Abstract
Our objective was to determine whether moderate obesity (Body Mass Index [BMI] ≥ 30 kg/m²) is associated with impaired conduit and microvascular endothelial function, and whether men or women are more susceptible to impairment of endothelial function related to moderate obesity. Forty-one middle aged, nondiabetic moderately obese (BMI 34.7 ± 4.0 kg/m2) and nonobese (BMI 24.3 ± 2.6 kg/m2) subjects of both sexes underwent noninvasive studies of endothelial function (brachial reactivity) and measurements of endothelial-dependent vasodilation of gluteal subcutaneous arterioles to acetylcholine (Ach). Endothelium-dependent vasodilation to Ach was decreased in the moderately obese compared with the nonobese (P < 0.001). Stratified analysis based on sex showed impairment of arteriolar endothelial function in women BMI ≥ 30 kg/m2 (P = 0.02), but not men. There was no difference between in vivo endothelial function flow-mediated dilation (FMD%) by BMI category. Sex-specific analysis showed FMD% was lower in women with BMI ≥ 30 kg/m2 compared to those with BMI < 30 kg/m2 (P = 0.02). No differences were seen in men based on BMI category (P = 0.18). In women, high sensitivity C-reactive protein (hsCRP) correlated with BMI (ρ = 0.68, P = 0.006). Moderate obesity is associated with impaired resistance arteriolar endothelial function. This is more prominent in women than men and is associated with systemic inflammation.
Highlights
Obesity has well-described adverse effects on cardiovascular health (Poirier et al 2006)
There were no significant differences in age, sex, history of HTN, smoking status, BP, lipid profiles, plasma insulin, average systolic (SBP), average diastolic blood pressure (DBP), and waist circumference
Our data demonstrate that moderate levels of obesity in nondiabetic humans impair resistance arteriolar endothelial function
Summary
Obesity has well-described adverse effects on cardiovascular health (Poirier et al 2006). Obesity-related changes to the arterial structure and function of medium and large arteries include increased arterial stiffness, noncompensatory dilatory remodeling, and impaired endothelial function, all of which are known to predict future adverse cardiovascular events (Ferreira et al 2004a, 2004b; Grassi et al 2009). Resistance arteriolar remodeling and endothelial dysfunction, observed in patients with hypertension (HTN) and type 2 diabetes (T2DM), predict the incidence of adverse a 2013 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of the American Physiological Society and The Physiological Society Endothelial dysfunction in this morbidly obese population is prevalent even in the absence of HTN and T2DM (Grassi et al 2009)
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