1
|
Thornton T, Mills D, Bliss E. The impact of lipopolysaccharide on cerebrovascular function and cognition resulting from obesity-induced gut dysbiosis. Life Sci 2024; 336:122337. [PMID: 38072189 DOI: 10.1016/j.lfs.2023.122337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/23/2023] [Accepted: 12/05/2023] [Indexed: 12/24/2023]
Abstract
Obesity is a worldwide epidemic coinciding with a concomitant increase in the incidence of neurodegenerative diseases, particularly dementia. Obesity is characterised by increased adiposity, chronic low-grade systemic inflammation, and oxidative stress, which promote endothelial dysfunction. Endothelial dysfunction reduces cerebrovascular function leading to reduced cerebral blood flow and, eventually, cognitive decline, thus predisposing to a neurodegenerative disease. Obesity is also characterised by gut dysbiosis and a subsequent increase in the lipopolysaccharide which increasingly activates toll-like receptor 4 (TLR4) and further promotes chronic low-grade systemic inflammation. This also disrupts the crosstalk within the gut-brain axis, thus influencing the functions of the central nervous system, including cognition. However, the mechanisms by which obesity-related increases in oxidative stress, inflammation and endothelial dysfunction are driven by, or associated with, increased systemic lipopolysaccharide leading to reduced cerebrovascular function and cognition, beyond normal ageing, have not been elucidated. Hence, this review examines how increased concentrations of lipopolysaccharide and the subsequent increased TLR4 activation observed in obesity exacerbate the development of obesity-induced reductions in cerebrovascular function and cognition.
Collapse
Affiliation(s)
- Tammy Thornton
- School of Health and Medical Sciences, University of Southern Queensland, Ipswich, QLD 4305, Australia; Respiratory and Exercise Physiology Research Group, School of Health and Medical Sciences, University of Southern Queensland, Ipswich, QLD 4305, Australia.
| | - Dean Mills
- School of Health and Medical Sciences, University of Southern Queensland, Ipswich, QLD 4305, Australia; Respiratory and Exercise Physiology Research Group, School of Health and Medical Sciences, University of Southern Queensland, Ipswich, QLD 4305, Australia; Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, QLD 4305, Australia; Molecular Biomarkers Research Group, University of Southern Queensland, Toowoomba, QLD 4350, Australia
| | - Edward Bliss
- School of Health and Medical Sciences, University of Southern Queensland, Ipswich, QLD 4305, Australia; Respiratory and Exercise Physiology Research Group, School of Health and Medical Sciences, University of Southern Queensland, Ipswich, QLD 4305, Australia; Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, QLD 4305, Australia; Molecular Biomarkers Research Group, University of Southern Queensland, Toowoomba, QLD 4350, Australia
| |
Collapse
|
2
|
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.
Collapse
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
| |
Collapse
|
3
|
S VC, S S, R NK, S N MS, P A A. Association of Serum Cystatin C Level With Carotid Arterial Wall Elastic Resistance as a Potential Marker for Detection of Early Stage Atherosclerosis. Cureus 2023; 15:e38543. [PMID: 37273348 PMCID: PMC10239270 DOI: 10.7759/cureus.38543] [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] [Accepted: 04/25/2023] [Indexed: 06/06/2023] Open
Abstract
BACKGROUND Early diagnosis of atherosclerosis is exigent in patients with known cardiovascular disease (CVD) risk factors. During the initial phases of atherosclerosis, appearance of plaques can be detected by the ultrasonic phased tracking method which measures the arterial wall elasticity. However, reliable and easily available biochemical markers are not evaluated in the diagnosis of early-stage atherosclerosis. So the current study was carried out to assess the serum cystatin C level as an atherosclerotic marker, by evaluating its association with carotid arterial elastic modulus using the phased tracking method. MATERIALS AND METHODS A cross-sectional study was conducted on 115 patients having risk factors for atherosclerosis but not meeting carotid intima-media thickness (IMT) criteria. The early-stage atherosclerosis was detected by using the ultrasonic phased tracking method and the patients were divided based on low and high carotid elastic modulus. Serum levels of cystatin-C were measured in association with IMT, and elastic modulus was calculated using a novel method. This study also put forth the evaluation of the sensitivity and specificity of cystatin C for early diagnosis of atherosclerosis. RESULTS Cystatin C was strongly related to carotid elasticity (r=0.650). Based on multi-linear regression analysis, cystatin C showed significant association with carotid elasticity (β=0.509; p<0.001). It also displayed significant positive association with high carotid elastic modulus (β=0.511; p=0.02). Cystatin C showed a sensitivity of 85% in the prediction of high carotid elastic modulus. CONCLUSION For patients who are at risk to evolve atherosclerosis but are not evident with arterial plaques, cystatin C exhibits a significant association with carotid wall elastic modulus, which eases the detection of atherosclerosis. Thus, cystatin C is a potential biochemical marker for early diagnosis of atherosclerosis.
Collapse
Affiliation(s)
- Vishnu Chander S
- Department of General Medicine, SRM Institute of Science and Technology, SRM Medical College Hospital and Research Centre, Faculty of Medicine and Health Sciences, Kattankulathur, IND
| | - Sarumathy S
- Department of Pharmacy Practice, SRM Institute of Science and Technology, SRM College of Pharmacy, Faculty of Medicine and Health Sciences, Kattankulathur, IND
| | - Nanda Kumar R
- Department of General Medicine, SRM Institute of Science and Technology, SRM Medical College Hospital and Research Centre, Faculty of Medicine and Health Sciences, Kattankulathur, IND
| | - Meenakshi Sundari S N
- Department of General Medicine, SRM Institute of Science and Technology, SRM Medical College Hospital and Research Centre, Faculty of Medicine and Health Sciences, Kattankulathur, IND
| | - Anuba P A
- Department of Pharmacy Practice, SRM Institute of Science and Technology, SRM College of Pharmacy, Faculty of Medicine and Health Sciences, Kattankulathur, IND
| |
Collapse
|
4
|
Vallée A. Arterial stiffness nomogram identification by cluster analysis: A new approach of vascular phenotype modeling. J Clin Hypertens (Greenwich) 2022; 24:1415-1426. [PMID: 36196587 PMCID: PMC9659882 DOI: 10.1111/jch.14571] [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: 08/05/2022] [Revised: 08/22/2022] [Accepted: 08/24/2022] [Indexed: 11/28/2022]
Abstract
Arterial stiffness, measured by arterial stiffness index (ASI), can be considered as a major denominator in cardiovascular diseases. Thus, it remains essential to highlight patient phenotyping profiles with high ASI values. A nomogram of arterial stiffness was evaluated by calculation of ASI nomogram. Theoretical ASI can be performed according to age, sex, mean blood pressure, and heart rate, allowing to form an individual ASI nomogram [(measured ASI - theoretical ASI)/theoretical ASI]. An ASI nomogram > 0 defined AS. This study investigates among UK Biobank participants without cardiovascular diseases, the hypothesis that K-means cluster analysis can be used to identify homogeneous phenotyping subgroups of participants according to ASI levels and then, the phenotype differences observed between these clusters. ASI nomogram was applied on 132 851 participants. K-means clustering was implemented with 10 clusters (optimal CCC value of 105.246). One cluster showed 100% rate of AS, corresponding to 25 393 participants (41.6% of the AS participants) with ASI nomogram = .26 (.22), ASI = 11.6 (2.3)m/s. A second cluster showed a 100% of non-AS, corresponding to 27 844 participants (38.8% of the participants with no arterial stiffness) with ASI nomogram = -.22 (.13), ASI = 7.1 (1.44)m/s. Threshold values of independent factors for differencing these two clusters were total cholesterol > 5.409 mmol/L (P < .001), triglycerides > 1.286 mmol/L (P < .001), smoking pack years > 11.8 pack/years, CRP > .99 (P < .001), daily alcohol consumption > 1.794 units/days and BMI > 26.641 kg/m2 (P < .001). Cluster analysis allowed to highlight homogeneous participants profile with or without AS. Determine the markers differencing these clusters participates in the management of cardiovascular preventive strategies.
Collapse
Affiliation(s)
- Alexandre Vallée
- Department of Epidemiology-Data-Biostatistics, Delegation of Clinical Research and Innovation (DRCI), Foch hospital, Suresnes, France
| |
Collapse
|
5
|
Alchourron E, Dubois J, Cloutier G, Stein N, Farhat Z, Roy-Cardinal MH, Moretti JB, Lapierre C, El Jalbout R. Non-Invasive Vascular Elastography as a One-Step Imaging Technique to Evaluate Early Vascular Changes in Children Compared to B-Mode-Based Intima-Media Thickness Technique : A Validation Study Using Inter- and Intra-Rater Reliability. Can Assoc Radiol J 2022; 74:422-431. [PMID: 36263774 DOI: 10.1177/08465371221134055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Childhood obesity is linked to higher adult mortality and morbidity from atherosclerosis. It is primordial to detect at-risk children earlier-on to prevent disease progression. Carotid intima-media thickness (IMT) is a subclinical radiological marker for early atherosclerosis. B-mode ultrasound is a known technique to assess IMT, but no gold standard technique exists in children. Non-invasive vascular elastography (NIVE) using speckle statistics is an innovative alternative to evaluate IMT and adds by providing translation, strain and shear strain measurements. Validation studies for both techniques lack in children. Purpose: Validate the reproducibility of the 2 techniques in Canadian children. Methods: We conducted a prospective study where anthropometry, blood pressure, IMT and elastography were measured. Six operators obtained 2 measurements for both carotid arteries using both techniques, for a total of 720 measurements. Inter- and intra-class correlation coefficients (ICC) were calculated for each measurement technique and elastography parameters. Results: 30 participants (13.0 ± 1.26 years, 17 girls) were recruited. Twelve were overweight. No significant difference was found in mean IMT between weight groups for either technique (P = .15 and P = .60). We found excellent inter- (ICC = .98 [95% Confidence Interval (CI): .97; .99]) and intra- (ICC = .90-.93) operator reliability for the B-mode technique, and good inter (ICC = .70 [95% CI: .47; .85]) and intra- (ICC = .71-.91) operator reliability for the NIVE-based technique. Poor reliability was found between techniques (ICC = .30 [95% CI: -.31; .65). For elastography parameters, translation was the most reliable (ICC = .94-.95). Conclusion: IMT measurement is reproducible in children but not between techniques. NIVE gives the advantage of evaluating elastography.
