1
|
The Effect of Bariatric Surgery on Circulating Levels of Oxidized Low-Density Lipoproteins Is Apparently Independent of Changes in Body Mass Index: A Systematic Review and Meta-Analysis. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:4136071. [PMID: 34912496 PMCID: PMC8668329 DOI: 10.1155/2021/4136071] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 10/10/2021] [Accepted: 11/15/2021] [Indexed: 01/08/2023]
Abstract
Background Obesity is related to dyslipidemia and increased circulating oxidated LDL (ox-LDL) concentrations that may predispose to atherosclerosis. Bariatric surgery may lower the risk of cardiovascular mortality. Elevated plasma ox-LDL has been associated with atherogenesis and atherosclerotic cardiovascular disease (ASCVD) events. The aim of this meta-analysis was to investigate the impact of bariatric surgery on proatherogenic circulating ox-LDL levels in patients with severe obesity. Methods Four databases were systematically searched from inception to May 1, 2021. Also, to clarify the heterogeneity of studies with regard to treatment duration, research design, and the demographic features, a random-effects model and the generic inverse variance weighting approach were utilized. To determine the association with the estimated effect size, a random-effect meta-regression approach was performed. Finally, a meta-regression analysis was conducted to explore the influence of, respectively, baseline and changes in body mass index (BMI), baseline ox-LDL, and postsurgery follow-up period with the estimated effect size of surgery on ox-LDL levels. Results Meta-analysis of 11 studies including 470 subjects showed a significant decline in circulating ox-LDL following bariatric surgery (SMD: -0.971, 95% CI: -1.317, -0.626, p < 0.001, I2: 89.43%). The results of meta-regression did not show any significant association between the changes in ox-LDL after bariatric surgery and baseline BMI, duration of follow-up or baseline ox-LDL values. However, there was a significant association between ox-LDL alteration and percentage of BMI change. Conclusion Bariatric surgery in patients who had severe obesity causes a decrease of circulating ox-LDL that was apparently dependent in BMI changes.
Collapse
|
2
|
Gokce N, Karki S, Dobyns A, Zizza E, Sroczynski E, Palmisano JN, Mazzotta C, Hamburg NM, Pernar LI, Carmine B, Carter CO, LaValley M, Hess DT, Apovian CM, Farb MG. Association of Bariatric Surgery With Vascular Outcomes. JAMA Netw Open 2021; 4:e2115267. [PMID: 34251443 PMCID: PMC8276087 DOI: 10.1001/jamanetworkopen.2021.15267] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
IMPORTANCE Bariatric surgical weight loss is associated with reduced cardiovascular mortality; however, the mechanisms underlying this association are incompletely understood. OBJECTIVES To identify variables associated with vascular remodeling after bariatric surgery and to examine how sex, race, and metabolic status are associated with microvascular and macrovascular outcomes. DESIGN, SETTING, AND PARTICIPANTS This population-based longitudinal cohort included 307 individuals who underwent bariatric surgery. Participants were enrolled in the bariatric weight loss program at Boston Medical Center, a large, multi-ethnic urban hospital, with presurgical and postsurgical assessments. Data were collected from December 11, 2001 to August 27, 2019. Data were analyzed in September 2019. EXPOSURE Bariatric surgery. MAIN OUTCOMES AND MEASURES Flow-mediated dilation (FMD) and reactive hyperemia (RH) (as measures of macrovascular and microvascular function, respectively) and clinical variables were measured preoperatively at baseline and at least once postoperatively within 12 months of the bariatric intervention. RESULTS A total of 307 participants with obesity (mean [SD] age, 42 [12] years; 246 [80%] women; 199 [65%] White; mean [SD] body mass index, 46 [8]) were enrolled in this study. Bariatric surgery was associated with significant weight loss and improved macrovascular and microvascular function across subgroups of sex, race, and traditional metabolic syndrome (mean [SD] pre- vs postsurgery weight: 126 [25] kg vs 104 [25] kg; P < .001; mean [SD] pre- vs postsurgery FMD: 9.1% [5.3] vs 10.2% [5.1]; P < .001; mean [SD] pre- vs postsurgery RH: 764% [400] vs 923% [412]; P < .001). Factors associated with change in vascular phenotype correlated most strongly with adiposity markers and several metabolic variables depending on vascular territory (eg, association of weight change with change in RH: estimate, -3.2; 95% CI, -4.7 to -1.8; association of hemoglobin A1c with change in FMD: estimate, -0.5; 95% CI, -0.95 to -0.05). While changes in macrovascular function among individuals with metabolically healthy obesity were not observed, the addition of biomarker assessment using high-sensitivity C-reactive protein plasma levels greater than 2 mg/dL identified participants with seemingly metabolically healthy obesity who had low-grade inflammation and achieved microvascular benefit from weight loss surgery. CONCLUSIONS AND RELEVANCE The findings of this study suggest that bariatric intervention is associated with weight loss and favorable remodeling of the vasculature among a wide range of individuals with cardiovascular risk. Moreover, differences in arterial responses to weight loss surgery by metabolic status were identified, underscoring heterogeneity in physiological responses to adiposity change and potential activation of distinct pathological pathways in clinical subgroups. As such, individuals with metabolically healthy obesity represent a mixed population that may benefit from more refined phenotypic classification.
