scholarly journals Impact of metabolic syndrome parameters and different fat depots on arterial stiffness in patients with abdominal obesity

2021 ◽  
Vol 17 (4) ◽  
pp. 55-62
Author(s):  
Marina V. Andreevskaia ◽  
Ekaterina A. Zheleznova ◽  
Juliya V. Zhernakova ◽  
Irina E. Chazova ◽  
Merab A. Shariia ◽  
...  

Overweight is closely associated with development of cardiovascular disorders. Currently, the terms metabolically healthy abdominal obesity (MHAO) and metabolically unhealthy obesity, i.e., metabolic syndrome (MS) are stated. Comparison target organs status and their link with fat depots in persons of these categories is of important scientific and practical interest. Aim. To assess arterial stiffness in young people with abdominal obesity with / without MS by various methods as well as its link with various fat stores and other metabolic factors. Materials and methods. 116 people, 18- to 45-year-old, with abdominal obesity were divided into two groups: MHAO (n=46), aged 40 [34; 43] years and MS (n=70), aged 40 [35; 44] years. The control group (CG) included 16 conditionally healthy volunteers without obesity, aged 32 [27; 35] years (p0.01). All subjects were assessed for height, body weight, body mass index, and waist circumference. Lipid profile, glucose, 2-hour glucose tolerance test, insulin, leptin, adiponectin, HOMA-IR were determined. 24-hour blood pressure monitoring was performed. Subcutaneous, visceral, perivascular, epicardial fat volumes and, the ratio of subcutaneous fat to visceral fat were determined by computed tomography. Arterial stiffness was determined according to CAVI (Cardio-Ankle Vascular Index), brachial-ankle pulse wave velocity baPWV (VaSera 1000), aortic pulse wave velocity aoPWV (EnVisor ultrasound system). Results. aoPWV were significantly different between groups (p0.01). In persons with MS: 6.61.1 m/s, in MHAO and CG groups: 4.30.9 m/s and 5.51.0 m/s, respectively. Significant differences in baPWV were found only in MS group 13.88.2 m/s (p0.01) compared with CG and MHAO groups: 10.981.2 and 12.33.8 m/s, respectively. The CAVI index did not differ significantly between groups. There were reliable relationships between aoPWV and baPWV and almost all MS factors. The highest correlation coefficient was between aoPWV and visceral (r=0.55; p0.01) and epicardial (r=0.45; p0.01) fats. A close relationship between aoPWV and HOMA IR was revealed (r=0.42; p0.01). Correlation analysis showed a higher quality relationship between aoPWV and MS markers, insulin resistance, and fat depots compared to baPWV. According to multivariate regression analysis, the main contribution to the formation aoPWV is made by body mass index, systolic blood pressure, and epicardial fat. Conclusion. The most sensitive to metabolic factors and the volume of fat depots was aoPWV indicator. Significant differences on some metabolic risk factors and aoPWV between the control group and MHAO raises doubts about the correctness of the term metabolically healthy obesity.

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Anna K Poon ◽  
Michelle L Snyder ◽  
Elizabeth Selvin ◽  
James S Pankow ◽  
David Couper ◽  
...  

