The influence of obesity on calf blood flow and vascular reactivity in older adults

Luke S Acree, Philip C Comp, Thomas L Whitsett, Polly S Montgomery, Kevin J Nickel, Anette S Fjeldstad, Cecilie Fjeldstad, Andrew W Gardner, Luke S Acree, Philip C Comp, Thomas L Whitsett, Polly S Montgomery, Kevin J Nickel, Anette S Fjeldstad, Cecilie Fjeldstad, Andrew W Gardner

Abstract

Objective: To determine whether differences in vascular reactivity existed among normal weight, overweight, and obese older men and women, and to examine the association between abdominal fat distribution and vascular reactivity.

Methods: Eighty-seven individuals who were 60 years of age or older (age = 69 +/- 7 yrs; mean +/- SD) were grouped into normal weight (BMI < 25; n = 30), overweight (BMI > or = 25 and < 30; n = 28), or obese (BMI > or = 30; n = 29) categories. Calf blood flow (BF) was assessed by venous occlusion strain-gauge plethysmography at rest and post-occlusive reactive hyperemia.

Results: Post-occlusive reactive hyperemia BF was lower (p = 0.038) in the obese group (5.55 +/- 4.67%/min) than in the normal weight group (8.34 +/- 3.89%/min). Additionally, change in BF from rest to post-occlusion in the obese group (1.93 +/- 2.58%/min) was lower (p = 0.001) than in the normal weight group (5.21 +/- 3.59%/min), as well as the percentage change (75 +/- 98% vs. 202 +/- 190%, p = 0.006, respectively). After adjusting for age, prevalence in hypertension and calf skinfold thickness, change in BF values remained lower (p < 0.05) in obese subjects compared to the normal weight subjects. Lastly, the absolute and percentage change in BF were significantly related to BMI (r = -0.44, p < 0.001, and r = -0.37, p < 0.001, respectively) and to waist circumference (r = -0.36, p = 0.001, and r = -0.32, p = 0.002).

Conclusion: Obesity and abdominal adiposity impair vascular reactivity in older men and women, and these deleterious effects on vascular reactivity are independent of conventional risk factors.

Figures

Figure 1
Figure 1
The relationship between body mass index and the percentage change in calf blood flow from rest to post-occlusive reactive hyperemia (r = -0.37, p

Figure 2

The relationship between waist circumference…

Figure 2

The relationship between waist circumference and percentage change in calf blood flow from…

Figure 2
The relationship between waist circumference and percentage change in calf blood flow from rest to post-occlusive reactive hyperemia (r = -0.32, p = 0.002).
Figure 2
Figure 2
The relationship between waist circumference and percentage change in calf blood flow from rest to post-occlusive reactive hyperemia (r = -0.32, p = 0.002).