Collapse
Affiliation(s)
- Noyan Gokce
- Department of Medicine and Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, Massachusetts
| | - Shakun Karki
- Department of Medicine and Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, Massachusetts
| | - Alyssa Dobyns
- Department of Medicine and Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, Massachusetts
| | - Elaina Zizza
- Department of Medicine and Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, Massachusetts
| | - Emily Sroczynski
- Department of Medicine and Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, Massachusetts
| | - Joseph N. Palmisano
- Department of Public Health, Boston University School of Medicine, Boston, Massachusetts
| | - Celestina Mazzotta
- Department of Medicine and Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, Massachusetts
| | - Naomi M. Hamburg
- Department of Medicine and Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, Massachusetts
| | - Luise I. Pernar
- Department of General Surgery, Boston University School of Medicine, Boston, Massachusetts
| | - Brian Carmine
- Department of General Surgery, Boston University School of Medicine, Boston, Massachusetts
| | - Cullen O. Carter
- Department of General Surgery, Boston University School of Medicine, Boston, Massachusetts
| | - Michael LaValley
- Department of Public Health, Boston University School of Medicine, Boston, Massachusetts
| | - Donald T. Hess
- Department of General Surgery, Boston University School of Medicine, Boston, Massachusetts
| | - Caroline M. Apovian
- Section of Endocrinology, Diabetes, Nutrition, and Weight Management, Department of Medicine, Boston Medical Center and Boston University School of Medicine, Boston, Massachusetts
| | - Melissa G. Farb
- Department of Medicine and Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, Massachusetts
| |
Collapse
|
3
|
De Lorenzo A, Estato V, Castro-Faria-Neto HC, Tibirica E. Obesity-Related Inflammation and Endothelial Dysfunction in COVID-19: Impact on Disease Severity. J Inflamm Res 2021; 14:2267-2276. [PMID: 34079332 PMCID: PMC8166352 DOI: 10.2147/jir.s282710] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 05/13/2021] [Indexed: 12/13/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has put into evidence another pandemic – obesity. Currently, several studies have documented the association between obesity and COVID-19 severity. The mechanisms underlying the increased risk of complications and mortality in obese patients with COVID-19 are of diverse nature. Inflammation plays a central role in obesity. Metabolic alterations seen in obese patients are related to an inflammatory response, and several studies report elevated levels of circulating inflammatory cytokines in obese patients. Also, deregulated expression of adipokines, such as leptin and resistin, increase the expression of vascular adhesion molecule 1 and intercellular adhesion molecule 1 that contribute to increased vascular leukocyte adhesiveness and additional oxidative stress. Additionally, it is now recognized that the chronic impairment of systemic vascular endothelial function in patients with cardiovascular and metabolic disorders, including obesity, when intensified by the detrimental effects of SARS-CoV-2 over the endothelium, may explain their worse outcomes in COVID-19. In fact, vascular endothelial dysfunction may contribute to a unfavorable response of the endothelium to the infection by SARS-CoV-2, whereas alterations in cardiac structure and function and the prothrombotic environment in obesity may also provide a link to the increased cardiovascular events in these patients.
