BackgroundMetabolic syndrome (MetS) is associated with structural and functional vascular abnormalities, which may lead to increased arterial stiffness, more frequent cardiovascular events and higher mortality. However, the role played by clustering of risk factors and the combining pattern of MetS risk factors and their association with the arterial stiffness have yet to be fully understood. Age, hypertension and diabetes mellitus seem to be strongly associated with increased pulse wave velocity (PWV). This study aimed at determining the clustering and combining pattern of MetS risk factors and their association with the arterial stiffness in non-diabetic and non-hypertensive patients.MethodsRecently diagnosed and untreated patients with MetS (n = 64, 49 ± 8 year, 32 ± 4 kg/m2) were selected, according to ATP III criteria and compared to a control group (Control, n = 17, 49 ± 6 year, 27 ± 2 kg/m2). Arterial stiffness was evaluated by PWV in the carotid-femoral segment. Patients were categorized and analyzed according MetS risk factors clustering (3, 4 and 5 factors) and its combinations.ResultsPatients with MetS had increased PWV when compared to Control (7.8 ± 1.1 vs. 7.0 ± 0.5 m/s, p < 0.001). In multivariate analysis, the variables that remained as predictors of PWV were age (β = 0.450, p < 0.001), systolic blood pressure (β = 0.211, p = 0.023) and triglycerides (β = 0.212, p = 0.037). The increased number of risk factors reflected in a progressive increase in PWV. When adjusted to systolic blood pressure, PWV was greater in the group with 5 risk factors when compared to the group with 3 risk factors and Control (8.5 ± 0.4 vs. 7.5 ± 0.2, p = 0.011 and 7.2 ± 0.3 m/s, p = 0.012). Similarly, the 4 risk factors group had higher PWV than the Control (7.9 ± 0.2 vs. 7.2 ± 0.3, p = 0.047).ConclusionsThe number of risk factors seems to increase arterial stiffness. Notably, besides age and increased systolic blood pressure, alterations in the triglycerides worsened the stiffness of large vessels, emphasizing the importance in addressing this risk factor in MetS patients.
BackgroundThe increasing prevalence of obesity worldwide impacts childhood and adolescence, and this trend points to a significant growth rate of non‐transmissible chronic diseases in the near future. Endothelial dysfunction is an early marker of cardiovascular risk.ObjectiveTo determine a) whether obese adolescents have endothelial dysfunction and b) whether cardiovascular risk factors and obstructive sleep apnea (OSA) are associated with endothelial dysfunction.MethodsWe studied 20 obese adolescents (OA; median age 14 years, 100.9±20.3 kg), post pubescent, sedentary, not following any special diet or receiving any drug treatment, and compared them with 10 lean adolescents (LA, median age 15 years, 54.4±5.3 kg) paired for sex. Metabolic syndrome risk factors (MetS, International Diabetes Federation), vascular function (flow‐mediated dilation, FMD, and Reactive Hyperemia Index, RHI, by peripheral arterial tonometry, EndoPAT®), functional capacity and OSA using the apnea‐hypopnea index (AHI, polysomnography) were assessed.ResultsThe OA presented higher waist (WC) and cervical circumference, as well as higher proportion of body fat, triglycerides, SBP, DBP, LDL‐c and lower HDL‐c than the LA group. In the OA, 35% presented MetS, which was absent in the LA group. OSA was present in 86.6% of the OA and 50% of LA (AHI>1 event/hour). There was no difference between groups in the AHI, VO2 peak and RHI. The OA presented lower FMD than LA (6.17±2.72 vs. 9.37±2.20%, p=0.005). There was an association between FMD and WC (r=−0.506, p=0.008) and FMD and SBP (r=−0.493, p=0.006).ConclusionOSA was observed in most adolescents, regardless of obesity. OA presented MetS and endothelial dysfunction. Increased WC and SBP seem to be involved in this alteration.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.
Studies have shown that excess of fat in central region is the main substrate for pathophysiological alterations that leads obesity‐associated insulin resistance. Lately, in the medical practice the use of the waist circumference (WC) instead waist‐to‐hip ratio (WHR) is more usual. We hypothesized that WHR is a better tool to infer insulin resistance in young obese women. The aim of this study was to evaluate the insulin‐sensitive/insulin‐resistant in young obese women within central and peripheral body fat distribution. We studied 61 young obese women (BMI 30 to 40 kg/m2) with WC ≥ 88 cm and without comorbidities. They were divided into: with central fat distribution (CF), defined as waist‐to‐hip ratio (WHR) ≥ 0.85 cm (n=30, 33±7 y), and with peripheral fat distribution (PF) with WHR < 0.85 cm (n=31, 33±6 y). All volunteers were submitted to anthropometric, glycemic and insulin measurements and indexes: fasting, HOMA‐IR, QUICKI and area under the curve (AUC) during the Oral Glucose Tolerance Test (OGTT) to assess the insulin sensitivity. Despite the fat distribution, CF and PF shown similar anthropometric measures (weight= 86.8±8.5 vs.87.6±8.3 kg, WC= 109±6 vs.106±8 cm, BMI= 33.2±2.7 vs. 33.7±2.4 kg/m2; respectively, p>0.05). Also, both obese groups, CF and PF, showed normal fasting glucose (84±10 vs. 82±10 mg/dL, p=0.420), based in the IDF criteria (<100mg/dL). However, the group CF compared with PF presented elevated fasting insulin (17.8±8.2 vs. 12.6±6.8 uUI/mL, p=0.008), HOMA‐IR (3.7±1.9 vs. 2.6±1.6 uUI/mL, p=0.011), reduced QUICKI (0.322±0.025 vs. 0.340±0.025, p=0.007). Furthermore, the group CF compared with PF had lower insulin sensitivity as AUCglucose/AUCinsulin ratio from OGTT (1.42±0.67 vs. 2.12±0.86, p=0.001). In conclusion, our data demonstrated that in young obese women with similar WC and fasting glucose, the central body fat distribution increase insulin‐resistant, emphasizing the importance in used the waist‐to‐hip ratio as important tool for identify the additional risk factor in obesity young women.Support or Funding Information#Universidade Nove de Julho (UNINOVE), SP ‐ Brazil.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.
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