determined by a six-item-test battery and physical activity by use of a questionnaire. Central retinal arteriolar equivalent (CRAE), central retinal venular equivalent (CRVE) and the arteriolar-to-venular diameter ratio (AVR) were assessed with a non-mydriatic vessel analyzer (SVA-T) using a computer-based program. RESULTS Compared with normal weight children (n=254), obese children (n=39) showed higher leptin (P<0.001), higher insulin (P<0.001), higher IL-6 (P<0.001) and lower adiponectin levels (P=0.013). Obese children demonstrated wider CRVE (P=0.041) and lower AVR (P<0.001). Higher leptin levels were associated with wider CRVE (P=0.032) and lower AVR (P=0.010), that was BMI dependent. Insulin levels were associated with arteriolar (P=0.045) and venular dilatation (P=0.034) after adjustment for BMI. No significant associations between adiponectin levels, IL-6 levels, physical fitness or physical activity and retinal vessel diameter were observed. Lower leptin levels were independently correlated with higher physical fitness (r=-0.33; P<0.001). CONCLUSION Leptin and insulin levels are associated with changes of the retinal microcirculation. Especially insulin seems to be a good target marker for the cardiometabolic risk assessment in children since elevated insulin levels are independently associated with microvascular end-organ alterations at an early stage. Lifestyle intervention studies are warranted to examine whether improvement of physical fitness or weight reduction can affect cardiometabolic risk markers and reverse alterations of the retinal microcirculation.
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Affiliation(s)
- M Siegrist
- Department of Prevention, Rehabilitation and Sports Medicine, Technische Universität München, Klinikum rechts der Isar, Munich, Germany
| | - H Hanssen
- 1] Department of Prevention, Rehabilitation and Sports Medicine, Technische Universität München, Klinikum rechts der Isar, Munich, Germany [2] Division of Sports Medicine, Institute of Exercise and Health Sciences, University of Basel, Basel, Switzerland
| | - M Neidig
- Department of Prevention, Rehabilitation and Sports Medicine, Technische Universität München, Klinikum rechts der Isar, Munich, Germany
| | - M Fuchs
- Department of Prevention, Rehabilitation and Sports Medicine, Technische Universität München, Klinikum rechts der Isar, Munich, Germany
| | - F Lechner
- Department of Prevention, Rehabilitation and Sports Medicine, Technische Universität München, Klinikum rechts der Isar, Munich, Germany
| | - M Stetten
- Department of Prevention, Rehabilitation and Sports Medicine, Technische Universität München, Klinikum rechts der Isar, Munich, Germany
| | - K Blume
- Department of Prevention, Rehabilitation and Sports Medicine, Technische Universität München, Klinikum rechts der Isar, Munich, Germany
| | - C Lammel
- Department of Prevention, Rehabilitation and Sports Medicine, Technische Universität München, Klinikum rechts der Isar, Munich, Germany
| | - B Haller
- Institute of Medical Statistics and Epidemiology, Technische Universität München, Klinikum rechts der Isar, Munich, Germany
| | - M Vogeser
- Department of Clinical Chemistry, University of Munich, Grosshadern Campus, Munich, Germany
| | - K G Parhofer
- Department of Internal Medicine II, University of Munich, Grosshadern Campus, Munich, Germany
| | - M Halle
- 1] Department of Prevention, Rehabilitation and Sports Medicine, Technische Universität München, Klinikum rechts der Isar, Munich, Germany [2] DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany [3] Else Kröner-Fresenius-Zentrum am Klinikum rechts der Isar, Technische Universität München, Munich, Germany
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14
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Influence of blood pressure and body mass index on retinal vascular caliber in preschool-aged children. J Hum Hypertens 2013; 27:523-8. [PMID: 23448844 DOI: 10.1038/jhh.2013.15] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Revised: 01/06/2013] [Accepted: 01/16/2013] [Indexed: 11/08/2022]
Abstract
We assessed the associations between body mass index (BMI) and blood pressure (BP) with the retinal microvasculature among preschool-aged children. Three hundred and seventy-nine children aged 3-<6 years old had gradable retinal photographs, and quantifiable retinal vascular caliber using validated computer-based methods. Weight, height, BMI, waist circumference and BP were obtained using standardized protocols. Mean (±s.d.) BMI and systolic BP in preschool-aged children were 16.0 (±1.8) kg m(-2) and 93.2 (±9.9) mm Hg, respectively. After multivariable adjustment, each kg m(-2) increase in BMI was associated with a 1.06 μm narrowing of retinal arteriolar caliber (P=0.01) and 1.12 μm widening of retinal venular caliber (P=0.02). Children in the 95th percentile (obese) compared with those in the <85th percentile (healthy weight) had narrower retinal arteriolar caliber (∼6.1 μm, Ptrend=0.01) and wider retinal venular caliber (∼6.4 μm, Ptrend=0.01). Each 10 mm Hg increase in systolic BP was associated with a 1.70 μm narrower retinal arteriolar caliber (multivariable-adjusted P=0.02). We show that BMI and systolic BP have inverse linear associations with retinal arteriolar caliber, and BMI has a positive linear association with retinal venular caliber during early childhood. These findings suggests that the influence of BP and BMI on small vessels are continuous and commence early in life.