Collapse
Affiliation(s)
| | - Vanessa Estato
- Laboratorio de Imunofarmacologia, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, RJ, Brail
| | | | | |
Collapse
|
4
|
Houben AJ, Stehouwer CD. Microvascular dysfunction: Determinants and treatment, with a focus on hyperglycemia. ENDOCRINE AND METABOLIC SCIENCE 2021. [DOI: 10.1016/j.endmts.2020.100073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
|
5
|
Laiginhas R, Guimarães M, Nora M, Chibante J, Falcão M. Gastric Bypass Improves Microvascular Perfusion in Patients with Obesity. Obes Surg 2021; 31:2080-2086. [PMID: 33420672 DOI: 10.1007/s11695-021-05223-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 01/02/2021] [Accepted: 01/04/2021] [Indexed: 12/11/2022]
Abstract
PURPOSE Basic science research has shown that obesity is associated with microvascular endothelial dysfunction. However, whether bariatric surgery impacts the microvascular networks has yet to be explored. This study sought to evaluate the impact of gastric bypass in the retinal microvasculature. METHODS Patients with obesity (BMI ≥ 35 kg/m2) scheduled to gastric bypass were consecutively recruited and included in the study. Patients were evaluated before surgery and 6-12 months after the intervention. Macular microvascular properties were evaluated using optical coherence tomography (OCT) angiography. Foveal avascular zone area, perimeter, circularity, and foveal and perifoveal vascular density (in both superficial and deep vascular plexus) were computed. RESULTS In total, 40 eyes from 20 patients were included (30% male, mean BMI 43.4 ± 4.5 kg/m2 (range 35.7-51.4). From these, 45% were diabetic before bariatric surgery. After surgery, there was a significant increase in foveal avascular zone circularity (from 0.85 ± 0.09 to 0.92 ± 0.07, p = 0.001) and vascular density in perifoveal deep vascular plexus (from 0.69 ± 0.12 to 0.73 ± 0.12; p = 0.04), whereas foveal avascular zone perimeter decreased (from 2.34 ± 0.37 to 2.20 ± 0.35 mm, p = 0.007). Preoperative diabetic status was not a predictor of microvascular retinal changes after bariatric surgery. However, after multivariate adjustments, the increased drop in HbA1c after the surgery remained associated with the increase in perifoveal vascular density in the deep vascular plexus (B = 0.05; 95% CI 0.05-0.10; p = 0.03). CONCLUSIONS Gastric bypass improves retinal microvascular perfusion as demonstrated by the increased parafoveal vascular density in the deep vascular plexus, increased foveal avascular zone circularity, and decreased foveal avascular zone perimeter.
Collapse
Affiliation(s)
- Rita Laiginhas
- PDICSS, Faculty of Medicine of Porto University (FMUP), Porto, Portugal
- Department of Ophthalmology, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | - Marta Guimarães
- Department of General Surgery, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, Portugal
- Unit for Multidisciplinary Research in Biomedicine (UMIB), Endocrine, Cardiovascular and Metabolic Research, University of Porto, Porto, Portugal
- Department of Anatomy, Institute of Biomedical Science Abel Salazar (ICBAS), University of Porto, Porto, Portugal
| | - Mário Nora
- Department of General Surgery, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, Portugal
- Unit for Multidisciplinary Research in Biomedicine (UMIB), Endocrine, Cardiovascular and Metabolic Research, University of Porto, Porto, Portugal
- Department of Anatomy, Institute of Biomedical Science Abel Salazar (ICBAS), University of Porto, Porto, Portugal
| | - João Chibante
- Department of Ophthalmology, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | - Manuel Falcão
- Department of Ophthalmology, Centro Hospitalar e Universitário São João, Porto, Portugal.
- Department of Surgery and Physiology, Faculty of Medicine of Porto University (FMUP), Porto, Portugal.
- Faculty of Medicine of the University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
| |
Collapse
|
6
|
Mak TK, Huang S, Guan B, Au H, Chong TH, Peng J, Chen F, Liang C, Lai W, Ho L, Wang C, Yang J. Bile acid, glucose, lipid profile, and liver enzyme changes in prediabetic patients 1 year after sleeve gastrectomy. BMC Surg 2020; 20:329. [PMID: 33317506 PMCID: PMC7737260 DOI: 10.1186/s12893-020-00998-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 12/02/2020] [Indexed: 12/14/2022] Open
Abstract
Background Few articles have studied individuals with prediabetes after sleeve gastrectomy. Bile acid and lipid levels remain inconsistent in postbariatric patients. The purpose of this study was to explore bile acid, glucose, lipid, and liver enzyme changes in patients with different diabetes statuses who underwent sleeve gastrectomy. The impact of bariatric surgery and its potential benefits for prediabetic patients was also discussed. Methods A total of 202 overweight and obese patients who underwent bariatric surgery in our hospital between January 2016 and October 2018 were retrospectively reviewed. Patients were divided into prediabetes (n = 32), nondiabetes (n = 144), and diabetes (n = 26) groups and analysed. Glucose and lipid data were collected from medical records at baseline and at each follow-up visit. Result Significant improvements in body weight, glucose and lipid levels, and liver enzymes (P ≤ 0.05) in prediabetic patients were found throughout the first year postoperatively. Improvement in glycaemic control was first seen one month postoperatively, followed by persistent improvement in the next 12 months. Total bile acid (TBA) decreased, which was associated with ALT improvement in prediabetic patients 1-year post-surgery. There were no significant differences in HbA1c, glucose, or triglycerides (TGs) between prediabetic and T2DM patients or between prediabetic and nondiabetic patients at 12 months post-surgery. Conclusion LSG is highly effective at interfering with glucose and lipid levels as well as total bile acid levels in prediabetic patients in the first year postoperatively. Thus, LSG is indeed an alternative for overweight and obese prediabetic patients.
