Oflaz H, Ozbey N, Mantar F, Genchellac H, Mercanoglu F, Sencer E, Molvalilar S, Orhan Y
Department of Cardiology, Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Diabetes Nutr Metab. 2003 Jun;16(3):176-81.
The aim of this study was to determine the associations between vascular endothelial function, intima-media thickness (IMT) of the common carotid artery and anthropometric/metabolic parameters in healthy obese women without obesity-related metabolic complications and age-matched healthy lean controls. Twenty-four obese [body mass index (BMI) > 30 kg/m2; age 31.4 +/- 7.4 yr] and 14 lean (BMI < 24 kg/m2; age 30.5 +/- 7.2 yr) women were studied. All of the subjects had normolipemia. Insulin resistance was calculated according to the homeostasis model assessment (HOMA) formula. Endothelial function was measured by flow-mediated dilation (FMD) of the brachial artery. IMT of the common carotid artery was calculated from high-resolution ultrasound imaging of the two common carotid arteries. Obese and lean women were matched with respect to age, smoking status, blood pressure, glucose, insulin concentrations and HOMA. IMT of common carotid artery was significantly higher (0.56 +/- 0.09 vs 0.45 +/- 0.06 mm, p < 0.001) and FMD (percentage of change from baseline) was significantly lower (13.3 +/- 6.5% vs 25.2 +/- 13.9%,p < 0.001) in the obese subjects. Lipid profile, blood pressure, indirect measurement of insulin resistance, leptin concentrations and anthropometric parameters did not predict the FMD or IMT in the obese and lean groups. It is concluded that even in healthy obese women with a normal metabolic profile, deterioration in endothelial function and early atherosclerotic changes are evident compared with healthy lean counterparts. Some undetermined factors in our study other than obesity-related well-known risk factors could be responsible for this observation.
本研究的目的是确定无肥胖相关代谢并发症的健康肥胖女性以及年龄匹配的健康瘦女性中,血管内皮功能、颈总动脉内膜中层厚度(IMT)与人体测量学/代谢参数之间的关联。研究了24名肥胖女性[体重指数(BMI)>30 kg/m2;年龄31.4±7.4岁]和14名瘦女性(BMI<24 kg/m2;年龄30.5±7.2岁)。所有受试者均血脂正常。根据稳态模型评估(HOMA)公式计算胰岛素抵抗。通过肱动脉的血流介导的血管舒张(FMD)来测量内皮功能。颈总动脉的IMT由两条颈总动脉的高分辨率超声成像计算得出。肥胖和瘦女性在年龄、吸烟状况、血压、血糖、胰岛素浓度和HOMA方面进行了匹配。肥胖受试者的颈总动脉IMT显著更高(0.56±0.09 vs 0.45±0.06 mm,p<0.001),而FMD(相对于基线的变化百分比)显著更低(13.3±6.5% vs 25.2±13.9%,p<0.001)。在肥胖和瘦人群组中,血脂谱、血压、胰岛素抵抗的间接测量、瘦素浓度和人体测量学参数均不能预测FMD或IMT。得出的结论是,即使在代谢状况正常的健康肥胖女性中,与健康瘦女性相比,内皮功能恶化和早期动脉粥样硬化变化也很明显。除了肥胖相关的已知危险因素外,我们研究中的一些未确定因素可能导致了这一观察结果。