Kose Merve Polat, Piskinpasa Mehmet Emin, Hacioglu Yalcin, Karabag Turgut
Saglik Bilimleri University, Istanbul Education and Research Hospital, Department of Internal Medicine.
Saglik Bilimleri University, Istanbul Education and Research Hospital, Department of Family Medicine.
Rom J Intern Med. 2024 Jul 9;62(4):404-413. doi: 10.2478/rjim-2024-0024. Print 2024 Dec 1.
On the cardiovascular system, obesity accelerates atherosclerosis progression, inducing pathophysiological changes that are detectable already from young adults. Endothelial dysfunction is one of the earliest vascular alterations observed in obesity. In this study, we aimed to determine endothelial functions and carotid intima-media thickness in patients with obesity without overt cardiovascular disease.
The study was conducted with 112 individuals with obesity without overt cardiovascular disease and any chronical diseases (BMI>30 kg/m) (84 female, 28 male, mean age: 46.3±11.2 years) and 49 healthy individuals with no diseases (33 female, 16 male, mean age: 44.6±10.2 years). All patients were examined for endothelial functions by the flow-mediated dilatation (FMD) method and carotid intima-media thicknesses (CIMT). All measurements were performed by the same imaging specialist, averaging 3 different measurements. In addition to the body mass index and waist circumference visceral adiposity index (VAI) and triponderal mass index (TPI) also calculated.
The percentage of FMD obtained by brachial artery ultrasound was significantly lower, visceral adipose tissue, perirenal adipose tissue thicknesses measured by abdominal ultrasound and CIMT were significantly thicker in Group 1 compared to Group 2. FMD had a negative significant correlation with body mass index, visceral adipose tissue thickness, perirenal adipose tissue thickness, and waist and hip circumferences, and carotid intima-media thickness and CIMT had a significant correlation with visceral adipose tissue thickness, perirenal adipose tissue thickness, VAI, TPI and waist, hip circumferences.
Individuals with obesity have impaired endothelial functions and greater carotid intima-media thicknesses compared to healthy individuals. This impairment in endothelial functions is proportional to the amount of visceral and perirenal fat accumulation. Parameterss reflecting visceral fat distribution such as VAI and TPI are also related with these impairment.
在心血管系统方面,肥胖会加速动脉粥样硬化进程,引发从年轻人阶段就可检测到的病理生理变化。内皮功能障碍是肥胖中最早观察到的血管改变之一。在本研究中,我们旨在确定无明显心血管疾病的肥胖患者的内皮功能和颈动脉内膜中层厚度。
该研究纳入了112名无明显心血管疾病及任何慢性疾病的肥胖个体(体重指数>30kg/m²)(84名女性,28名男性,平均年龄:46.3±11.2岁)以及49名无疾病的健康个体(33名女性,16名男性,平均年龄:44.6±10.2岁)。所有患者均通过血流介导的血管舒张(FMD)方法检测内皮功能,并测量颈动脉内膜中层厚度(CIMT)。所有测量均由同一位影像专家进行,对3次不同测量结果取平均值。此外,还计算了体重指数、腰围、内脏脂肪指数(VAI)和三重量指数(TPI)。
与第2组相比,第1组通过肱动脉超声获得的FMD百分比显著更低,腹部超声测量的内脏脂肪组织、肾周脂肪组织厚度以及CIMT显著更厚。FMD与体重指数、内脏脂肪组织厚度、肾周脂肪组织厚度、腰围和臀围呈显著负相关,颈动脉内膜中层厚度和CIMT与内脏脂肪组织厚度、肾周脂肪组织厚度、VAI、TPI以及腰围、臀围呈显著相关。
与健康个体相比,肥胖个体存在内皮功能受损以及更厚的颈动脉内膜中层厚度。内皮功能的这种损害与内脏和肾周脂肪堆积量成正比。反映内脏脂肪分布的参数如VAI和TPI也与这些损害相关。