Collapse
Affiliation(s)
- Tsz Kin Mak
- Department of Gastrointestinal Surgery, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China
| | - Shifang Huang
- Department of Intensive Care Unit, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China
| | - Bingsheng Guan
- Department of Gastrointestinal Surgery, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China
| | - Hoyin Au
- International School, Jinan University, Guangzhou, 510630, China
| | - Tsz Hong Chong
- Department of Gastrointestinal Surgery, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China
| | - Juzheng Peng
- Department of Gastrointestinal Surgery, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China
| | - Fazhi Chen
- Department of Gastrointestinal Surgery, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China
| | - Chuqiao Liang
- International School, Jinan University, Guangzhou, 510630, China
| | - Wanjing Lai
- International School, Jinan University, Guangzhou, 510630, China
| | - LongLam Ho
- International School, Jinan University, Guangzhou, 510630, China
| | - Cunchuan Wang
- Department of Gastrointestinal Surgery, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China.
| | - Jingge Yang
- Department of Gastrointestinal Surgery, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China.
| |
Collapse
|
7
|
Streese L, Königstein K, Goricki L, Infanger D, Wölnerhanssen B, Peters T, Schmidt-Trucksäss A, Hanssen H. Short- and Long-Term Effects of Bariatric Surgery on Vascular Phenotype. Obes Surg 2020; 29:1301-1308. [PMID: 30617916 DOI: 10.1007/s11695-018-03679-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Retinal microvascular diameters and large artery stiffness are valid biomarkers of cardiovascular risk. This study assessed short- and long-term micro- and macrovascular improvements after bariatric surgery (BS). METHODS Sixteen patients (44 ± 12 years) underwent BS in this observational study. Two weeks before as well as 6 weeks and 4 years after surgery, retinal vessel analysis and assessment of brachial-ankle pulse wave velocity (baPWV), cardio-ankle vascular index (CAVI), and anthropometry were performed. Three patients were lost to follow-up. RESULTS Six weeks after BS, retinal arteriolar diameters (CRAE) were wider (180.1 μm vs. 188.1 μm; p = 0.001), and the arteriolar-to-venular diameter ratio (AVR) was higher (0.82 vs. 0.86; p < 0.001) compared to baseline levels. During the 4 years of follow-up, the retinal changes sustained but further improvements did not occur. Both indices of large artery stiffness, baPWV and CAVI, remained unchanged 6 weeks and 4 years after surgery. CONCLUSIONS Retinal microvascular phenotype improved 6 weeks after BS. The improvements in microvascular health were maintained during 4 years of follow-up but, despite significant further reductions in body mass index, did not improve further long-term. baPWV and CAVI were unaffected after surgery indicating that BS primarily affects microvascular phenotype rather than large artery stiffness. Retinal vessel imaging seems to be a feasible diagnostic tool to monitor microvascular health after BS. Normalization of BMI and blood pressure may be necessary to achieve long-term improvement of large artery phenotype after BS.
Collapse
Affiliation(s)
- Lukas Streese
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Birsstr. 320 B, 4052, Basel, Switzerland
| | - Karsten Königstein
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Birsstr. 320 B, 4052, Basel, Switzerland
| | - Lara Goricki
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Birsstr. 320 B, 4052, Basel, Switzerland
| | - Denis Infanger
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Birsstr. 320 B, 4052, Basel, Switzerland
| | | | - Thomas Peters
- St. Clara Research Ltd, St. Claraspital, Basel, Switzerland
| | - Arno Schmidt-Trucksäss
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Birsstr. 320 B, 4052, Basel, Switzerland
| | - Henner Hanssen
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Birsstr. 320 B, 4052, Basel, Switzerland.
