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Hu F, Zhou W, Wang T, Yu C, Zhu L, Bao H, Cheng X. Association between six different types of anthropometric indices and arterial stiffness measured by brachial-ankle pulse wave velocity in hypertensive Chinese adults. Heliyon 2024; 10:e28523. [PMID: 38601660 PMCID: PMC11004534 DOI: 10.1016/j.heliyon.2024.e28523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 03/19/2024] [Accepted: 03/20/2024] [Indexed: 04/12/2024] Open
Abstract
Background The associations of body fat parameters with arterial stiffness measured by brachial-ankle pulse wave velocity in hypertensive patients were scarce. Methods This cross-sectional study analyzed 4322 hypertensive adults. The correlations between the anthropometric indexes (body mass index [BMI], waist circumference, waist-tohip ratio [WHR], waist-to-height ratio [WHtR], a body shape index [ABSI], body round index [BRI]) and ba-PWV values were analyzed using multivariable linear regression model. Results In both sex categories, linear regression models showed that BMI levels were inversely related to baPWV (adjusted-β per SD increase in male: -0.51, 95% CI -0.66 to -0.36, P < 0.001; female: -0.50, 95% CI -0.63 to -0.37, P < 0.001). Waist circumference positively correlated with baPWV only in male hypertensive individuals. BaPWV positively correlated to WHR or WHtR levels (adjusted-β per SD increase: 0.32, 95% CI 0.21 to 0.43, P < 0.001; 0.64, 95% CI 0.47 to 0.82, P < 0.001; respectively), ABSI (adjusted-β per SD increase for ABSI × 100: 0.27, 95% CI 0.18 to 0.36, P < 0.001) and BRI (adjusted-β per SD increase: 0.64, 95% CI 0.46 to 0.81, P < 0.001) levels. The relationship between anthropometric indices and arterial stiffness based on baPWV values were also consistent. ABSI had the highest predictive power of arterial stiffness (area under the curve, 0.594; P < 0.001). Conclusion In Chinese adults with hypertension, BMI was inversely related to baPWV, while WHR, WHtR, ABSI and BRI were positively related. Waist circumference positively correlated with baPWV only in male hypertensive individuals.
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Affiliation(s)
- Feng Hu
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, China
- Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou, 350000, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, 330006, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, 330006, China
| | - Wei Zhou
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, 330006, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, 330006, China
- Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Tao Wang
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, 330006, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, 330006, China
- Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Chao Yu
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, 330006, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, 330006, China
- Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Lingjuan Zhu
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, 330006, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, 330006, China
- Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Huihui Bao
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, 330006, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, 330006, China
- Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Xiaoshu Cheng
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, 330006, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, 330006, China
- Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
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Abstract
Arterial stiffness and hypertension are closely related in pathophysiology. Chronic high blood pressure (BP) can lead to arterial wall damage by mechanical stress, endothelial dysfunction, increased inflammation, oxidative stress, and renin-angiotensin-aldosterone system (RAAS) activation. Hypertension also increases collagen fiber production and accelerates elastin fiber degradation. Stiffened arteries struggle with BP changes, raising systolic BP and pulse pressure. The resulting increased systolic pressure further hardens arteries, creating a harmful cycle of inflammation and calcification. Arterial stiffness data can predict target organ damage and future cardiovascular events in hypertensive patients. Thus, early detection of arterial stiffness aids in initiating preventive measures and treatment plans to protect against progression of vascular damage. While various methods exist for measuring arterial stiffness, pulse wave velocity is a non-invasive, simple measurement method that maximizes effectiveness. Healthy lifestyle changes, RAAS blockers, and statins are known to reduce arterial stiffness. Further research is needed to ascertain if improving arterial stiffness will enhance prognosis in hypertensive patients.
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Affiliation(s)
- Hack-Lyoung Kim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, 5 Boramae-Ro, Dongjak-Gu, Seoul, 07061, Republic of Korea.
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Kim HL, Joh HS, Lim WH, Seo JB, Kim SH, Zo JH, Kim MA. Associations of Estimated Pulse Wave Velocity with Body Mass Index and Waist Circumference among General Korean Adults. Metabolites 2023; 13:1082. [PMID: 37887407 PMCID: PMC10608635 DOI: 10.3390/metabo13101082] [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: 09/21/2023] [Revised: 10/03/2023] [Accepted: 10/13/2023] [Indexed: 10/28/2023] Open
Abstract
The correlation between body fat parameters and arterial stiffness is still under debate. This study aimed to examine the associations of body mass index (BMI) and waist circumference (WC) with estimated pulse wave velocity (ePWV). We utilized data from 14,228 subjects (mean age 53.4 ± 16.8 years; 56.9% were female) from the Korean National Health and Nutrition Examination Survey. The ePWV was calculated using a formula based on age and blood pressure. Simple linear correlation analyses revealed significant associations between both BMI and ePWV (r = 0.098; p < 0.001) and WC and ePWV (r = 0.291; p < 0.001), with a stronger correlation observed between WC and ePWV. Multiple linear regression analysis demonstrated that WC remained significantly associated with ePWV after adjusting for potential confounders (β = 0.020; p = 0.001). However, a statistically significant association was not found between BMI and ePWV (β = 0.011; p = 0.076). Multiple binary logistic regression analysis further indicated that both higher BMI and WC were independently associated with higher ePWV, but the association was more pronounced between WC and ePWV than between BMI and ePWV. These findings underscore a stronger correlation between visceral obesity (as indicated by WC) and arterial stiffness (as indicated by ePWV) compared to overall obesity (as indicated by BMI). This highlights the potential significance of abdominal obesity in assessing cardiovascular risk.
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Affiliation(s)
- Hack-Lyoung Kim
- Division of Cardiology, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Republic of Korea; (H.S.J.); (W.-H.L.); (J.-B.S.); (S.-H.K.); (J.-H.Z.); (M.-A.K.)
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Can M, Kocabas M, Yarar Z, Burgucu HÇ, Karaköse M, Yerlikaya FH, Türkmen K, Kulaksızoğlu M, Karakurt F. Evaluation of subclinical atherosclerosis in obese patients with three noninvasive methods: Arterial stiffness, carotid intima-media thickness, and biomarkers of endothelial dysfunction. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2023; 67:e000622. [PMID: 37252704 PMCID: PMC10665069 DOI: 10.20945/2359-3997000000622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 07/05/2022] [Indexed: 05/31/2023]
Abstract
Objective In this study, we aimed to evaluate subclinical atherosclerosis in patients with obesity who had cardiovascular disease risk indicators such as arterial stiffness, which is evaluated using pulse wave velocity (PWV), carotid intima-media thickness (CIMT), and biomarkers of endothelial dysfunction such as endocan, ADAMTS97, and ADAMTS9. Subjects and methods Sixty obese subjects, including 23 subjects with body mass index (BMI) ≥ 40, 37 subjects with BMI ≥ 30 but < 40, and 60 age-and sex-matched control subjects, were included in our study. Serum endocan, ADAMTS97, and ADAMTS9 levels as well as PWV and CIMT measurements of the subjects in the obese and control groups were performed. Results In the obesity group, PWV levels were significantly higher than they were in the control group and endocan levels were significantly lower than they were in the control group. When we compared the obese group with BMI ≥ 40 and the control group, the BMI ≥ 40 group had significantly higher PWV and CIMT levels than the control group had, whereas endocan, ADAMTS7, and ADAMTS9 levels were similar to those of the control group. When we compared the obese group with BMI ≥ 30 < 40 to the control group, endocan levels were lower in the group with BMI ≥30 < 40, and PWV and CIMT levels were similar to the control group. Conclusion We found that arterial stiffness and CIMT increased in obese patients with BMI ≥ 40 and that increased arterial stiffness was associated with age, systolic blood pressure, and HBA1C. In addition, we found that the endocan levels were lower in obese patients than they were in nonobese control individuals.
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Affiliation(s)
- Mustafa Can
- Department of Endocrinology and Metabolism, Muş State Hospital, Muş, Turkey,
| | - Muhammet Kocabas
- Department of Endocrinology and Metabolism, Tokat State Hospital, Tokat, Turkey
| | - Zeliha Yarar
- Department of Endocrinology and Metabolism, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Hatice Çalışkan Burgucu
- Department of Endocrinology and Metabolism, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Melia Karaköse
- Department of Endocrinology and Metabolism, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | | | - Kültigin Türkmen
- Department of Nephrology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Mustafa Kulaksızoğlu
- Department of Endocrinology and Metabolism, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Feridun Karakurt
- Department of Endocrinology and Metabolism, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
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Rodríguez-Vargas GS, Santos-Moreno P, Rubio-Rubio JA, Bautista-Niño PK, Echeverri D, Gutiérrez-Castañeda LD, Sierra-Matamoros F, Navarrete S, Aparicio A, Saenz L, Rojas-Villarraga A. Vascular Age, Metabolic Panel, Cardiovascular Risk and Inflammaging in Patients With Rheumatoid Arthritis Compared With Patients With Osteoarthritis. Front Cardiovasc Med 2022; 9:894577. [PMID: 35865390 PMCID: PMC9295407 DOI: 10.3389/fcvm.2022.894577] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 06/08/2022] [Indexed: 12/14/2022] Open
Abstract
IntroductionThe risk of cardiovascular disease (CVD) in patients with rheumatoid arthritis (RA) is 1.5–2 times higher than the general population. The fundamental risk factor for CVD is age, related to alterations at the arterial level. The aim of the study was to compare vascular age (VA) in RA patients under a strict treat-to-target (T2T) strategy with Osteoarthritis (OA) patients without strict follow up and to assess the influence of inflammaging (chronic, sterile, low-grade inflammation related to aging) and metabolic markers on VA.Materials and MethodsThis was an analytical cross-sectional study. Patients with RA (under a strict a T2T strategy) and OA patients without strict clinical follow-up were included. Patients with a history of uncontrolled hypertension, CVD, and/or current smoking were excluded. Sociodemographic, physical activity, and toxic exposure data were obtained. Waist-hip ratio and body mass index (BMI) were measured. DAS-28 (RA) and inflammatory markers, lipid profile, and glycaemia were analyzed. Pulse wave velocity (PWV) was measured (oscillometric method, Arteriograph-TensioMed®). VA was calculated based on PWV. Eleven components of inflammaging [six interleukins, three metalloproteinases (MMP), and two tissue inhibitors of metalloproteinases (TIMP)] were evaluated (Luminex® system). Univariate and bivariate analyzes (Mann Whitney U and chi-square) and correlations (Spearmans Rho) were done to compare the two groups.ResultsA total of 106 patients (74% women) were included, 52/RA and 54/OA. The mean age was 57 (Interquartile range - IQR 9 years). The BMI, waist circumference, and weight were higher in patients with OA (p < 0.001). RA patients had low disease activity (DAS-28-CRP). There were no differences in VA, inflammaging nor in PWV between the two groups. VA had a positive, but weak correlation, with age and LDL. In group of RA, VA was higher in those who did not receive methotrexate (p = 0.013). LDL levels correlated with MMP1, TIMP1, and TIMP2.ConclusionsWhen comparing RA patients with low levels of disease activity with OA patients with poor metabolic control, there are no differences in VA. Furthermore, methotrexate also influences VA in RA patients. This shows that implemented therapies may have an impact on not only the inflammatory state of the joint but also CVD risk.
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Affiliation(s)
- Gabriel-Santiago Rodríguez-Vargas
- Research Institute, Fundación Universitaria de Ciencias de la Salud-FUCS, Bogotá, Colombia
- Rheumatology, Biomab - Center for Rheumatoid Arthritis, Bogotá, Colombia
- *Correspondence: Gabriel-Santiago Rodríguez-Vargas
| | | | | | | | - Darío Echeverri
- Cardiovascular Prevention Program, Fundación Cardioinfantil-Instituto de Cardiología, Bogotá, Colombia
| | - Luz-Dary Gutiérrez-Castañeda
- Research Institute, Fundación Universitaria de Ciencias de la Salud-FUCS, Bogotá, Colombia
- Basic Sciences Laboratory, Fundación Universitaria de Ciencias de la Salud-FUCS, Bogotá, Colombia
| | | | - Stephania Navarrete
- Basic Sciences Laboratory, Fundación Universitaria de Ciencias de la Salud-FUCS, Bogotá, Colombia
| | - Anggie Aparicio
- Basic Sciences Laboratory, Fundación Universitaria de Ciencias de la Salud-FUCS, Bogotá, Colombia
| | - Luis Saenz
- Cardiovascular Prevention Program, Fundación Cardioinfantil-Instituto de Cardiología, Bogotá, Colombia
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Sultan EZM, Rabea H, Elberry AA, Mahmoud HB. Effect of Amlodipine/Nebivolol combination therapy on central BP and PWV compared to Amlodipine/Valsartan combination therapy. Egypt Heart J 2022; 74:15. [PMID: 35286492 PMCID: PMC8921398 DOI: 10.1186/s43044-022-00254-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 03/03/2022] [Indexed: 11/10/2022] Open
Abstract
Background Pulse wave velocity (PWV) and central blood pressure (CBP) have been intoduced into managment of hypertensive patients. PWV is positively correlated with arterial wall stiffness while central aortic pressure becomes better predictor of cardiovascular outcome than peripheral pressure. Reduction in CBP provides protective properties against subclinical organ damage. This work aims to investigate the effect of a new combination therapy of Amlodipine/Nebivolol (A/N) on central BP, peripheral BP and PWV. The results of using this combination will be compared to the well-established fixed-dose combination of Amlodipine/Valsartan (A/V). The study conducted between October 2018 and August 2020. One hundred and two hypertensive patients were assigned for Amlodipine 10 mg/Valsartan 160 mg combination therapy (A/V, n = 52) or Amlodipine 10 mg/Nebivolol 5 mg combination therapy (A/N, n = 50) by simple 1:1 randomization. Office, central blood pressure and PWV were measured on first (0 week), second (4–8 weeks) and third visit (10–12). Difference in BP (in each arm and between arms) was calculated along all visits. Results No statistical significant difference was found between A/V and A/N regarding age, gender, BMI and CV history. OBP, CBP and PWV were significantly reduced in each arm, but no differences were found when comparing both arm results to each other. Recorded side effects were insignificant. Conclusions The new combination therapy Amlodipine/Nebivolol (A/N) affords a significant reduction in CBP, PBP and PWV with minor and tolerable side effects. It has provided comparable results to Amlodipine/Valsartan (A/V) combination therapy.