Collapse
Affiliation(s)
- Emilie Alchourron
- Radiology, Research Center, 25461CHU Sainte-Justine, Montreal, Quebec, Canada.,Faculty of Medecine, Université de Montréal, Montreal, Quebec, Canada
| | - Josée Dubois
- Radiology, Research Center, 25461CHU Sainte-Justine, Montreal, Quebec, Canada.,Medical Imaging Department, Sainte-Justine University Hospital, Montreal, Quebec, Canada
| | - Guy Cloutier
- Laboratory of Biorheology and Medical Ultrasonics, 177460University of Montreal Hospital Research Center, Montreal, Quebec, Canada
| | - Nina Stein
- Pediatric Radiology, 103398McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Ziad Farhat
- Pediatric Radiology, 3682IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Marie-Hélène Roy-Cardinal
- Laboratory of Biorheology and Medical Ultrasonics, 177460University of Montreal Hospital Research Center, Montreal, Quebec, Canada
| | - Jean-Baptiste Moretti
- Radiology, Research Center, 25461CHU Sainte-Justine, Montreal, Quebec, Canada.,Faculty of Medecine, Université de Montréal, Montreal, Quebec, Canada
| | - Chantale Lapierre
- Medical Imaging Department, Sainte-Justine University Hospital, Montreal, Quebec, Canada
| | - Ramy El Jalbout
- Radiology, Research Center, 25461CHU Sainte-Justine, Montreal, Quebec, Canada.,Medical Imaging Department, Sainte-Justine University Hospital, Montreal, Quebec, Canada
| |
Collapse
|
6
|
The effects of high-intensity interval training and moderate-intensity continuous training on visceral fat and carotid hemodynamics parameters in obese adults. J Exerc Sci Fit 2022; 20:355-365. [PMID: 36186829 PMCID: PMC9486563 DOI: 10.1016/j.jesf.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 08/14/2022] [Accepted: 09/02/2022] [Indexed: 11/23/2022] Open
Abstract
Objectives The present study aimed to examine the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on visceral fat and hemodynamic parameters in obese adults. Methods Fifty-two males were included in this study and divided into three groups: HIIT group (n = 21, age = 20.86 ± 1.62 years, BF (%) = 30.10 ± 5.02), MICT group (n = 22, age = 20.76 ± 1.14 years, BF (%) = 30.19 ± 5.76), and control group (CON) (n = 9, age = 21.38 ± 1.77 years, BF (%) = 30.40 ± 5.10). The HIIT and MICT groups received the exercise intervention three to four times per week for eight weeks (HIIT: exercise intensity 80–95% HRmax, circuit; MICT: exercise intensity 60–70% HRmax, running), and the control (CON) group received health education and guidance without exercise intervention. The body compositions and serum lipid indexes were tested to calculated LAP and VAI. The color doppler ultrasound diagnostic technology was used to test the artery diameter and blood velocity before and after the intervention. Based on the test data, MATLAB software and Womersley theory were used to calculate the hemodynamic parameters of the common carotid artery, including wall shear stress, flow rate, blood pressure, oscillatory shear index, elasticity modulus, dynamic resistance, artery diameter, arterial stiffness, circumferential strain and pulsatility index. Results We found that lipid accumulation product (LAP) was significantly decreased in both the HIIT group (p < 0.01) and MICT (p < 0.05) group but not in the CON group (p > 0.05). In contrast, visceral adiposity index (VAI) decreased in both the HIIT and MICT groups and increased in the CON group, although the difference among groups was not significant (p > 0.05). After 8 weeks of intervention, the blood velocity and wall shear stress were greater after HIIT and MICT intervention (p < 0.01). Artery diameter, oscillatory shear index, arterial stiffness, and pulsatility index decreased significantly, and circumferential strain increased significantly in the HIIT group (all, p < 0.01, p < 0.05) but not in the MICT group (p > 0.05). Dynamic resistance was significantly decreased in the MICT group. There was no difference in the CON group after the period of intervention (all, p > 0.05). LAP was positively related to artery diameter (r = 0.48, p = 0.011), blood pressure (r = 0.46, p = 0.002), flow rate (r = 0.31, p = 0.04), oscillatory shear index (r = 0.44, p = 0.03), and elasticity modulus (r = 0.33, p = 0.029) but inversely related to circumferential strain (r = −0.36, p = 0.028). The VAI was also positively associated with artery diameter (r = 0.33, p = 0.03), elasticity modulus (r = 0.38, p = 0.009), and arterial stiffness (r = 0.39, p = 0.012). In addition, the VAI was negatively correlated with the circumferential strain (r = −0.33, p = 0.04). Conclusion The present study demonstrated that both HIIT and MICT exercises for 8 weeks could effectively enhance visceral fat indices and partial hemodynamic parameters. Therefore, HIIT and MICT exert important effects on reducing fat content and improving hemodynamic environment. But HIIT on oscillatory shear index, arterial stiffness, circumferential strain, and pulsatility index was superior to MICT. In addition, there are close correlations between visceral fat and partial hemodynamic parameters of the common carotid artery.
Collapse
|
7
|
Yang E, Park SH, Lee S, Oh D, Choi HY, Park HC, Jhee JH. Pulse pressure and the risk of renal hyperfiltration in young adults: Results from Korea National Health and Nutrition Examination Survey (2010–2019). Front Med (Lausanne) 2022; 9:911267. [PMID: 36177333 PMCID: PMC9513024 DOI: 10.3389/fmed.2022.911267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 08/08/2022] [Indexed: 11/26/2022] Open
Abstract
Background High pulse pressure (PP) is associated with increased risk of decline of kidney function. However, little is known about the association between PP and RHF in young adults. This study aimed to evaluate the association between PP and RHF in healthy young adults. Methods Data were retrieved from the Korea National Health and Nutrition Examination Survey from 2010 to 2019. A total of 10,365 participants aged 19–39 years with no hypertension and normal kidney function were analyzed. RHF was defined as logarithm transformed estimated glomerular filtration rate (eGFR) with residuals >90th percentile after adjustment for sex, logarithm transformed age, weight, and height. Participants were divided into tertile based on PP levels. Results The prevalence of RHF was higher in higher PP tertile group (6.6, 10.5, and 12.7% in T1, T2, and T3; P for trend < 0.001). In multivariable logistic regression analyses, the risk for RHF was increased in higher PP tertiles compared to the lowest tertile [odds ratio (OR), 1.42; 95% confidence interval (CI), 1.19–1.69 in T2; OR, 1.44; 95% CI, 1.20–1.73 in T3]. When PP levels were treated as continuous variable, the risk of RHF was increased 2.36 per 1.0 increase of PP (P < 0.001). In subgroup analyses stratified sex, histories of diabetes or dyslipidemia, and isolated systolic hypertension or isolated diastolic hypertension, there were no significant interactions with PP for the risk for RHF, suggesting that high PP was associated with increased risk of RHF regardless of subgroups. However, the subgroup with BMI showed significant interaction with PP for the risk of RHF, indicating that participants with BMI ≥ 25 kg/m2 were at higher risk of RHF with increasing PP levels than those with BMI < 25 kg/m2 (OR, 1.89; 95% CI, 1.25–2.87 in BMI < 25 kg/m2; OR, 3.16; 95% CI, 1.74–5.73 in BMI ≥ 25 kg/m2; P for interaction = 0.01). Conclusion High PP is associated with an increased risk of RHF in healthy young adults and this association is prominent in obese young adults. The assessment of PP and associated RHF may give benefit to early detect the potential risk of CKD development in young adults.
Collapse
Affiliation(s)
- Eunji Yang
- Division of Nephrology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Sang Ho Park
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Seoyoung Lee
- Division of Nephrology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Donghwan Oh
- Division of Nephrology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Hoon Young Choi
- Division of Nephrology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
- Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, South Korea
| | - Hyeong Cheon Park
- Division of Nephrology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
- Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, South Korea
| | - Jong Hyun Jhee
- Division of Nephrology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
- *Correspondence: Jong Hyun Jhee,
| |
Collapse
|
8
|
Vallée A. Arterial Stiffness Determinants for Primary Cardiovascular Prevention among Healthy Participants. J Clin Med 2022; 11:jcm11092512. [PMID: 35566636 PMCID: PMC9105622 DOI: 10.3390/jcm11092512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/13/2022] [Accepted: 04/27/2022] [Indexed: 12/27/2022] Open
Abstract
Background: Arterial stiffness (AS), measured by arterial stiffness index (ASI), can be considered as a major denominator in cardiovascular (CV) diseases. Thus, it remains essential to highlight the risk factors influencing its increase among healthy participants. Methods: According to European consensus, AS is defined as ASI > 10 m/s. The purpose of this study was to investigate the determinants of the arterial stiffness (ASI > 10 m/s) among UK Biobank normotensive and healthy participants without comorbidities and previous CV diseases. Thus, a cross-sectional study was conducted on 22,452 healthy participants. Results: Participants were divided into two groups, i.e., ASI > 10 m/s (n = 5782, 25.8%) and ASI < 10 m/s (n = 16,670, 74.2%). All the significant univariate covariables were included in the multivariate analysis. The remaining independent factors associated with AS were age (OR = 1.063, threshold = 53.0 years, p < 0.001), BMI (OR = 1.0450, threshold = 24.9 kg/m2, p < 0.001), cystatin c (OR = 1.384, threshold = 0.85 mg/L, p = 0.011), phosphate (OR = 2.225, threshold = 1.21 mmol/L, p < 0.001), triglycerides (OR = 1.281, threshold = 1.09 mmol/L, p < 0.001), mean BP (OR = 1.028, threshold = 91.2 mmHg, p < 0.001), HR (OR = 1.007, threshold = 55 bpm, p < 0.001), Alkaline phosphate (OR = 1.002, threshold = 67.9 U/L, p = 0.004), albumin (OR = 0.973, threshold = 46.0 g/L, p < 0.001), gender (male, OR = 1.657, p < 0.001) and tobacco use (current, OR = 1.871, p < 0.001). Conclusion: AS is associated with multiple parameters which should be investigated in future prospective studies. Determining the markers of increased ASI among healthy participants participates in the management of future CV risk for preventive strategies.