| |
Collapse
|
8
|
Vicente‐Munuera P, Burgos‐Panadero R, Noguera I, Navarro S, Noguera R, Escudero LM. The topology of vitronectin: A complementary feature for neuroblastoma risk classification based on computer-aided detection. Int J Cancer 2020; 146:553-565. [PMID: 31173338 PMCID: PMC6899647 DOI: 10.1002/ijc.32495] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 04/30/2019] [Accepted: 05/27/2019] [Indexed: 12/13/2022]
Abstract
Tumors are complex networks of constantly interacting elements: tumor cells, stromal cells, immune and stem cells, blood/lympathic vessels, nerve fibers and extracellular matrix components. These elements can influence their microenvironment through mechanical and physical signals to promote tumor cell growth. To get a better understanding of tumor biology, cooperation between multidisciplinary fields is needed. Diverse mathematic computations and algorithms have been designed to find prognostic targets and enhance diagnostic assessment. In this work, we use computational digital tools to study the topology of vitronectin, a glycoprotein of the extracellular matrix. Vitronectin is linked to angiogenesis and migration, two processes closely related to tumor cell spread. Here, we investigate whether the distribution of this molecule in the tumor stroma may confer mechanical properties affecting neuroblastoma aggressiveness. Combining image analysis and graph theory, we analyze different topological features that capture the organizational cues of vitronectin in histopathological images taken from human samples. We find that the Euler number and the branching of territorial vitronectin, two topological features, could allow for a more precise pretreatment risk stratification to guide treatment strategies in neuroblastoma patients. A large amount of recently synthesized VN would create migration tracks, pinpointed by both topological features, for malignant neuroblasts, so that dramatic change in the extracellular matrix would increase tumor aggressiveness and worsen patient outcomes.
Collapse
Affiliation(s)
- Pablo Vicente‐Munuera
- Departamento de Biología CelularInstituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Roció/CSIC/Universidad de SevillaSevilleSpain
- Biomedical Network Research Centre on Neurodegenerative Diseases (CIBERNED)MadridSpain
| | - Rebeca Burgos‐Panadero
- Department of Pathology, Medical SchoolUniversity of Valencia/INCLIVAValenciaSpain
- Biomedical Network Research Centre on Oncology (CIBERONC)MadridSpain
| | - Inmaculada Noguera
- Central Support Service for Experimental Research (SCSIE), University of ValenciaValenciaSpain
| | - Samuel Navarro
- Department of Pathology, Medical SchoolUniversity of Valencia/INCLIVAValenciaSpain
- Biomedical Network Research Centre on Oncology (CIBERONC)MadridSpain
| | - Rosa Noguera
- Department of Pathology, Medical SchoolUniversity of Valencia/INCLIVAValenciaSpain
- Biomedical Network Research Centre on Oncology (CIBERONC)MadridSpain
| | - Luis M. Escudero
- Departamento de Biología CelularInstituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Roció/CSIC/Universidad de SevillaSevilleSpain
- Biomedical Network Research Centre on Neurodegenerative Diseases (CIBERNED)MadridSpain
| |
Collapse
|
9
|
Gryglewska B, Głuszewska A, Zarzycki B, Dzieża-Grudnik A, Fedyk-Łukasik M, Major P, Budzyński A, Gąsowski J, Grodzicki T. Post-occlusive reactive hyperemic response of skin microcirculation among extremely obese patients in the short and long term after bariatric surgery. Microcirculation 2019; 27:e12600. [PMID: 31782233 DOI: 10.1111/micc.12600] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 11/25/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To assess changes of post-occlusive reactive hyperemic response in skin microcirculation among extremely obese patients 10 days and 6 months after bariatric surgery for patients with and without hypertension. METHODS Skin blood flow was measured using PeriFlux laser Doppler fluxmetry. Data were analyzed in the entire group and two subgroups: with and without hypertension. RESULTS Data from 88 patients (mean age 42.1 ± 11.2 years, 40.5% men) were analyzed. Six months after bariatric surgery, the time to reach peak flows had been shortened (2.4 ± 1.7 vs 2.1 ± 1.0 seconds, P < .05) and the area of hyperemia had increased (1027 ± 791 vs 1386 ± 699 AU*s, P < .05). The total power of post-occlusive reactive hyperemic after occlusion had been augmented mainly with power intensification of endothelial and myogenic origin. Post-occlusive reactive hyperemic parameters had changed mainly in the subgroup with hypertension. Variations of anthropometric parameters, metabolic characteristic, and adipokines mainly influenced on studied hyperemic flow parameters variations after the intervention in multiple regression analysis. CONCLUSION Cutaneous post-occlusive reactive hyperemic reactivity in time and frequency domains improved 6 months after bariatric surgery, and improvements in microvascular function were observed mainly in patients with hypertension. Variations of anthropometric parameters, metabolic characteristics, and adipokines had influence on hyperemic flow reactivity.