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Affiliation(s)
- El-Zahraa M Sultan
- Cardiology Department, Beni-Suef University Hospital, Beni-Suef City, 62511, Egypt.
| | - Hoda Rabea
- Clinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef City, 62511, Egypt
| | - Ahmed A Elberry
- Department of Pharmacy Practice, Pharmacy Program, Batterjee Medical College, Jeddah, 21442, Saudi Arabia
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Sobhani S, Vakili S, Javid Jam D, Aryan R, Khadem‐Rezaiyan M, Eslami S, Alinezhad‐Namaghi M. Relationship between anthropometric indices and arterial stiffness: Insights from an epidemiologic study. Obes Sci Pract 2022; 8:494-499. [PMID: 35949287 PMCID: PMC9358735 DOI: 10.1002/osp4.582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 11/17/2021] [Accepted: 12/10/2021] [Indexed: 11/12/2022] Open
Affiliation(s)
- Sahar Sobhani
- Department of Nursing and Midwifery Faculty of Nursing Gonabad University of Medical Sciences Gonabad Iran
| | - Saba Vakili
- Medical Genetics Research Center Mashhad University of Medical Sciences Mashhad Iran
| | - Dina Javid Jam
- Department of Clinical Biochemistry Faculty of Medicine Mashhad University of Medical Sciences Mashhad Iran
| | - Reihaneh Aryan
- Clinical Research Development Unit Imam Reza Hospital Mashhad University of Medical Sciences Mashhad Iran
| | - Majid Khadem‐Rezaiyan
- Clinical Research Development Unit Faculty of Medicine Mashhad University of Medical Sciences Mashhad Iran
| | - Saeid Eslami
- Department of Medical Informatics Faculty of Medicine Mashhad University of Medical Sciences Mashhad Iran
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Association between body fat parameters and arterial stiffness. Sci Rep 2021; 11:20536. [PMID: 34654852 PMCID: PMC8519992 DOI: 10.1038/s41598-021-00175-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 09/23/2021] [Indexed: 11/17/2022] Open
Abstract
The influence of body fat on arterial stiffness remains controversial. This study was performed to investigate the associations between four different types of body fat parameters and brachial-ankle pulse wave velocity (baPWV). A total of 3758 subjects (mean age, 53.4 ± 8.8 years; females, 36.3%) who underwent health check-up were retrospectively analyzed. Anthropometric parameters including body mass index (BMI), waist circumference (WC) and waist–hip ratio (WHR) were assessed, and visceral fat area (VFA) was calculated by bioelectrical impedance analysis. In simple linear correlation analyses, baPWV was associated with WC, WHR and VFA (P < 0.001 for each), but not with BMI (P = 0.175). In multivariable analyses, BMI and WC were not associated with baPWV (P > 0.05 for each). Even after controlling for potential confounders, higher baPWV was significantly associated not only with higher WHR [for > 0.90 in men and > 0.85 in women: odds ratio (OR), 1.23; 95% confidence interval (CI), 1.06–1.42; P = 0.005; for the highest tertile compared to the lowest tertile: OR, 1.38; 95% CI, 1.15–1.66; P < 0.001], but also with higher VFA (for ≥ 100 cm2: OR, 1.39; 95% CI, 1.20–1.60; P < 0.001; for the highest tertile compared to the lowest tertile: OR, 1.77; 95% CI, 1.48–2.12; P < 0.001). Our study showed that baPWV was correlated with WHR and VFA, but not with BMI and WC. This implies that arterial stiffness may be more strongly associated with abdominal obesity than overall obesity.
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Brinkley TE, Leng I, Bailey MJ, Houston DK, Hugenschmidt CE, Nicklas BJ, Hundley WG. Effects of Exercise and Weight Loss on Proximal Aortic Stiffness in Older Adults With Obesity. Circulation 2021; 144:684-693. [PMID: 34333991 DOI: 10.1161/circulationaha.120.051943] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Obesity may accelerate age-related increases in aortic stiffness. Although aerobic exercise training generally has favorable effects on aortic structure and function, exercise alone may not be sufficient to improve aortic stiffness in older adults with obesity. We determined the effects of aerobic exercise training with and without moderate- to high-caloric restriction (CR) on the structure and function of the proximal aorta in 160 older (65-79 years) men and women with obesity (body mass index=30-45 kg/m2). METHODS Participants were randomly assigned to 1 of 3 groups: aerobic exercise training only (treadmill 4 days/week for 30 minutes at 65% to 70% of heart rate reserve; n=56), aerobic exercise training plus moderate CR (n=55), or aerobic exercise training plus more intensive CR (n=49) for 20 weeks. Aortic pulse wave velocity, aortic distensibility, and other measures of aortic structure and function were assessed by cardiovascular magnetic resonance imaging. Pearson correlation coefficients were examined to assess associations between changes in proximal aortic stiffness and changes in fitness, fatness, and other potential confounders. RESULTS Weight loss in the aerobic exercise training plus moderate CR (-8.0 kg [95% CI, -9.17 to -6.87]) and aerobic exercise training plus more intensive CR (-8.98 kg [95% CI, -10.23 to -7.73) groups was significantly greater compared with the aerobic exercise training-only group (-1.66 kg [95% CI, -2.94 to -0.38]; P<0.017 for both). There were significant treatment effects for descending aorta distensibility (P=0.008) and strain (P=0.004) and aortic arch pulse wave velocity (P=0.01) with the aerobic exercise training plus moderate CR group having a 21% increase in distensibility (P=0.016) and an 8% decrease in pulse wave velocity (P=0.058). None of the aortic stiffness measures changed significantly in the aerobic exercise training-only or aerobic exercise training plus more intensive CR groups, and there were no significant changes in any other measure of aortic structure or function in these groups. Overall, increases in aortic distensibility were correlated with improvements in body weight and body fat distribution, but these associations were not statistically significant after adjustment for multiple comparisons. CONCLUSIONS In older adults with obesity, combining aerobic exercise with moderate CR leads to greater improvements in proximal aortic stiffness than exercise alone. Registration: URL: https://clinicaltrials.gov; Unique identifier: NCT01048736.
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Affiliation(s)
- Tina E Brinkley
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine (T.E.B., D.K.H., C.E.H., B.J.N.)
| | - Iris Leng
- Division of Public Health Sciences, Department of Biostatistics and Data Science (I.L.)
| | - Margie J Bailey
- Hypertension and Vascular Research Center (M.J.B.), Wake Forest School of Medicine, Winston-Salem, NC
| | - Denise K Houston
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine (T.E.B., D.K.H., C.E.H., B.J.N.)
| | - Christina E Hugenschmidt
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine (T.E.B., D.K.H., C.E.H., B.J.N.)
| | - Barbara J Nicklas
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine (T.E.B., D.K.H., C.E.H., B.J.N.)
| | - W Gregory Hundley
- Department of Internal Medicine, Virginia Commonwealth University, Richmond (W.G.H.)
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Raimundo R, Saraiva F, Moreira R, Moreira S, Ferreira AF, Cerqueira RJ, Amorim MJ, Pinho P, Barros AS, Lourenço AP, Leite-Moreira A. Arterial Stiffness Changes in Severe Aortic Stenosis Patients Submitted to Valve Replacement Surgery. Arq Bras Cardiol 2021; 116:475-482. [PMID: 33909777 PMCID: PMC8159560 DOI: 10.36660/abc.20190577] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 12/27/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Little is known about the impact of severe aortic stenosis (AS) in aortic stiffness and if there is any change after removing AS barrier with aortic valve replacement (AVR) surgery. OBJECTIVE To estimate carotid-femoral pulse wave velocity (PWV) changes after AVR surgery and to define PWV predictors in severe AS patients. METHODS Single-center retrospective cohort, including patients with severe AS who underwent AVR surgery with bioprostheses, between February 2017 and January 2019 and performed PWV measurements (Complior®) before and after the procedure (2±1 months). Before and after AVR, PWV values were compared through paired tests. The associations of PWV with clinical data were studied and linear regression models were applied to estimate pre and postoperative PWV independent predictors. The significance level was set at 5%. RESULTS We included 150 patients in the sample, with mean age of 72±8 years, and 51% being males. We found a statistically significant increase in PWV values after surgery (9.0±2.1 m/s vs. 9.9±2.2, p<0.001, before and after AVR, respectively) and an inverse association with AS severity variables. In the linear regression model, age and systolic blood pressure (SBP) were established as independent predictors of higher pre- and postoperative PWV, while higher mean valvular gradient emerged as a determinant of lower pre-AVR PWV. CONCLUSION We documented an inverse correlation of arterial stiffness with the severity of AS in patients with AS, and a significant increase in PWV values after AVR surgery. Advanced age and higher SBP were associated with higher PWV values, although arterial function measurements were within the normal range. (Arq Bras Cardiol. 2021; 116(3):475-482).
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Affiliation(s)
- Renata Raimundo
- University of PortoFaculty of MedicineDepartment of Surgery and PhysiologyPortoPortugalCardiovascular Research and Development Center, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto - Portugal,Correspondência: Renata Melo Raimundo • Faculdade de Medicina da Universidade do Porto - Departamento de Cirurgia e Fisiologia - Alameda Prof. Hernâni Monteiro Porto 4200-319 – Portugal. E-mail:
| | - Francisca Saraiva
- University of PortoFaculty of MedicineDepartment of Surgery and PhysiologyPortoPortugalCardiovascular Research and Development Center, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto - Portugal
| | - Raquel Moreira
- University of PortoFaculty of MedicineDepartment of Surgery and PhysiologyPortoPortugalCardiovascular Research and Development Center, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto - Portugal
| | - Soraia Moreira
- University of PortoFaculty of MedicineDepartment of Surgery and PhysiologyPortoPortugalCardiovascular Research and Development Center, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto - Portugal
| | - Ana Filipa Ferreira
- University of PortoFaculty of MedicineDepartment of Surgery and PhysiologyPortoPortugalCardiovascular Research and Development Center, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto - Portugal
| | - Rui J. Cerqueira
- University of PortoFaculty of MedicineDepartment of Surgery and PhysiologyPortoPortugalCardiovascular Research and Development Center, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto - Portugal,Centro Hospitalar Universitário São JoãoDepartment of Cardiothoracic SurgeryPortoPortugalDepartment of Cardiothoracic Surgery, Centro Hospitalar Universitário São João, Porto - Portugal
| | - Mario Jorge Amorim
- University of PortoFaculty of MedicineDepartment of Surgery and PhysiologyPortoPortugalCardiovascular Research and Development Center, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto - Portugal,Centro Hospitalar Universitário São JoãoDepartment of Cardiothoracic SurgeryPortoPortugalDepartment of Cardiothoracic Surgery, Centro Hospitalar Universitário São João, Porto - Portugal
| | - Paulo Pinho
- Centro Hospitalar Universitário São JoãoDepartment of Cardiothoracic SurgeryPortoPortugalDepartment of Cardiothoracic Surgery, Centro Hospitalar Universitário São João, Porto - Portugal
| | - António Sousa Barros
- University of PortoFaculty of MedicineDepartment of Surgery and PhysiologyPortoPortugalCardiovascular Research and Development Center, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto - Portugal
| | - André P. Lourenço
- University of PortoFaculty of MedicineDepartment of Surgery and PhysiologyPortoPortugalCardiovascular Research and Development Center, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto - Portugal,Centro Hospitalar Universitário São JoãoDepartment of AnesthesiologyPortoPortugalDepartment of Anesthesiology, Centro Hospitalar Universitário São João, Porto - Portugal
| | - Adelino Leite-Moreira
- University of PortoFaculty of MedicineDepartment of Surgery and PhysiologyPortoPortugalCardiovascular Research and Development Center, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto - Portugal,Centro Hospitalar Universitário São JoãoDepartment of Cardiothoracic SurgeryPortoPortugalDepartment of Cardiothoracic Surgery, Centro Hospitalar Universitário São João, Porto - Portugal
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11
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Wang FM, Yang C, Tanaka H, Coresh J, Ndumele CE, Matsushita K. Increase in arterial stiffness measures after bariatric surgery. Atherosclerosis 2021; 320:19-23. [PMID: 33508519 DOI: 10.1016/j.atherosclerosis.2021.01.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 12/15/2020] [Accepted: 01/12/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND AIMS The relationship between obesity and arterial stiffness is complex, with a potential interaction by age (inverse association at younger age and positive at older age) and conflicting reports on the effect of lifestyle-based weight loss on arterial stiffness. Little is understood about post-bariatric surgery changes in arterial stiffness. This study aimed to examine post-bariatric surgery changes in arterial stiffness and identify factors associated with greater changes in arterial stiffness. METHODS In 72 patients (mean age 44.5 years, 72.2% female), we evaluated two arterial stiffness measures, cardio-ankle vascular index (CAVI) and heart-ankle pulse wave velocity (haPWV), one month prior to and 6 months after bariatric surgery. Another follow-up visit was conducted 12 months after bariatric surgery in a subset of 58 participants. RESULTS Six months after bariatric surgery, an evident decrease was seen in body mass index, heart rate, and systolic blood pressure. In contrast, both CAVI and haPWV significantly increased at 6 months (+0.64 [0.42, 0.87] and +0.24 [0.04, 0.44] m/s, respectively). Among 58 patients with relevant data, CAVI and haPWV remained elevated 12 months after bariatric surgery (+0.80 [0.53, 1.07] and +0.40 [0.17, 0.62] m/s, respectively). Being non-diabetic and having larger decreases in post-surgery heart rate were independently associated with greater increases in post-surgical CAVI. CONCLUSIONS Arterial stiffness measures, CAVI and haPWV, were elevated after bariatric surgery despite other favorable cardiometabolic changes. Further studies are necessary to elucidate the underlying mechanism and prognostic implications of this elevation in arterial stiffness measures after bariatric surgery.
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Affiliation(s)
- Frances M Wang
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Chao Yang
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Josef Coresh
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Chiadi E Ndumele
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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12
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Paiman EHM, de Mutsert R, Widya RL, Rosendaal FR, Jukema JW, Lamb HJ. The role of insulin resistance in the relation of visceral, abdominal subcutaneous and total body fat to cardiovascular function. Nutr Metab Cardiovasc Dis 2020; 30:2230-2241. [PMID: 32912791 DOI: 10.1016/j.numecd.2020.07.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 06/30/2020] [Accepted: 07/06/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIMS The separate cardiovascular effects of type 2 diabetes and adiposity remain to be examined. This study aimed to investigate the role of insulin resistance in the relations of visceral (VAT), abdominal subcutaneous (aSAT) adipose tissue and total body fat (TBF) to cardiovascular remodeling. METHODS AND RESULTS In this cross-sectional analysis of the population-based Netherlands Epidemiology of Obesity study, 914 middle-aged individuals (46% men) were included. Participants underwent magnetic resonance imaging. Standardized linear regression coefficients (95%CI) were calculated, adjusted for potential confounding factors. All fat depots and insulin resistance (HOMA-IR), separate from VAT and TBF, were associated with lower mitral early and late peak filling rate ratios (E/A): -0.04 (-0.09;0.01) per SD (54 cm2) VAT; -0.05 (-0.10;0.00) per SD (94 cm2) aSAT; -0.09 (-0.16;-0.02) per SD (8%) TBF; -0.11 (-0.17;-0.05) per 10-fold increase in HOMA-IR, whereas VAT and TBF were differently associated with left ventricular (LV) end-diastolic volume: -8.9 (-11.7;-6.1) mL per SD VAT; +5.4 (1.1;9.7) mL per SD TBF. After adding HOMA-IR to the model to evaluate the mediating role of insulin resistance, change in E/A was -0.02 (-0.07;0.04) per SD VAT; -0.03 (-0.08;0.02) per SD aSAT; -0.06 (-0.13;0.01) per SD TBF, and change in LV end-diastolic volume was -7.0 (-9.7;-4.3) mL per SD VAT. In women, adiposity but not HOMA-IR was related to higher aortic arch pulse wave velocity. CONCLUSION Insulin resistance was associated with reduced diastolic function, separately from VAT and TBF, and partly mediated the associations between adiposity depots and lower diastolic function.