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Panazzolo DG, Sicuro FL, Clapauch R, Maranhão PA, Bouskela E, Kraemer-Aguiar LG. Obesity, metabolic syndrome, impaired fasting glucose, and microvascular dysfunction: a principal component analysis approach. BMC Cardiovasc Disord 2012; 12:102. [PMID: 23148545 PMCID: PMC3534385 DOI: 10.1186/1471-2261-12-102] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2011] [Accepted: 11/08/2012] [Indexed: 02/06/2023] Open
Abstract
Background We aimed to evaluate the multivariate association between functional microvascular variables and clinical-laboratorial-anthropometrical measurements. Methods Data from 189 female subjects (34.0±15.5 years, 30.5±7.1 kg/m2), who were non-smokers, non-regular drug users, without a history of diabetes and/or hypertension, were analyzed by principal component analysis (PCA). PCA is a classical multivariate exploratory tool because it highlights common variation between variables allowing inferences about possible biological meaning of associations between them, without pre-establishing cause-effect relationships. In total, 15 variables were used for PCA: body mass index (BMI), waist circumference, systolic and diastolic blood pressure (BP), fasting plasma glucose, levels of total cholesterol, high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), triglycerides (TG), insulin, C-reactive protein (CRP), and functional microvascular variables measured by nailfold videocapillaroscopy. Nailfold videocapillaroscopy was used for direct visualization of nutritive capillaries, assessing functional capillary density, red blood cell velocity (RBCV) at rest and peak after 1 min of arterial occlusion (RBCVmax), and the time taken to reach RBCVmax (TRBCVmax). Results A total of 35% of subjects had metabolic syndrome, 77% were overweight/obese, and 9.5% had impaired fasting glucose. PCA was able to recognize that functional microvascular variables and clinical-laboratorial-anthropometrical measurements had a similar variation. The first five principal components explained most of the intrinsic variation of the data. For example, principal component 1 was associated with BMI, waist circumference, systolic BP, diastolic BP, insulin, TG, CRP, and TRBCVmax varying in the same way. Principal component 1 also showed a strong association among HDL-c, RBCV, and RBCVmax, but in the opposite way. Principal component 3 was associated only with microvascular variables in the same way (functional capillary density, RBCV and RBCVmax). Fasting plasma glucose appeared to be related to principal component 4 and did not show any association with microvascular reactivity. Conclusions In non-diabetic female subjects, a multivariate scenario of associations between classic clinical variables strictly related to obesity and metabolic syndrome suggests a significant relationship between these diseases and microvascular reactivity.