Collapse
Affiliation(s)
- Alexandre Vallée
- Department of Epidemiology-Data-Biostatistics, Delegation of Clinical Research and Innovation (DRCI), Foch Hospital, 92150 Suresnes, France
| |
Collapse
|
9
|
Craig JC, Bunsawat K. Low Fitness and High Fatness: The "Double Whammy" on Vascular Health. THE KOREAN JOURNAL OF SPORTS MEDICINE 2021; 39:91-94. [PMID: 35317193 PMCID: PMC8936800 DOI: 10.5763/kjsm.2021.39.3.91] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Jesse C. Craig
- Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Kanokwan Bunsawat
- Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| |
Collapse
|
10
|
Impact of body mass index on duplex parameters of cranial vessels among the Egyptian population. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2021. [DOI: 10.1186/s41983-021-00367-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Obesity is a major health problem that affects different vascular systems, including cerebrovascular circulation. Carotid duplex is the best screening tool for early diagnosis of cerebrovascular changes in relation to different risk factors including obesity. The present study aims to evaluate the effect of body mass index on the parameters of extracranial vessels in healthy subjects using vascular duplex ultrasonography.
Results
The intimal medial thickness in the common carotid is found to increase as the body mass index and body weight increase (directly related), with this increase being significant (P-value < 0.05).
Conclusion
These findings indicate that increase in body mass index can adversely affect duplex parameters of the common carotid artery.
Clinical trial registration NCT03252652. Registered August 16th 2017
Collapse
|
11
|
Tricot GK, Novelli FII, Cambri LT. Obesity does not Impair Ambulatory Cardiovascular and Autonomic Responses Post-exercise. Int J Sports Med 2021; 42:1083-1091. [PMID: 33772502 DOI: 10.1055/a-1393-6184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study aimed to assess whether obesity and/or maximal exercise can change 24 h cardiac autonomic modulation and blood pressure in young men. Thirty-nine men (n: 20; 21.9±1.8 kg·m-2, and n: 19; 32.9±2.4 kg·m-2) were randomly assigned to perform a control (non-exercise) and an experimental day exercise (after maximal incremental test). Cardiac autonomic modulation was evaluated through frequency domain heart rate variability (HRV). Obesity did not impair the ambulatory HRV (p>0.05), however higher diastolic blood pressure during asleep time (p=0.02; group main effect) was observed. The 24 h and awake heart rate was higher on the experimental day (p<0.05; day main effect), regardless of obesity. Hypotension on the experimental day, compared to control day, was observed (p<0.05). Obesity indicators were significantly correlated with heart rate during asleep time (Rho=0.34 to 0.36) and with ambulatory blood pressure(r/Rho=0.32 to 0.53). Furthermore, the HRV threshold workload was significantly correlated with ambulatory heart rate (r/Rho=- 0.38 to-0.52). Finally, ambulatory HRV in obese young men was preserved; however, diastolic blood pressure was increased during asleep time. Maximal exercise caused heart rate increase and 24h hypotension, with decreased cardiac autonomic modulation in the first hour, regardless of obesity.
Collapse
|
12
|
Ho A, Cheung CY, Wong JS, Zhang Y, Tang FY, Kam KW, Young AL, Chen LJ, Ip P, Wong TY, Pang CP, Tham CC, Yam JC. Independent and Synergistic Effects of High Blood Pressure and Obesity on Retinal Vasculature in Young Children: The Hong Kong Children Eye Study. J Am Heart Assoc 2021; 10:e018485. [PMID: 33496185 PMCID: PMC7955451 DOI: 10.1161/jaha.120.018485] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background High blood pressure (BP) and obesity are becoming increasingly prevalent among children globally. Although prior studies have shown their adverse impacts on macrovascular health, less is known about their effects on microvascular heath. This study aims to evaluate the independent and synergistic effects of hypertensive BP and obesity on retinal vasculature in young children. Method and Results 1006 children aged 6 to 8 years were recruited from the Hong Kong Children Eye Study. Quantitative retinal vascular parameters, including central retinal arteriolar and venular equivalents and retinal arteriolar and venular fractal dimensions, were measured from retinal photographs following a standardized protocol. BP and body mass index were categorized according to reference values from American Academy of Pediatrics and International Obesity Task Force guidelines respectively. Children with hypertensive systolic BP had the narrowest central retinal arteriolar equivalents compared with children with either elevated or normotensive systolic BP (162.4, 164.6, and 167.1 µm; P-trend <0.001). Increased standardized systolic BP was associated with narrower central retinal arteriolar equivalents (β=-2.276 µm, P<0.001), wider central retinal venular equivalents (1.177, P=0.007), and decreased arteriolar fractal dimensions (β=-0.004, P=0.034). Children with obesity had the smallest arteriolar fractal dimensions compared with children with overweightness and normal weight (1.211, 1.234, and 1.240; P-trend=0.004). Children with both hypertensive BP and either overweightness or obesity had the narrowest central retinal arteriolar equivalents and smallest arteriolar Df (P-trend<0.001 and P-trend=0.007). Conclusions Our findings demonstrate the potential synergistic or additive effects for both hypertensive BP and obesity on retinal vasculature in children.
Collapse
Affiliation(s)
- Agnes Ho
- Department of Ophthalmology and Visual Sciences The Chinese University of Hong Kong Hong Kong SAR China
| | - Carol Y Cheung
- Department of Ophthalmology and Visual Sciences The Chinese University of Hong Kong Hong Kong SAR China
| | - Jason S Wong
- Department of Ophthalmology and Visual Sciences The Chinese University of Hong Kong Hong Kong SAR China
| | - Yuzhou Zhang
- Department of Ophthalmology and Visual Sciences The Chinese University of Hong Kong Hong Kong SAR China
| | - Fang Yao Tang
- Department of Ophthalmology and Visual Sciences The Chinese University of Hong Kong Hong Kong SAR China
| | - Ka Wai Kam
- Department of Ophthalmology and Visual Sciences The Chinese University of Hong Kong Hong Kong SAR China.,Department of Ophthalmology and Visual Sciences Prince of Wales Hospital Hong Kong SAR China
| | - Alvin L Young
- Department of Ophthalmology and Visual Sciences The Chinese University of Hong Kong Hong Kong SAR China.,Department of Ophthalmology and Visual Sciences Prince of Wales Hospital Hong Kong SAR China
| | - Li Jia Chen
- Department of Ophthalmology and Visual Sciences The Chinese University of Hong Kong Hong Kong SAR China.,Department of Ophthalmology and Visual Sciences Prince of Wales Hospital Hong Kong SAR China.,Hong Kong Hub of Paediatric Excellence The Chinese University of Hong Kong Hong Kong SAR China
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine LKS Faculty of Medicine The University of Hong Kong Hong Kong SAR China
| | - Tien Y Wong
- Singapore Eye Research Institute Singapore National Eye Center Duke-NUS Medical SchoolNational University of Singapore Singapore
| | - Chi Pui Pang
- Department of Ophthalmology and Visual Sciences The Chinese University of Hong Kong Hong Kong SAR China.,Hong Kong Hub of Paediatric Excellence The Chinese University of Hong Kong Hong Kong SAR China
| | - Clement C Tham
- Department of Ophthalmology and Visual Sciences The Chinese University of Hong Kong Hong Kong SAR China.,Department of Ophthalmology and Visual Sciences Prince of Wales Hospital Hong Kong SAR China.,Hong Kong Hub of Paediatric Excellence The Chinese University of Hong Kong Hong Kong SAR China.,Hong Kong Eye Hospital Hong Kong SAR China
| | - Jason C Yam
- Department of Ophthalmology and Visual Sciences The Chinese University of Hong Kong Hong Kong SAR China.,Department of Ophthalmology and Visual Sciences Prince of Wales Hospital Hong Kong SAR China.,Hong Kong Hub of Paediatric Excellence The Chinese University of Hong Kong Hong Kong SAR China.,Hong Kong Eye Hospital Hong Kong SAR China.,Department of Ophthalmology Hong Kong Children's Hospital Hong Kong SAR China
| |
Collapse
|
13
|
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: 15] [Impact Index Per Article: 3.8] [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.
Collapse
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
| |
Collapse
|
14
|
Soares EMKVK, Smith D, Grossi Porto LG. Worldwide prevalence of obesity among firefighters: a systematic review protocol. BMJ Open 2020; 10:e031282. [PMID: 31924634 PMCID: PMC6955470 DOI: 10.1136/bmjopen-2019-031282] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 12/03/2019] [Accepted: 12/04/2019] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Obesity may interfere with job performance and increase the risk of injury during firefighting activity. Obesity also has many deleterious effects on health indices and is associated with higher all-cause mortality. Studies report a high prevalence of obesity in the fire service. Also, firefighters' work schedule (12-hour to 24-hour shifts) and food availability during night shifts may be related to weight gain. Studies in American firefighters have shown annual weight gain between 0.5 and 1.5 kg. This study aims to report the obesity prevalence in the fire service to describe how it varies based on country and region, job status, type of firefighter and gender. METHODS AND ANALYSIS The main outcome evaluated will be obesity prevalence. We will systematically search the literature databases PubMed, Medline, Web of Science, Sportdiscus, Academic Search Premier, Cumulative Index of Nursing and Allied Health Literature (CINAHL), SciTech Premium Collection, Sports Medicine & Education Index, Research Library and Scopus. One reviewer will perform the search. Two independent reviewers will select studies, extract data from eligible studies and evaluate their methodological and reporting quality. Agreement between reviewers will be measured using Cohen's kappa. Other data of interest will include age, body mass index, body fat percentage, job status (career, volunteer or military), years of service and type of firefighter (eg, structural and wildland firefighter). We will produce a narrative summary of our findings. Tables will be generated to summarise data. ETHICS AND DISSEMINATION This systematic review does not require ethics clearance since published studies with non-identifiable data will be used. The results of the systematic review will be disseminated via publication in a peer-reviewed journal and through conference presentations. PROSPERO REGISTRATION NUMBER CRD42019129122.
Collapse
Affiliation(s)
- Edgard Melo Keene Von Koenig Soares
- Faculdade de Educação Física, Universidade de Brasilia, Brasilia, Distrito Federal, Brazil
- Health and Human Physiological Sciences/First Responder Health and Safety Laboratory, Skidmore College, Saratoga Springs, New York, USA
| | - Denise Smith
- Health and Human Physiological Sciences/First Responder Health and Safety Laboratory, Skidmore College, Saratoga Springs, New York, USA
| | - Luiz Guilherme Grossi Porto
- Faculdade de Educação Física, Universidade de Brasilia, Brasilia, Distrito Federal, Brazil
- Department of Environmental Health, Harvard University TH Chan School of Public Health, Boston, Massachusetts, USA
| |
Collapse
|
15
|
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.