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Affiliation(s)
- Elisabeth H M Paiman
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands.
| | - Renée de Mutsert
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Ralph L Widya
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Frits R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - J Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Hildo J Lamb
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
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13
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Wong A, Figueroa A, Fischer SM, Bagheri R, Park SY. The Effects of Mat Pilates Training on Vascular Function and Body Fatness in Obese Young Women With Elevated Blood Pressure. Am J Hypertens 2020; 33:563-569. [PMID: 32236522 DOI: 10.1093/ajh/hpaa026] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 02/11/2020] [Accepted: 02/16/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Effective nonpharmacological interventions targeting the enhancement of vascular function and decline of body fatness (BF) in obese individuals are indispensable for the prevention of hypertension and cardiovascular events in young adults. Mat Pilates training (MPT) has gained significant popularity worldwide, yet its effects on vascular function and body composition are understudied. We examined the effects of MPT on vascular function and BF in young obese women with elevated blood pressure (BP). METHODS Twenty-eight young obese women with elevated BP were randomized to an MPT (n = 14) or a nonexercising control (CON, n = 14) group for 12 weeks. Systemic arterial stiffness (brachial-ankle pulse wave velocity (baPWV)), brachial and aortic BP, wave reflection (augmentation index (AIx)), plasma nitric oxide (NO) levels, and BF percentage (BF%) were assessed before and after 12 weeks. RESULTS MPT significantly reduced (P ˂ 0.05) baPWV (-0.7 ± 0.2 m/s), AIx (-4 ± 1%), brachial systolic BP (-5 ± 1 mm Hg), aortic systolic BP (-6 ± 1 mm Hg), and BF% (-2 ± 1%), while significantly increasing plasma NO (6 ± 2 µM) (P ˂ 0.05) compared with CON. MPT improved systemic arterial stiffness, aortic BP, wave reflection, circulating plasma NO, and BF% in young obese women with elevated BP. CONCLUSIONS MPT may be an effective intervention for the improvement of vascular function and BF in young obese women with elevated BP, a population at risk for hypertension and early vascular complications. CLINICAL TRIALS REGISTRATION Trial Number NCT03907384.
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Affiliation(s)
- Alexei Wong
- Department of Health and Human Performance, Marymount University, Arlington, VA, USA
| | - Arturo Figueroa
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Stephen M Fischer
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Reza Bagheri
- Department of Exercise Physiology, University of Isfahan, Isfahan, Iran
| | - Song-Young Park
- Department of Health and Kinesiology, University of Nebraska-Omaha, Omaha, NE, USA
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14
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Bielecka-Dabrowa A, Bartlomiejczyk MA, Sakowicz A, Maciejewski M, Banach M. The Role of Adipokines in the Development of Arterial Stiffness and Hypertension. Angiology 2020; 71:754-761. [PMID: 32431166 DOI: 10.1177/0003319720927203] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The study aimed to assess the role and the relationship of adipokines as well as parameters of arterial stiffness in newly diagnosed hypertension. Forty-nine newly diagnosed hypertensive cases (median age 47 ± 6 years) and 48 normotensive patients (median age 47 ± 6 years) were enrolled to this study. Patients underwent echocardiography, noninvasive assessment of hemodynamic parameters using SphygmoCor tonometer (Atcor Med). The levels of the adipokines-leptin, adiponectin, and resistin-were investigated. The augmentation pressure, augmentation index, and pulse wave velocity (PWV) were higher in patients with hypertension compared with controls (Ps < .05). Patients with hypertension had higher E/E' ratio, higher diameter of left atrium, and lower tricuspid annular plane systolic excursion compared with the control group (Ps < .05). Patients with hypertension had significant higher levels of leptin (ng/mL) and lower levels of adiponectin (μg/mL) compared with normotensive patients. The multivariate analysis showed that PWV (odds ratio [OR] 1.95, 95% CI, 1.2-2.9; P = .002) and leptin level (OR 1.01, 95% CI, 1.004-1.031; P = .01) were significantly associated with hypertension. Arterial stiffness as determined by PWV and leptin are associated with newly diagnosed hypertension. Elevated serum leptin level may influence the potential mechanism leading to sympathetic activation.
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Affiliation(s)
- Agata Bielecka-Dabrowa
- Department of Hypertension, Medical University of Lodz, Poland.,Department of Cardiology and Congenital Diseases of Adults, Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland
| | | | - Agata Sakowicz
- Department of Medical Biotechnology, Medical University of Lodz, Poland
| | - Marek Maciejewski
- Department of Cardiology and Congenital Diseases of Adults, Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland
| | - Maciej Banach
- Department of Hypertension, Medical University of Lodz, Poland.,Department of Cardiology and Congenital Diseases of Adults, Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland
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15
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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.
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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.
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17
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Tang B, Luo F, Zhao J, Ma J, Tan I, Butlin M, Avolio A, Zuo J. Relationship between body mass index and arterial stiffness in a health assessment Chinese population. Medicine (Baltimore) 2020; 99:e18793. [PMID: 32011479 PMCID: PMC7220472 DOI: 10.1097/md.0000000000018793] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Pulse wave velocity (PWV) is a reliable measurement of arterial stiffness. Our study assesses the association between body mass index (BMI) and brachial-ankle PWV (baPWV) in a healthy cohort and seeks to explain possible mechanisms associated with the obesity paradox.A cross-sectional study was conducted in 578 normal individuals. The mean age was 48.3 ± 14.6 years, and 468 (81.0%) were men. 288 subjects (49.8%) were overweight and obese. baPWV and ankle-brachial index (ABI) were performed to evaluate arterial stiffness and atherosclerosis respectively. Normal weight was defined as 18.5 < BMI <25 kg/m, overweight as 25 ≤ BMI < 28 kg/m and obesity as BMI ≥28 kg/m.The overweight/obese subjects had significantly higher baPWV than the normal-weight group (1490.0 ± 308.0/1445.2 ± 245.2 cm/s vs 1371.2 ± 306.4 cm/s, P < .001). For the whole cohort, baPWV showed a significant positive correlation with BMI (r = 0.205, P < .001). However, baPWV was significantly lower as BMI increased: 1490.0 ± 308.0 cm/s (overweight); 1445.2 ± 245.2 cm/s (obese); P < .001) when adjusted for age, gender, heart rate, mean blood pressure, and cardiovascular risk factors (glucose, cholesterol, triglyceride, and low-density lipoprotein). For the whole cohort BMI was negatively associated with baPWV (β = -0.06, P = .042). ABI showed no relationship with BMI. In a middle-age healthy Chinese population, arterial stiffness measured as baPWV increased with BMI.Evidence of reduced arterial stiffness with increasing BMI when accounting for all other cardiovascular risk factors may contribute to underlying factors involved in the obesity paradox that becomes more prominent with increasing age.
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Affiliation(s)
| | - Fangxiu Luo
- Department of Pathology, Shanghai Jiaotong University School of Medicine
| | | | - Jing Ma
- Department of Health Assessment, Ruijin Hospital North, Shanghai Jiao Tong School of Medicine, Shanghai, China
| | - Isabella Tan
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - Mark Butlin
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - Alberto Avolio
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - Junli Zuo
- Department of Geriatric Medicine
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
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18
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García-Prieto CF, Gil-Ortega M, Vega-Martín E, Ramiro-Cortijo D, Martín-Ramos M, Bordiú E, Sanchez-Pernaute A, Torres A, Aránguez I, Fernández-Alfonso M, Rubio MA, Somoza B. Beneficial Effect of Bariatric Surgery on Abnormal MMP-9 and AMPK Activities: Potential Markers of Obesity-Related CV Risk. Front Physiol 2019; 10:553. [PMID: 31133882 PMCID: PMC6517546 DOI: 10.3389/fphys.2019.00553] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 04/18/2019] [Indexed: 12/30/2022] Open
Abstract
Bariatric surgery (BS) results in sustained weight loss and may reverse inflammation, metabolic alterations, extracellular matrix remodeling and arterial stiffness. We hypothesize that increased stiffening in omental arteries from obese patients might be associated with an increase in MMP activity and a decrease in p-AMPK, together with systemic oxidative stress and inflammation. Moreover, BS could contribute to reversing these alterations. This study was conducted with 38 patients of Caucasian origin: 31 adult patients with morbid obesity (9 men and 22 women; mean age 46 years and BMI = 42.7 ± 1.0 kg/m2) and 7 non-obese subjects (7 women; mean age 45 years and BMI = 22.7 ± 0.6 kg/m2). Seventeen obese patients were studied before and 12 months after BS. The stiffness index β, an index of intrinsic arterial stiffness, was determined in omental arteries and was significantly higher in obese patients. Levels of phosphorylated AMPK (p-AMPKThr-172) and SIRT-1 were significantly lower in peripheral blood mononuclear cells (PBMCs) from obese patients than those from non-obese patients (p < 0.05) and were normalized after BS. Total and active MMP-9 activities, LDH, protein carbonyls and uric acid were higher in obese patients and reduced by BS. Moreover, there was a correlation between plasmatic LDH levels and the stiffness index β. BS has a beneficial effect on abnormal MMP-9, LDH and AMPK activities that might be associated with the development of arterial stiffness in obese patients. Since these parameters are easily measured in blood samples, they could constitute potential biomarkers of cardiovascular risk in morbid obesity.
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Affiliation(s)
- Concha F García-Prieto
- Departamento de Ciencias Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Madrid, Spain
| | - Marta Gil-Ortega
- Departamento de Ciencias Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Madrid, Spain
| | - Elena Vega-Martín
- Departamento de Farmacología, Facultad de Farmacia, Instituto Pluridisciplinar, Universidad Complutense de Madrid, Madrid, Spain
| | - David Ramiro-Cortijo
- Departamento de Fisiología, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain
| | - Miriam Martín-Ramos
- Departamento de Farmacología, Facultad de Farmacia, Instituto Pluridisciplinar, Universidad Complutense de Madrid, Madrid, Spain
| | - Elena Bordiú
- Servicio de Endocrinología y Nutrición, Facultad de Medicina, Hospital Clínico San Carlos, Instituto de Investigaciones Sanitarias San Carlos, Universidad Complutense de Madrid, Madrid, Spain
| | - Andrés Sanchez-Pernaute
- Servicio de Cirugía, Facultad de Medicina, Hospital Clínico San Carlos, Instituto de Investigaciones Sanitarias San Carlos, Universidad Complutense de Madrid, Madrid, Spain
| | - Antonio Torres
- Servicio de Cirugía, Facultad de Medicina, Hospital Clínico San Carlos, Instituto de Investigaciones Sanitarias San Carlos, Universidad Complutense de Madrid, Madrid, Spain
| | - I Aránguez
- Departamento de Bioquímica, Facultad de Farmacia, Universidad Complutense de Madrid, Madrid, Spain
| | - María Fernández-Alfonso
- Departamento de Farmacología, Facultad de Farmacia, Instituto Pluridisciplinar, Universidad Complutense de Madrid, Madrid, Spain
| | - Miguel A Rubio
- Servicio de Endocrinología y Nutrición, Facultad de Medicina, Hospital Clínico San Carlos, Instituto de Investigaciones Sanitarias San Carlos, Universidad Complutense de Madrid, Madrid, Spain
| | - Beatriz Somoza
- Departamento de Ciencias Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Madrid, Spain
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19
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Syed-Abdul MM, Hu Q, Jacome-Sosa M, Padilla J, Manrique-Acevedo C, Heimowitz C, Parks EJ. Effect of carbohydrate restriction-induced weight loss on aortic pulse wave velocity in overweight men and women. Appl Physiol Nutr Metab 2018; 43:1247-1256. [DOI: 10.1139/apnm-2018-0113] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Increased aortic stiffness, measured by carotid-to-femoral pulse wave velocity (PWV), is an independent predictor of cardiovascular disease, and past data have shown that low-fat and low-energy diets, fed for 8–24 weeks, lower PWV. The purpose of this study was to determine whether a reduction in PWV would be achieved by dietary carbohydrate (CHO) restriction, shown to bring about weight loss over a shorter timeframe. Men (n = 10, age: 41.8 ± 10.2 years, BMI: 34.2 ± 3.0 kg/m2 (mean ± SD)) and women (n = 10, age: 38.6 ± 6.1 years, BMI: 33.5 ± 3.8 kg/m2) with characteristics of insulin resistance and the metabolic syndrome consumed a structured, CHO-restricted diet for 4 weeks (energy deficit, 645 kcal/day). For the whole group, subjects lost 5.4% ± 0.5% (P < 0.001) of body weight and experienced significant reductions in blood pressure (6%–8%), plasma insulin (34%), and triglycerides (34%). PWV was reduced by 6% ± 2% (7.1 ± 0.2 m/s to 6.7 ± 0.2 m/s, P = 0.008) and surprisingly, in women, it fell significantly (from 7.2 ± 0.3 m/s to 6.3 ± 0.3 m/s, P = 0.028), while no changes were observed in men (7.2 ± 0.3 vs. 7.0 ± 0.3 m/s, P = 0.144). This is the first study to demonstrate that weight loss can improve PWV in as little as 4 weeks and that dietary CHO restriction may be an effective treatment for reducing aortic stiffness in women. Future studies are needed to establish the mechanisms by which dietary CHO restriction may confer more cardiovascular benefits to women than to men.
