Differences in hemodynamic response to metaboreflex activation between obese patients with metabolic syndrome and healthy subjects with obese phenotype

Patients suffering from obesity and metabolic syndrome (OMS) manifest a dysregulation in hemodynamic response during exercise, with an exaggerated systemic vascular increase. However, it is not clear whether this is the consequence of metabolic syndrome per se or whether it is due to concomitant obesity. The aim of the present investigation was to discover whether OMS and noncomplicated obesity resulted in different hemodynamic responses during the metaboreflex. Twelve metabolically healthy but obese subjects (MHO; 7 women), 13 OMS patients (5 women), and 12 normal age-matched controls (CTL; 6 women) took part in this study. All participants underwent a postexercise muscle ischemia protocol to evaluate the metaboreflex activity. Central hemodynamics were evaluated by impedance cardiography. The main result shows an exaggerated increase in systemic vascular resistance from baseline during the metaboreflex in the OMS patients as compared with the other groups (481.6 ± 180.3, −0.52 ± 177.6, and −60.5 ± 58.6 dynes·s−1·cm−5 for the OMS, the MHO, and the CTL groups, respectively; P < 0.05). Moreover, the MHO subjects and the CTL group showed an increase in cardiac output during the metaboreflex (288.7 ± 325.8 and 703.8 ± 276.2 ml/m increase with respect to baseline), whereas this parameter tended to decrease in the OMS group (−350 ± 236.5 ml/m). However, the blood pressure response, which tended to be higher in the OMS patients, was not statistically different between groups. The results of the present investigation suggest that OMS patients have an exaggerated vasoconstriction in response to metaboreflex activation and that this fact is not due to obesity per se.

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Effects of acute vasodilation on the hemodynamic response to muscle metaboreflex

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.00397.2013 ◽

2013 ◽

Vol 305 (9) ◽

pp. H1387-H1396 ◽

Cited By ~ 21

Author(s):

Elisabetta Marongiu ◽

Massimo Piepoli ◽

Raffaele Milia ◽

Luca Angius ◽

Marco Pinna ◽

...

Keyword(s):

Impedance Cardiography ◽

Blood Pressure Response ◽

Hemodynamic Response ◽

Sublingual Administration ◽

Complex Interplay ◽

Hemodynamic Changes ◽

Muscle Metaboreflex ◽

Muscle Ischemia ◽

Diastolic Time ◽

Control Exercise

The aim of the present study was to test the contribution of stroke volume (SV) in hemodynamic response to muscle metaboreflex activation in healthy individuals. We hypothesized that an acute decrease in cardiac afterload and preload due to the administration of a vasodilating agent could reduce postexercise muscle ischemia (PEMI)-induced SV response. Ten healthy males (age 33.6 ± 1.3 yr) were enrolled and randomly assigned to the following study protocol: 1) PEMI session, 2) control exercise recovery (CER) session, 3) PEMI after sublingual administration of 5 mg of isosorbide dinitrate (ISDN), and 4) CER after ISDN. Central hemodynamics were evaluated by means of impedance cardiography. The main findings were a blunted SV response during metaboreflex following acute arterial and venous vasodilation, associated with a reduction in cardiac diastolic time and filling, and a decrement of systemic vascular resistance. These hemodynamic changes restrain blood pressure response during metaboreflex activation. Our results indicate that hemodynamic response to metaboreflex activation is a highly integrated phenomenon encompassing complex interplay between heart rate, cardiac performance, preload, and afterload and that impairment of one or more of these parameters leads to altered hemodynamic response to metaboreflex.