Collapse
Affiliation(s)
- Barbara Gryglewska
- Department of Internal Medicine and Gerontology, Medical College, Jagiellonian University, Kraków, Poland
| | - Anna Głuszewska
- Department of Internal Medicine and Gerontology, Medical College, Jagiellonian University, Kraków, Poland
| | - Bartosz Zarzycki
- Department of Internal Medicine and Gerontology, Medical College, Jagiellonian University, Kraków, Poland
| | - Anna Dzieża-Grudnik
- Department of Internal Medicine and Gerontology, Medical College, Jagiellonian University, Kraków, Poland
| | - Małgorzata Fedyk-Łukasik
- Department of Internal Medicine and Gerontology, Medical College, Jagiellonian University, Kraków, Poland
| | - Piotr Major
- Department of Internal Medicine and Gerontology, Medical College, Jagiellonian University, Kraków, Poland.,2nd Department of General Surgery, Medical College, Jagiellonian University, Kraków, Poland
| | - Andrzej Budzyński
- Department of Internal Medicine and Gerontology, Medical College, Jagiellonian University, Kraków, Poland.,2nd Department of General Surgery, Medical College, Jagiellonian University, Kraków, Poland
| | - Jerzy Gąsowski
- Department of Internal Medicine and Gerontology, Medical College, Jagiellonian University, Kraków, Poland
| | - Tomasz Grodzicki
- Department of Internal Medicine and Gerontology, Medical College, Jagiellonian University, Kraków, Poland
| |
Collapse
|
10
|
Ministrini S, Fattori C, Ricci MA, Bianconi V, Paltriccia R, Boni M, Paganelli MT, Vaudo G, Lupattelli G, Pasqualini L. Microcirculatory Improvement Induced by Laparoscopic Sleeve Gastrectomy Is Related to Insulin Sensitivity Retrieval. Obes Surg 2019; 28:3151-3158. [PMID: 29752665 DOI: 10.1007/s11695-018-3290-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
AIMS Microvascular dysfunction is a potential factor explaining the association of obesity, insulin resistance, and vascular damage in morbidly obese subjects. The purpose of the study was to evaluate possible determinants of microcirculatory improvement 1 year after laparoscopic sleeve gastrectomy (LSG) intervention. METHODS Thirty-seven morbidly obese subjects eligible for bariatric surgery were included in the study. Post-occlusive reactive hyperemia (PORH) of the forearm skin was measured as area of hyperemia (AH) by laser-Doppler flowmetry before LSG and after a 1-year follow-up. RESULTS After intervention, we observed a significant reduction in BMI, HOMA index, HbA1c, and a significant increase of AH in all patients after surgery; this variation was significant only in those patients having insulin resistance or prediabetes/diabetes. Although significant correlation between the increase of AH and the reduction of both BMI, HOMA index, and HbA1c was observed, BMI was the only independent predictor of AH variation after LSG at the linear regression analysis. CONCLUSIONS Our study shows that LSG intervention is correlated with a significant improvement in the microvascular function of morbidly obese subjects; this improvement seems to be related to the baseline degree of insulin-resistance and to the retrieval of insulin-sensitivity post-intervention.
Collapse
Affiliation(s)
- Stefano Ministrini
- Department of Medicine, Università degli Studi di Perugia, Perugia, Italy.