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Affiliation(s)
- Majid M. Syed-Abdul
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO 65211, USA
| | - Qiong Hu
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO 65211, USA
| | - Miriam Jacome-Sosa
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO 65211, USA
| | - Jaume Padilla
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO 65211, USA
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO 65211, USA
- Department of Child Health, School of Medicine, University of Missouri, Columbia, MO 65212, USA
| | - Camila Manrique-Acevedo
- Division of Endocrinology, School of Medicine, University of Missouri, Columbia, MO 65212, USA
| | | | - Elizabeth J. Parks
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO 65211, USA
- Department of Child Health, School of Medicine, University of Missouri, Columbia, MO 65212, USA
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20
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Liang KW, Lee WJ, Lee IT, Lin SY, Wang JS, Lee WL, Sheu WHH. Regaining body weight after weight reduction further increases pulse wave velocity in obese men with metabolic syndrome. Medicine (Baltimore) 2018; 97:e12730. [PMID: 30290684 PMCID: PMC6200464 DOI: 10.1097/md.0000000000012730] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Subjects with metabolic syndrome (MetS) or obesity have worse arterial stiffness. However, there have been no studies addressing time-sequential changes in pulse wave velocity (PWV) after weight loss and then regaining weight in obese non-diabetic men with MetS.We prospectively enrolled 40 obese, non-diabetic men with MetS undergoing a 3-month weight reduction program. Another 26 lean and healthy men were recruited for comparisons. Oral glucose tolerance test and brachial ankle (ba) PWV were assessed in study subjects. Eighteen obese non-diabetic MetS and 15 lean control subjects had follow-ups at the 60th month.The body weight of obese MetS decreased from 94.8 ± 7.6 to 86.1 ± 9.0 (N = 18, P < .001) after a 3-month weight reduction program but regained gradually thereafter to 93.6 ± 11.6 kg at the 60th month (P < .001 versus 3rd month). baPWV decreased after weight loss slightly (P = .240) while weight regain significantly increased the baPWV (from 3rd month, 1358 ± 168 to 60th month 1539 ± 264 cm/sec, P < .001). Systolic and diastolic blood pressure increments correlated with the increment of baPWV after weight regain. At the 60th month, lean controls (N = 15) had increases in body weight while their baPWV increased non-significantly. The increments of baPWV after weight regain in obese MetS were significantly higher than the increment of baPWV in lean controls after weight gain.In conclusion, regaining body weight after weight reduction worsened arterial stiffness with significant increase of baPWV in obese non-diabetic MetS.
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Affiliation(s)
- Kae-Woei Liang
- Cardiovascular Center, Taichung Veterans General Hospital, Taichung
- Cardiovascular Research Center, Department of Medicine, National Yang Ming University School of Medicine, Taipei
| | - Wen-Jane Lee
- Department of Medical Research, Taichung Veterans General Hospital
- Tung-Hai University
| | - I-Te Lee
- Cardiovascular Research Center, Department of Medicine, National Yang Ming University School of Medicine, Taipei
- Division of Endocrinology and Metabolism, Department of Medicine, Taichung Veterans General Hospital
- Department of Medicine, Chung Shan Medical University
| | - Shih-Yi Lin
- Cardiovascular Research Center, Department of Medicine, National Yang Ming University School of Medicine, Taipei
- Division of Endocrinology and Metabolism, Department of Medicine, Taichung Veterans General Hospital
- Center of Geriatrics and Gerontology, Taichung Veterans General Hospital
| | - Jun-Sing Wang
- Cardiovascular Research Center, Department of Medicine, National Yang Ming University School of Medicine, Taipei
- Division of Endocrinology and Metabolism, Department of Medicine, Taichung Veterans General Hospital
| | - Wen-Lieng Lee
- Cardiovascular Center, Taichung Veterans General Hospital, Taichung
- Cardiovascular Research Center, Department of Medicine, National Yang Ming University School of Medicine, Taipei
| | - Wayne H-H Sheu
- Cardiovascular Research Center, Department of Medicine, National Yang Ming University School of Medicine, Taipei
- Division of Endocrinology and Metabolism, Department of Medicine, Taichung Veterans General Hospital
- Institute of Biomedical Sciences, National Chung Hsing University, Taichung, Taiwan
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Isaykina OY, Rozanov VB, Alexandrov AA, Ivanova EI, Pugoeva HS. Influence of Childhood and Adulthood Obesity on Arterial Stiffnes and Central Blood Pressure in Men. RATIONAL PHARMACOTHERAPY IN CARDIOLOGY 2018. [DOI: 10.20996/1819-6446-2018-14-4-543-551] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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22
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Swift DL, McGee JE, Earnest CP, Carlisle E, Nygard M, Johannsen NM. The Effects of Exercise and Physical Activity on Weight Loss and Maintenance. Prog Cardiovasc Dis 2018; 61:206-213. [PMID: 30003901 DOI: 10.1016/j.pcad.2018.07.014] [Citation(s) in RCA: 240] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Accepted: 07/08/2018] [Indexed: 01/12/2023]
Abstract
Obesity represents a major health problem in the United States and is associated with increased prevalence of cardiovascular (CV) disease risk factors. Physical activity (PA) and exercise training (ET) are associated with reduced CV risk, improved cardiometabolic risk factors, and facilitated weight loss through creating a negative energy balance. Clinicians need to counsel overweight and obese patients on how much PA/ET is needed to promote weight loss and weight loss maintenance. This will help establish realistic expectations and maximize improvements in CV risk factors. Although the minimum guidelines for aerobic PA (150 min of moderate or 75 min of vigorous physical activity per week) can improve CV health, these levels are generally inadequate for clinically significant weight loss or weight maintenance without caloric restriction. The purpose of this review is to evaluate the role of ET to promote clinically significant weight loss and promote weight maintenance. In particular, we will evaluate the likelihood of weight loss from ET programs composed of aerobic training only, resistance training only and programs that combine diet and ET. We will also explore the role of PA in promoting short-term and long-term weight maintenance.
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Affiliation(s)
- Damon L Swift
- Department of Kinesiology, East Carolina University, Greenville, NC, United States of America; Human Performance Laboratory, East Carolina University, Greenville, NC, United States of America.
| | - Joshua E McGee
- Department of Kinesiology, East Carolina University, Greenville, NC, United States of America; Human Performance Laboratory, East Carolina University, Greenville, NC, United States of America
| | - Conrad P Earnest
- Department of Kinesiology, Texas A&M University, College Station, TX, United States of America
| | - Erica Carlisle
- Department of Kinesiology, East Carolina University, Greenville, NC, United States of America; Human Performance Laboratory, East Carolina University, Greenville, NC, United States of America
| | - Madison Nygard
- Department of Kinesiology, East Carolina University, Greenville, NC, United States of America; Human Performance Laboratory, East Carolina University, Greenville, NC, United States of America
| | - Neil M Johannsen
- Department of Kinesiology, Louisiana State University, Baton Rouge, LA, United States of America
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23
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Pizard A. In need of signalling pathway data. Eur J Heart Fail 2018; 20:1202-1204. [PMID: 29893008 DOI: 10.1002/ejhf.1219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 04/22/2018] [Indexed: 11/10/2022] Open
Affiliation(s)
- Anne Pizard
- Inserm 1024, Institut de Biologie de l'École Normale Supérieure (IBENS), PSL University of Paris, Paris, France; CHRU-Nancy, Vandoeuvre-lès-Nancy, France
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Cocciolone AJ, Hawes JZ, Staiculescu MC, Johnson EO, Murshed M, Wagenseil JE. Elastin, arterial mechanics, and cardiovascular disease. Am J Physiol Heart Circ Physiol 2018; 315:H189-H205. [PMID: 29631368 DOI: 10.1152/ajpheart.00087.2018] [Citation(s) in RCA: 154] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Large, elastic arteries are composed of cells and a specialized extracellular matrix that provides reversible elasticity and strength. Elastin is the matrix protein responsible for this reversible elasticity that reduces the workload on the heart and dampens pulsatile flow in distal arteries. Here, we summarize the elastin protein biochemistry, self-association behavior, cross-linking process, and multistep elastic fiber assembly that provide large arteries with their unique mechanical properties. We present measures of passive arterial mechanics that depend on elastic fiber amounts and integrity such as the Windkessel effect, structural and material stiffness, and energy storage. We discuss supravalvular aortic stenosis and autosomal dominant cutis laxa-1, which are genetic disorders caused by mutations in the elastin gene. We present mouse models of supravalvular aortic stenosis, autosomal dominant cutis laxa-1, and graded elastin amounts that have been invaluable for understanding the role of elastin in arterial mechanics and cardiovascular disease. We summarize acquired diseases associated with elastic fiber defects, including hypertension and arterial stiffness, diabetes, obesity, atherosclerosis, calcification, and aneurysms and dissections. We mention animal models that have helped delineate the role of elastic fiber defects in these acquired diseases. We briefly summarize challenges and recent advances in generating functional elastic fibers in tissue-engineered arteries. We conclude with suggestions for future research and opportunities for therapeutic intervention in genetic and acquired elastinopathies.
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Affiliation(s)
- Austin J Cocciolone
- Department of Biomedical Engineering, Washington University , St. Louis, Missouri
| | - Jie Z Hawes
- Department of Mechanical Engineering and Materials Science, Washington University , St. Louis, Missouri
| | - Marius C Staiculescu
- Department of Mechanical Engineering and Materials Science, Washington University , St. Louis, Missouri
| | - Elizabeth O Johnson
- Department of Mechanical Engineering and Materials Science, Washington University , St. Louis, Missouri
| | - Monzur Murshed
- Faculty of Dentistry, Department of Medicine, and Shriners Hospital for Children, McGill University , Montreal, Quebec , Canada
| | - Jessica E Wagenseil
- Department of Mechanical Engineering and Materials Science, Washington University , St. Louis, Missouri
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25
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Bäckdahl J, Andersson DP, Eriksson-Hogling D, Caidahl K, Thorell A, Mileti E, Daub CO, Arner P, Rydén M. Long-Term Improvement in Aortic Pulse Wave Velocity After Weight Loss Can Be Predicted by White Adipose Tissue Factors. Am J Hypertens 2018; 31:450-457. [PMID: 29177471 DOI: 10.1093/ajh/hpx201] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 11/20/2017] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Arterial stiffness, measured by pulse wave velocity (PWV), is linked to obesity, cardiovascular disease, and all-cause mortality. Short-term weight loss improves PWV, but the long-term effects are unknown. We investigated the effect of pronounced long-term weight loss on PWV and whether anthropometric/metabolic parameters and/or white adipose tissue (WAT) phenotype could predict this change in PWV. METHODS Eighty-two obese subjects were examined before and 2 years after Roux-en-Y gastric bypass. Analyses included anthropometrics, routine clinical chemistry, and hyperinsulinemic-euglycemic clamp. Arterial stiffness was measured as aortic PWV (aPWV) using the Arteriograph device. WAT mass and distribution were assessed by dual-X-ray absorptiometry. Baseline visceral and subcutaneous WAT samples were obtained to measure adipocyte cell size. Transcriptomic profiling of subcutaneous WAT was performed in a subset of subjects (n = 30). RESULTS At the 2-year follow-up, there were significant decreases in body mass index (39.4 ± 3.5 kg/m2 vs. 26.6 ± 3.4 kg/m2; P < 0.0001) and aPWV (7.8 ± 1.5 m/s vs. 7.2 ± 1.4 m/s; P = 0.006). Multiple regression analyses showed that baseline subcutaneous adipocyte volume was associated with a reduction in aPWV (P = 0.014), after adjusting for confounders. Expression analyses of 52 genes implicated in arterial stiffness showed that only one, COL4A1, independently predicted improvements in aPWV after adjusting for confounders (P = 0.006). CONCLUSIONS Bariatric surgery leads to long-term reduction in aPWV. This improvement can be independently predicted by subcutaneous adipocyte volume and WAT COL4A1 expression, which suggests that subcutaneous WAT has a role in regulating aPWV. CLINICAL TRIALS REGISTRATION Trial Number NCT01727245 (clinicaltrials.gov).
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Affiliation(s)
- Jesper Bäckdahl
- Department of Medicine (H7), Karolinska Institutet, C2-94, Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - Daniel P Andersson
- Department of Medicine (H7), Karolinska Institutet, C2-94, Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - Daniel Eriksson-Hogling
- Department of Medicine (H7), Karolinska Institutet, C2-94, Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - Kenneth Caidahl
- Department of Molecular Medicine and Surgery, Karolinska Institutet, C8:27, Karolinska University Hospital, Solna, Stockholm, Sweden
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anders Thorell
- Department of Clinical Science, Danderyds Hospital, Karolinska Institutet, Stockholm, Sweden
- Department of Surgery, Ersta Hospital, Stockholm, Sweden
| | - Enrichetta Mileti
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - Carsten O Daub
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - Peter Arner
- Department of Medicine (H7), Karolinska Institutet, C2-94, Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - Mikael Rydén
- Department of Medicine (H7), Karolinska Institutet, C2-94, Karolinska University Hospital, Huddinge, Stockholm, Sweden
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Affiliation(s)
- Kristen L Nowak
- From the University of Colorado Anschutz Medical Campus, Aurora (K.L.N., M.C.); and University of Colorado Boulder (M.J.R., D.R.S.).
| | - Matthew J Rossman
- From the University of Colorado Anschutz Medical Campus, Aurora (K.L.N., M.C.); and University of Colorado Boulder (M.J.R., D.R.S.)
| | - Michel Chonchol
- From the University of Colorado Anschutz Medical Campus, Aurora (K.L.N., M.C.); and University of Colorado Boulder (M.J.R., D.R.S.)
| | - Douglas R Seals
- From the University of Colorado Anschutz Medical Campus, Aurora (K.L.N., M.C.); and University of Colorado Boulder (M.J.R., D.R.S.)
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Kuo CH, Lin YL, Lee CJ, Wang CH, Lai YH, Liou HH, Hsu BG. Hyperleptinemia positively associated with central arterial stiffness in hemodialysis patients. PLoS One 2018; 13:e0190694. [PMID: 29304064 PMCID: PMC5755912 DOI: 10.1371/journal.pone.0190694] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 12/19/2017] [Indexed: 12/14/2022] Open
Abstract
Objective Leptin plays a role in stimulating vascular inflammation, vascular smooth muscle hypertrophy, and augmenting blood pressure, which contributes to the pathogenesis of atherosclerosis and leads to arterial stiffness. This vascular damage, measured by carotid-femoral pulse wave velocity (cfPWV), is recognized as an independent predictor of cardiovascular mortality in hemodialysis (HD) patients. The aim of this study was to evaluate the relationship between serum leptin and arterial stiffness in HD patients. Patients and methods In 112 of the 126 HD patients were eligible and their biochemical data were collected for analysis. Serum leptin level was measured using a commercial enzyme-linked immunosorbent assay kit. Carotid-femoral pulse wave velocity was measured by a validated tonometry system (SphygmoCor). Those have cfPWV values above 10 m/s are defined as the high arterial stiffness group. Results Among the participants, thirty-eight of them who were in the high arterial stiffness group, had a higher prevalence of diabetes mellitus (p = 0.002), age (p = 0.029), body mass index (BMI, p = 0.018), body fat mass (p = 0.001), hemoglobin (p = 0.040), and serum leptin levels (P<0.001). Multivariable logistic regression analysis showed that leptin (odds ratio [OR] 1.09; 95% confidence interval [CI] 1.04–1.14; p <0.001), diabetes (OR 7.17; CI 1.39–37.00; p = 0.019), body fat mass (OR 1.16; CI 1.02–1.33; p = 0.027); and hemoglobin (OR 2.11; CI 1.15–3.87; p = 0.015) were independently associated with arterial stiffness in HD patients. Conclusion In our study, hyperleptinemia was positively correlated to the high cfPWV and thus was related to high arterial stiffness in HD patients.