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The prevalence of metabolically healthy obesity according to the sample of the Moscow region

Obesity and metabolism ◽

10.14341/omet2017451-56 ◽

2017 ◽

Vol 14 (4) ◽

pp. 51-56 ◽

Cited By ~ 2

Author(s):

Elena V. Ostrovskaya ◽

Tatiana I. Romantsova ◽

Andrei N. Gerasimov ◽

Tamara E. Novoselova

Keyword(s):

Metabolic Syndrome ◽

Carbohydrate Metabolism ◽

Medical Records ◽

Density Lipoprotein ◽

Homa Index ◽

Obese Patients ◽

Hip Circumference ◽

Metabolically Healthy Obese ◽

Healthy Obese ◽

Metabolically Healthy

Introduction. Obesity is a major factor for cardiometabolic risk. However, there is a category of obese patients without disorders of lipid, carbohydrate metabolism and cardiovascular disease metabolically healthy obese (MHO). Aim. Our goal was to investigate the prevalence and characteristics of this phenotype compared to patients with metabolic syndrome (MS). Materials and methods. To evaluate the prevalence of the MHO phenotype we analyzed 389 medical records of females aged 1860 years with obesity. Three types of MHO criteria were used: 1) HOMA index (2.7); 2) IDF-criteria of metabolic syndrome, 2005; 3) the BioSHaRE-EU 2013 criteria (obese patients without any symptoms of MS). We conducted a comparative analysis of anthropometry, status of lipid and carbohydrate metabolism, the functional state of the liver. Results. The MHO prevalence was: 34.5% according to HOMA index, according to the definitions of MS 2005 38.6%, in BioSHaRE-EU 9.6%. In groups of MHO and MS dyslipidemia was observed in 27.3 and 49.5% (p0.05), hypertension in 25% and 71.6% (p0.05), steatogepatosis in 47.7% vs 51.3% (p0.05) of observations, respectively. Among comorbidities the gynecological pathology was most prevalent - 50.8 and 61.4% (p0.05), disorders of carbohydrate metabolism differed significantly in frequency- 6.82 and 39.1% of patients (p0.05). Patients with MHO had a shorter duration of the existence of obesity than MS (18.7 vs. 24 years) (p=0.0004) and less likely to have attempted to reduce weight 85.8% and 91.6%. Average BMI, waist circumference, hip circumference, fasting glucose, total cholesterol, insulin basal, basal C-peptide, HOMA index in groups of MHO and MS differed significantly (p0.05). Median ALT was 20 and 23.2 U/l, AST 20 and 23 U/l, triglycerides 1.1 and 1.8 mmol/l, high-density lipoprotein 1.4 and 1.1 mmol/l, respectively. Conclusions. The MHO prevalence was maximal according to the MS definitions from 2005, and minimal with BioSHaRE-EU criteria. The main analyzed indicators differed significantly in groups MHO and MS. Longer obesity existence in the MS group may suggest an instability of MHO phenotype over time.

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Erythrocyte 2,3-Diphosphoglycerate as Related to Diabetes and Obesity

Clinical Chemistry ◽

10.1093/clinchem/21.10.1414 ◽

1975 ◽

Vol 21 (10) ◽

pp. 1414-1415 ◽

Cited By ~ 5

Author(s):

Anastasios Kalofoutis ◽

Gérard Jullien ◽

Antonios Koutselinis ◽

Constantinos Miras

Keyword(s):

Healthy Subjects ◽

Diabetic Patients ◽

Obese Patients ◽

Obese Subjects ◽

Diabetes And Obesity

Abstract 2,3-Diphosphoglycerate was determined in the erythrocytes of 17 diabetic and 18 obese patients. Results for obese subjects were significantly (P < .01) different from those obtained for 21 healthy subjects. Results for obese and diabetic patients also differed significantly (P < .01), but not those for diabetic and healthy subjects. Hemoglobin, hematocrit, or bicarbonate measurements did not differ among the three groups.

