Laboratory of Experimental Cardiology, Department of Cardiology, Vall d'Hebron Research Institute, Autonomous University of Barcelona, Barcelona, Spain.
Laboratory of Experimental Cardiology, Department of Cardiology, Vall d'Hebron Research Institute, Autonomous University of Barcelona, Barcelona, Spain.
J Mol Cell Cardiol. 2015 Jul;84:154-61. doi: 10.1016/j.yjmcc.2015.04.023. Epub 2015 May 5.
Obesity is a major risk factor for cardiovascular morbidity and mortality. However, some studies suggest that among patients with established cardiovascular disease, obesity is associated with better prognosis, a phenomenon described as the obesity paradox. In this study we tested the hypothesis that obesity with hyperinsulinemia and without hyperglycemia attenuates the impact of transient coronary occlusion on left ventricular remodeling and function. B6D2F1 mice from both genders fed with a high fat diet (HFD) or control diet for 6 months were subjected to 45 min of coronary occlusion and 28 days of reperfusion. Left ventricular dimensions and function were assessed by serial echocardiography, and infarct size was determined by Picrosirius red staining. HFD mice developed obesity with hypercholesterolemia and hyperinsulinemia in the absence of hyperglycemia or hypertension. During the period of feeding, no changes were observed in ventricular mass, volume or function, or in vascular reactivity. HFD attenuated the consequences of transient coronary occlusion as shown by a marked reduction in infarct size (51%, P = 0.021) and cardiac dilation, as well as improved left ventricular function as compared to control diet animals. These effects were associated with enhanced reperfusion injury salvage kinases (RISK) pathway function in HFD hearts shown as increased Akt and GSK3β phosphorylation. These results demonstrate that dietary obesity without hyperglycemia or hypertension attenuates the impact of ischemia/reperfusion injury in association with increased insulin signaling and RISK activation. This study provides experimental support to the controversial concept of the obesity paradox in humans.
肥胖是心血管发病率和死亡率的一个主要危险因素。然而,一些研究表明,在已患有心血管疾病的患者中,肥胖与更好的预后相关,这种现象被描述为肥胖悖论。在这项研究中,我们检验了这样一个假设,即伴有高胰岛素血症而无高血糖的肥胖症可减轻短暂性冠状动脉闭塞对左心室重构和功能的影响。我们将雌雄两性的 B6D2F1 小鼠用高脂饮食(HFD)或对照饮食喂养 6 个月,然后进行 45 分钟的冠状动脉闭塞和 28 天的再灌注。通过连续超声心动图评估左心室尺寸和功能,并通过 Picrosirius 红染色测定梗死面积。HFD 可导致肥胖症、高胆固醇血症和高胰岛素血症,但无高血糖或高血压。在喂养期间,未观察到心室质量、体积或功能的变化,或血管反应性的变化。HFD 减轻了短暂性冠状动脉闭塞的后果,表现为梗死面积(减少 51%,P = 0.021)和心脏扩张明显减少,以及与对照饮食动物相比左心室功能得到改善。这些作用与 HFD 心脏中再灌注损伤挽救激酶(RISK)途径功能增强有关,表现为 Akt 和 GSK3β 磷酸化增加。这些结果表明,无高血糖或高血压的饮食性肥胖症可减轻缺血/再灌注损伤的影响,与胰岛素信号转导和 RISK 激活增加有关。这项研究为人类肥胖悖论的争议性概念提供了实验支持。