Microvascular dysfunction: a direct link among BMI, waist circumference and glucose homeostasis in young overweight/obese normoglycemic women?

Abstract

Objective: Capillary recruitment is impaired in obesity (OB), possibly worsening glucose and insulin availability to target organs. In this study, we investigated whether functional microvascular parameters were correlated with clinical-anthropometrical data and whether these parameters would influence OB-related metabolic disorders, especially glucose homeostasis, in young overweight (OW)/obese women. Design: Cross-sectional clinical study of microvascular reactivity in young OW/obese women. Subjects and methods: A total of 10 lean (23.1 ± 3.2 years, body mass index (BMI) 22.3 ± 1.6 kg m À2 ) and 42 OW/obese (24.9±3.5 years; BMI 34.5±5.7 (25.7-46.5) kg m À2 ) sedentary non-smoking women were evaluated. Lipid profile, fasting plasma glucose (PG), post-load PG (75 g-2 h), insulin, C-reactive protein, HOMA-IR (homeostasis model assessment for insulin resistance) index and anthropometric variables (weight, BMI, waist and hip circumferences, waist-to-hip ratio and blood pressure (BP)) were determined. Functional microvascular parameters (functional capillary density, red blood cell velocity at baseline and peak (RBCV max ), and time taken to reach RBCV max (TRBCV max ) during post-occlusive reactive hyperemia after 1 min arterial occlusion) were evaluated by nailfold videocapillaroscopy. Results: The time taken to reach RBCV max was significantly longer in OW/obese patients compared with control subjects (8.6±2.4 versus 5.7±1.1 s, Po0.001), and its delay was directly associated with adiposity levels, systolic BP and insulin resistance, and inversely related to high-density lipoprotein-cholesterol. Post-load PG could be correlated with TRBCV max (R ¼ 0.48, Po0.05) and RBCV max (R ¼ À0.29, Po0.05), and it was influenced by weight, waist circumference and TRBCV max (adjusted R 2 ¼ 24%) as well. Conclusions: In the investigated group of young OW/obese women, the direct correlation between post-load PG and TRBCV max links microvascular parameters with metabolic variables and suggests a key role for microcirculation in OB-related metabolic disorders.

Organic grape juice intake improves functional capillary density and postocclusive reactive hyperemia in triathletes

“…Microcirculatory function is strongly influenced by body mass,17 diabetes, and oxidative status 36. Altered microvascular structures may contribute to insulin resistance by limiting the rate of glucose delivery and insulin-mediated glucose uptake 37.…”

Brazil nuts intake improves lipid profile, oxidative stress and microvascular function in obese adolescents: a randomized controlled trial

“…Nailfold videocapillaroscopy (NVC) was carried out and analyzed according to a standardized, well-validated methodology on the 4 th finger of the left hand [7]. The exam, always made by the same observer who was not aware of any patient data, recorded continuously microvascular parameters for later measurements using the Cap Image software [21].…”

New concepts in microvascular function and metabolic diseases: importance of cephalic phase of insulin response

“…Some aspects that relate microcirculation to metabolic disease are important to consider and are listed as follows: a) not only post-receptor of receptor defects on insulin signaling are involved in insulin resistance, but microvascular dysfunction also plays a role in the pathophysiology of insulin resistance [15][16][17][18][19] and glucose homeostasis, 20 b) impaired capillary recruitment seems to be involved in insulin resistance due to decreased tissue perfusion 18,21 and c) subjects with insulin resistance have microvascular dysfunction even in absence of hyperglycemia. 20,22,23 From these points of view, it is supposed that both metabolic and hemodynamic actions of insulin could be related to the strong associations between vascular diseases and insulin resistant states, such as obesity, metabolic syndrome and/or type 2 diabetes.…”

“…20,22,23 From these points of view, it is supposed that both metabolic and hemodynamic actions of insulin could be related to the strong associations between vascular diseases and insulin resistant states, such as obesity, metabolic syndrome and/or type 2 diabetes.…”