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High Frequency of Obesity in Acne Keloidalis Nuchae Patients: A Hypothesis from a Brazilian Study

Skin Appendage Disorders ◽

10.1159/000509203 ◽

2020 ◽

Vol 6 (6) ◽

pp. 374-378

Author(s):

Andrea Mizuno Matsunaga ◽

Violeta Duarte Tortelly ◽

Carla Jorge Machado ◽

Ludmila Ribeiro Pedrosa ◽

Daniel Fernandes Melo

Keyword(s):

Metabolic Syndrome ◽

High Frequency ◽

Related Factor ◽

Obese Patients ◽

Inflammatory Condition ◽

Chronic Inflammatory Condition ◽

General Physicians ◽

Male Patients ◽

Per Se ◽

The Relationship

Acne keloidalis nuchae (AKN) is a chronic inflammatory condition that almost exclusively affects the occipital and nape areas. Although not completely understood, its etiopathogenesis seems to be multifactorial, including association with metabolic syndrome (MetS). Despite being commonly seen in patients with MetS, obesity per se as a possible related factor for AKN has yet to be studied. The aim of this study was to evaluate the relationship between obesity and AKN in a series of patients. Eight male patients, with a median age of 38 years (range 15–48), were included. Overweight/obesity was found in 8/8 (100%), with median BMI of 32.2 (range 27.7–43.85 kg/m<sup>2</sup>), including 2 patients with class 3 obesity. We hypothesize adipose tissue accumulation in the nape, the only moving part of the scalp, leads to redundant skin folds, more friction, and inflammation, triggering AKN. This paper highlights the possible relationship between AKN and overweight/obesity, hypothesizing a mechanism for their contribution to the etiopathogenesis of this scalp disorder. To the best of our knowledge, this is the first study focused specifically in this association. While general physicians should pay attention to the appearing of AKN in overweight/obese patients, dermatologists must be aware that AKN patients should be assessed beyond the skin.

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Association between being metabolically healthy/unhealthy and metabolic syndrome in Iranian adults

PLoS ONE ◽

10.1371/journal.pone.0262246 ◽

2022 ◽

Vol 17 (1) ◽

pp. e0262246

Author(s):

Ozra Tabatabaei-Malazy ◽

Sahar Saeedi Moghaddam ◽

Masoud Masinaei ◽

Nazila Rezaei ◽

Sahar Mohammadi Fateh ◽

...

Keyword(s):

Metabolic Syndrome ◽

Public Awareness ◽

Normal Weight ◽

Healthy Lifestyles ◽

Adult Treatment Panel ◽

Metabolically Healthy Obesity ◽

Anthropometric Data ◽

Metabolic Markers ◽

Obese Subjects ◽

Metabolically Healthy

Introduction The prevalence of metabolically healthy obesity (MHO) varies based on different criteria. We assessed the prevalence of MHO and metabolic unhealthiness based on body mass index (BMI) and their association with metabolic syndrome (MetS) in a nation-wide study. Methods Data were taken from the STEPs 2016 study, from 18,459 Iranians aged ≥25 years. Demographic, metabolic, and anthropometric data were collected. Subjects were stratified by BMI, metabolic unhealthiness, and having MetS. The latter was defined based on National Cholesterol Education Program Adult Treatment Panel III 2004 (NCEP ATP III), was then assessed. Results The prevalence of MHO and metabolic unhealthiness in obese subjects was 7.5% (about 3.6 million) and 18.3% (about 8.9 million), respectively. Most of the metabolic unhealthy individuals were female (53.5%) or urban residents (72.9%). Low physical activity was significantly and positively associated (Odds Ratio: 1.18, 95% CI: 1.04–1.35) with metabolic unhealthiness, while being a rural residence (0.83, 0.74–0.93), and having higher education (0.47, 0.39–0.58) significantly but negatively affected it. Dyslipidemia was the most frequent MetS component with a prevalence rate of 46.6% (42.1–51.1), 62.2% (60.8–63.6), 76.3% (75.1–77.5), and 83.4% (82.1–84.6) among underweight, normal weight, overweight and obese phenotypes, respectively. Conclusion BMI aside, an additional set of criteria such as metabolic markers should be taken into account to identify normal weight but metabolically unhealthy individuals. Given the highest prevalence of dyslipidemia among obese subjects, further interventions are required to raise public awareness, promote healthy lifestyles and establish lipid clinics.