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Affiliation(s)
- Chiu-Huang Kuo
- Division of Nephrology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Yu-Li Lin
- Division of Nephrology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Chung-Jen Lee
- Department of Nursing, Tzu Chi University of Science and Technology, Hualien, Taiwan
| | - Chih-Hsien Wang
- Division of Nephrology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
- School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Yu-Hsien Lai
- Division of Nephrology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Hung-Hsiang Liou
- Division of Nephrology, Department of Medicine, Hsin-Jen Hospital, New Taipei City, Taiwan
- * E-mail: (BGH); (HHL)
| | - Bang-Gee Hsu
- Division of Nephrology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
- School of Medicine, Tzu Chi University, Hualien, Taiwan
- * E-mail: (BGH); (HHL)
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Caterini JE, Banks L, Wells GD, Cifra B, Slorach C, McCrindle BW, Seed M. Magnetic resonance imaging reveals elevated aortic pulse wave velocity in obese and overweight adolescents. Clin Obes 2017; 7:360-367. [PMID: 28834246 DOI: 10.1111/cob.12206] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 06/07/2017] [Accepted: 07/07/2017] [Indexed: 12/01/2022]
Abstract
The aortic pulse wave velocity (PWV) measured via cardiac magnetic resonance (CMR) can be used to non-invasively assess changes in arterial stiffness and potential underlying vascular dysfunction. This technique could unmask early arterial dysfunction in overweight and obese youth at risk for cardiovascular disease. We sought to determine the association between vascular stiffness, percentage body fat, body mass index (BMI), and cardiac function in adolescents across the weight spectrum through both CMR and standard applanation tonometry (AT)-based PWV measurements. PWV and left-ventricular cardiac function were assessed using 3.0 T CMR in obese and overweight (OB/OW) participants (n = 12) and controls (n = 7). PWV was also estimated via carotid-femoral AT. OB/OW participants did not differ from healthy-weight controls regarding cardiometabolic risk factors or physical activity levels, but there was a trend towards higher levels of triglycerides in obese/overweight participants (P = 0.07). Mean PWV was higher in obese participants when corrected for age and sex (P = 0.01), and was positively associated with BMI (β = 0.51, P = 0.02). PWV estimated through AT was not significantly different between groups. Cardiac function measured by left-ventricular ejection fraction z-score was inversely associated with mean PWV (β = -0.57, P = 0.026). Increasing arterial stiffness and decreasing cardiac function were evident among our overweight and obese cohort. PWV estimated by CMR could detect early increases in arterial stiffness vs. traditional AT measurements of PWV.
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Affiliation(s)
- J E Caterini
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
| | - L Banks
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
- Labatt Family Heart Centre, Hospital for Sick Children, Toronto, Canada
| | - G D Wells
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
- Translational Medicine, Hospital for Sick Children, Toronto, Canada
| | - B Cifra
- Labatt Family Heart Centre, Hospital for Sick Children, Toronto, Canada
| | - C Slorach
- Labatt Family Heart Centre, Hospital for Sick Children, Toronto, Canada
| | - B W McCrindle
- Labatt Family Heart Centre, Hospital for Sick Children, Toronto, Canada
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - M Seed
- Labatt Family Heart Centre, Hospital for Sick Children, Toronto, Canada
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Canada
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Levelt E, Piechnik SK, Liu A, Wijesurendra RS, Mahmod M, Ariga R, Francis JM, Greiser A, Clarke K, Neubauer S, Ferreira VM, Karamitsos TD. Adenosine stress CMR T1-mapping detects early microvascular dysfunction in patients with type 2 diabetes mellitus without obstructive coronary artery disease. J Cardiovasc Magn Reson 2017; 19:81. [PMID: 29070069 PMCID: PMC5655826 DOI: 10.1186/s12968-017-0397-8] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 10/12/2017] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is associated with coronary microvascular dysfunction in the absence of obstructive coronary artery disease (CAD). Cardiovascular magnetic resonance (CMR) T1-mapping at rest and during adenosine stress can assess coronary vascular reactivity. We hypothesised that the non-contrast T1 response to vasodilator stress will be altered in patients with T2DM without CAD compared to controls due to coronary microvascular dysfunction. METHODS Thirty-one patients with T2DM and sixteen matched healthy controls underwent CMR (3 T) for cine, rest and adenosine stress non-contrast T1-mapping (ShMOLLI), first-pass perfusion and late gadolinium enhancement (LGE) imaging. Significant CAD (>50% coronary luminal stenosis) was excluded in all patients by coronary computed tomographic angiography. RESULTS All subjects had normal left ventricular (LV) ejection and LV mass index, with no LGE. Myocardial perfusion reserve index (MPRI) was lower in T2DM than in controls (1.60 ± 0.44 vs 2.01 ± 0.42; p = 0.008). There was no difference in rest native T1 values (p = 0.59). During adenosine stress, T1 values increased significantly in both T2DM patients (from 1196 ± 32 ms to 1244 ± 44 ms, p < 0.001) and controls (from 1194 ± 26 ms to 1273 ± 44 ms, p < 0.001). T2DM patients showed blunted relative stress non-contrast T1 response (T2DM: ΔT1 = 4.1 ± 2.9% vs. CONTROLS ΔT1 = 6.6 ± 2.6%, p = 0.007) due to a blunted maximal T1 during adenosine stress (T2DM 1244 ± 44 ms vs. controls 1273 ± 44 ms, p = 0.045). CONCLUSIONS Patients with well controlled T2DM, even in the absence of arterial hypertension and significant CAD, exhibit blunted maximal non-contrast T1 response during adenosine vasodilatory stress, likely reflecting coronary microvascular dysfunction. Adenosine stress and rest T1 mapping can detect subclinical abnormalities of the coronary microvasculature, without the need for gadolinium contrast agents. CMR may identify early features of the diabetic heart phenotype and subclinical cardiac risk markers in patients with T2DM, providing an opportunity for early therapeutic intervention.
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Affiliation(s)
- Eylem Levelt
- University of Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - Stefan K Piechnik
- University of Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Alexander Liu
- University of Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Rohan S Wijesurendra
- University of Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Masliza Mahmod
- University of Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Rina Ariga
- University of Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Jane M Francis
- University of Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | | | - Kieran Clarke
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK
| | - Stefan Neubauer
- University of Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Vanessa M Ferreira
- University of Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Theodoros D Karamitsos
- University of Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.
- 1st Department of Cardiology, Aristotle University of Thessaloniki, AHEPA Hospital St. Kyriakidi 1, 54636, Thessaloniki, Greece.
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Widya RL, de Mutsert R, Westenberg JJM, Gast KB, den Heijer M, le Cessie S, Smit JWA, Jukema JW, Rosendaal FR, de Roos A, Lamb HJ. Is Hepatic Triglyceride Content Associated with Aortic Pulse Wave Velocity and Carotid Intima-Media Thickness? The Netherlands Epidemiology of Obesity Study. Radiology 2017; 285:73-82. [DOI: 10.1148/radiol.2017160916] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Ralph L. Widya
- From the Departments of Radiology (R.L.W., J.J.M.W., A.d.R., H.J.L.), Clinical Epidemiology (R.d.M., K.B.G., M.d.H., S.l.C., F.R.R.), Internal Medicine (K.B.G.), Medical Statistics and Bio-informatics (S.l.C.), Endocrinology (R.L.W., J.W.A.S.), and Cardiology (J.W.J.), Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, the Netherlands; Department of Internal Medicine, VU University Medical Center,
| | - Renée de Mutsert
- From the Departments of Radiology (R.L.W., J.J.M.W., A.d.R., H.J.L.), Clinical Epidemiology (R.d.M., K.B.G., M.d.H., S.l.C., F.R.R.), Internal Medicine (K.B.G.), Medical Statistics and Bio-informatics (S.l.C.), Endocrinology (R.L.W., J.W.A.S.), and Cardiology (J.W.J.), Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, the Netherlands; Department of Internal Medicine, VU University Medical Center,
| | - Jos J. M. Westenberg
- From the Departments of Radiology (R.L.W., J.J.M.W., A.d.R., H.J.L.), Clinical Epidemiology (R.d.M., K.B.G., M.d.H., S.l.C., F.R.R.), Internal Medicine (K.B.G.), Medical Statistics and Bio-informatics (S.l.C.), Endocrinology (R.L.W., J.W.A.S.), and Cardiology (J.W.J.), Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, the Netherlands; Department of Internal Medicine, VU University Medical Center,
| | - Karin B. Gast
- From the Departments of Radiology (R.L.W., J.J.M.W., A.d.R., H.J.L.), Clinical Epidemiology (R.d.M., K.B.G., M.d.H., S.l.C., F.R.R.), Internal Medicine (K.B.G.), Medical Statistics and Bio-informatics (S.l.C.), Endocrinology (R.L.W., J.W.A.S.), and Cardiology (J.W.J.), Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, the Netherlands; Department of Internal Medicine, VU University Medical Center,
| | - Martin den Heijer
- From the Departments of Radiology (R.L.W., J.J.M.W., A.d.R., H.J.L.), Clinical Epidemiology (R.d.M., K.B.G., M.d.H., S.l.C., F.R.R.), Internal Medicine (K.B.G.), Medical Statistics and Bio-informatics (S.l.C.), Endocrinology (R.L.W., J.W.A.S.), and Cardiology (J.W.J.), Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, the Netherlands; Department of Internal Medicine, VU University Medical Center,
| | - Saskia le Cessie
- From the Departments of Radiology (R.L.W., J.J.M.W., A.d.R., H.J.L.), Clinical Epidemiology (R.d.M., K.B.G., M.d.H., S.l.C., F.R.R.), Internal Medicine (K.B.G.), Medical Statistics and Bio-informatics (S.l.C.), Endocrinology (R.L.W., J.W.A.S.), and Cardiology (J.W.J.), Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, the Netherlands; Department of Internal Medicine, VU University Medical Center,
| | - Johannes W. A. Smit
- From the Departments of Radiology (R.L.W., J.J.M.W., A.d.R., H.J.L.), Clinical Epidemiology (R.d.M., K.B.G., M.d.H., S.l.C., F.R.R.), Internal Medicine (K.B.G.), Medical Statistics and Bio-informatics (S.l.C.), Endocrinology (R.L.W., J.W.A.S.), and Cardiology (J.W.J.), Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, the Netherlands; Department of Internal Medicine, VU University Medical Center,
| | - J. Wouter Jukema
- From the Departments of Radiology (R.L.W., J.J.M.W., A.d.R., H.J.L.), Clinical Epidemiology (R.d.M., K.B.G., M.d.H., S.l.C., F.R.R.), Internal Medicine (K.B.G.), Medical Statistics and Bio-informatics (S.l.C.), Endocrinology (R.L.W., J.W.A.S.), and Cardiology (J.W.J.), Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, the Netherlands; Department of Internal Medicine, VU University Medical Center,
| | - Frits R. Rosendaal
- From the Departments of Radiology (R.L.W., J.J.M.W., A.d.R., H.J.L.), Clinical Epidemiology (R.d.M., K.B.G., M.d.H., S.l.C., F.R.R.), Internal Medicine (K.B.G.), Medical Statistics and Bio-informatics (S.l.C.), Endocrinology (R.L.W., J.W.A.S.), and Cardiology (J.W.J.), Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, the Netherlands; Department of Internal Medicine, VU University Medical Center,
| | - Albert de Roos
- From the Departments of Radiology (R.L.W., J.J.M.W., A.d.R., H.J.L.), Clinical Epidemiology (R.d.M., K.B.G., M.d.H., S.l.C., F.R.R.), Internal Medicine (K.B.G.), Medical Statistics and Bio-informatics (S.l.C.), Endocrinology (R.L.W., J.W.A.S.), and Cardiology (J.W.J.), Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, the Netherlands; Department of Internal Medicine, VU University Medical Center,
| | - Hildo J. Lamb
- From the Departments of Radiology (R.L.W., J.J.M.W., A.d.R., H.J.L.), Clinical Epidemiology (R.d.M., K.B.G., M.d.H., S.l.C., F.R.R.), Internal Medicine (K.B.G.), Medical Statistics and Bio-informatics (S.l.C.), Endocrinology (R.L.W., J.W.A.S.), and Cardiology (J.W.J.), Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, the Netherlands; Department of Internal Medicine, VU University Medical Center,
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Oxidative and inflammatory signals in obesity-associated vascular abnormalities. Clin Sci (Lond) 2017; 131:1689-1700. [DOI: 10.1042/cs20170219] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 05/19/2017] [Accepted: 05/22/2017] [Indexed: 02/07/2023]
Abstract
Obesity is associated with increased cardiovascular morbidity and mortality in part due to vascular abnormalities such as endothelial dysfunction and arterial stiffening. The hypertension and other health complications that arise from these vascular defects increase the risk of heart diseases and stroke. Prooxidant and proinflammatory signaling pathways as well as adipocyte-derived factors have emerged as critical mediators of obesity-associated vascular abnormalities. Designing treatments aimed specifically at improving the vascular dysfunction caused by obesity may provide an effective therapeutic approach to prevent the cardiovascular sequelae associated with excessive adiposity. In this review, we discuss the recent evidence supporting the role of oxidative stress and cytokines and inflammatory signals within the vasculature as well as the impact of the surrounding perivascular adipose tissue (PVAT) on the regulation of vascular function and arterial stiffening in obesity. In particular, we focus on the highly plastic nature of the vasculature in response to altered oxidant and inflammatory signaling and highlight how weight management can be an effective therapeutic approach to reduce the oxidative stress and inflammatory signaling and improve vascular function.
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Mallat S, Jurjus A, Bou Assi T, Jurjus A, Shams A, El Sayegh S, Berbari A. Markers of arterial stiffness in a sample of Lebanese subjects with Grade I essential hypertension. SAGE Open Med 2017; 5:2050312117712886. [PMID: 28611919 PMCID: PMC5466276 DOI: 10.1177/2050312117712886] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 05/10/2017] [Indexed: 01/18/2023] Open
Abstract
Objectives: Arterial stiffness is becoming a major global condition associated with an increased risk of cardiovascular problems and death. Several markers have been linked to arterial stiffness. Methods: To determine and evaluate these relations, anthropometric parameters (weight, height, and pulse rate), biochemical profile, and central and peripheral indices of arterial function were measured in 114 Lebanese subjects with Grade I essential hypertension. Results: Age was associated with a higher pulse wave velocity (p = .001), central systolic blood pressure (p = .013), central pulse pressure (p = .028), central augmentation index (p ≤ .0001) with a lower heart rate (p = .08), and glomerular filtration rate (p = .019). Pulse wave velocity was found to be higher in older subjects (>65 years) and correlated with higher body mass index (r = .85) independent of age. Aging also correlated with higher plasma glucose and alterations in calcium–phosphorus metabolism. Conclusion: Aging is associated with increased arterial stiffness which is reflected by an increase in the pulse wave velocity, augmentation index, central pulse pressure, and central systolic blood pressure with a reduction in heart rate. Also, a higher body mass index and a lower estimated glomerular filtration rate (< 60 mL/min/1.73 m2) are associated with increased arterial stiffness while calcium and phosphorus metabolism may play a role by promoting vascular calcification.