Collapse
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
| |
Collapse
|
16
|
Czippelova B, Turianikova Z, Krohova J, Wiszt R, Lazarova Z, Pozorciakova K, Ciljakova M, Javorka M. Arterial Stiffness and Endothelial Function in Young Obese Patients - Vascular Resistance Matters. J Atheroscler Thromb 2019; 26:1015-1025. [PMID: 30930343 PMCID: PMC6845697 DOI: 10.5551/jat.47530] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 02/13/2019] [Indexed: 12/11/2022] Open
Abstract
AIM Motivated by the paradoxical and differing results of the early atherosclerosis related indices - Cardio-Ankle Vascular Index (CAVI) reflecting arterial stiffness and Reactive Hyperemia Index (RHI) evaluating endothelium dependent flow-induced vasodilation - in obesity, we aimed to assess CAVI and RHI in obese adolescents and young adults in the context of differences in systemic vascular resistance (SVR). METHODS We examined 29 obese (14f, 15.4 [12.3-18.5] y; BMI: 33.2±4.4 kg.m-2) and 29 non-obese gender and age matched adolescents and young adults (BMI: 21.02±2.3 kg.m-2). CAVI and RHI were measured using VaSera VS-1500 (Fukuda Denshi, Japan) and Endo-PAT 2000 (Itamar Medical, Israel), respectively. Hemodynamic measures were recorded using volume-clamp plethysmography (Finometer Pro, FMS, Netherlands) and impedance cardiography (CardioScreen 2000, Medis GmbH, Germany). SVR and sympathetic activity related indices - Velocity Index (VI) and Heather Index (HI), and LFSAP (spectral power in low frequency band of systolic blood pressure oscillations) were determined. RESULTS In obese group, CAVI (4.59±0.88 vs. 5.18±0.63, p=0.002) and its refined version CAVI0 (6.46±1.39 vs.7.33±0.99, p=0.002) were significantly lower. No significant difference in RHI was found. SVR and sympathetic activity indices were all significantly lower in the obese group than in the non-obese group. RHI correlated positively with SVR (r=0.390, p=0.044) in obese subjects. CONCLUSION Our results indicate that both indices used for the detection of early atherosclerotic changes are influenced by vascular tone. Vascular resistance could influence CAVI and RHI results impairing their interpretation.
Collapse
Affiliation(s)
- Barbora Czippelova
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Department of Physiology, Martin, Slovakia
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Biomedical Centre Martin, Martin, Slovakia
| | - Zuzana Turianikova
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Department of Physiology, Martin, Slovakia
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Biomedical Centre Martin, Martin, Slovakia
| | - Jana Krohova
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Department of Physiology, Martin, Slovakia
| | - Radovan Wiszt
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Department of Physiology, Martin, Slovakia
| | - Zuzana Lazarova
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Department of Physiology, Martin, Slovakia
| | - Katarina Pozorciakova
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital Martin, Clinic of Children and Adolescents, Martin, Slovakia
| | - Miriam Ciljakova
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital Martin, Clinic of Children and Adolescents, Martin, Slovakia
| | - Michal Javorka
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Department of Physiology, Martin, Slovakia
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Biomedical Centre Martin, Martin, Slovakia
| |
Collapse
|
17
|
Aminuddin A, Salamt N, Ahmad Fuad AF, Chin KY, Ugusman A, Soelaiman IN, Wan Ngah WZ. Vascular Dysfunction among Malaysian Men with Increased BMI: An Indication of Synergistic Effect of Free Testosterone and Inflammation. MEDICINA (KAUNAS, LITHUANIA) 2019; 55:E575. [PMID: 31500378 PMCID: PMC6780688 DOI: 10.3390/medicina55090575] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 09/04/2019] [Accepted: 09/04/2019] [Indexed: 12/31/2022]
Abstract
Background and objectives: Obesity is associated with poor vascular function and may lead to future cardiovascular disease (CVD). Obesity is also related to increased inflammation and a low testosterone level. This study was conducted to determine the relationship between inflammation, testosterone level, and vascular function among subjects with an increased body mass index (BMI) and to determine whether both low testosterone and high inflammation have synergistic effects towards vascular dysfunction. Materials and Methods: A total of 303 men aged 40-80 years were recruited from Klang Valley, Malaysia. Their height, weight, blood pressure (BP), lipid, blood glucose level, total testosterone (TT), free testosterone (FT), and C-reactive protein (CRP) were measured. The carotid femoral pulse wave velocity (PWVCF) and augmentation index (AI) were also recorded as markers of vascular function. Results: The mean age of all the subjects was 54.46 ± 9.77 years. Subjects were divided into a low/normal body mass index (BMI) group (BMI < 25 kg/m2; NG, n = 154) and high BMI group (BMI ≥ 25 kg/m2; OG, n = 149). The mean BMI for NG was 22.20 ± 1.94 kg/m2 while for OG was 28.87 ± 3.24 kg/m2 (p < 0.01). The level of TT (OG = 21.13 ± 6.44 versus NG = 16.18 ± 6.16 nmol/L, p < 0.01) and FT (OG = 0.34 ± 0.12 versus NG = 0.39 ± 0.11 nmol/L, p < 0.01) were reduced while the level of CRP [OG = 1.05 (2.80) versus NG = 0.50 (1.50) mmol/L, p = 0.01] was increased in OG compared to NG. PWVCF (OG = 8.55 ± 1.34 versus NG = 8.52 ± 1.42 m/s, p = 0.02) and AI (OG = 16.91% ± 6.00% versus 15.88% ± 5.58%, p < 0.01) were significantly increased in OG after adjustment for other CVD risk factors. The subjects that had both a low FT and an increased CRP had higher AI when compared to those with a high CRP and high FT (p < 0.01). Conclusions: The increased BMI was associated with vascular dysfunction, mediated by a low testosterone level and increased inflammation. Furthermore, having both conditions concurrently lead to higher vascular dysfunction. Weight loss, testosterone supplementation, and the anti-inflammatory agent may be beneficial for men to prevent vascular dysfunction.
Collapse
Affiliation(s)
- Amilia Aminuddin
- Department of Physiology, Universiti Kebangsaan Malaysia Medical Center, 56000 Cheras, Kuala Lumpur, Malaysia.
| | - Norizam Salamt
- Department of Physiology, Universiti Kebangsaan Malaysia Medical Center, 56000 Cheras, Kuala Lumpur, Malaysia.
| | - Ahmad Faiz Ahmad Fuad
- Department of Physiology, Universiti Kebangsaan Malaysia Medical Center, 56000 Cheras, Kuala Lumpur, Malaysia.
| | - Kok-Yong Chin
- Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Center, 56000 Cheras, Kuala Lumpur, Malaysia.
| | - Azizah Ugusman
- Department of Physiology, Universiti Kebangsaan Malaysia Medical Center, 56000 Cheras, Kuala Lumpur, Malaysia.
| | - Ima Nirwana Soelaiman
- Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Center, 56000 Cheras, Kuala Lumpur, Malaysia.
| | - Wan Zurinah Wan Ngah
- Department of Biochemistry, Universiti Kebangsaan Malaysia Medical Center, 56000 Cheras, Kuala Lumpur, Malaysia.
| |
Collapse
|
18
|
Yang H, Zhao J, Deng X, Tan I, Butlin M, Avolio A, Zuo J. Pulse wave velocity is decreased with obesity in an elderly Chinese population. J Clin Hypertens (Greenwich) 2019; 21:1379-1385. [PMID: 31471955 DOI: 10.1111/jch.13659] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 07/18/2019] [Accepted: 07/26/2019] [Indexed: 01/01/2023]
Abstract
Obesity is generally considered an undesirable risk factor for cardiovascular disease; however, obese subjects with heart failure paradoxically can have better outcomes than their lean counterparts. This study aimed to investigate this characteristic in an elderly Chinese population. Elderly participants (N = 414, age 77 ± 11 years, 211 males) were recruited from a Chinese community-dwelling elderly population. Subjects were divided into 3 groups according to body mass index (BMI ≤ 25, normal; 25-28, overweight; and ≥28, obese). Arterial stiffness was assessed by brachial-ankle pulse wave velocity (baPWV), and the atherosclerosis status was evaluated with the ankle brachial index (ABI). Brachial systolic blood pressure (BSBP) was significantly higher as BMI increased (135 ± 18.4, 138 ± 18.3, 147 ± 17.6 mm Hg; P = .003) adjusted for age, sex, and heart rate. However, baPWV was significantly lower as BMI increased (baPWV 1830 ± 18, 1793 ± 25, 1704 ± 36 cm/s; P = .008) in the three groups, even with additional adjustment for BSBP. BMI showed a significant negative correlation with baPWV (r = -.170, P = .001) after adjusting for confounding factors. Using multiple linear regression, BMI was negatively and independently associated with baPWV (β = -.190, P < .001) especially for age <80 years. Arterial stiffness, as measured by baPWV, is lower in overweight subjects in a Chinese elderly population compared to those with normal body weight. ABI showed no relationship with BMI. These findings suggest that reduced arterial stiffness in the overweight population, independent of confounding factors, may contribute to the explanation of the "obesity paradox."
Collapse
Affiliation(s)
- Hui Yang
- Department of Geriatric Medicine, Ruijin Hospital North, Shanghai Jiaotong School of Medicine, Shanghai, China
| | - Jiehui Zhao
- Daning Community Health Service Center, Shanghai, China
| | - Xueqin Deng
- Department of Geriatric Medicine, Ruijin Hospital North, Shanghai Jiaotong School of Medicine, Shanghai, China
| | - Isabella Tan
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia
| | - Mark Butlin
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia
| | - Alberto Avolio
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia
| | - Junli Zuo
- Department of Geriatric Medicine, Ruijin Hospital North, Shanghai Jiaotong School of Medicine, Shanghai, China.,Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia
| |
Collapse
|
19
|
Moon I, Jin KN, Kim HL, Suh HJ, Lim WH, Seo JB, Kim SH, Zo JH, Kim MA. Association of arterial stiffness with aortic calcification and tortuosity. Medicine (Baltimore) 2019; 98:e16802. [PMID: 31415390 PMCID: PMC6831173 DOI: 10.1097/md.0000000000016802] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Impact of arterial stiffness on aortic morphology has not been well evaluated. We sought to investigate the association of brachial-ankle pulse wave velocity (baPWV) with aortic calcification and tortuosity.A total of 181 patients (65.4 ± 10.4 years, males 59.7%) who underwent computed tomographic angiography and baPWV measurement within 1 month of study entry were retrospectively reviewed. Aortic calcification was quantified by the calcium scoring software system. Aortic tortuosity was defined as the length of the midline in the aorta divided by the length of linear line from the aortic root to the distal end of the thoraco-abdominal aorta. In simple correlation analyses, baPWV was correlated with aortic calcification (r = 0.36, P < .001) and tortuosity (r = 0.16, P = .030). However, these significances disappeared after controlling for confounders in multivariate analyses. Factors showing an independent association with aortic calcification were age (β = 0.37, P < .001), hypertension (β = 0.19, P = .003), diabetes mellitus (β = 0.12, P = .045), smoking (β = 0.17, P = .016), and estimated glomerular filtration rate (β = -0.25, P = .002). Factors showing an independent association with aortic tortuosity were age (β = 0.34, P < .001), body mass index (β = -0.19, P = .018), and diabetes mellitus (β = -0.21, P = .003).In conclusion, baPWV reflecting arterial stiffness was not associated with aortic calcification and tortuosity. Traditional cardiovascular risk factors were more influential to aortic geometry. Further studies with a larger sample size are needed to confirm our results.