References

    1. Andreyeva T, Sturm R, Ringel JS. Moderate and severe obesity have large differences in health care costs. Obes Res. 2004;12:1936–1943.
    1. Sturm R. The effects of obesity, smoking, and drinking on medical problems and costs. Health Aff. 2002;21:245–254. doi: 10.1377/hlthaff.21.2.245.
    1. Allison DB, Fontaine KR, Manson JE, Stevens J, VanItallie TB. Annual deaths attributable to obesity in the United States. JAMA. 1999;282:1530–1538. doi: 10.1001/jama.282.16.1530.
    1. Daviglus ML, Liu K, Yan LL, Pirzada A, Manheim L, Manning W, Garside DB, Wang R, Dyer AR, Greenland P, Stamler J. Relation of body mass index in young adulthood and middle age to medicare expenditures in older age. JAMA. 2004;292:2743–2749. doi: 10.1001/jama.292.22.2743.
    1. Freedman DS, Kahn LK, Serdula MK, Galuska DA, Dietz WH. Trends and Correlates of class three obesity in the United States from 1990 through 2000. JAMA. 2002;288:1758–1761. doi: 10.1001/jama.288.14.1758.
    1. Must A, Spadano J, Coakley EH, Field AE, Colditz G, Dietz WH. The disease burden associated with overweight and obesity. JAMA. 1999;282:1523–1529. doi: 10.1001/jama.282.16.1523.
    1. Suwaidi JA, Higano ST, Holmes DR, Lennon R, Lerman A. Obesity is independently associated with coronary endothelial dysfunction in patients with normal or mildly diseased coronary arteries. J Am Coll Cardiol. 2001;27:1523–1528. doi: 10.1016/S0735-1097(01)01212-8.
    1. Perticone F, Ceravolo R, Candigliota M, Ventura G, Iacopino S, Sinopoli F, Mattioli PL. Obesity and body fat distribution induce endothelial dysfunction by oxidative stress: protective effect of vitamin C. Diabetes. 2001;50:159–165. doi: 10.2337/diabetes.50.1.159.
    1. Luscher TF, Tanner FC, Tschudi MR, Noll G. Endothelial dysfunction in coronary artery disease. Ann Rev Med. 1993;44:395–418. doi: 10.1146/annurev.me.44.020193.002143.
    1. Petrofsky JS, Bweir SM, Lee S, Libarona M. Does local heating really help diabetic patients increase circulation. J Orthop Neuro Surg. 2003;21:40–46.
    1. Petrofsky J, Lee S, Cuneo M. Effects of aging and type 2 diabetes on resting and post occlusive hyperemia of the forearm; the impact of rosiglitazone. BMC Endocrine Disorders. 2005;5:4. doi: 10.1186/1472-6823-5-4.
    1. Hodge AM, Zimmet PZ. The epidemiology of obesity. J Clin Endocrinol Metab. 1994;8:577–599.
    1. Kingwell BA, Formosa M, Muhlmann M, Bradley SJ, McConell GK. Type 2 diabetic individuals have impaired leg blood flow responses to exercise. Diabetes Care. 2003;26:899–904. doi: 10.2337/diacare.26.3.899.
    1. World Health Organization . Obesity: Preventing and managing the global epidemic. Report of a WHO consultation on obesity. Geneva, World Health Org; 1998.
    1. Flegal KM, Carroll MD, Ogden CL, Johnson CL. Prevalence and trends in obesity among US adults, 1999–2000. JAMA. 2002;288:1723–1727. doi: 10.1001/jama.288.14.1723.
    1. Sciacqua A, Candigliota M, Ceravolo R, Scozzafava A, Sinopoli F, Corsonello A, Sesti G, Perticone F. Weight loss in combination with physical activity improves endothelial dysfunction in human obesity. Diabetes Care. 2003;26:1673–1678. doi: 10.2337/diacare.26.6.1673.
    1. Gardner AW, Killewich LA, Katzel LI, Womack CJ, Montgomery PS, Otis RB, Fonong T. Relationship between free-living daily physical activity and peripheral circulation in patients with intermittent claudication. Angiology. 1999;50:289–97.
    1. Weitz JI, Byrne J, Clagett GP, Farkouh ME, Porter JM, Sackett DL, Strandness DE, Jr, Taylor LM. Diagnosis and treatment of chronic arterial insufficiency of the lower extremities: a critical review. Circulation. 1996;94:3026–49.
    1. Expert Panel Executive summary of the clinical guidelines on the identification, evaluation, and treatment of overweight an obesity in adults. Arch Intern Med. 1998;158:1855–1867. doi: 10.1001/archinte.158.17.1855.
    1. Gardner AW, Simeminski DJ, Killewich LA. The effect of cigarette smoking on free-living daily physical activity in older claudication patients. Angiology. 1997;48:947–955.
    1. Brook RD, Bard RL, Rubenfire M, Ridker PM, Rajagopalan S. Usefulness of visceral obesity (waist to hip ratio) in predicting vascular endothelial function in healthy overweight adults. Am J Cardiol. 2001;88:1264–1269. doi: 10.1016/S0002-9149(01)02088-4.
    1. Baldeweg SE, Pink AM, Yudkin JS, Coppack SW. The relationship between obesity, vascular reactivity and endothelial dysfunction in subjects with non-insulin dependent diabetes mellitus. Int J Obes. 2000. pp. S134–S135.
    1. Martin WH, Ogawa T, Kohrt WM, Malley MT, Korte E, Kieffer PS, Schechtman KB. Effects of aging, gender, and physical training on peripheral vascular function. Circulation. 1991;84:654–664.
    1. Olive JL, DeVan AE, McCully KK. The effects of aging and activity on muscle blood flow. Dyn Med. 2002;1:2. doi: 10.1186/1476-5918-1-2.
    1. McVeigh GE, Brennan GM, Johnston GD, McDermott BJ, McGrath LT, Henry WR, Andrews JW, Hayes JR. Impaired endothelium-dependent and independent vasodilation in patients with type 2 (non-insulin dependent) diabetes mellitus. Diabetologia. 1992;35:771–776.
    1. Taddei S, Virdis A, Ghiadoni L, Magagna A, Salvetti A. Vitamin C improves endothelium-dependent vasodilation by restoring nitric oxide activity in essential hypertension. Circulation. 1998;97:2222–2229.
    1. Ting HH, Timini FK, Haley EA, Roddy MA, Ganz P, Creager MA. Vitamin C improves endothelium-dependent vasodilation in forearm resistance vessels of humans with hypercholesterolemia. Circulation. 1997;95:2617–2622.
    1. Gerhard M, Roddy M, Creager S, Creager M. Aging progressively impairs endothelium-dependent vasodilation in forearm resistance vessels of humans. Hypertension. 1996;27:849–853.
    1. DeSouza CA, Shapiro LF, Clevenger CM, Dinenno FA, Monahan KD, Tanaka H, Seals DR. Regular aerobic exercise prevents and restores age-related declines in endothelium-dependent vasodilation in healthy men. Circulation. 2000;102:1351–1357.
    1. Hamdy O, Ledbury S, Mullooly C, Jarema C, Porter S, Ovalle K, Moussa A, Caselli A, Caballero AE, Economides PA, Veves A, Horton ES. Lifestyle modification improves endothelial function in obese subjects with the insulin resistance syndrome. Diabetes Care. 2003;26:2119–2125. doi: 10.2337/diacare.26.7.2119.
    1. Heitzer T, Just H, Muszel T. Antioxidant vitamin C improves endothelial dysfunction in chronic smokers. Circulation. 1996;94:6–9.
    1. Hashimoto M, Akishita M, Eto M, Kozaki K, Ako J, Sugimoto N, Yoshizumi M, Toba K, Ouchi Y. The impairment of flow-mediated vasodilatation in obese men with visceral fat accumulation. Int J Obes. 1998;22:477–484. doi: 10.1038/sj.ijo.0800620.
    1. Yudkin JS. Adipose tissue, insulin action and vascular disease: inflammatory signals. Int J Obes. 2003;27:S25–S28. doi: 10.1038/sj.ijo.0802496.
    1. Ziccardi P, Nappo F, Biugliano G, Esposito K, Marfella R, Cioffi M, D'Andrea F, Molinari AM, Giugliano D. Reduction of inflammatory cytokine concentrations and improvement of endothelial functions in obese women after weight loss over one year. Circulation. 2002;105:804–809. doi: 10.1161/hc0702.104279.

Source: PubMed

Szponzorok és közreműködők

Egészségi állapot

Kábítószer-beavatkozások

3
Iratkozz fel