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Affiliation(s)
- Diogo G Panazzolo
- Clinical and Experimental Research Laboratory on Vascular Biology (BioVasc),Biomedical Center, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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Buss C, Kraemer-Aguiar LG, Maranhão PA, Marinho C, de Souza MDGC, Wiernsperger N, Bouskela E. Novel findings in the cephalic phase of digestion: a role for microcirculation? Physiol Behav 2011; 105:1082-7. [PMID: 22197630 DOI: 10.1016/j.physbeh.2011.12.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2011] [Revised: 11/22/2011] [Accepted: 12/07/2011] [Indexed: 11/16/2022]
Abstract
The cephalic phase of digestion (CPD) has been extensively investigated in terms of digestion and metabolism. Nevertheless, microcirculatory changes required to prepare peripheral tissues in order to dispose nutrients have never been assessed. In this study, microvascular function has been evaluated to determine its behavior and potential association to hormonal secretions during CPD. Thirty-nine healthy male subjects, 23.4 ± 0.5 years (mean ± SD) and BMI of 23.3 ± 2.3 kg/m(2), were randomized into receiving cognitive-sensorial stimuli to elicit CPD (CPD group, n=20) or not (control group, n=19), after a 12-h overnight fast. Main outcomes were differences in resting and peak functional capillary density (FCD, cap/mm(2)); resting red blood cell velocity (RBCV), peak RBCV (RBCV(max)) and time taken to reach it (TRBCV(max)); peak flow and vasomotion, before and after CPD and their associations with insulin and/or pancreatic polypeptide (PP). In the CPD group, basal FCD (24.9 ± 7.6 to 28.3 ± 8.1, p=0.005), peak FCD (27.8 ± 6.3 to 32.6 ± 7.1, p=0.002), RBCV (0.306 ± 0.031 to 0.330 ± 0.027 mm/s, p=0.005), RBCV(max) (0.336 ± 0.029 to 0.398 ± 0.292 mm/s, p=0.005) and peak flow (23.5 ± 14.3 to 26.9 ± 15.8 PU, p<0.01) increased while TRBCV(max) decreased (4.9 ± 1.5 to 3.5 ± 1.2s, p=0.01). No significant changes could be detected in the control group. Groups have not presented differences for insulin, but PP significantly increased in the CPD group and was positively associated to basal FCD increase (rho=0.527, p=0.03). In conclusion, neurally-mediated anticipatory responses of digestion elicited functional capillary recruitment associated to PP in healthy men, suggesting a precocious role for microcirculation in the physiology of digestion and nutrient homeostasis.
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Affiliation(s)
- Caroline Buss
- State University of Rio de Janeiro, Biomedical Center, Clinical and Experimental Research Laboratory on Vascular Biology (BioVasc), Rio de Janeiro, RJ, Brazil
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Jonk AM, Houben AJ, Schaper NC, de Leeuw PW, Serné EH, Smulders YM, Stehouwer CD. Obesity is associated with impaired endothelial function in the postprandial state. Microvasc Res 2011; 82:423-9. [PMID: 21875604 DOI: 10.1016/j.mvr.2011.08.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2011] [Revised: 08/04/2011] [Accepted: 08/13/2011] [Indexed: 11/29/2022]
Abstract
Adequate microvascular perfusion is essential for the regulation of tissue metabolism. Therefore, defects in microvascular function may play a role in obesity-associated insulin resistance. Steady-state hyperinsulinemia during a euglycemic hyperinsulinemic clamp stimulates endothelium-dependent vasodilation and capillary recruitment, which contribute to increased glucose uptake. These phenomena have been shown to be blunted in obesity. If insulin's effects on microcirculatory function indeed play a physiological role in regulating insulin-mediated glucose uptake, such effects should be demonstrable not only during steady-state hyperinsulinemia, but also after meal ingestion. We investigated whether similar responses occur after ingestion of a glucose load or a mixed meal. We examined the effects of a glucose drink, a mixed meal drink, or a control drink (water) on skin capillary density (i.e. baseline capillary density, hyperemic capillary recruitment, and density during venous congestion, using capillaroscopy) and skin endothelium-(in)dependent vasodilation (using laser-Doppler flowmetry with iontophoresis of acetylcholine and sodium nitroprusside) in 20 lean and 19 obese individuals. In lean individuals, neither the glucose nor the mixed meal drink induced a significant effect on capillary density or endothelium-(in)dependent vasodilation. Possibly this is related to the modest plasma insulin levels as compared to the insulin clamp. In obese individuals, the mixed meal drink, compared to the control drink, decreased baseline skin perfusion (P<0.05) and acetylcholine-mediated vasodilation (P<0.05), while no effect of the drinks on capillary density was found. Compared to lean individuals, obese individuals had impaired acetylcholine-mediated vasodilation after meal ingestion (P=0.02). The latter findings are consistent with impaired postprandial microvascular function in obesity.
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Affiliation(s)
- Amy M Jonk
- Department of Internal Medicine, Maastricht University Medical Centre and Cardiovascular Research Institute Maastricht, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands.