Introduction: Arterial stiffness is an indicator of subclinical cardiovascular disease (CVD) and is associated with increased CVD risk. The determinants of arterial stiffness may be explained in part by a clustering of metabolic abnormalities (as defined by the metabolic syndrome). Our goal was to examine the association of central and peripheral arterial stiffness (as measured by carotid-femoral, brachial-ankle, and femoral-ankle pulse wave velocity) with the metabolic syndrome in older adults. We predicted higher arterial stiffness (i.e. higher pulse wave velocity measurements) in persons with compared to persons without the metabolic syndrome. Methods: We analyzed 3542 persons without diabetes at the ARIC Visit 5 examination in 2011-13 (61% female; 18% African American; median age 75 yrs). The metabolic syndrome was defined as ≥3 of the following: (1) abdominal obesity (waist circumference ≥102 cm in males and ≥88 cm in females); (2) hypertriglyceridemia (≥150 mg/dL), (3) low HDL-cholesterol (<40 mg/dL in males and <50 mg/dL in females), (4) high blood pressure (BP) (systolic BP ≥130 mmHg and/or diastolic BP≥85 mmHg and/or BP-lowering medications), and (5) high fasting glucose (≥100 mg/dL). Pulse wave velocity (PWV) included carotid-femoral PWV (cfPWV), brachial-ankle PWV (baPWV), and femoral-ankle PWV (faPWV); values were measured using the Colin VP-1000 Plus system (Omron Co., Ltd., Kyoto, Japan). Multivariable regression, with adjustment for age, sex, and race-center, was used to evaluate the association of cfPWV, baPWV, and faPWV with the metabolic syndrome, with each component metabolic abnormality, and with the number of metabolic abnormalities. Results: The prevalence of metabolic syndrome was 49% (SE 2); the three metabolic abnormalities with the highest prevalence were abdominal obesity (63% (SE 1)), elevated fasting glucose (60% (SE 1)), and high blood pressure (76% (SE 1)). A majority of participants had two (29% (SE 3)) or three (28% (SE 3)) metabolic abnormalities. Persons with the metabolic syndrome had a higher mean cfPWV (54 cm/s; 95% CI: 35, 73 cm/s), higher mean baPWV (22; 95% CI: 2, 42 cm/s, respectively), and lower mean faPWV (-18 cm/s; 95% CI: -31, -6 cm/s) compared to persons without the metabolic syndrome. Each additional metabolic abnormality was associated with a 28 cm/s (95% CI: 20, 36 cm/s) higher cfPWV, 19 cm/s (95% CI: 11, 27 cm/s) higher baPWV, and 6 cm/s (95% CI: -11, -1 cm/s) lower faPWV. Conclusion: Metabolic syndrome and each additional metabolic abnormality was positively associated with cfPWV and baPWV, and inversely associated with faPWV in older adults. Abdominal obesity, elevated fasting glucose, and high blood pressure were the most common metabolic abnormalities in this cohort of older men and women. Having the metabolic syndrome and its abnormalities may contribute to arterial stiffness that is predictive of CVD events and mortality.


2021 ◽  
pp. 1-8
Author(s):  
Cansu Sivrikaya Yildirim ◽  
Pelin Kosger ◽  
Tugcem Akin ◽  
Birsen Ucar

Abstract Children with a family history of hypertension have higher blood pressure and hypertensive pathophysiological changes begin before clinical findings. Here, the presence of arterial stiffness was investigated using central blood pressure measurement and pulse wave analysis in normotensive children with at least one parent with essential hypertension. Twenty-four-hour ambulatory pulse wave analysis monitoring was performed by oscillometric method in a study group of 112 normotensive children of hypertensive parents aged between 7 and 18 comparing with a control group of 101 age- and gender-matched normotensive children of normotensive parents. Pulse wave velocity, central systolic and diastolic blood pressure, systolic, diastolic and mean arterial blood pressure values were higher in the study group than the control group (p < 0.001, p = 0.002, p = 0.008, p = 0.001, p = 0.005, p = 0.001, p = 0.001, respectively). In all age groups (7–10, 11–14, and 15–18 years), pulse wave velocity was higher in the study group than the control group (p < 0.001). Pulse wave velocity was higher in children whose both parents are hypertensive compared to the children whose only mothers are hypertensive (p = 0.011). Pulse wave velocity values were positively correlated with age, weight, height, and body mass index (p < 0.05). Higher pulse wave velocity, central systolic and diastolic blood pressure values detected in the study group can be considered as early signs of hypertensive vascular changes. Pulse wave analysis can be a reliable, non-invasive, and reproducible method that can allow taking necessary precautions regarding lifestyle to prevent disease and target organ damage by detecting early hypertensive changes in genetically risky children.


Stroke ◽  
2021 ◽  
Author(s):  
Alastair J.S. Webb ◽  
Amy Lawson ◽  
Sara Mazzucco ◽  
Linxin Li ◽  
Peter M. Rothwell ◽  
...  