Collapse
Affiliation(s)
| | - Kwang Nam Jin
- Department of Radiology, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | | | | | | | | | | | | | | |
Collapse
|
20
|
Hwaung P, Heo M, Bourgeois B, Kennedy S, Shepherd J, Heymsfield SB. Greater Height Is Associated with a Larger Carotid Lumen Diameter. MEDICINES 2019; 6:medicines6020057. [PMID: 31091706 PMCID: PMC6631842 DOI: 10.3390/medicines6020057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 05/09/2019] [Accepted: 05/13/2019] [Indexed: 11/16/2022]
Abstract
Background: Previous studies link tall stature with a reduced ischemic stroke risk. One theory posits that tall people have larger cerebral artery lumens and therefore have a lower plaque occlusion risk than those who are short. Previous studies have not critically evaluated the associations between height and cerebral artery structure independent of confounding factors. Methods: The hypothesis linking stature with cerebral artery lumen size was tested in 231 adults by measuring the associations between height and common carotid artery diameter (CCAD) and intima-media thickness (IMT) after controlling for recognized vascular influencing factors (e.g., adiposity, blood pressure, plasma lipids, etc.). Results: Height remained a significant CCAD predictor across all developed multiple regression models. These models predict a ~0.03 mm increase in CCAD for each 1-cm increase in height in this sample. This magnitude of CCAD increase with height represents over a 60% enlargement of the artery's lumen area across adults varying in stature from short (150 cm) to tall (200 cm). By contrast, IMT was non-significantly correlated with height across all developed regression models. Conclusions: People who are tall have a larger absolute CCAD than people who are short, while IMT is independent of stature. These observations potentially add to the growing cardiovascular literature aimed at explaining the lower risk of ischemic strokes in tall people.
Collapse
Affiliation(s)
- Phoenix Hwaung
- Pennington Biomedical Research Center, LSU System, Baton Rouge, LA 70808, USA.
| | - Moonseong Heo
- Department of Public Health Sciences, Clemson University, Clemson, SC 29631, USA.
| | - Brianna Bourgeois
- Pennington Biomedical Research Center, LSU System, Baton Rouge, LA 70808, USA.
| | - Samantha Kennedy
- Department of Public Health Sciences, Clemson University, Clemson, SC 29631, USA.
| | - John Shepherd
- University of Hawaii Cancer Center, Honolulu, HI 96813, USA.
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, LSU System, Baton Rouge, LA 70808, USA.
| |
Collapse
|
21
|
Walker AE, Breevoort SR, Durrant JR, Liu Y, Machin DR, Dobson PS, Nielson EI, Meza AJ, Islam MT, Donato AJ, Lesniewski LA. The pro-atherogenic response to disturbed blood flow is increased by a western diet, but not by old age. Sci Rep 2019; 9:2925. [PMID: 30814657 PMCID: PMC6393500 DOI: 10.1038/s41598-019-39466-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 01/24/2019] [Indexed: 12/12/2022] Open
Abstract
Atherogenic remodeling often occurs at arterial locations with disturbed blood flow (i.e., low or oscillatory) and both aging and western diet (WD) increase the likelihood for pro-atherogenic remodeling. However, it is unknown if old age and/or a WD modify the pro-atherogenic response to disturbed blood flow. We induced disturbed blood flow by partial carotid ligation (PCL) of the left carotid artery in young and old, normal chow (NC) or WD fed male B6D2F1 mice. Three weeks post-PCL, ligated carotid arteries had greater intima media thickness, neointima formation, and macrophage content compared with un-ligated arteries. WD led to greater remodeling and macrophage content in the ligated artery compared with NC mice, but these outcomes were similar between young and old mice. In contrast, nitrotyrosine content, a marker of oxidative stress, did not differ between WD and NC fed mice, but was greater in old compared with young mice in both ligated and un-ligated carotid arteries. In primary vascular smooth muscle cells, aging reduced proliferation, whereas conditioned media from fatty acid treated endothelial cells increased proliferation. Taken together, these findings suggest that the remodeling and pro-inflammatory response to disturbed blood flow is increased by WD, but is not increased by aging.
Collapse
Affiliation(s)
- Ashley E Walker
- Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA. .,Department of Human Physiology, University of Oregon, Eugene, Oregon, USA.
| | - Sarah R Breevoort
- Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA
| | | | - Yu Liu
- Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Daniel R Machin
- Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA.,Geriatrics Research Education and Clinical Center, Veteran's Affairs Medical Center, Salt Lake City, Utah, USA
| | - Parker S Dobson
- Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Elizabeth I Nielson
- Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Antonio J Meza
- Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Md Torikul Islam
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah, USA
| | - Anthony J Donato
- Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA.,Geriatrics Research Education and Clinical Center, Veteran's Affairs Medical Center, Salt Lake City, Utah, USA.,Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah, USA
| | - Lisa A Lesniewski
- Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA.,Geriatrics Research Education and Clinical Center, Veteran's Affairs Medical Center, Salt Lake City, Utah, USA.,Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah, USA
| |
Collapse
|
22
|
Adeva-Andany MM, Ameneiros-Rodríguez E, Fernández-Fernández C, Domínguez-Montero A, Funcasta-Calderón R. Insulin resistance is associated with subclinical vascular disease in humans. World J Diabetes 2019; 10:63-77. [PMID: 30788044 PMCID: PMC6379732 DOI: 10.4239/wjd.v10.i2.63] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 02/11/2019] [Accepted: 02/12/2019] [Indexed: 02/05/2023] Open
Abstract
Insulin resistance is associated with subclinical vascular disease that is not justified by conventional cardiovascular risk factors, such as smoking or hypercholesterolemia. Vascular injury associated to insulin resistance involves functional and structural damage to the arterial wall that includes impaired vasodilation in response to chemical mediators, reduced distensibility of the arterial wall (arterial stiffness), vascular calcification, and increased thickness of the arterial wall. Vascular dysfunction associated to insulin resistance is present in asymptomatic subjects and predisposes to cardiovascular diseases, such as heart failure, ischemic heart disease, stroke, and peripheral vascular disease. Structural and functional vascular disease associated to insulin resistance is highly predictive of cardiovascular morbidity and mortality. Its pathogenic mechanisms remain undefined. Prospective studies have demonstrated that animal protein consumption increases the risk of developing cardiovascular disease and predisposes to type 2 diabetes (T2D) whereas vegetable protein intake has the opposite effect. Vascular disease linked to insulin resistance begins to occur early in life. Children and adolescents with insulin resistance show an injured arterial system compared with youth free of insulin resistance, suggesting that insulin resistance plays a crucial role in the development of initial vascular damage. Prevention of the vascular dysfunction related to insulin resistance should begin early in life. Before the clinical onset of T2D, asymptomatic subjects endure a long period of time characterized by insulin resistance. Latent vascular dysfunction begins to develop during this phase, so that patients with T2D are at increased cardiovascular risk long before the diagnosis of the disease.
Collapse
Affiliation(s)
- María M Adeva-Andany
- Internal Medicine Department, Hospital General Juan Cardona, Ferrol 15406, Spain
| | | | | | | | | |
Collapse
|
23
|
Arena R, Daugherty J, Bond S, Lavie CJ, Phillips S, Borghi-Silva A. The combination of obesity and hypertension: a highly unfavorable phenotype requiring attention. Curr Opin Cardiol 2018; 31:394-401. [PMID: 27070650 DOI: 10.1097/hco.0000000000000294] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW Body habitus is a key lifestyle characteristic whose current status and future projections are disconcerting. The percentage of the global population who are either overweight or obese has substantially increased, with no indication that any country has a solution to this issue. Hypertension is a key unfavorable health metric that, like obesity, has disastrous health implications if left uncontrolled. Poor lifestyle characteristics and health metrics often cluster together to create complex and difficult to treat phenotypes. Excess body mass is such an example, creating an obesity-hypertension phenotype, which is the focus of this review. RECENT FINDINGS An increased risk for hypertension is clearly linked to obesity, indicating that the two conditions are intimately linked. The cascade of obesity-induced pathophysiologic adaptations creates a clear path to hypertension. Adopting a healthy lifestyle is a primary intervention for the prevention as well as treatment of the obesity-hypertension phenotype. SUMMARY The obesity-hypertension phenotype is highly prevalent and has disastrous health implications. A primordial prevention strategy, focused on lifelong healthy lifestyle patterns, is the optimal approach for this condition. For those individuals already afflicted by the obesity-hypertension phenotype, interventions must aggressively focus on weight loss and blood pressure control.
Collapse
Affiliation(s)
- Ross Arena
- aDepartment of Physical Therapy and the Integrative Physiology Laboratory, College of Applied Health Sciences bDepartment of Biomedical and Health Information Sciences, College of Applied Science, University of Illinois, Chicago, Illinois cDepartment of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-The University of Queensland School of Medicine; New Orleans, Louisiana, USA dCardiopulmonary Physiotherapy Laboratory, Federal University of São Carlos, São Paulo, Brazil
| | | | | | | | | | | |
Collapse
|
24
|
Kim J, Mohler ER, Keenan BT, Maislin D, Arnardottir ES, Gislason T, Benediktsdottir B, Gudmundsdottir S, Sifferman A, Staley B, Pack FM, Maislin G, Chirinos JA, Townsend RR, Pack AI, Kuna ST. Carotid Artery Wall Thickness in Obese and Nonobese Adults With Obstructive Sleep Apnea Before and Following Positive Airway Pressure Treatment. Sleep 2018; 40:4037435. [PMID: 28934533 DOI: 10.1093/sleep/zsx126] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Study objectives Debate persists as to whether obstructive sleep apnea (OSA) is an independent risk factor for atherosclerosis. The purpose of this study was to compare carotid intima-media thickness (IMT), an early sign of atherosclerosis, in obese and nonobese adults with OSA before and following positive airway pressure (PAP) treatment. Methods A total of 206 adults newly diagnosed with OSA with an apnea-hypopnea index (AHI) of 15-75 events/hour and 53 controls with AHI <10 were studied. Waist circumference was used to classify participants as obese and nonobese. Bilateral common carotid artery B-mode ultrasound was performed at baseline to assess IMT, arterial diameter, arterial-wall mass, and circumferential wall stress. Measurements were repeated in 118 participants with OSA who completed a 4-month PAP treatment and had an average daily use over that period of ≥4 hours/day. Results No significant differences in carotid IMT, diameter, or arterial-wall mass were present at baseline between participants with OSA and controls stratified by waist circumference, after adjusting for other cardiovascular risk factors. In participants with OSA, who had adequate PAP adherence over the 4-month treatment, carotid artery diameter significantly increased (mean change [95% confidence interval] = 0.13 [0.06, 0.20] mm; p = .0004), but no significant changes in carotid IMT, arterial-wall mass, and circumferential stress were observed in obese and nonobese participants. Conclusions Regardless of obesity status, carotid IMT is not increased in adults with moderate to severe OSA versus controls and does not change following 4 months of PAP treatment.