| | - Chiara Fattori
- Department of Medicine, Università degli Studi di Perugia, Perugia, Italy
| | | | - Vanessa Bianconi
- Department of Medicine, Università degli Studi di Perugia, Perugia, Italy
| | - Rita Paltriccia
- Department of Medicine, Università degli Studi di Perugia, Perugia, Italy
| | - Marcello Boni
- General Surgery, ASL Umbria2, "S.Giovanni Battista" Hospital, Foligno, PG, Italy
| | | | - Gaetano Vaudo
- Department of Medicine, Università degli Studi di Perugia, Perugia, Italy
| | | | | |
Collapse
|
11
|
Fujii N, McGarr GW, Ichinose M, Nishiyasu T, Kenny GP. Tetraethylammonium, glibenclamide, and 4‐aminopyridine modulate post‐occlusive reactive hyperemia in non‐glabrous human skin with no roles of
NOS
and
COX. Microcirculation 2019; 27:e12586. [DOI: 10.1111/micc.12586] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 07/25/2019] [Accepted: 08/18/2019] [Indexed: 12/30/2022]
Affiliation(s)
- Naoto Fujii
- Faculty of Health and Sport Sciences University of Tsukuba Tsukuba City Japan
| | - Gregory W. McGarr
- Human and Environmental Physiology Research Unit University of Ottawa Ottawa ON Canada
| | - Masashi Ichinose
- Human Integrative Physiology Laboratory School of Business Administration Meiji University Tokyo Japan
| | - Takeshi Nishiyasu
- Faculty of Health and Sport Sciences University of Tsukuba Tsukuba City Japan
| | - Glen P. Kenny
- Human and Environmental Physiology Research Unit University of Ottawa Ottawa ON Canada
| |
Collapse
|
12
|
Loader J, Khouri C, Taylor F, Stewart S, Lorenzen C, Cracowski JL, Walther G, Roustit M. The continuums of impairment in vascular reactivity across the spectrum of cardiometabolic health: A systematic review and network meta-analysis. Obes Rev 2019; 20:906-920. [PMID: 30887713 DOI: 10.1111/obr.12831] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 01/03/2019] [Accepted: 01/03/2019] [Indexed: 12/12/2022]
Abstract
This study aimed to assess, for the first time, the change in vascular reactivity across the full spectrum of cardiometabolic health. Systematic searches were conducted in MEDLINE and EMBASE databases from their inception to March 13, 2017, including studies that assessed basal vascular reactivity in two or more of the following health groups (aged ≥18 years old): healthy, overweight, obesity, impaired glucose tolerance, metabolic syndrome, or type 2 diabetes with or without complications. Direct and indirect comparisons of vascular reactivity were combined using a network meta-analysis. Comparing data from 193 articles (7226 healthy subjects and 19344 patients), the network meta-analyses revealed a progressive impairment in vascular reactivity (flow-mediated dilation data) from the clinical onset of an overweight status (-0.41%, 95% CI, -0.98 to 0.15) through to the development of vascular complications in those with type 2 diabetes (-4.26%, 95% CI, -4.97 to -3.54). Meta-regressions revealed that for every 1 mmol/l increase in fasting blood glucose concentration, flow-mediated dilation decreased by 0.52%. Acknowledging that the time course of disease may vary between patients, this study demonstrates multiple continuums of vascular dysfunction where the severity of impairment in vascular reactivity progressively increases throughout the pathogenesis of obesity and/or insulin resistance, providing information that is important to enhancing the timing and effectiveness of strategies that aim to improve cardiovascular outcomes.
Collapse
Affiliation(s)
- Jordan Loader
- Department of Medicine, Austin Health, The University of Melbourne, Melbourne, Australia.,Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.,LAPEC EA4278, Avignon Université, Avignon, France
| | - Charles Khouri
- Inserm U1042, Université Grenoble Alpes, Grenoble, France.,Clinical Pharmacology, Grenoble Alpes University Hospital, Grenoble, France
| | - Frances Taylor
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Simon Stewart
- Hatter Institute for Reducing Cardiovascular Disease in Africa, The University of Cape Town, Cape Town, South Africa
| | - Christian Lorenzen
- School of Exercise Science, Australian Catholic University, Melbourne, Australia
| | - Jean-Luc Cracowski
- Inserm U1042, Université Grenoble Alpes, Grenoble, France.,Clinical Pharmacology, Grenoble Alpes University Hospital, Grenoble, France
| | - Guillaume Walther
- LAPEC EA4278, Avignon Université, Avignon, France.,School of Exercise Science, Australian Catholic University, Melbourne, Australia
| | - Matthieu Roustit
- Inserm U1042, Université Grenoble Alpes, Grenoble, France.,Clinical Pharmacology, Grenoble Alpes University Hospital, Grenoble, France
| |
Collapse
|
13
|
Marini E, Mariani PG, Ministrini S, Pippi R, Aiello C, Reginato E, Siepi D, Innocente S, Lombardini R, Paltriccia R, Kararoudi MN, Lupattelli G, De Feo P, Pasqualini L. Combined aerobic and resistance training improves microcirculation in metabolic syndrome. J Sports Med Phys Fitness 2018; 59:1571-1576. [PMID: 30421869 DOI: 10.23736/s0022-4707.18.09077-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Exercise intervention improves macrovascular function in metabolic syndrome (MeS) patients, but few studies have evaluated the effect of exercise on microcirculatory dysfunction, which plays a key role in the development of MeS and its correlated organ damage. We carried out this intervention study to evaluate the influence of an aerobic and resistance training on skin microvascular reactivity in MeS patients. METHODS Postocclusive reactive hyperemia (PORH) of the forearm skin was evaluated, by laser-Doppler flowmetry, before and after a 12-week program of aerobic and resistance training in 15 MeS patients referring to our Lipid Metabolism Outpatients Clinic, together with anthropometric, fitness and metabolic parameters; 15 matched MeS patients who did not exercise, served as a control group. The exercise training consisted of 2 sessions/week of aerobic and resistant exercise. RESULTS Following exercise program, we observed a significant reduction in body weight, fat mass, fasting blood glucose, serum HbA1c and triglycerides, while HDL-cholesterol significantly increased. The exercise-treated group experienced a significant improvement in the area of hyperemia (AH) after PORH, and in all fitness parameters: VO2max, strength on the pulldown lat machine, chest press, leg press and leg extension. A significant correlation emerged between the increase in AH and the reduction in HbA1c and between increase in AH and strength at the chest press, and at the leg extension. CONCLUSIONS Our study showed that a short-term combined aerobic-resistance training positively affects microvascular reactivity in MeS patients. This improvement is correlated with the reduction of HbA1c and fitness parameters, and particularly with increased muscle strength at the upper and lower limbs.