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Investigation of endocannabinoids and endocannabinoid-related compounds in obese subjects during an hedonic eating experimental test

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.782 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S551-S551

Author(s):

V. Ruzzi ◽

A.M. Monteleone ◽

F. Monaco ◽

G. Fico ◽

A. Cervino ◽

...

Keyword(s):

Experimental Test ◽

Plasma Levels ◽

Healthy Subjects ◽

Normal Weight ◽

Obese Patients ◽

Food Ingestion ◽

Obese Subjects ◽

Baseline Values ◽

Competing Interest ◽

Related Compounds

IntroductionHedonic eating refers to the consumption of food just for pleasure and not for energetic needs. Endocannabinoids and endocannabinoid-related compounds play an important role in food-related reward and are likely involved in hedonic eating.ObjectivesIn a previous study we found that in normal weight healthy subjects plasma levels of 2 arachidonoylglycerol (2-AG) decreased progressively after food ingestion in both hedonic and non-hedonic eating condition, but they were significantly higher in hedonic eating. Plasma levels of anandamide (AEA), oleoylethanolamide (OEA) and palmitoylethanolamide (PEA), instead, progressively decreased in both eating conditions without significant differences.AimsIn order to investigate the physiology of endocannabinoids in obesity, we assessed the responses of AEA, 2-AG, OEA and PEA to hedonic and non-hedonic eating in obese individuals.MethodsFourteen satiated obese patients consumed favorite (hedonic eating) and non-favorite (non-hedonic eating) foods in two experimental sessions. During the tests, blood was collected to measure peripheral levels of AEA, 2-AG, OEA and PEA.ResultsPlasma levels of 2-AG progressively decreased in non-hedonic eating whereas they gradually increased after hedonic eating. Plasma levels of AEA decreased progressively in non-hedonic eating, whereas they initially decreased after the exposure to the favorite food and then returned to baseline values after its consumption. The responses of OEA and PEA to favorite and non-favorite food did not show significant differences.ConclusionsThese findings demonstrate that, compared to normal weight healthy subjects, obese subjects exhibit different responses of peripheral endocannabinoids to the ingestion of food for pleasure and this could have implications for the onset/maintenance of obesity.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Vasodilator responses and endothelin-dependent vasoconstriction in metabolically healthy obesity and the metabolic syndrome

AJP Endocrinology and Metabolism ◽

10.1152/ajpendo.00278.2015 ◽

2015 ◽

Vol 309 (9) ◽

pp. E787-E792 ◽

Cited By ~ 26

Author(s):

Francesca Schinzari ◽

Micaela Iantorno ◽

Umberto Campia ◽

Nadia Mores ◽

Valentina Rovella ◽

...

Keyword(s):

Metabolic Syndrome ◽

Vascular Reactivity ◽

Forearm Blood Flow ◽

Control Group ◽

Obese Patients ◽

Metabolic Abnormalities ◽

Metabolically Healthy Obesity ◽

Arterial Infusion ◽

The Metabolic Syndrome ◽

Metabolically Healthy

Patients with metabolically healthy obesity (MHO) do not present the cluster of metabolic abnormalities that define the metabolic syndrome (MetS). Whether MHO is associated with lower impairment of vasoreactivity than the MetS is unknown. For this purpose, forearm blood flow (FBF) responses were measured by strain-gauge plethysmography during the intra-arterial infusion of acetylcholine (ACh), sodium nitroprusside (SNP), and/or the selective endothelin type A (ETA) receptor blocker BQ-123 in 119 obese individuals with MHO ( n = 34) or with the MetS ( n = 85) and in healthy lean controls ( n = 56). ACh and SNP caused a significant vasodilation in both obese and lean participants (all P < 0.001). However, the response to both agents was significantly lower in the obese than in the control group (both P < 0.001). Among the obese participants, the reactivity to ACh was higher in MHO than in MetS patients, whereas the responsiveness to SNP was equally impaired in both groups ( P = 0.45). Infusion of BQ-123 significantly increased FBF in obese patients ( P < 0001), but not in the lean participants; hence, FBF following ETA receptor blockade was higher in both obese groups than in controls (both P < 0.001). FBF response to BQ-123 was significantly higher in patients with the MetS than in those with MHO ( P = 0.007). In conclusion, patients with MHO have abnormal vascular reactivity, although their endothelial dysfunction is less pronounced than in patients with the MetS. These findings indicate that obesity is associated with vascular damage independent of those metabolic abnormalities underlying the MetS.