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Affiliation(s)
- Samir Mallat
- Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Abdo Jurjus
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Tarek Bou Assi
- Department of Laboratory Medicine, Psychiatric Hospital of the Cross, Jal El Dib, Lebanon
| | - Alice Jurjus
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Ali Shams
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Skye El Sayegh
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Adel Berbari
- Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.,Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
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Nagayama D, Imamura H, Sato Y, Yamaguchi T, Ban N, Kawana H, Ohira M, Saiki A, Shirai K, Tatsuno I. Inverse relationship of cardioankle vascular index with BMI in healthy Japanese subjects: a cross-sectional study. Vasc Health Risk Manag 2016; 13:1-9. [PMID: 28053538 PMCID: PMC5189698 DOI: 10.2147/vhrm.s119646] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Objective The objective of this study is to investigate the association of body mass index (BMI) with arterial stiffness assessed by cardioankle vascular index (CAVI). Subjects and methods A retrospective cross-sectional study was conducted in 23,257 healthy Japanese subjects (12,729 men and 10,528 women, aged 47.1 ± 12.5 years, BMI 22.9 ± 3.4 kg/m2) who underwent health screening between 2004 and 2006 in Japan. Exclusion criteria were current medication use and a past history of cardiovascular disease, hypertension, stroke, diabetes, and nephritis. Results Male subjects showed significantly higher BMI, CAVI, and triglycerides and lower high-density lipoprotein (HDL)-cholesterol compared with female subjects. Next, the subjects were divided into tertiles of BMI: lower, middle, and upper, in a gender-specific manner. After adjusting for confounders including age, systolic blood pressure, and HDL-cholesterol identified by multiple regression analysis, the mean CAVI decreased progressively as BMI tertile increased in both genders. Furthermore, a negative inverse relationship between BMI and adjusted CAVI was observed throughout the BMI distribution. Multivariate logistic regression model for contributors of high CAVI (≥90th percentile) identified obesity (odds ratios (95% confidence interval): 0.804 (0.720–0.899)], older age [15.6 (14.0–17.4)], male gender [2.26 (2.03–2.51)], hypertension [2.28 (2.06–2.54)], impaired fasting glucose [1.17 (1.01–1.37)], and low HDL-cholesterol [0.843 (0.669–1.06)] as independent factors. Conclusion We demonstrated an inverse relationship between CAVI and BMI in healthy Japanese subjects, suggesting that systemic accumulation of adipose tissue per se may lead to a linear decrease of arterial stiffness in nonobese and obese subjects without metabolic disorders.
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Affiliation(s)
- Daiji Nagayama
- Center of Endocrinology and Metabolism, Shin-Oyama City Hospital, Oyama-City; Center of Diabetes, Endocrinology and Metabolism
| | | | - Yuta Sato
- Center of Diabetes, Endocrinology and Metabolism
| | | | - Noriko Ban
- Center of Diabetes, Endocrinology and Metabolism
| | | | | | | | - Kohji Shirai
- Department of Vascular Function, Sakura Medical Center, Toho University, Sakura-City, Japan
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Li P, Wang L, Liu C. Overweightness, obesity and arterial stiffness in healthy subjects: a systematic review and meta-analysis of literature studies. Postgrad Med 2016; 129:224-230. [PMID: 27915493 DOI: 10.1080/00325481.2017.1268903] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The relationship between overweightness, obesity and arterial stiffness remains unclear. We performed a meta-analysis evaluating the impact of obesity/overweightness on arterial stiffness in healthy subjects. METHODS Literature searches were conducted using databases (eg, MEDLINE, EMBASE) and citations cross-referenced. Studies evaluating the relationship between obesity/overweightness and cfPWV, baPWV, and AIx were systematically searched. A total of 10 studies (1,124 obese/overweight subjects, 1,884 controls) were included. RESULTS Compared to controls, obese/overweight subjects showed a significantly higher cfPWV (SMD 0.50 m/s; 95%CI 0.15, 0.86; P = 0.005), baPWV (SMD 0.41 m/s; 95% CI 0.08, 0.74; P = 0.014), and AIx (SMD 1.02;95%CI 0.16, 1.87; P < 0.0001). When analyzing 'high quality' studies, the difference in arterial stiffness among obese/overweight subjects and controls remain (SMD 0.73 m/s; 95%CI 0.16, 1.30; P = 0.013). CONCLUSION Arterial stiffness, a recognized marker of cardio vascular risk, is increased in obese/overweight subjects without overt cardiovascular diseases.
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Affiliation(s)
- Ping Li
- a Department of Endocrinology, Beijing Shijitan Hospital , Capital Medical University , Beijing , China
| | - Lei Wang
- b Department of Radiology , Hebei General Hospital , Hebei Province , China
| | - Chao Liu
- c Department of Endocrinology , Hebei Medical University , Hebei Province , China
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Zuo L, He F, Tinsley GM, Pannell BK, Ward E, Arciero PJ. Comparison of High-Protein, Intermittent Fasting Low-Calorie Diet and Heart Healthy Diet for Vascular Health of the Obese. Front Physiol 2016; 7:350. [PMID: 27621707 PMCID: PMC5002412 DOI: 10.3389/fphys.2016.00350] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 08/02/2016] [Indexed: 12/14/2022] Open
Abstract
AIM It has been debated whether different diets are more or less effective in long-term weight loss success and cardiovascular disease prevention among men and women. To further explore these questions, the present study evaluated the combined effects of a high-protein, intermittent fasting, low-calorie diet plan compared with a heart healthy diet plan during weight loss, and weight loss maintenance on blood lipids and vascular compliance of obese individuals. METHODS The experiment involved 40 obese adults (men, n = 21; women, n = 19) and was divided into two phases: (a) 12-week high-protein, intermittent fasting, low-calorie weight loss diet comparing men and women (Phase 1) and (b) a 1-year weight maintenance phase comparing high-protein, intermittent fasting with a heart healthy diet (Phase 2). Body weight, body mass index (BMI), blood lipids, and arterial compliance outcomes were assessed at weeks 1 (baseline control), 12 (weight loss), and 64 (12 + 52 week; weight loss maintenance). RESULTS At the end of weight loss intervention, concomitant reductions in body weight, BMI and blood lipids were observed, as well as enhanced arterial compliance. No sex-specific differences in responses were observed. During phase 2, the high-protein, intermittent fasting group demonstrated a trend for less regain in BMI, low-density lipoprotein (LDL), and aortic pulse wave velocity than the heart healthy group. CONCLUSION Our results suggest that a high-protein, intermittent fasting and low-calorie diet is associated with similar reductions in BMI and blood lipids in obese men and women. This diet also demonstrated an advantage in minimizing weight regain as well as enhancing arterial compliance as compared to a heart healthy diet after 1 year.
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Affiliation(s)
- Li Zuo
- Radiologic Sciences and Respiratory Therapy Division, School of Health and Rehabilitation Sciences, The Ohio State University College of Medicine, The Ohio State University Wexner Medical CenterColumbus, OH, USA
| | - Feng He
- Department of Kinesiology, California State University, ChicoChico, CA, USA
- Human Nutrition and Metabolism Laboratory, Health and Exercise Sciences Department, Skidmore CollegeSaratoga Springs, NY, USA
| | - Grant M. Tinsley
- Department of Kinesiology and Sport Management, Texas Tech UniversityLubbock, TX, USA
| | - Benjamin K. Pannell
- Radiologic Sciences and Respiratory Therapy Division, School of Health and Rehabilitation Sciences, The Ohio State University College of Medicine, The Ohio State University Wexner Medical CenterColumbus, OH, USA
| | - Emery Ward
- Human Nutrition and Metabolism Laboratory, Health and Exercise Sciences Department, Skidmore CollegeSaratoga Springs, NY, USA
| | - Paul J. Arciero
- Human Nutrition and Metabolism Laboratory, Health and Exercise Sciences Department, Skidmore CollegeSaratoga Springs, NY, USA
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Chen K, Li P, Li YJ, Li T, Mu YM. Sex disparity in the association between hypertriglyceridemic waist phenotype and arterial stiffness in Chinese healthy subjects. Postgrad Med 2016; 128:783-789. [PMID: 27437733 DOI: 10.1080/00325481.2016.1214060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2022]
Abstract
OBJECTIVE To investigate the association between hypertriglyceridemic waist (HTGW) phenotype and arterial stiffness in a Chinese population without hypertension, diabetes and cardiovascular diseases. METHODS A total number of 3028 subjects aged 40 years and over were enrolled in this cross-sectional study. All participants provided a clinical history and underwent a physical examination. Brachial-ankle pulse wave velocity (baPWV) was used to evaluate arterial stiffness. HTGW phenotype was defined as the simultaneous presence of waist circumference ≥90/80 cm and triglycerides ≥2.0/1.5 mmol/L in men/women. RESULTS The prevalence of HTGW phenotype was 7.5% among healthy participants in China (Beijing), 7.4% in men and 7.5% in women. Women with HTGW phenotype had a higher level of baPWV compared with normal WC and normal triglyceride (NWNT) group (P < 0.05), but no significant difference was observed in men (P > 0.05). Multiple logistic regression analysis showed HTGW phenotype was significantly associated with baPWV after controlling for multiple factors in women. However, no significant relationship was observed in men. CONCLUSIONS The present study supports that HTGW phenotype is associated with increased arterial stiffness in women but not in men.
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Affiliation(s)
- Kang Chen
- a Department of Endocrinology , Chinese PLA General Hospital , Beijing , China
| | - Ping Li
- b Department of Endocrinology, Beijing Shijitan Hospital , Capital Medical University , Beijing , China
| | - Yi-Jun Li
- b Department of Endocrinology, Beijing Shijitan Hospital , Capital Medical University , Beijing , China
| | - Ting Li
- a Department of Endocrinology , Chinese PLA General Hospital , Beijing , China
| | - Yi-Ming Mu
- a Department of Endocrinology , Chinese PLA General Hospital , Beijing , China
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Lee DM, Battson ML, Jarrell DK, Cox-York K, Foster MT, Weir TL, Gentile CL. Fuzhuan tea reverses arterial stiffening after modest weight gain in mice. Nutrition 2016; 33:266-270. [PMID: 27717663 DOI: 10.1016/j.nut.2016.07.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 07/06/2016] [Accepted: 07/16/2016] [Indexed: 12/23/2022]
Abstract
OBJECTIVES The aim of this study was to examine the effects of a Western diet (WD) and supplementation with Fuzhuan tea on large artery stiffness, as determined by aortic pulse wave velocity (aPWV). METHODS Mice were subjected to a standard diet (SD; n = 12) or WD (n = 10) for 7 mo, and were then separated to receive nonsupplemented drinking water (SD-W and WD-W) or water supplemented with Fuzhuan tea (SD-T and WD-T) (200 mg/kg daily); mice were then maintained on their respective diets for an additional 2 mo. RESULTS After the initial 7-mo feeding period, WD elicited a modest and significantly greater increase in body weight than did SD (39.6 ± 0.71 versus 34.5 ± 1.16 g; P < 0.01). PWV was significantly elevated in WD but not in SD (459.3 ± 4.8 versus 422.4 ± 6.4 cm/s; P < 0.001). Following an additional 2 mo, PWV continued to increase in WD-W, but returned to control levels in WD-T (WD-W: 519.8 ± 12.8; WD-T: 426.5 ± 18.6; SD-W: 429.7 ± 8.6; SD-T: 429.1 ± 6.1 cm/s; P < 0.001, WD-W versus all groups). The increase in PWV in WD-W was accompanied by an increase in aortic collagen (WD-W: 38.8 ± 4.6 versus SD-W: 17.5 ± 5.1 percent cross-sectional area; P < 0.05). CONCLUSION The results of the present study suggest that the increase in arterial stiffness after modest, diet-induced weight gain can be reversed by supplementation with Fuzhuan tea.
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Affiliation(s)
- Dustin M Lee
- Department of Food Science & Human Nutrition, Colorado State University, Fort Collins, CO
| | - Micah L Battson
- Department of Food Science & Human Nutrition, Colorado State University, Fort Collins, CO
| | - Dillon K Jarrell
- Department of Food Science & Human Nutrition, Colorado State University, Fort Collins, CO
| | - Kimberly Cox-York
- Department of Food Science & Human Nutrition, Colorado State University, Fort Collins, CO
| | - Michelle T Foster
- Department of Food Science & Human Nutrition, Colorado State University, Fort Collins, CO
| | - Tiffany L Weir
- Department of Food Science & Human Nutrition, Colorado State University, Fort Collins, CO
| | - Christopher L Gentile
- Department of Food Science & Human Nutrition, Colorado State University, Fort Collins, CO.
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Abstract
BACKGROUND Obesity is an important risk factor for cardiovascular disease and has become a major concern in healthcare due to its high prevalence worldwide. The aim of the present study was to investigate the impact of BMI on central blood pressure (BP) and pulse wave velocity (PWV) in normotensive and hypertensive patients. PATIENTS AND METHODS Normotensive and hypertensive adult patients who attended the outpatient clinic of cardiovascular risk were included. Peripheral BP was obtained in the brachial artery by using an oscillometric device (OMRON M-6). Central aortic BP waveform was reconstructed from the radial artery pressure waveforms (SphygmoCor, AtCor Medical, Sydney, Australia) and central BP was calculated. Carotid-femoral PWV was measured by an automatic device (Complior, Artech, France). RESULTS We examined a total of 351 patients [50.7% women; 77 patients normal-weight (BMI < 25 kg/m)], 274 patients overweight or obese (BMI ≥25 kg/m). Central SBP showed a positive association with male sex and mean BP, but a negative association with overweight/obesity. PWV was positively associated with age, male sex, central BP, peripheral BP and BP treatment, whereas BMI of at least 25 kg/m led to a decrease in PWV in patients with the same central SBP levels. Likewise, PWV was lower in the overweight/obese group compared to the normal-weight group at the same central SBP. CONCLUSION Overweight and obesity tend to have lower central SBP as compared to lean patients, mainly in women. Further research is required to assess the interaction between body weight and vascular dynamics and their clinical implications.
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Kim HJ, Son J, Jin E, Lee J, Park S. Effects of exercise and L-arginine intake on inflammation in aorta of high-fat diet induced obese rats. J Exerc Nutrition Biochem 2016; 20:36-40. [PMID: 27298811 PMCID: PMC4899898 DOI: 10.20463/jenb.2016.03.20.1.6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 02/25/2016] [Accepted: 03/14/2016] [Indexed: 01/22/2023] Open
Abstract
PURPOSE In the present study, we investigated the effect of exercise and arginine on the inflammatory makers and Cu-Mn superoxide dismutase (SOD) expression in the aortas of high-fat-induced obese rats. METHODS Fifty 6-month-old male Sprague-Dawley rats were randomly assigned as follows: HF-Con: high-fat diet, HF-Ex: high-fat diet and exercise, HF-Ex+A: high-fat diet and combined exercise and arginine, HF-A: high-fat diet and arginine. The high-fat diet was fed for 12 weeks following 1 week of environmental adaptation with mixed solid chow. The rats performed treadmill exercise 6 times per week for 12 weeks at20 m/min for 60 min. L-argininewas mixed with saline and orally administered at 150 mg/kg once a day. Expressions of inflammatory markers (including NF- κB, TNF-α, COX-2) and SOD were evaluated using western blotting. RESULTS NF-κB expression decreased significantly (p<0.05) in the HF-Ex group compared with HF-Con group, and we found additional effects(p<0.01) on NF-κB expression in HF-EX+A compared withHF-Ex. TNF-α expression decreased significantly (p<0.01) in HF-Ex, FH-Ex+A, and FH-A compared with HF-Con. In a similar trend with NF-κB expression, COX-2 expression decreased significantly in HF-Ex compared withHF-Con. In Cu-Mn SOD expression, there was no difference between HF and HF-Ex, but significant increases (p<0.01) inCu-Mn SOD werefound in HF-Ex+A and HF-A. CONCLUSION Based on our results, treatment that combines exercise and arginine might be effective for modulatingvascular inflammation and oxidative stress in obesity.