Collapse
Affiliation(s)
- Jinyoung Kim
- School of Nursing, University of Pennsylvania, Philadelphia, PA.,Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, PA
| | - Emile R Mohler
- Department of Medicine, Cardiovascular Division, Section of Vascular Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Brendan T Keenan
- Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, PA
| | - David Maislin
- Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, PA
| | - Erna Sif Arnardottir
- Department of Respiratory Medicine and Sleep, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Thorarinn Gislason
- Department of Respiratory Medicine and Sleep, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Bryndis Benediktsdottir
- Department of Respiratory Medicine and Sleep, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Sigrun Gudmundsdottir
- Department of Respiratory Medicine and Sleep, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
| | - Andrea Sifferman
- Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, PA
| | - Bethany Staley
- Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, PA
| | - Frances M Pack
- Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, PA
| | - Greg Maislin
- Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, PA.,Division of Sleep Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Julio A Chirinos
- Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, PA.,Department of Medicine, Cardiovascular Division, Section of Vascular Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Raymond R Townsend
- Renal-Electrolyte and Hypertension Division, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Allan I Pack
- Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, PA.,Division of Sleep Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Samuel T Kuna
- Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, PA.,Division of Sleep Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.,Department of Medicine, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA
| |
Collapse
|
25
|
Lourenço Dias AR, de Souza KA, de Jesus Lima de Sousa LC, dos Santos KM, Kolesny Tricot G, de Araújo JA, Teresa Cambri L, Arsa G. Higher blood pressure and lower cardiac vagal activity in obese young individuals in supine and seated position. J Clin Transl Res 2018; 3:328-337. [PMID: 30895274 PMCID: PMC6426250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Obesity triggers alterations in hemodynamic and autonomic control. There are few studies that investigate the effects of overweight and obesity in early adulthood on hemodynamic and autonomic variables. AIM The aim of this study was to determine whether overweight and obesity in young individuals cause alterations in hemodynamic parameters and heart rate variability (HRV) in supine and seated position, and to correlate these variables with anthropometric features. METHODS Measurements were performed in 40 young untrained male study participants. The subjects were eutrophic (22.8 ± 0.3 kg/m2, N = 19), overweight (27.0 ± 0.5 kg/m2, N = 10), and obese (33.5 ± 0.8 kg/m2, N = 11). After 5 min in supine and seated position, the R-R intervals and blood pressure (BP) were recorded. RESULTS The systolic blood pressure were higher in overweight (supine, 122.9 ± 2.3 mmHg) and obese (supine, 123.9 ± 2.2; seated, 121.7 ± 2.3 mmHg) individuals compared to eutrophic individuals (supine, 111.8 ± 1.64; seated, 111.3 ± 1.8 mmHg) (p ⩽ 0.05). Obese subjects exhibited lower HRV (SD1, RMSSD, pNN50) compared to eutrophic individuals when seated. In obese subjects, the heart rate (HR) increased and HRV decreased (p ≤ 0.05) when seated versus supine position. The body mass, body mass index (BMI), and waist and abdominal circumferences correlated positively with BP (r = 0.40-0.64, p ≤ 0.05), while the BMI, waist circumference, BP, and HR were negatively correlated (r = -0.32 -0.62, p ≤ 0.05) with HRV (pNN50 and HF) in both body positions. BMI, waist circumference, BP and HR correlated negat- ively with additional HRV indices (SD1, SD2, RMSSD, TP, and LF) when seated. CONCLUSIONS Obese and overweight individuals presented higher SBP, and obese individuals had lower HRV and cardiac vagal activity, associated with anthropometric variables. RELEVANCE FOR PATIENTS The monitoring of HRV in obese subjects in seated position allows improved prognosis of metabolic consequences to cardiac autonomic control.
Collapse
Affiliation(s)
| | - Katrice Almeida de Souza
- Graduate Program on Physical Education, Federal University of Mato Grosso, Cuiaba, Mato Grosso, Brazil
| | | | | | - Gabriel Kolesny Tricot
- Graduate Program on Physical Education, Federal University of Mato Grosso, Cuiaba, Mato Grosso, Brazil
| | - Jaqueline Alves de Araújo
- Graduate Program on Physical Education, Federal University of Mato Grosso, Cuiaba, Mato Grosso, Brazil
| | - Lucieli Teresa Cambri
- Graduate Program on Physical Education, Federal University of Mato Grosso, Cuiaba, Mato Grosso, Brazil
| | - Gisela Arsa
- Graduate Program on Physical Education, Federal University of Mato Grosso, Cuiaba, Mato Grosso, Brazil
| |
Collapse
|
26
|
Obara-Moszynska M, Rajewska-Tabor J, Rozmiarek S, Karmelita-Katulska K, Kociemba A, Rabska-Pietrzak B, Janus M, Siniawski A, Mrozinski B, Graczyk-Szuster A, Niedziela M, Pyda M. The Usefulness of Magnetic Resonance Imaging of the Cardiovascular System in the Diagnostic Work-Up of Patients With Turner Syndrome. Front Endocrinol (Lausanne) 2018; 9:609. [PMID: 30459711 PMCID: PMC6232706 DOI: 10.3389/fendo.2018.00609] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Accepted: 09/25/2018] [Indexed: 01/03/2023] Open
Abstract
Cardiovascular defects occur in 50% of patients with Turner syndrome (TS). The aim of the study was to estimate the usefulness of cardiac magnetic resonance imaging (CMR) and magnetic resonance angiography (angio-MR) as diagnostics in children and adolescents with TS. Forty-one females with TS, aged 13.9 ± 2.2 years, were studied. CMR was performed in 39 patients and angio-MR in 36. Echocardiography was performed in all patients. The most frequent anomalies diagnosed on CMR and angio-MR were as follows: elongation of the ascending aorta (AA) and aortic arch, present in 16 patients (45.7%), a bicuspid aortic valve (BAV), present in 16 patients (41.0%), and partial anomalous pulmonary venous return (PAPVR), present in six patients (17.1%). Aortic dilatation (Z-score > 2) was mostly seen at the sinotubular junction (STJ) (15 patients; 42.8%), the AA (15 patients; 42.8%), the thoracoabdominal aorta at the level of a diaphragm (15 patients; 42.8%), and the transverse segment (14 patients; 40.0%). An aortic size index (ASI) above 2.0 cm/m2 was present in six patients (17.1%) and above 2.5 cm/m2 in three patients (8.6%). The left ventricular end-diastolic volume (EDV), end-systolic volume (ESV), and stroke volume (SV) were diminished (Z-score < -2) in 10 (25.6%), 9 (23.1%), and 8 patients (20.5%), respectively. A webbed neck was correlated with the presence of vascular anomalies (p = 0.006). The age and body mass index (BMI) were correlated with the diameter of the aorta. Patients with BAV had a greater aortic diameter at the ascending aorta (AA) segment (p = 0.026) than other patients. ASI was correlated with aortic diameter and descending aortic diameter (AD/DD) ratio (p = 0.002; r = 0.49). There was a significant correlation between the right ventricular (p = 0.002, r = 0.46) and aortic diameters at the STJ segment (p = 0.0047, r = 0.48), as measured by echocardiography and CMR. Magnetic resonance can identify cardiovascular anomalies, dilatation of the aorta, pericardial fluid, and functional impairment of the ventricles not detected by echocardiography. BMI, age, BAV, and elongation of the AA influence aortic dilatation. The ASI and AD/DD ratio are important markers of aortic dilatation. The performed diagnostics did not indicate a negative influence of GH treatment on the cardiovascular system.
Collapse
Affiliation(s)
- Monika Obara-Moszynska
- Department of Pediatric Endocrinology and Rheumatology, Poznan University of Medical Sciences, Poznan, Poland
- *Correspondence: Monika Obara-Moszynska
| | - Justyna Rajewska-Tabor
- Cardiac Magnetic Resonance Unit, First Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland
| | - Szymon Rozmiarek
- Cardiac Magnetic Resonance Unit, First Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Anna Kociemba
- Cardiac Magnetic Resonance Unit, First Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland
| | - Barbara Rabska-Pietrzak
- Department of Pediatric Endocrinology and Rheumatology, Poznan University of Medical Sciences, Poznan, Poland
| | - Magdalena Janus
- Cardiac Magnetic Resonance Unit, First Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland
| | - Andrzej Siniawski
- Cardiac Magnetic Resonance Unit, First Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland
| | - Bartlomiej Mrozinski
- Department of Pediatric Cardiology, Nephrology and Hypertension, Poznan University of Medical Sciences, Poznan, Poland
| | - Agnieszka Graczyk-Szuster
- Cardiac Magnetic Resonance Unit, First Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland
| | - Marek Niedziela
- Department of Pediatric Endocrinology and Rheumatology, Poznan University of Medical Sciences, Poznan, Poland
| | - Malgorzata Pyda
- Cardiac Magnetic Resonance Unit, First Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland
| |
Collapse
|
27
|
Bunsawat K, Ranadive SM, Lane-Cordova AD, Yan H, Kappus RM, Fernhall B, Baynard T. The effect of acute maximal exercise on postexercise hemodynamics and central arterial stiffness in obese and normal-weight individuals. Physiol Rep 2017; 5:5/7/e13226. [PMID: 28364031 PMCID: PMC5392516 DOI: 10.14814/phy2.13226] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 03/03/2017] [Accepted: 03/05/2017] [Indexed: 12/11/2022] Open
Abstract
Central arterial stiffness is associated with incident hypertension and negative cardiovascular outcomes. Obese individuals have higher central blood pressure (BP) and central arterial stiffness than their normal‐weight counterparts, but it is unclear whether obesity also affects hemodynamics and central arterial stiffness after maximal exercise. We evaluated central hemodynamics and arterial stiffness during recovery from acute maximal aerobic exercise in obese and normal‐weight individuals. Forty‐six normal‐weight and twenty‐one obese individuals underwent measurements of central BP and central arterial stiffness at rest and 15 and 30 min following acute maximal exercise. Central BP and normalized augmentation index (AIx@75) were derived from radial artery applanation tonometry, and central arterial stiffness was obtained via carotid‐femoral pulse wave velocity (cPWV) and corrected for central mean arterial pressure (cPWV/cMAP). Central arterial stiffness increased in obese individuals but decreased in normal‐weight individuals following acute maximal exercise, after adjusting for fitness. Obese individuals also exhibited an overall higher central BP (P < 0.05), with no exercise effect. The increase in heart rate was greater in obese versus normal‐weight individuals following exercise (P < 0.05), but there was no group differences or exercise effect for AIx@75. In conclusion, obese (but not normal‐weight) individuals increased central arterial stiffness following acute maximal exercise. An assessment of arterial stiffness response to acute exercise may serve a useful detection tool for subclinical vascular dysfunction.