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Relation of uric acid with components of metabolic syndrome before and after Roux-en-Y gastric bypass in morbidly obese subjects

Arquivos Brasileiros de Endocrinologia & Metabologia ◽

10.1590/s0004-27302011000100005 ◽

2011 ◽

Vol 55 (1) ◽

pp. 38-45 ◽

Cited By ~ 11

Author(s):

Ary Serpa Neto ◽

Felipe Martin Bianco Rossi ◽

Leonardo Guedes Moreira Valle ◽

Gabriel Kushiyama Teixeira ◽

Marçal Rossi

Keyword(s):

Metabolic Syndrome ◽

Gastric Bypass ◽

Uric Acid ◽

Morbidly Obese ◽

Obese Patients ◽

Metabolic Abnormalities ◽

Blood Samples ◽

Glucose Levels ◽

Before And After ◽

Obese Subjects

OBJECTIVE: The purpose of the study was to investigate the prevalence of hyperuricemia in morbidly obese subjects before and after Roux-en-Y gastric bypass (RYGBP) and its relationship with metabolic syndrome abnormalities. SUBJECTS AND METHOD: We evaluated 420 morbidly obese patients. Pre and postoperative (8 months after RYGBP) blood samples were drawn. Obese patients underwent laparoscopic RYGBP and after eight months all the tests were repeated. RESULTS: The overall prevalence of hyperuricemia was 34.28%. Hyperuricemia was more common in men than in women (51.72 vs. 29.72%; p = 0.0002). Men with hyperuricemia were more likely to have diabetes (p = 0.034) and more elevated fasting plasma glucose levels (p = 0.027). Women with hyperuricemia were more likely to have hypertension (p = 0.003), metabolic syndrome (p = 0.001), elevated triglycerides (p = 0.001) and GGT (p = 0.009), and decreased HDL (p = 0.011). After surgery, uric acid levels decreased from 5.60 ± 1.28 to 4.23 ± 1.20 (p < 0.0001). The prevalence of hyperuricemia decreased from 33.6% to 6.4% (p < 0.0001), in men from 48.3% to 17.2% (p < 0.0001) and in women from 29.7% to 3.6% (p < 0.0001). CONCLUSION: Concentrations of uric acid were associated with the prevalence of metabolic abnormalities in this sample of morbidly obese patients. Also, weight loss after RYGBP can reduce uric acid levels and the prevalence of hyperuricemia.

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The relationship between features of metabolic syndrome and blood adipocytokine concentrations in the morbid obese patients during dynamic weight loss

Open Medicine ◽

10.2478/s11536-006-0015-x ◽

2006 ◽

Vol 1 (2) ◽

pp. 136-147 ◽

Cited By ~ 1

Author(s):

Joanna Jankiewicz-Wika ◽

Krzysztof Kołomecki ◽

Jacek Cywiński ◽

Katarzyna Piestrzeniewicz ◽

Henryk Stępień ◽

...