Background and Purpose: Blood pressure variability (BPV) from beat to beat is associated with an increased risk of cardiovascular events and enables rapid assessment of BPV, but the underlying causes of elevated BPV are unclear. Methods: In consecutive patients within 4 to 6 weeks of transient ischemic attack or nondisabling stroke (OXVASC [Oxford Vascular Study]), continuous noninvasive blood pressure was measured beat to beat over 5 minutes (Finometer). Arterial stiffness was measured by carotid-femoral pulse wave velocity (Sphygmocor). After automated and manual data cleaning, associations between BPV (residual coefficient of variation), demographic factors, and arterial stiffness were determined for both systolic and diastolic blood pressure, by ANOVA and linear models. Relationships between demographic factors and arterial stiffness were determined by interaction terms and mediation. Results: Among 1013 patients, 54 (5.3%) were in AF, and 51 (5%) had low-quality recordings. In a general linear model including the remaining 908 participants, systolic BPV (SBPV) was most strongly associated with age ( P =0.00003), body mass index (BMI; P =0.003), and arterial stiffness ( P =0.008), with weaker independent associations with current smoking ( P =0.01) and a low diastolic blood pressure ( P =0.046). However, while there was a linear increase in SBPV with BMI in men, in women, SBPV was lowest for a BMI in the normal range but was greater below 20 or above 30 (ANOVA, P =0.012; BMI-sex interaction, P =0.03). Although BMI and pulse wave velocity were partially independent, increased pulse wave velocity mediated ≈32% of the relationship between increased BMI and SBPV ( P <0.001). Conclusions: Vascular aging, manifest as arterial stiffness, was a strong determinant of increased SBPV and partially mediated the effect of increased BMI. However, although high BMI was independently associated with SBPV in both sexes, a low BMI was associated with increased SBPV only in women. SBPV may partially mediate the relationship between BMI and cardiovascular events, while obesity may provide a modifiable target to reduce SBPV and cardiovascular events.


2018 ◽  
Vol 15 (4) ◽  
pp. 76-82
Author(s):  
E A Zheleznova ◽  
Yu V Zhernakova ◽  
I E Chazova ◽  
A N Rogoza ◽  
A R Zairova ◽  
...  

Obesity plays a key role in the epidemic of type 2 diabetes mellitus (DM), cardiovascular and cerebrovascular diseases. Most studies confirm the association of increased arterial stiffness with obesity. However, the interrelation of various fat depots with one of the main indicators of vascular wall stiffness - the cardiovascular vascular index (CAVI) is currently not clear. The purpose of this study is to assess arterial stiffness in people with abdominal obesity without metabolic syndrome (MS) and with MS, the connection of fat depots (visceral, subcutaneous, perivascular, epicardial fat) with the stiffness parameter CAVI. Materials and methods. 68 people with abdominal obesity (AO) at the age of 18-45 years. The study included height, weight, BMI, waist circumference, and biochemical blood tests (fast glucose and glucose tolerance, uric acid, creatinine, GFR - MDRD, lipid profile, insulin, HOMA-IR). 24-hour blood pressure monitoring, computed tomography (Aquilion One Vision Edition, Toshiba, Japan) with the definition of subcutaneous, visceral, perivascular, epicardial fat, and also calculated the ratio subcutaneous to visceral fat. It was determined CAVI on the VaSera 1000 unit (Fukuda Denshi, Japan) to assess arterial stiffness. Abdominal obesity was derteming by cut off waist circumference >80 cm for women and >94 cm for men. As a result, we were formed 2 groups: persons with abdominal obesity and the presence of no more than one additional risk factor (metabolically healthy) - group 1, persons with MS (abdominal obesity in combination with 2 and more extra risk factors) - group 2, the control group consisted of healthy individuals (n=15) without obesity - group 0. Results. There was no statistically significant difference between CAVI groups. Correlations of CAVI with age r=0.340 (p=0.005), with daytime mean systolic blood pressure - SBPm average (r=0.280, p=0.021) and with mean diastolic blood pressure - DBPm average (r=0.329, p=0.006), with night SBPm average (r=0.233, p=0.014) and with DBPm average (r=0.297, p=0.014), with the volume of periaortic fat (r=0.218, p=0.074) were found. An inverse correlation was found between CAVI and BMI (r=-0.279, p=0.021), with subcutaneous fat depot (r=-0.285, p=0.019) and with the ratio of subcutaneous to visceral fat (r=-0.303, p=0.012). According to the multivariate regression analysis, the most significant impact on CAVI is exerted by age, daytime SBPm, BMI, and the volume of periaortic fat


