Adverse effects of long-term weight gain on microvascular endothelial function.
Adverse effects of long-term weight gain on microvascular endothelial function.
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DOI：
10.1016/j.orcp.2018.06.008
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发表时间：
2018-09
影响因子：
4.3
通讯作者：
Kullo IJ
中科院分区：
文献类型：
--
作者：
Coutinho T;Turner ST;Kullo IJ
内皮功能障碍是动脉粥样硬化级联反应的第一阶段，与心血管事件独立相关。我们评估了体重、腰围、体脂百分比和瘦体重指数的纵向变化与内皮功能变化的关系。521名社区受试者属于高血压同胞，无心肌梗死或卒中病史，他们的人体测量和内皮功能评估平均间隔8.5年。通过肱动脉超声评估内皮功能，测量血流介导的扩张和反应性充血。我们使用多变量线性回归和广义估计方程来评估人体测量指标的纵向变化（Δ）与Δ血流介导的扩张和反应性充血的相关性，调整潜在的混杂因素。平均±标准差年龄为57.6±8.7岁，58%为女性，72%为高血压。大多数（84%）在基线时超重或肥胖。随访结束时，血流介导的扩张和反应性充血平均分别增加1.9±7.6%和51.2±605.8%。在多变量线性回归中，人体测量指标的变化与血流介导的扩张变化无关。然而，Δ重量（β±SE：Δ腰围（−6.78±2.21）和Δ体脂百分比（−19.72±5.62，P<0.0001）与Δ反应性充血呈负相关。Δ瘦体重指数与Δ反应性充血无关。在无心血管事件史的受试者中，体重、腰围和体脂百分比的长期增加与微血管内皮功能进行性恶化相关，但与导管血管内皮功能无关，与风险因素无关。
Endothelial dysfunction is the first stage of the atherosclerotic cascade, and independently associated with cardiovascular events. We evaluated the associations of longitudinal changes in weight, waist circumference, body fat percentage and lean mass index with changes in endothelial function. 521 community-based subjects who belonged to hypertensive sibships and had no history of myocardial infarction or stroke had their anthropometric measures and endothelial function assessed a mean of 8.5 years apart. Endothelial function was assessed with brachial artery ultrasound, yielding measures of flow-mediated dilation and reactive hyperemia. We used multivariable linear regression with generalized estimating equations to assess the associations of longitudinal changes (Δ) in anthropometric measures with Δ flow-mediated dilation and reactive hyperemia, adjusting for potential confounders. Mean ± standard deviation age was 57.6±8.7 years, 58% were women, and 72% were hypertensive. Most (84%) were overweight or obese at baseline. At end of follow-up, flow-mediated dilation and reactive hyperemia increased by 1.9±7.6% and 51.2±605.8% on average, respectively. In multivariable linear regression, changes in anthropometric measures were not associated with changes in flow-mediated dilation. However, Δ weight (β±SE: −9.00±2.35), Δ waist circumference (−6.78±2.21) and Δ body fat percentage (−19.72±5.62, P<0.0001 for each) were inversely associated with Δ reactive hyperemia. Δ lean mass index was not associated with Δ reactive hyperemia. Long-term increases in weight, waist circumference and body fat percentage are associated with progressive worsening of microvascular endothelial function, but not conduit vessel endothelial function, in subjects without a history of cardiovascular events, independently of risk factors.
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影响因子：
20.1
作者：
Sansbury BE;Cummins TD;Tang Y;Hellmann J;Holden CR;Harbeson MA;Chen Y;Patel RP;Spite M;Bhatnagar A;Hill BG
通讯作者：
Hill BG
影响因子：
7.6
作者：
BARON, RM;KENNY, DA
通讯作者：
KENNY, DA
影响因子：
24
作者：
Coutinho, Thais;Goel, Kashish;Lopez-Jimenez, Francisco
通讯作者：
Lopez-Jimenez, Francisco
影响因子：
4.9
作者：
Sheehan, TJ;DuBrava, S;Fang, Z
通讯作者：
Fang, Z
影响因子：
3.6
作者：
DEURENBERG, P;WESTSTRATE, JA;SEIDELL, JC
通讯作者：
SEIDELL, JC