Collapse
Affiliation(s)
- Kanokwan Bunsawat
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois
| | | | - Abbi D Lane-Cordova
- Department of Preventive Medicine, Northwestern University, Chicago, Illinois
| | - Huimin Yan
- Department of Exercise and Health Sciences University of Massachusetts Boston, Boston, Massachusetts
| | - Rebecca M Kappus
- Department of Health and Exercise Science, Appalachian State University, Boone, North Carolina
| | - Bo Fernhall
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois
| | - Tracy Baynard
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois
| |
Collapse
|
28
|
The relationship between obesity and hypertension: an updated comprehensive overview on vicious twins. Hypertens Res 2017; 40:947-963. [DOI: 10.1038/hr.2017.75] [Citation(s) in RCA: 101] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 04/07/2017] [Accepted: 04/14/2017] [Indexed: 02/07/2023]
|
29
|
Alvarez-Alvarado S, Jaime SJ, Ormsbee MJ, Campbell JC, Post J, Pacilio J, Figueroa A. Benefits of whole-body vibration training on arterial function and muscle strength in young overweight/obese women. Hypertens Res 2017; 40:487-492. [DOI: 10.1038/hr.2016.178] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 11/14/2016] [Accepted: 11/30/2016] [Indexed: 12/22/2022]
|
30
|
Hall MH, Mulukutla S, Kline CE, Samuelsson LB, Taylor BJ, Thayer JF, Krafty RT, Frank E, Kupfer DJ. Objective Sleep Duration Is Prospectively Associated With Endothelial Health. Sleep 2017; 40:2845957. [PMID: 28364470 PMCID: PMC6084747 DOI: 10.1093/sleep/zsw003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2017] [Indexed: 01/25/2023] Open
Abstract
Study Objectives The mechanisms linking short sleep duration to cardiovascular disease (CVD) are poorly understood. Emerging evidence suggests that endothelial dysregulation may lie along the causal pathway linking sleep duration to cardiovascular risk, although current evidence in humans is based on cross-sectional studies. Our objective was to evaluate the prospective association between objectively assessed sleep duration and clinical indices of endothelial health. Methods A total of 141 medically healthy adults underwent an overnight laboratory sleep study when they were between the ages of 21 and 60 years. Total sleep time was objectively assessed by polysomnography at study entry. Endothelial health, including brachial artery diameter (BAD) and flow-mediated dilation (FMD), was measured 18.9 ± 4.6 years later. Medical health and psychiatric status were assessed at both time points. Approximately half of the sample had a lifetime history of major depressive disorder. Results In univariate analyses, shorter sleep duration was associated with increased BAD (β = -0.24, p = .004) and decreased FMD (β = 0.17, p = .042). BAD, but not FMD, remained significantly associated with sleep duration after adjusting for sex, age, body mass index (BMI), smoking, diabetes, hypertension, and lifetime history of major depressive disorder (MDD) at T2. The association between sleep duration and BAD was stronger than the association between BAD and an aggregate measure of CVD risk including three or more of the following risk factors: male sex, age ≥ 65 years, smoker, BMI ≥ 30, diabetes, hypertension, and MDD. Conclusions Objectively assessed short sleep duration was prospectively associated with increased BAD over a 12- to 30-year period.
Collapse
Affiliation(s)
- Martica H Hall
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Suresh Mulukutla
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Christopher E Kline
- Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, PA
| | | | - Briana J Taylor
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA
| | - Julian F Thayer
- Department of Psychology, Ohio State University, Columbus, OH
| | - Robert T Krafty
- Department of Biostatistics, University of Pittsburgh School of Public Health, Pittsburgh, PA
| | - Ellen Frank
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - David J Kupfer
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| |
Collapse
|
31
|
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.
Collapse
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
| |
Collapse
|
32
|
Ali MI, Chen X, Didion SP. Heterozygous eNOS deficiency is associated with oxidative stress and endothelial dysfunction in diet-induced obesity. Physiol Rep 2015; 3:e12630. [PMID: 26660551 PMCID: PMC4760452 DOI: 10.14814/phy2.12630] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 10/22/2015] [Accepted: 10/26/2015] [Indexed: 01/08/2023] Open
Abstract
Heterozygous endothelial nitric oxide synthase (eNOS) deficiency is associated with normal endothelium-dependent responses, however, little is known regarding the mechanisms that maintain or impair endothelial function with heterozygous eNOS deficiency. The goals of this study were to (1) determine mechanism(s) which serve to maintain normal endothelial function in the absence of a single eNOS gene; and (2) to determine whether heterozygous eNOS deficiency predisposes blood vessels to endothelial dysfunction in response to a high-fat diet (HFD). Responses of carotid arteries were examined in wild-type (eNOS(+/+)) and heterozygous eNOS-deficient (eNOS(+/-)) treated with either vehicle (saline), N(G)-nitro-L-arginine (L-NNA, 100 μmol/L), an inhibitor of nitric oxide synthase, or 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one (ODQ, 1 μmol/L), an inhibitor of soluble guanylyl cyclase (sGC), and in eNOS(+/+) and eNOS(+/-) mice fed a control (10%) or a 45% HFD (kcal from fat). Responses to acetylcholine (ACh) were similar in vehicle-treated arteries from eNOS(+/+) and eNOS(+/-) mice, and were equally inhibited by L-NNA and ODQ. Phosphorylation of eNOS Ser1176, a site associated with increased eNOS activity, was significantly greater in eNOS(+/-) mice most likely as a compensatory response for the loss of a single eNOS gene. In contrast, responses to ACh were markedly impaired in carotid arteries from eNOS(+/-), but not eNOS(+/+), mice fed a HFD. Vascular superoxide levels as well as plasma levels of the pro-inflammatory cytokine interleukin-6 (IL-6) were selectively increased in HFD-fed eNOS(+/-) mice. In reconstitution experiments, IL-6 produced concentration-dependent impairment of endothelial responses as well as greater increases in NADPH-stimulated superoxide levels in arteries from eNOS(+/-) mice fed a control diet compared to eNOS(+/+) mice. Our findings of increased Ser1176-phosphorylation reveal a mechanism by which NOS- and sGC-dependent endothelial function can be maintained with heterozygous eNOS deficiency. In addition, heterozygous eNOS deficiency predisposes blood vessels to developing endothelial dysfunction in response to a HFD. The impairment produced by a HFD in eNOS(+/-) mice appears to be mediated by IL-6-induced increases in vascular superoxide. These findings serve as an important example of eNOS haploinsufficiency, one that may contribute to the development of carotid artery disease in obese humans.
Collapse
Affiliation(s)
- M Irfan Ali
- Vascular Biology Center, Georgia Regents University, Augusta, Georgia
| | - Xunsheng Chen
- Vascular Biology Center, Georgia Regents University, Augusta, Georgia
| | - Sean P Didion
- Department of Pharmacology and Department of Neurology, The University of Mississippi Medical Center, Jackson, Mississippi
| |
Collapse
|
33
|
Kalfon R, Campbell J, Alvarez-Alvarado S, Figueroa A. Aortic Hemodynamics and Arterial Stiffness Responses to Muscle Metaboreflex Activation With Concurrent Cold Pressor Test. Am J Hypertens 2015; 28:1332-8. [PMID: 25904650 DOI: 10.1093/ajh/hpv043] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Accepted: 02/06/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Overweight/obese young men have increased sympatho-excitation to cold and pain stress-induced by the cold pressor test (CPT) that may lead to abnormal hemodynamic responses. Concurrent CPT and exercise may augment the sympathetic-induced increases in aortic blood pressure (BP), pressure wave reflection (augmentation index, AIx), and arterial stiffness (pulse wave velocity, PWV). Since obesity is related with hypertension and sympathetic activity, we evaluated the aortic hemodynamic and PWV responses to muscle metaboreflex activation imposed by postexercise muscle ischemia (PEMI) concurrent with CPT in overweight/obese men. METHODS In 16 healthy (body mass index >25 and <40kg/m(2)) men (24±2 years), heart rate (HR), brachial BP, aortic BP, augmented pressure (AP), AIx, AIx adjusted to 75 beats/min (AIx@75), reflection time (Tr), first (P1) and second systolic peak (P2, wave reflection magnitude), and PWV (brachial-ankle PWV, baPWV) were evaluated at baseline, during isometric-handgrip exercise (IHG), and PEMI with (PEMI + CPT) and without CPT. RESULTS During IHG, brachial BP, aortic BP, AP, AIx, AIx@75, P1, and P2 increased ( P < 0.01) while Tr decreased ( P < 0.05) compared with baseline. During PEMI, all hemodynamic parameters remained elevated ( P < 0.05) and baPWV increased (P < 0.05) while Tr and HR returned to baseline. Compared with PEMI, the increases in HR, brachial BP, aortic BP, AIx@75, P1, P2, and baPWV were greater ( P < 0.05) during PEMI + CPT. During PEMI + CPT, Tr remained lower ( P < 0.05) than baseline. CONCLUSIONS Cold exposure with concurrent metaboreflex activation induces a significant increase in aortic hemodynamics and arterial stiffness, which may explain the high risk of adverse cardiovascular events during physiological stress. CLINICAL TRIALS REGISTRATION Trial Number NCT02104375.