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Affiliation(s)
- Hee-jae Kim
- Physical Activity and Performance Institute (PAPI), Konkuk University, SeoulRepublic of Korea
| | - Junseok Son
- Health and Exercise Science, Institute of Sport Science, Seoul National University, SeoulRepublic of Korea
| | - Eunhee Jin
- Department of Sports Science, Sungkyunkwan University, SuwonRepublic of Korea
| | - Jin Lee
- Department of Anatomy and Cell Biology, College of Medicine, Han Yang University, SeoulRepublic of Korea
| | - Sok Park
- Department of Sports Leadership, Kwangwoon University, SeoulRepublic of Korea
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Abstract
Adipokines are hormones produced by adipocytes and have been involved in multiple pathologic pathways, including inflammatory and cardiovascular complications in essential hypertension. Arterial stiffness is a frequent vascular complication that represents increased cardiovascular risk in hypertensive patients. Adipokines, such as adiponectin, leptin and resistin, might be implicated in hypertension, as well as in vascular alterations associated with this condition. Arterial stiffness has proven to be a predictor of cardiovascular events. Obesity and target-organ damage such as arterial stiffness are features associated with hypertension. This review aims to update the association between adipokines and arterial stiffness in essential and resistant hypertension (RHTN).
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Yu H, Chen J, Lu J, Bao Y, Tu Y, Zhang L, Zhang P, Jia W. Decreased visceral fat area correlates with improved arterial stiffness after Roux-en-Y gastric bypass in Chinese obese patients with type 2 diabetes mellitus: a 12-month follow-up. Surg Obes Relat Dis 2016; 12:550-555. [DOI: 10.1016/j.soard.2015.09.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 08/03/2015] [Accepted: 09/02/2015] [Indexed: 12/31/2022]
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Hughes TM, Craft S, Lopez OL. Review of 'the potential role of arterial stiffness in the pathogenesis of Alzheimer's disease'. Neurodegener Dis Manag 2016; 5:121-35. [PMID: 25894876 DOI: 10.2217/nmt.14.53] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Arterial stiffness is emerging as an important risk marker for poor brain aging and dementia through its associations with cerebral small vessel disease, stroke, β-amyloid deposition, brain atrophy and cognitive impairment. Arterial stiffness directly relates the detrimental effects of hypertension on peripheral organs with dire consequences for the extensive microvasculature structure of the kidneys and brain. In this review, we discuss the evidence linking arterial stiffness, hypertension and brain structural abnormalities in older adults. In particular, we discuss the potential mechanisms linking arterial stiffness to brain β-amyloid deposition and dementia and potential therapeutic strategies to prevent hypertension's adverse effects on the brain.
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Affiliation(s)
- Timothy M Hughes
- Department of Internal Medicine, Division of Gerontology & Geriatric Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1207, USA
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Levelt E, Mahmod M, Piechnik SK, Ariga R, Francis JM, Rodgers CT, Clarke WT, Sabharwal N, Schneider JE, Karamitsos TD, Clarke K, Rider OJ, Neubauer S. Relationship Between Left Ventricular Structural and Metabolic Remodeling in Type 2 Diabetes. Diabetes 2016; 65:44-52. [PMID: 26438611 PMCID: PMC4890658 DOI: 10.2337/db15-0627] [Citation(s) in RCA: 148] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 09/24/2015] [Indexed: 12/31/2022]
Abstract
Concentric left ventricular (LV) remodeling is associated with adverse cardiovascular events and is frequently observed in patients with type 2 diabetes mellitus (T2DM). Despite this, the cause of concentric remodeling in diabetes per se is unclear, but it may be related to cardiac steatosis and impaired myocardial energetics. Thus, we investigated the relationship between myocardial metabolic changes and LV remodeling in T2DM. Forty-six nonhypertensive patients with T2DM and 20 matched control subjects underwent cardiovascular magnetic resonance to assess LV remodeling (LV mass-to-LV end diastolic volume ratio), function, tissue characterization before and after contrast using T1 mapping, and (1)H and (31)P magnetic resonance spectroscopy for myocardial triglyceride content (MTG) and phosphocreatine-to-ATP ratio, respectively. When compared with BMI- and blood pressure-matched control subjects, subjects with diabetes were associated with concentric LV remodeling, higher MTG, impaired myocardial energetics, and impaired systolic strain indicating a subtle contractile dysfunction. Importantly, cardiac steatosis independently predicted concentric remodeling and systolic strain. Extracellular volume fraction was unchanged, indicating the absence of fibrosis. In conclusion, cardiac steatosis may contribute to concentric remodeling and contractile dysfunction of the LV in diabetes. Because cardiac steatosis is modifiable, strategies aimed at reducing MTG may be beneficial in reversing concentric remodeling and improving contractile function in the hearts of patients with diabetes.
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MESH Headings
- Adenosine Triphosphate/metabolism
- Adipose Tissue/metabolism
- Adipose Tissue/pathology
- Adult
- Case-Control Studies
- Coronary Angiography
- Diabetes Mellitus, Type 2/complications
- Diabetes Mellitus, Type 2/metabolism
- Diabetes Mellitus, Type 2/pathology
- Diabetes Mellitus, Type 2/physiopathology
- Echocardiography
- Female
- Heart/physiopathology
- Humans
- Hypertrophy, Left Ventricular/complications
- Hypertrophy, Left Ventricular/metabolism
- Hypertrophy, Left Ventricular/pathology
- Hypertrophy, Left Ventricular/physiopathology
- Magnetic Resonance Imaging, Cine
- Magnetic Resonance Spectroscopy
- Male
- Middle Aged
- Myocardium/metabolism
- Myocardium/pathology
- Phosphocreatine/metabolism
- Phosphorus Isotopes
- Proton Magnetic Resonance Spectroscopy
- Systole
- Tomography, X-Ray Computed
- Triglycerides/metabolism
- Ventricular Remodeling
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Affiliation(s)
- Eylem Levelt
- Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford, U.K. Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, U.K
| | - Masliza Mahmod
- Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford, U.K
| | - Stefan K Piechnik
- Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford, U.K
| | - Rina Ariga
- Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford, U.K
| | - Jane M Francis
- Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford, U.K
| | - Christopher T Rodgers
- Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford, U.K
| | - William T Clarke
- Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford, U.K
| | | | - Jurgen E Schneider
- Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford, U.K
| | - Theodoros D Karamitsos
- Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford, U.K. First Department of Cardiology, Aristotle University, Thessaloniki, Greece
| | - Kieran Clarke
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, U.K
| | - Oliver J Rider
- Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford, U.K
| | - Stefan Neubauer
- Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford, U.K.
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Rider OJ, Banerjee R, Rayner JJ, Shah R, Murthy VL, Robson MD, Neubauer S. Investigating a Liver Fat. Arterioscler Thromb Vasc Biol 2016; 36:198-203. [DOI: 10.1161/atvbaha.115.306561] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 10/26/2015] [Indexed: 12/21/2022]
Abstract
Objective—
To investigate the relationship between hepatic fat content, circulating triglyceride levels and aortic stiffness in adult and childhood obesity.
Approach and Results—
Seventy-seven adults and 18 children across a wide range of body mass index (18.5–52.6 kg/m
2
; percentile 8–100) with no identifiable cardiac risk factors underwent; 1H- magnetic resonance spectroscopy to quantify hepatic fat content and magnetic resonance imaging to assess aortic pulse wave velocity (PWV) and regional distensibility. In adults, multivariable regression showed age (β=0.09;
P
=0.02), liver fat (β=2.5;
P
=0.04), and serum triglyceride (β=0.47;
P
=0.01) to be independent predictors of PWV. Age and blood pressure–adjusted, moderated regression showed that 43% of the total negative effect of hepatic fat on PWV is attributable to indirect effects via increased triglyceride (
P
=0.005). In addition, regional distensibility was positively correlated with hepatic fat (ascending;
r
=−0.35; descending,
r
=−0.23; abdominal,
r
=−0.41; all
P
<0.001). Similar to that seen in adults, PWV (
r
=0.72;
P
<0.001) and abdominal regional distensibility (
r
=−0.52;
P
<0.001) were correlated with liver fat in children.
Conclusions—
Increasing age, liver fat, and triglyceride are all related to increased aortic stiffness in adults. Even when controlling for the effects of age and blood pressure, hepatic fat has a negative effect on PWV, with substantial indirect effect occurring via increased circulating triglyceride level. This relationship between hepatic fat and aortic stiffness occurs early in the obesity process and is also seen in children. As such, hepatic fat content is a potential therapeutic target to treat the elevated vascular risk in obesity.
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Affiliation(s)
- Oliver J. Rider
- From the Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom (O.J.R., R.B., J.J.R., M.D.R., S.N.); Beth Israel Deaconess Medical Center, Boston, MA (R.S.); and Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor (V.L.M.)
| | - Rajarshi Banerjee
- From the Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom (O.J.R., R.B., J.J.R., M.D.R., S.N.); Beth Israel Deaconess Medical Center, Boston, MA (R.S.); and Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor (V.L.M.)
| | - Jennifer J. Rayner
- From the Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom (O.J.R., R.B., J.J.R., M.D.R., S.N.); Beth Israel Deaconess Medical Center, Boston, MA (R.S.); and Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor (V.L.M.)
| | - Ravi Shah
- From the Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom (O.J.R., R.B., J.J.R., M.D.R., S.N.); Beth Israel Deaconess Medical Center, Boston, MA (R.S.); and Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor (V.L.M.)
| | - Venkatesh L. Murthy
- From the Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom (O.J.R., R.B., J.J.R., M.D.R., S.N.); Beth Israel Deaconess Medical Center, Boston, MA (R.S.); and Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor (V.L.M.)
| | - Matthew D. Robson
- From the Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom (O.J.R., R.B., J.J.R., M.D.R., S.N.); Beth Israel Deaconess Medical Center, Boston, MA (R.S.); and Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor (V.L.M.)
| | - Stefan Neubauer
- From the Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom (O.J.R., R.B., J.J.R., M.D.R., S.N.); Beth Israel Deaconess Medical Center, Boston, MA (R.S.); and Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor (V.L.M.)
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Comprehensive multi-modality assessment of regional and global arterial structure and function in adults born preterm. Hypertens Res 2015; 39:39-45. [PMID: 26399455 PMCID: PMC4709461 DOI: 10.1038/hr.2015.102] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Revised: 06/08/2015] [Accepted: 07/08/2015] [Indexed: 02/03/2023]
Abstract
Preterm birth is associated with higher blood pressure, which could be because preterm birth alters early aortic elastin and collagen development to cause increased arterial stiffness. We measured central and conduit artery size and multiple indices of arterial stiffness to define the extent and severity of macrovascular changes in individuals born preterm. A total of 102 young adults born preterm and 102 controls who were born after an uncomplicated pregnancy underwent cardiovascular magnetic resonance on a Siemens 1.5 T scanner to measure the aortic cross-sectional area in multiple locations. Ultrasound imaging with a Philips CX50 and linear array probe was used to measure carotid and brachial artery diameters. Carotid-femoral pulse wave velocity and the augmentation index were measured by SphygmoCor, brachial-femoral pulse wave velocity by Vicorder and aortic pulse wave velocity by cardiovascular magnetic resonance. The cardio-ankle vascular index (CAVI) was used as a measurement of global stiffness, and ultrasound was used to assess peripheral vessel distensibility. Adults born preterm had 20% smaller thoracic and abdominal aortic lumens (2.19 ± 0.44 vs. 2.69 ± 0.60 cm(2), P<0.001; 1.25 ± 0.36 vs. 1.94 ± 0.45 cm(2), P<0.001, respectively) but similar carotid and brachial diameters to adults born at term. Pulse wave velocity was increased (5.82 ± 0.80 vs. 5.47 ± 0.59 m s(-1), P<0.01, 9.06 ± 1.25 vs. 8.33 ± 1.28 m s(-1), P=0.01, 5.23 ± 1.19 vs. 4.75 ± 0.91 m s(-1), P<0.01) and carotid distensibility was decreased (4.75 ± 1.31 vs. 5.60 ± 1.48 mm Hg(-1)10(3), P<0.001) in this group compared with the group born at term. However, the global and peripheral arterial stiffness measured by CAVI and brachial ultrasound did not differ (5.95 ± 0.72 vs. 5.98 ± 0.60, P=0.80 and 1.07 ± 0.48 vs. 1.19 ± 0.54 mm Hg(-1)10(3), P=0.12, respectively). Adults who are born preterm have significant differences in their aortic structure from adults born at term, but they have relatively small differences in central arterial stiffness that may be partially explained by blood pressure variations.
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Harhay MO, Kizer JR, Criqui MH, Lima JAC, Tracy R, Bluemke DA, Kawut SM. Adipokines and the Right Ventricle: The MESA-RV Study. PLoS One 2015; 10:e0136818. [PMID: 26348768 PMCID: PMC4562601 DOI: 10.1371/journal.pone.0136818] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 08/10/2015] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Obesity is associated with changes in both right (RV) and left (LV) ventricular morphology, but the biological basis of this finding is not well established. We examined whether adipokine levels were associated with RV morphology and function in a population-based multiethnic sample free of clinical cardiovascular disease. METHODS We examined relationships of leptin, resistin, TNF-α, and adiponectin with RV morphology and function (from cardiac MRI) in participants (n = 1,267) free of clinical cardiovascular disease from the Multi-Ethnic Study of Atherosclerosis (MESA)-RV study. Multivariable regressions (linear, quantile [25th and 75th] and generalized additive models [GAM]) were used to examine the independent association of each adipokine with RV mass, RV end-diastolic volume (RVEDV), RV end-systolic volume (RVESV), RV stroke volume (RVSV) and RV ejection fraction (RVEF). RESULTS Higher leptin levels were associated with significantly lower levels of RV mass, RVEDV, RVESV and stroke volume, but not RVEF, after adjustment for age, gender, race, height and weight. These associations were somewhat attenuated but still significant after adjustment for traditional risk factors and covariates, and were completely attenuated when correcting for the respective LV measures. There were no significant interactions of age, gender, or race/ethnicity on the relationship between the four adipokines and RV structure or function. CONCLUSIONS Leptin levels are associated with favorable RV morphology in a multi-ethnic population free of cardiovascular disease, however these associations may be explained by a yet to be understood bi-ventricular process as this association was no longer present after adjustment for LV values. These findings complement the associations previously shown between adipokines and LV structure and function in both healthy and diseased patients. The mechanisms linking adipokines to healthy cardiovascular function require further investigation.
