Alvares Thiago Silveira, Pinheiro Vivian, Gomes Tatiane, Murias Juan Manuel, Nogueira Soares Rogerio
Multidisciplinary Center UFRJ-Macaé, Federal University of Rio de Janeiro, Macaé, Rio de Janeiro, Brazil.
College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar.
Am J Physiol Heart Circ Physiol. 2025 Jan 1;328(1):H93-H100. doi: 10.1152/ajpheart.00731.2024. Epub 2024 Dec 2.
Although affecting both sexes, loss of sex hormones and consequently increased risk for cardiovascular disease (CVD) render particular features to vascular aging in females. More importantly, although the female's vasculature is more sensitive to CVD risk factors, CVD is often underdiagnosed in women. In the present study, we investigated vascular function in the arm and leg skeletal muscle microvasculature and conduit artery in young and older females. We also applied a mixed-effect regression analysis to examine the relationship between vascular function and CVD risk factors in women. We showed that the detrimental effects of age in conduit artery vascular function, as assessed by flow-mediated dilation (%FMD), were more evident in the lower limb (older, 2.6 ± 0.5 vs. young, 7.2 ± 0.9%; = 0.0116) compared with the upper limb (older, 5.3 ± 0.5 vs. young, 7.3 ± 0.4%; = 0.175). In addition, we demonstrate that CVD risk factors, mainly plasma lipid levels [very low-density lipoprotein cholesterol (VLDL-c): = 0.415, = 0.007; high-density lipoprotein cholesterol (HDL-c): = 0.313, = 0.024; triglycerides: = 0.422, = 0.006] and insulin sensitivity index [homeostasis model assessment of insulin resistance (HOMA-IR): = 0.635, < 0.001; QUICKI: = 0.792, < 0.001], were exclusively associated with upper limb skeletal muscle microvascular function in older females. In aggregate, our findings provide novel evidence that impairments in conduit artery function in older females are more pronounced in the lower limb vasculature compared with the upper limb. Also, we demonstrate that older women's upper limb microvasculature function may be more susceptible to the impact of CVD risk factors than lower limb microvasculature function and both limb's conduit arteries. Even though the vasculature of older females has been suggested to be more sensitive to the detrimental effects of traditional cardiovascular risk factors, cardiovascular disease in women is often underdiagnosed. We show that aging-associated vascular dysfunction is more evident in the lower limb conduit arteries compared with the upper limb in older women. More importantly, we demonstrate that traditional cardiovascular risk factors were exclusively associated with upper limb skeletal muscle microvascular function in older females.
尽管性激素缺乏会影响两性，但由此导致的心血管疾病（CVD）风险增加使女性血管衰老具有特殊特征。更重要的是，尽管女性的脉管系统对CVD风险因素更敏感，但CVD在女性中常常诊断不足。在本研究中，我们调查了年轻和老年女性手臂和腿部骨骼肌微血管及输送动脉的血管功能。我们还应用混合效应回归分析来研究女性血管功能与CVD风险因素之间的关系。我们发现，通过血流介导的扩张（%FMD）评估，年龄对输送动脉血管功能的有害影响在下肢更为明显（老年组，2.6±0.5 vs. 年轻组，7.2±0.9%；P = 0.0116），而在上肢则不那么明显（老年组，5.3±0.5 vs. 年轻组，7.3±0.4%；P = 0.175）。此外，我们证明CVD风险因素，主要是血浆脂质水平[极低密度脂蛋白胆固醇（VLDL-c）：r = 0.415，P = 0.007；高密度脂蛋白胆固醇（HDL-c）：r = 0.313，P = 0.024；甘油三酯：r = 0.422，P = 0.006]和胰岛素敏感性指数[胰岛素抵抗的稳态模型评估（HOMA-IR）：r = 0.635，P < 0.001；定量胰岛素敏感性检查指数（QUICKI）：r = 0.792，P < 0.001]，仅与老年女性上肢骨骼肌微血管功能相关。总体而言，我们的研究结果提供了新的证据，表明老年女性输送动脉功能的损害在下肢脉管系统中比在上肢更为明显。此外，我们证明老年女性的上肢微血管功能可能比下肢微血管功能和双下肢的输送动脉更容易受到CVD风险因素的影响。尽管有研究表明老年女性的脉管系统对传统心血管风险因素的有害影响更敏感，但女性的心血管疾病常常诊断不足。我们发现，与上肢相比，老年女性下肢输送动脉中与衰老相关的血管功能障碍更为明显。更重要的是，我们证明传统心血管风险因素仅与老年女性上肢骨骼肌微血管功能相关。