Collapse
Affiliation(s)
- Roy Kalfon
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL, USA; Department of Molecular Genetics, The Rappaport Family Institute for Research in the Medical Sciences, Technion-Israel Institute of Technology, Haifa, Israel
| | - Jeremiah Campbell
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL, USA
| | - Stacey Alvarez-Alvarado
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL, USA
| | - Arturo Figueroa
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL, USA;
| |
Collapse
|
34
|
Chen Q, Chiheb S, Fysekidis M, Jaber Y, Brahimi M, Nguyen MT, Millasseau S, Cosson E, Valensi P. Arterial stiffness is elevated in normotensive type 2 diabetic patients with peripheral neuropathy. Nutr Metab Cardiovasc Dis 2015; 25:1041-1049. [PMID: 26474725 DOI: 10.1016/j.numecd.2015.08.001] [Citation(s) in RCA: 12] [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: 07/06/2014] [Revised: 06/19/2015] [Accepted: 08/02/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND AIMS Arterial stiffness, a measure of macrovascular damage predictive of poor cardio-vascular outcomes, is strongly related to age and hypertension (HT). In diabetic patients peripheral neuropathy (PN) has been found to be associated with increased arterial stiffness, which might be due to the concomitant presence of HT. The aim of this study was to examine in type-2 diabetic patients, the relationship between arterial stiffness and presence or absence of PN and HT separately. METHODS AND RESULTS Arterial stiffness was measured with the gold standard carotid-femoral pulse wave velocity (PWV) in 447 type-2 diabetic subjects of whom 66% were hypertensive, 53% had PN, and 40% had both. Patients with PN were older, more often hypertensive and had higher PWV than those free of PN. Patients were separated according to the presence or absence of PN and HT. PWV values above the 90th percentile age- and blood pressure-adjusted reference range (PWV+) were different across these groups (p < 0.005) with the following respective prevalences: 27.2%, 53.4%, 33.3% and 30.6%. Only PWV+ was significantly associated with PN and hypertension in the interaction analysis. CONCLUSION Well controlled hypertensive patients did not have elevated arterial stiffness compared to normotensive patients. This might be due to anti-hypertensive treatment although our study design does not allow us to confirm it. A strong association between PN and arterial stiffness was only present in normotensive patients, suggesting that normotensive type 2 diabetic patients with PN and elevated arterial stiffness should be carefully managed to prevent future macrovascular complications.
Collapse
Affiliation(s)
- Q Chen
- Department of Endocrinology-Diabetology-Nutrition, Jean Verdier Hospital, AP-HP, Paris-Nord University, CRNH-IdF, CINFO, Bondy, France; Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shangai, China
| | - S Chiheb
- Department of Endocrinology-Diabetology-Nutrition, Jean Verdier Hospital, AP-HP, Paris-Nord University, CRNH-IdF, CINFO, Bondy, France
| | - M Fysekidis
- Department of Endocrinology-Diabetology-Nutrition, Jean Verdier Hospital, AP-HP, Paris-Nord University, CRNH-IdF, CINFO, Bondy, France
| | - Y Jaber
- Department of Endocrinology-Diabetology-Nutrition, Jean Verdier Hospital, AP-HP, Paris-Nord University, CRNH-IdF, CINFO, Bondy, France
| | - M Brahimi
- Department of Endocrinology-Diabetology-Nutrition, Jean Verdier Hospital, AP-HP, Paris-Nord University, CRNH-IdF, CINFO, Bondy, France
| | - M T Nguyen
- Department of Endocrinology-Diabetology-Nutrition, Jean Verdier Hospital, AP-HP, Paris-Nord University, CRNH-IdF, CINFO, Bondy, France
| | - S Millasseau
- Pulse Wave Consulting, Saint Leu la Foret, France
| | - E Cosson
- Department of Endocrinology-Diabetology-Nutrition, Jean Verdier Hospital, AP-HP, Paris-Nord University, CRNH-IdF, CINFO, Bondy, France; UMR U1153 Inserm/U1125 Inra/Cnam/Univ Paris 13, Research Center in Epidemiology and Biostatistic Sorbonne-Paris-Cité, Bobigny, France
| | - P Valensi
- Department of Endocrinology-Diabetology-Nutrition, Jean Verdier Hospital, AP-HP, Paris-Nord University, CRNH-IdF, CINFO, Bondy, France.
| |
Collapse
|
35
|
Kozakova M, Palombo C, Morizzo C, Højlund K, Hatunic M, Balkau B, Nilsson PM, Ferrannini E. Obesity and carotid artery remodeling. Nutr Diabetes 2015; 5:e177. [PMID: 26302064 PMCID: PMC4558557 DOI: 10.1038/nutd.2015.26] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2015] [Accepted: 06/18/2015] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND/OBJECTIVE The present study tested the hypothesis that obesity-related changes in carotid intima-media thickness (IMT) might represent not only preclinical atherosclerosis but an adaptive remodeling meant to preserve circumferential wall stress (CWS) in altered hemodynamic conditions characterized by body size-dependent increase in stroke volume (SV) and blood pressure (BP). SUBJECTS/METHODS Common carotid artery (CCA) luminal diameter (LD), IMT and CWS were measured in three different populations in order to study: (A) cross-sectional associations between SV, BP, anthropometric parameters and CCA LD (266 healthy subjects with wide range of body weight (24-159 kg)); (B) longitudinal associations between CCA LD and 3-year IMT progression rate (ΔIMT; 571 healthy non-obese subjects without increased cardiovascular (CV) risk); (C) the impact of obesity on CCA geometry and CWS (88 obese subjects without CV complications and 88 non-obese subjects matched for gender and age). RESULTS CCA LD was independently associated with SV that was determined by body size. In the longitudinal study, baseline LD was an independent determinant of ΔIMT, and ΔIMT of subjects in the highest LD quartile was significantly higher (28±3 μm) as compared with those in the lower quartiles (8±3, 16±4 and 16±3 μm, P=0.001, P<0.05 and P=0.01, respectively). In addition, CCA CWS decreased during the observational period in the highest LD quartile (from 54.2±8.6 to 51.6±7.4 kPa, P<0.0001). As compared with gender- and age-matched lean individuals, obese subjects had highly increased CCA LD and BP (P<0.0001 for both), but only slightly higher CWS (P=0.05) due to a significant increase in IMT (P=0.005 after adjustment for confounders). CONCLUSIONS Our findings suggest that in obese subjects, the CCA wall thickens to compensate the luminal enlargement caused by body size-induced increase in SV, and therefore, to normalize the wall stress. CCA diameter in obesity could represent an additional biomarker, depicting the impact of altered hemodynamics on arterial wall.
Collapse
Affiliation(s)
- M Kozakova
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - C Palombo
- Department of Surgical, Medical, Molecular Pathology and Critical Care, University of Pisa, Pisa, Italy
| | - C Morizzo
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - K Højlund
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
| | - M Hatunic
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - B Balkau
- INSERM, CESP, Center for Research in Epidemiology and Population Health, U1018, University Paris Sud, Villejuif, France
| | - P M Nilsson
- Department of Clinical Science, Lund University, Skåne University Hospital, Malmö, Sweden
| | - E Ferrannini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| |
Collapse
|
36
|
Abstract
In low socio-economic status communities in South Africa, African men showed a low BMI. Data on the effect of low BMI on cardiovascular function are scant. The present study aimed to assess the associations between low BMI and markers of cardiovascular function such as pulse wave velocity (PWV) and blood pressure in Africans aged 35-65 years, with low socio-economic status. The study population (n 496) was stratified into a low-BMI group with BMI ≤ 20 kg/m² and a normal-BMI group with BMI >20 kg/m² and ≤ 25 kg/m². Blood pressure (Omron HEM-757) and PWV (Complior SP; Artech-Medical) was determined. Africans with low BMI showed an increased arterial stiffness with significantly higher PWV compared with the normal-BMI group (men: P= 0.001; women: P= 0.026), which remained after adjustment. In men with low BMI, PWV correlated negatively with BMI before (r -0.204; P= 0.012) and after (r -0.200; P= 0.020) adjustment. Forward stepwise regression analyses indicated a negative association between PWV and BMI in African men. A J-curve was evident suggesting a detrimental effect of low BMI on cardiovascular function in Africans. A low BMI may contribute to the high prevalence of cardiovascular-related morbidity and mortality within a developing country.
Collapse
|
37
|
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.
Collapse
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;
| |
Collapse
|
38
|
Hawkins M, Gabriel KP, Cooper J, Storti KL, Sutton-Tyrrell K, Kriska A. The impact of change in physical activity on change in arterial stiffness in overweight or obese sedentary young adults. Vasc Med 2014; 19:257-263. [PMID: 24879662 DOI: 10.1177/1358863x14536630] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Arterial stiffness is associated with cardiovascular events and mortality. Lifestyle factors such as physical activity (PA) may reduce arterial stiffness. The purpose of this study is to determine the impact of change in PA on 1-year change in arterial stiffness in 274 overweight/obese sedentary young adults. The Slow Adverse Vascular Effects of excess weight (SAVE) trial was a study evaluating the relationships between weight loss, dietary sodium, and vascular health. PA was measured with the ActiGraph AM7164 accelerometer. Intensity of activity was determined using established cut-points. Arterial stiffness was assessed by brachial-ankle pulse wave velocity (baPWV) using an automated device. Analysis of covariance compared changes in total accelerometer counts, minutes/day in light-intensity PA (LPA), moderate-to-vigorous PA (MVPA), and sedentary time, by categories of change in baPWV. Models were adjusted for time since baseline visit, age, sex, race, homeostatis model of assessment of insulin resistance, mean arterial pressure, heart rate, and weight change. Total accelerometer counts and time spent in MVPA increased from baseline to 12 months while time spent in LPA significantly decreased. Mean baPWV was similar at each time point. Those who showed decreased baPWV also showed an increase in total accelerometer counts per day and time spent in MVPA in the fully adjusted models (p<0.001). Changes in sedentary time and time spent in LPA were not associated with changes in baPWV. These results indicate that even modest increases in MVPA can reduce arterial stiffness, a risk factor for future cardiovascular events.
Collapse
Affiliation(s)
- Marquis Hawkins
- Division of Biostatistics & Epidemiology, Department of Public Health, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA
| | - Kelley P Gabriel
- Division of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Jennifer Cooper
- Nationwide Children's Hospital Research Institute, Columbus, OH, USA
| | - Kristi L Storti
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kim Sutton-Tyrrell
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA Co-author is deceased
| | - Andrea Kriska
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| |
Collapse
|