Collapse
Affiliation(s)
- Ettore Marini
- Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, Italy -
| | - Pietro G Mariani
- Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, Italy
| | - Stefano Ministrini
- Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, Italy
| | - Roberto Pippi
- Department of Medicine, Healthy Lifestyle Institute CURIAMO, University of Perugia, Perugia, Italy
| | - Cristina Aiello
- Department of Medicine, Healthy Lifestyle Institute CURIAMO, University of Perugia, Perugia, Italy
| | - Elisa Reginato
- Department of Medicine, Healthy Lifestyle Institute CURIAMO, University of Perugia, Perugia, Italy
| | - Donatella Siepi
- Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, Italy
| | - Salvatore Innocente
- Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, Italy
| | - Rita Lombardini
- Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, Italy
| | - Rita Paltriccia
- Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, Italy
| | - Meisam N Kararoudi
- The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Graziana Lupattelli
- Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, Italy
| | - Pierpaolo De Feo
- Department of Medicine, Healthy Lifestyle Institute CURIAMO, University of Perugia, Perugia, Italy
| | - Leonella Pasqualini
- Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, Italy
| |
Collapse
|
14
|
Moreno-Castellanos N, Guzmán-Ruiz R, Cano DA, Madrazo-Atutxa A, Peinado JR, Pereira-Cunill JL, García-Luna PP, Morales-Conde S, Socas-Macias M, Vázquez-Martínez R, Leal-Cerro A, Malagón MM. The Effects of Bariatric Surgery-Induced Weight Loss on Adipose Tissue in Morbidly Obese Women Depends on the Initial Metabolic Status. Obes Surg 2015; 26:1757-67. [DOI: 10.1007/s11695-015-1995-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
|
15
|
Effects of Roux-en-Y gastric bypass surgery on visceral and subcutaneous fat density by computed tomography. Obes Surg 2015; 25:381-5. [PMID: 25381117 DOI: 10.1007/s11695-014-1485-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
We aimed to test the hypothesis that noninvasive fat density by computed tomography (CT) increases after Roux-en-Y gastric bypass (RYGB) and correlates with improved cardiometabolic risk. We examined 21 obese adults before and 12 months after RYGB and 16 obese nonsurgical controls followed for 12 months. Visceral (VAT) and subcutaneous adipose tissue (SAT) density increased after RYGB (P < 0.0001) while remaining stable in controls (P ≥ 0.1). In RYGB subjects, 12-month increase in VAT density correlated with decreased C-reactive protein (CRP) independent of change in VAT area or BMI (both P < 0.05). Twelve-month increase in SAT density correlated with increased HDL cholesterol independent of change in SAT area (P = 0.048), BMI (P = 0.03), or statin use (P = 0.002), and 1 unit increase in SAT density had increased odds of higher total abdominal fat loss (P = 0.002).
Collapse
|
16
|
Liu L, Liu J, Gao Y, Yu X, Dou D, Huang Y. Protein kinase Cδ contributes to phenylephrine-mediated contraction in the aortae of high fat diet-induced obese mice. Biochem Biophys Res Commun 2014; 446:1179-83. [DOI: 10.1016/j.bbrc.2014.03.065] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 03/17/2014] [Indexed: 12/22/2022]
|