2018 ◽  
Vol 23 (5) ◽  
pp. 419-425 ◽  
Author(s):  
Klaas Frederik Franzen ◽  
Johannes Willig ◽  
Silja Cayo Talavera ◽  
Moritz Meusel ◽  
Friedhelm Sayk ◽  
...  

The introduction of electronic cigarettes has led to widespread discussion on the cardiovascular risks compared to conventional smoking. We therefore conducted a randomized cross-over study of the acute use of three tobacco products, including a control group using a nicotine-free liquid. Fifteen active smokers were studied during and after smoking either a cigarette or an electronic cigarette with or without nicotine (eGo-T CE4 vaporizer). Subjects were blinded to the nicotine content of the electronic cigarette and were followed up for 2 hours after smoking a cigarette or vaping an electronic cigarette. Peripheral and central blood pressures as well as parameters of arterial stiffness were measured by a Mobil-O-Graph® device. The peripheral systolic blood pressure rose significantly for approximately 45 minutes after vaping nicotine-containing liquid ( p<0.05) and for approximately 15 minutes after smoking a conventional cigarette ( p<0.01), whereas nicotine-free liquids did not lead to significant changes during the first hour of follow-up. Likewise, heart rate remained elevated approximately 45 minutes after vaping an electronic cigarette with nicotine-containing liquid and over the first 30 minutes after smoking a cigarette in contrast to controls. Elevation of pulse wave velocity was independent from mean arterial pressure as well as heart rate in the electronic cigarette and cigarette groups. In this first of its kind trial, we observed changes in peripheral and central blood pressure and also in pulse wave velocity after smoking a cigarette as well as after vaping a nicotine-containing electronic cigarette. These findings may be associated with an increased long-term cardiovascular risk.


Hypertension ◽  
2021 ◽  
Vol 78 (5) ◽  
pp. 1270-1277
Author(s):  
Shouling Wu ◽  
Lulu Song ◽  
Lulin Wang ◽  
Shuohua Chen ◽  
Mingyang Wu ◽  
...  

Metabolically healthy obesity is an unstable state and its transition to a metabolically unhealthy phenotype confers an increased risk of cardiovascular disease. However, it remains unclear whether changes in metabolic health over time are associated with arterial stiffness progression, a key player in the pathophysiology of cardiovascular disease. We aimed to investigate the associations of changes in metabolic health across body mass index categories with arterial stiffness and its progression. This study included 22 153 participants without cardiovascular disease or cancer at baseline from the Kailuan Study. Arterial stiffness was assessed using brachial-ankle pulse wave velocity at baseline and repeated after a mean follow-up of 3.1 years. Changes in metabolic health across body mass index categories were evaluated between the first survey (2006–2007) and the first brachial-ankle pulse wave velocity measurement. Multivariate linear regression models were used. Among initial metabolically healthy obese individuals, 53.4% (n=928) converted to a metabolically unhealthy phenotype. Compared with metabolically healthy normal-weight individuals who remained metabolically healthy, metabolically healthy obese individuals who converted to a metabolically unhealthy phenotype showed a 110.7 (95% CI, 90.8–130.6) cm/s higher increase in baseline brachial-ankle pulse wave velocity and a 22.8 (95% CI, 12.4–33.2) cm/s per year higher acceleration in arterial stiffness progression. Individuals who were initially metabolically unhealthy or converted so during follow-up across body mass index categories had higher baseline brachial-ankle pulse wave velocity and arterial stiffness progression than those who remained metabolically healthy. These data suggest that metabolically healthy individuals who develop an unhealthy phenotype across all body mass index categories are at increased risks of arterial stiffness and its progression.