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Maranhão PA, Kraemer-Aguiar LG, de Oliveira CL, Kuschnir MCC, Vieira YR, Souza MGC, Koury JC, Bouskela E. Brazil nuts intake improves lipid profile, oxidative stress and microvascular function in obese adolescents: a randomized controlled trial. Nutr Metab (Lond) 2011; 8:32. [PMID: 21619692 PMCID: PMC3123174 DOI: 10.1186/1743-7075-8-32] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2011] [Accepted: 05/28/2011] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Obesity is a chronic disease associated to an inflammatory process resulting in oxidative stress that leads to morpho-functional microvascular damage that could be improved by some dietary interventions. In this study, the intake of Brazil nuts (Bertholletia excelsa), composed of bioactive substances like selenium, α- e γ- tocopherol, folate and polyunsaturated fatty acids, have been investigated on antioxidant capacity, lipid and metabolic profiles and nutritive skin microcirculation in obese adolescents. METHODS Obese female adolescents (n = 17), 15.4 ± 2.0 years and BMI of 35.6 ± 3.3 kg/m2, were randomized 1:1 in two groups with the diet supplemented either with Brazil nuts [BNG, n = 08, 15-25 g/day (equivalent to 3 to 5 units/day)] or placebo [PG (lactose), n = 09, one capsule/day] and followed for 16 weeks. Anthropometry, metabolic-lipid profiles, oxidative stress and morphological (capillary diameters) and functional [functional capillary density, red blood cell velocity (RBCV) at baseline and peak (RBCVmax) and time (TRBCVmax) to reach it during post-occlusive reactive hyperemia, after 1 min arterial occlusion] microvascular variables were assessed by nailfold videocapillaroscopy at baseline (T0) and after intervention (T1). RESULTS T0 characteristics were similar between groups. At T1, BNG (intra-group variation) had increased selenium levels (p = 0.02), RBCV (p = 0.03) and RBCVmax (p = 0.03) and reduced total (TC) (p = 0.02) and LDL-cholesterol (p = 0.02). Compared to PG, Brazil nuts intake reduced TC (p = 0.003), triglycerides (p = 0.05) and LDL-ox (p = 0.02) and increased RBCV (p = 0.03). CONCLUSION Brazil nuts intake improved the lipid profile and microvascular function in obese adolescents, possibly due to its high level of unsaturated fatty acids and bioactive substances. TRIAL REGISTRATION Clinical Trials.gov NCT00937599.
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Affiliation(s)
- Priscila A Maranhão
- Clinical and Experimental Research Laboratory in Vascular Biology - BioVasc; Rua São Francisco Xavier, 524, Rio de Janeiro, CEP:20550-013 - Brazil
| | - Luiz G Kraemer-Aguiar
- Endocrinology, Department of Internal Medicine; Clinical and Experimental Research Laboratory in Vascular Biology - BioVasc; Rua São Francisco Xavier, 524, Rio de Janeiro, CEP:20550-013 - Brazil
| | - Cecilia L de Oliveira
- Nutrition Applied Department; Nutrition Institute - Rua São Francisco Xavier, 524, Rio de Janeiro, CEP: 20550-013 - Brazil
| | - Maria CC Kuschnir
- Study Center for Adolescent Health - NESA Av 28 de setembro,. 87, CEP: 20551-030, Rio de Janeiro - Brazil
| | - Yasmine R Vieira
- Clinical and Experimental Research Laboratory in Vascular Biology - BioVasc; Rua São Francisco Xavier, 524, Rio de Janeiro, CEP:20550-013 - Brazil
| | - Maria GC Souza
- Physiological Sciences Department; Clinical and Experimental Research Laboratory in Vascular Biology - BioVasc; Rua São Francisco Xavier, 524 , Rio de Janeiro CEP:20550-013 - Brazil
| | - Josely C Koury
- Study Center for Nutrition and Oxidative Stress; Nutrition Institute; Rua São Francisco Xavier, 524, Rio de Janeiro, CEP: 20550-013 - Brazil
| | - Eliete Bouskela
- Physiological Sciences and Clinical Medicine Departments; Clinical and Experimental Research Laboratory in Vascular Biology - BioVasc; Rua São Francisco Xavier, 524 Rio de Janeiro, CEP:20550-013 -Brazil
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