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Affiliation(s)
- Michael O. Harhay
- Penn Cardiovascular Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Jorge R. Kizer
- Department of Medicine, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, United States of America
| | - Michael H. Criqui
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, California, United States of America
| | - João A. C. Lima
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Russell Tracy
- Department of Laboratory Medicine, University of Vermont School of Medicine, Burlington, Vermont, United States of America
| | - David A. Bluemke
- Radiology and Imaging Sciences, National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health/Clinical Center, Bethesda, Maryland, United States of America
| | - Steven M. Kawut
- Penn Cardiovascular Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- * E-mail:
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47
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Brunner EJ, Shipley MJ, Ahmadi-Abhari S, Tabak AG, McEniery CM, Wilkinson IB, Marmot MG, Singh-Manoux A, Kivimaki M. Adiposity, obesity, and arterial aging: longitudinal study of aortic stiffness in the Whitehall II cohort. Hypertension 2015; 66:294-300. [PMID: 26056335 PMCID: PMC4490910 DOI: 10.1161/hypertensionaha.115.05494] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 05/12/2015] [Indexed: 01/28/2023]
Abstract
We sought to determine whether adiposity in later midlife is an independent predictor of accelerated stiffening of the aorta. Whitehall II study participants (3789 men; 1383 women) underwent carotid-femoral applanation tonometry at the mean age of 66 and again 4 years later. General adiposity by body mass index, central adiposity by waist circumference and waist:hip ratio, and fat mass percent by body impedance were assessed 5 years before and at baseline. In linear mixed models adjusted for age, sex, ethnicity, and mean arterial pressure, all adiposity measures were associated with aortic stiffening measured as increase in pulse wave velocity (PWV) between baseline and follow-up. The associations were similar in the metabolically healthy and unhealthy, according to Adult Treatment Panel-III criteria excluding waist circumference. C-reactive protein and interleukin-6 levels accounted for part of the longitudinal association between adiposity and PWV change. Adjusting for chronic disease, antihypertensive medication and risk factors, standardized effects of general and central adiposity and fat mass percent on PWV increase (m/s) were similar (0.14, 95% confidence interval: 0.05-0.24, P=0.003; 0.17, 0.08-0.27, P<0.001; 0.14, 0.05-0.22, P=0.002, respectively). Previous adiposity was associated with aortic stiffening independent of change in adiposity, glycaemia, and lipid levels across PWV assessments. We estimated that the body mass index-linked PWV increase will account for 12% of the projected increase in cardiovascular risk because of high body mass index. General and central adiposity in later midlife were strong independent predictors of aortic stiffening. Our findings suggest that adiposity is an important and potentially modifiable determinant of arterial aging.
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Affiliation(s)
- Eric J Brunner
- From the UCL Research Department of Epidemiology and Public Health, London, United Kingdom (E.J.B., M.J.S., S.A.-A., A.G.T., C.M.M., M.G.M., A.S.-M., M.K.); Semmelweis University Faculty of Medicine, 1st Department of Medicine, Budapest, Hungary (A.G.T.); Clinical Pharmacology Unit, Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, United Kingdom (C.M.M., J.B.W.); INSERM, Centre for Research in Epidemiology & Public Health, Hôpital Paul Brousse, Bâtiment, France (A.S.-M.).
| | - Martin J Shipley
- From the UCL Research Department of Epidemiology and Public Health, London, United Kingdom (E.J.B., M.J.S., S.A.-A., A.G.T., C.M.M., M.G.M., A.S.-M., M.K.); Semmelweis University Faculty of Medicine, 1st Department of Medicine, Budapest, Hungary (A.G.T.); Clinical Pharmacology Unit, Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, United Kingdom (C.M.M., J.B.W.); INSERM, Centre for Research in Epidemiology & Public Health, Hôpital Paul Brousse, Bâtiment, France (A.S.-M.)
| | - Sara Ahmadi-Abhari
- From the UCL Research Department of Epidemiology and Public Health, London, United Kingdom (E.J.B., M.J.S., S.A.-A., A.G.T., C.M.M., M.G.M., A.S.-M., M.K.); Semmelweis University Faculty of Medicine, 1st Department of Medicine, Budapest, Hungary (A.G.T.); Clinical Pharmacology Unit, Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, United Kingdom (C.M.M., J.B.W.); INSERM, Centre for Research in Epidemiology & Public Health, Hôpital Paul Brousse, Bâtiment, France (A.S.-M.)
| | - Adam G Tabak
- From the UCL Research Department of Epidemiology and Public Health, London, United Kingdom (E.J.B., M.J.S., S.A.-A., A.G.T., C.M.M., M.G.M., A.S.-M., M.K.); Semmelweis University Faculty of Medicine, 1st Department of Medicine, Budapest, Hungary (A.G.T.); Clinical Pharmacology Unit, Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, United Kingdom (C.M.M., J.B.W.); INSERM, Centre for Research in Epidemiology & Public Health, Hôpital Paul Brousse, Bâtiment, France (A.S.-M.)
| | - Carmel M McEniery
- From the UCL Research Department of Epidemiology and Public Health, London, United Kingdom (E.J.B., M.J.S., S.A.-A., A.G.T., C.M.M., M.G.M., A.S.-M., M.K.); Semmelweis University Faculty of Medicine, 1st Department of Medicine, Budapest, Hungary (A.G.T.); Clinical Pharmacology Unit, Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, United Kingdom (C.M.M., J.B.W.); INSERM, Centre for Research in Epidemiology & Public Health, Hôpital Paul Brousse, Bâtiment, France (A.S.-M.)
| | - Ian B Wilkinson
- From the UCL Research Department of Epidemiology and Public Health, London, United Kingdom (E.J.B., M.J.S., S.A.-A., A.G.T., C.M.M., M.G.M., A.S.-M., M.K.); Semmelweis University Faculty of Medicine, 1st Department of Medicine, Budapest, Hungary (A.G.T.); Clinical Pharmacology Unit, Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, United Kingdom (C.M.M., J.B.W.); INSERM, Centre for Research in Epidemiology & Public Health, Hôpital Paul Brousse, Bâtiment, France (A.S.-M.)
| | - Michael G Marmot
- From the UCL Research Department of Epidemiology and Public Health, London, United Kingdom (E.J.B., M.J.S., S.A.-A., A.G.T., C.M.M., M.G.M., A.S.-M., M.K.); Semmelweis University Faculty of Medicine, 1st Department of Medicine, Budapest, Hungary (A.G.T.); Clinical Pharmacology Unit, Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, United Kingdom (C.M.M., J.B.W.); INSERM, Centre for Research in Epidemiology & Public Health, Hôpital Paul Brousse, Bâtiment, France (A.S.-M.)
| | - Archana Singh-Manoux
- From the UCL Research Department of Epidemiology and Public Health, London, United Kingdom (E.J.B., M.J.S., S.A.-A., A.G.T., C.M.M., M.G.M., A.S.-M., M.K.); Semmelweis University Faculty of Medicine, 1st Department of Medicine, Budapest, Hungary (A.G.T.); Clinical Pharmacology Unit, Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, United Kingdom (C.M.M., J.B.W.); INSERM, Centre for Research in Epidemiology & Public Health, Hôpital Paul Brousse, Bâtiment, France (A.S.-M.)
| | - Mika Kivimaki
- From the UCL Research Department of Epidemiology and Public Health, London, United Kingdom (E.J.B., M.J.S., S.A.-A., A.G.T., C.M.M., M.G.M., A.S.-M., M.K.); Semmelweis University Faculty of Medicine, 1st Department of Medicine, Budapest, Hungary (A.G.T.); Clinical Pharmacology Unit, Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, United Kingdom (C.M.M., J.B.W.); INSERM, Centre for Research in Epidemiology & Public Health, Hôpital Paul Brousse, Bâtiment, France (A.S.-M.)
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48
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Petersen K, Blanch N, Keogh J, Clifton P. Weight Loss, Dietary Intake and Pulse Wave Velocity. Pulse (Basel) 2015; 3:134-40. [PMID: 26587462 DOI: 10.1159/000435792] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
We have recently conducted a meta-analysis to determine the effect of weight loss achieved by an energy-restricted diet with or without exercise, anti-obesity drugs or bariatric surgery on pulse wave velocity (PWV) measured at all arterial segments. Twenty studies, including 1,259 participants, showed that modest weight loss (8% of the initial body weight) caused a reduction in PWV measured at all arterial segments. However, due to the poor methodological design of the included studies, the results of this meta-analysis can only be regarded as hypothesis generating and highlight the need for further research in this area. In the future, well-designed randomised controlled trials are required to determine the effect of diet-induced weight loss on PWV and the mechanisms involved. In addition, there is observational evidence that dietary components such as fruit, vegetables, dairy foods, sodium, potassium and fatty acids may be associated with PWV, although evidence from well-designed intervention trials is lacking. In the future, the effect of concurrently improving dietary quality and achieving weight loss should be assessed in randomised controlled trials.
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Affiliation(s)
- Kristina Petersen
- Division of Health Sciences, School of Pharmacy and Medical Science, University of South Australia, Adelaide, S.A., Australia
| | - Natalie Blanch
- Division of Health Sciences, School of Pharmacy and Medical Science, University of South Australia, Adelaide, S.A., Australia
| | - Jennifer Keogh
- Division of Health Sciences, School of Pharmacy and Medical Science, University of South Australia, Adelaide, S.A., Australia
| | - Peter Clifton
- Division of Health Sciences, School of Pharmacy and Medical Science, University of South Australia, Adelaide, S.A., Australia
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49
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Strasser B, Arvandi M, Pasha EP, Haley AP, Stanforth P, Tanaka H. Abdominal obesity is associated with arterial stiffness in middle-aged adults. Nutr Metab Cardiovasc Dis 2015; 25:495-502. [PMID: 25770757 DOI: 10.1016/j.numecd.2015.01.002] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 12/26/2014] [Accepted: 01/18/2015] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIMS The relation between adiposity and arterial stiffness remains controversial. We determined whether abdominal and visceral adipose tissue may be a better predictor of arterial stiffness than general obesity in middle-aged adults. METHODS AND RESULTS A total of 146 participants (76 men, 70 women; 50 years) were studied. The automatic vascular screening device (Omron VP-1000plus) was used to measure blood pressure simultaneously in the arms and ankles and to determine arterial stiffness by pulse wave velocity (PWV). Using multiple linear regressions, the relations between indicators of obesity and arterial stiffness were examined after adjustment for confounders. Both carotid-femoral PWV and brachial-ankle PWV were significantly associated with BMI (both P < 0.05) but not with body fat percentage. Measures of abdominal obesity, including waist circumference and visceral fat mass (via DXA), were strongly associated with PWV and remained positively associated with arterial stiffness after adjustment for age and gender. Cardiovascular fitness as assessed by maximal oxygen consumption was related to body fat percentage but not with visceral fat. More favorable cardiovascular health profile was associated with both lower visceral fat mass and PWV (both P < 0.001). CONCLUSION Abdominal obesity and visceral fat are associated with large artery stiffness. These findings support the importance of adiposity measures as a risk factor for arterial stiffening in middle-aged adults.
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Affiliation(s)
- B Strasser
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX, USA; Institute for Nutritional Sciences and Physiology, University for Health Sciences, Medical Informatics and Technology, Hall in Tyrol, Austria.
| | - M Arvandi
- Institute of Public Health, Medical Decision Making and Health Technology Assessment, University for Health Sciences, Medical Informatics and Technology, Hall in Tyrol, Austria
| | - E P Pasha
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX, USA
| | - A P Haley
- Department of Psychology, University of Texas at Austin, Austin, TX, USA
| | - P Stanforth
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX, USA
| | - H Tanaka
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX, USA
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50
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Desamericq G, Tissot CM, Akakpo S, Tropeano AI, Millasseau S, Macquin-Mavier I. Carotid-femoral pulse wave velocity is not increased in obesity. Am J Hypertens 2015; 28:546-51. [PMID: 25300568 DOI: 10.1093/ajh/hpu190] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND There are conflicting results in the literature concerning the relationship between obesity and arterial stiffness, assessed by carotid-femoral pulse wave velocity (PWV). The discrepancies could be due to differences in carotid-femoral distance measurement and/or to the presence of pathologies frequently associated with obesity and which increase arterial stiffness. In this study, we examine the relationship between PWV and weight, without and with associated cardiovascular risk factors (diabetes and/or dyslipidemia). METHODS PWV was assessed with a Complior SP device (Alam Medical, France) in 2,034 patients referred for ambulatory blood pressure monitoring. The carotid-femoral distance used to calculate PWV was measured with a flexible tape and from the estimated straight carotid-femoral distance obtained with a published equation. RESULTS In the whole cohort, PWV did not differ significantly according to weight (9.6±2.1, 9.8±2.2 and 9.7±1.9 m/s in normal weight, overweight and obese subjects, respectively, with the distance measured with a tape). PWV was significantly higher in the four groups of patients with cardiovascular risk factors (e.g., 11.1±2.4, 11.0±2.7 and 10.4±2.0 m/s in normal weight, overweight, and obese subjects, respectively, in the group treated for diabetes and dyslipidemia) than in the group of patients without cardiovascular risk factors (8.5±1.6, 8.8±1.7 and 8.5±1.2 in normal weight, overweight, and obese subjects, respectively). There was no relationship between PWV value and weight status, whether or not there were cardiovascular risk factors, and whatever the distance used to calculate PWV. CONCLUSIONS In our cohort, obesity per se was not associated with increased arterial stiffness.
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Affiliation(s)
- Gaëlle Desamericq
- Université Paris Est, Faculté de Médecine, Créteil, France; AP-HP, Hôpital H. Mondor - A. Chenevier, Service de Pharmacologie Clinique, Créteil, France
| | - Claire-Marie Tissot
- Université Paris Est, Faculté de Médecine, Créteil, France; AP-HP, Hôpital H. Mondor - A. Chenevier, Service de Pharmacologie Clinique, Créteil, France
| | - Servais Akakpo
- Université Paris Est, Faculté de Médecine, Créteil, France; AP-HP, Hôpital H. Mondor - A. Chenevier, Service de Pharmacologie Clinique, Créteil, France
| | - Anne-Isabelle Tropeano
- Université Paris Est, Faculté de Médecine, Créteil, France; AP-HP, Hôpital H. Mondor - A. Chenevier, Service de Cardiologie, Créteil, France
| | | | - Isabelle Macquin-Mavier
- Université Paris Est, Faculté de Médecine, Créteil, France; AP-HP, Hôpital H. Mondor - A. Chenevier, Service de Pharmacologie Clinique, Créteil, France;
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