Keyword(s):

Metabolic Syndrome ◽

Weight Loss ◽

Vertical Banded Gastroplasty ◽

The Body ◽

Obese Patients ◽

Blood Concentrations ◽

Banded Gastroplasty ◽

The Metabolic Syndrome ◽

Dynamic Weight ◽

Obese Subjects

AbstractBariatric surgery is the most effective method to achieve weight loss in obese subjects.The aim of this study was to evaluate some adipocytokines and insulin, as well as parameters of metabolic syndrome of the obese patients, for three and six months after vertical banded gastroplasty, in the time of dynamic weight loss.Seven males and two females aged 28 to 49 years, with long lasting simple obesity and the presence of metabolic syndrome, were studied. After surgical treatment the values of the body mass index, waist circumference, systolic and diastolic blood pressure, total cholesterol, LDL cholesterol, triglycerides, and blood concentrations of leptin decreased significantly.Before surgical operation of all obese patients no statistically significant correlations between studied parameters were noted. Three and six months later a lot of correlations between studied parameters appeared.In conclusion, (a) vertical-banded gastroplasty is a valuable method in treatment of obese subjects, leading to a significant decrease in body weight and improvement in some parameters of metabolic syndrome in a few months after surgery, (b) adipocytokines, together with an unknown gastric factor, may be key factors in the control of some features of the metabolic syndrome.

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Association of Metabolic Syndrome With Prevalence of Obstructive Sleep Apnea and Remission After Sleeve Gastrectomy

Frontiers in Physiology ◽

10.3389/fphys.2021.650260 ◽

2021 ◽

Vol 12 ◽

Author(s):

Yufei Chen ◽

Lijia Chen ◽

Lingxia Ye ◽

Jiabin Jin ◽

Yingkai Sun ◽

...

Keyword(s):

Metabolic Syndrome ◽

Obstructive Sleep Apnea ◽

Sleeve Gastrectomy ◽

Sleep Apnea ◽

Laparoscopic Sleeve Gastrectomy ◽

Apnea Hypopnea Index ◽

Obese Patients ◽

Metabolic States ◽

Obstructive Sleep ◽

Metabolically Healthy

Obesity is an important risk factor for metabolic syndrome and obstructive sleep apnea (OSA). Bariatric surgery has been shown to effectively reduce weight and obesity-related comorbidities. However, the prevalence and severity of OSA in obese patients with different baseline metabolic states and the improvements of OSA after bariatric surgery remain unknown. The main aims of this study were to ascertain the prevalence of OSA in young Chinese obese patients with different metabolic states and to evaluate their respective OSA remission after laparoscopic sleeve gastrectomy. We first performed a cross-sectional study involving 123 metabolically healthy obese patients and 200 metabolically unhealthy obese patients (who had the same age and BMI ranges) to estimate the prevalence of OSA at baseline. Then we performed a retrospective study, which was registered at ClinicalTrials.gov (ref. NCT02653430) of 67 patients who underwent laparoscopic sleeve gastrectomy to evaluate the remission of OSA. Metabolically healthy and unhealthy obese patients had similar apnea-hypopnea index levels (16.6 ± 22.0 vs. 16.7 ± 18.7 events/h, P = 0.512) and prevalence of OSA (66.7% vs. 69.0%, P = 0.662). Male sex, age, waist circumference and lower liver-to-spleen ratio were independent risk factors for OSA. After laparoscopic sleeve gastrectomy, no difference was found in the decrease in body mass index (BMI) change (10.8 ± 4.8 vs. 10.8 ± 3.0 kg/m2, P = 0.996) or the decrease in the apnea-hypopnea index (18.9 ± 24.6 vs. 17.0 ± 24.0 events/h, P = 0.800). The remission of moderate-to-severe OSA was observed in the MHO (36.3%; 54.5–18.2%, P = 0.125) and MUO (32.2%; 66.1–33.9%, P = 0.001) patients. These results suggest that, in patients with obesity, metabolic syndrome does not add extra risk for the prevalence or severity of OSA. Both metabolically healthy and unhealthy obese patients could benefit equally from laparoscopic sleeve gastrectomy in terms of weight loss and obstructive sleep apnea remission.

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