2019 ◽  
Vol 16 (4) ◽  
pp. 80-86
Author(s):  
Ekaterina A Zheleznova ◽  
Juliya V Zhernakova ◽  
Olga A Pogorelova ◽  
Mariia I Tripoten ◽  
Nataliia V Blinova ◽  
...  

Aim. To evaluate the common carotid artery (CCA) intima-media complex thickness (IMT) and the presence of atherosclerotic plaques (ASP) in young people with abdominal obesity who don’t have metabolic syndrome and those who have it, as well as a link between fat depots (perivascular, visceral, subcutaneous, epicardial) and CCA IMT. Materials and methods. The study included 145 people aged 18-45 years. They were divided into 3 groups: group 1 (n=18) - healthy volunteers (control group), group 2 (n=48) - patients with abdominal obesity and no more than one additional risk factor (metabolically healthy) and group 3 (n=79) - patients with metabolic syndrome. In persons included in the study the following parameters were measured: the height, weight, body mass index, waist circumference, fasting blood glucose, glucose tolerance, uric acid, lipid profile, insulin and the insulin resistance index (HOMA-IR). They also were given a 24-hour blood pressure monitoring, and an evaluation of CCA IMT, a presence of ASP in the carotid arteries and a maximum degree of internal carotid stenosis was performed using the duplex scan of brachiocephalic arteries. Computed tomography (Aquilion One Vision Edition, Toshiba, Japan) with determining subcutaneous, visceral, perivascular, epicardial fat was performed, and the ratio of subcutaneous to visceral fat was calculated. Results. Significant differences in mean CCA IMT were revealed only between persons of group 1 and group 3 (p=0.025), while the median of IMT were within normal ranges (group 1: 0.49 [0.46; 0.56]; group 2: 0.53 [0.49; 0.59]; group 3: 0.56 [0.52; 0.62]). Significant differences in a distribution of individuals with increased IMT between groups were also not revealed. However, the proportion of individuals with ASP was significantly higher in group 2 compared with group 1 (p


2018 ◽  
Vol 29 (2) ◽  
pp. 6-10
Author(s):  
Khan MMR ◽  
Sana NK ◽  
PM Basak ◽  
BC Sarker ◽  
M Akhtarul Islam ◽  
...  

Background: Metabolic syndrome confers the risk of developing acute myocardial infarction which is the most common form of coronary heart disease and the single most important cause of premature death worldwide. The frequency and association of different components of metabolic syndrome on AMI are not well understood and has not been well evaluated.Objective: The aim of this study was to assess the components of the metabolic syndrome and its association with AMI patients. This study will help in awareness building in reducing AMI by early detection of components of metabolic syndrome.Patients and methods: This was a prospective observational study consisted of 325 AMI patients who were aged >20 years. Patients with first time AMI arriving in CCU of Rajshahi medical college during the period of 2012-2014, were included. Data were collected through interview, clinical examination, and laboratory tests within 24 hrs of AMI. Five components of metabolic syndrome were defined according to criteria set by modified NCEP ATP III (according to ethnic variation).Results: In AMI patients (n=325), no metabolic components were in 24 (7.4%) patients, one in 53 (16.3%), 2 components in 91(28.0%), 3 components were in 61(18.8%), 4 in 67(20.6%) and all 5 components were in 29 (8.9%) patients. In this study, there was no component in 7.4% of AMI patients, at least 1 component was 92.6%, at least 2 components were 76.3%, at least 3 components were 48.3%, at least 4 components were 29.5% and at least 5 components were 8.9%. The Metabolic syndrome was 48.3% (n=157). Among metabolic syndrome (≥3 components) in AMI (n=157, 48.3%) 4 components (20.6%) were more, next was 3 components (18.8%) and than 5 components (8.9%). Overall frequencies of components in acute myocardial infarction (n=325) were in order of abdominal obesity (54.8%) > high blood pressure (54.5%) > high FPG (54.2%) > Triglyceride (46.2%) and low HDL-C (46.2%) in acute myocardial infarction. Highest percentage was observed in abdominal obesity (54.8%) followed by high blood pressure (54.5%) and FPG (54.2%).TAJ 2016; 29(2): 6-10


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