Ounis-Skali Nadia, Bentley-Lewis Rhonda, Mitchell Gary F, Solomon Scott, Seely Ellen W
Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
J Am Soc Hypertens. 2007 Sep-Oct;1(5):341-6. doi: 10.1016/j.jash.2007.06.004.
Obesity is a known risk factor for cardiovascular disease (CVD) but the mechanism by which obesity contributes to cardiovascular risk is not well understood. Arterial stiffness is a CVD risk factor associated with obesity. We studied 16 obese body mass index (BMI > 30) and 10 lean (BMI < 25) healthy premenopausal women. We measured fasting glucose, insulin, and lipids, blood pressure, and arterial tonometry to assess arterial stiffness. Obese women had higher glucose, insulin, total cholesterol and triglyceride levels, blood pressures, cardiac output, and peak flow. Characteristic impedance was lower (146 +/- 31 [(dyne . s) . cm(-5)] vs. 187 +/- 48 [(dyne . s) . cm(-5)]; P = .01), aortic diameter was greater (2.54 +/- 0.20 cm vs. 2.29 +/- 0.21 cm; P < .01), and peripheral pulse pressure was similar in obese compared with lean women. Obesity in premenopausal women is associated with increased cardiac output and peak aortic flow. Increased aortic diameter in obese women was associated with reduced characteristic impedance, potentially preventing an increase in peripheral pulse pressure despite elevated flow, which suggests proximal aortic remodeling. When aortic remodeling and compensation for increased hemodynamic demands are limited by environmental or genetic interference, hypertension or CVD may result.
肥胖是已知的心血管疾病（CVD）风险因素，但肥胖导致心血管风险的机制尚不完全清楚。动脉僵硬度是与肥胖相关的心血管疾病风险因素。我们研究了16名肥胖（体重指数>30）和10名瘦（体重指数<25）的健康绝经前女性。我们测量了空腹血糖、胰岛素、血脂、血压和动脉张力测量法以评估动脉僵硬度。肥胖女性的血糖、胰岛素、总胆固醇和甘油三酯水平、血压、心输出量和峰值流量更高。特征阻抗更低（146±31[（达因·秒）·厘米⁻⁵] 对比 187±48[（达因·秒）·厘米⁻⁵]；P = 0.01），主动脉直径更大（2.54±0.20厘米 对比 2.29±0.21厘米；P < 0.01），与瘦女性相比，肥胖女性的外周脉压相似。绝经前女性肥胖与心输出量增加和主动脉峰值血流增加有关。肥胖女性主动脉直径增加与特征阻抗降低有关，这可能阻止了外周脉压的增加，尽管血流量增加，这提示近端主动脉重塑。当主动脉重塑和对增加的血流动力学需求的代偿受到环境或遗传干扰限制时，可能会导致高血压或心血管疾病。
