The presence of abdominal obesity is associated with changes in vascular function independently of other cardiovascular risk factors

• Published in: International journal of cardiology 2010-02, Vol.139 (1), p.32-41
• Main Authors: Rueda-Clausen, Christian F, Lahera, Vicente, Calderón, Jaime, Bolivar, Isabel Cristina, Castillo, Victor R, Gutiérrez, Melquisedec, Carreño, Marisol, Oubiña, Maria del Pilar, Cachofeiro, Victoria, López-Jaramillo, Patricio
• Format: Article
• Language: English
• Subjects: Abdominal obesity; Adiponectin; Adiponectin - blood; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Biomarkers - blood; Blood and lymphatic vessels; Blood Glucose; Cardiology. Vascular system; Cardiovascular; Coronary Artery Bypass - statistics & numerical data; Coronary artery bypass graft; Coronary Artery Disease - epidemiology; Coronary Artery Disease - metabolism; Coronary Artery Disease - surgery; Coronary heart disease; Female; Heart; Humans; Inflammation; Insulin - blood; Insulin Resistance; Internal mammary artery; Leptin; Leptin - blood; Lipids - blood; Male; Mammary Arteries - transplantation; Medical sciences; Metabolic diseases; Middle Aged; Multivariate Analysis; Obesity; Obesity, Abdominal - epidemiology; Obesity, Abdominal - metabolism; Risk Factors; Severity of Illness Index; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Vascular reactivity; Vasoconstriction - physiology
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2008.09.005

Abstract Background Because of the strong association between abdominal obesity (AO) and other cardiovascular risk factors, it has been difficult to determine which changes in vascular function are directly related to this condition. Our objective was to evaluate the changes in ex-vivo vascular reactivity, circulating levels of adipokines and inflammatory markers associated with the presence of AO in subjects who underwent coronary artery bypass graft (CABG) controlling by the presence of other cardiovascular risk factors. Methods Subjects scheduled for a CABG with ( n = 17) and without ( n = 17) AO (defined as a waist circumference ≥ 90 cm for male or ≥ 80 cm for female) whom were matched by several cardiovascular risk factors, were included in the study. Lipid profile and plasma levels of glucose, insulin, leptin, adiponectin and inflammatory markers were measured. Internal mammary artery segments were used for ex-vivo vascular reactivity experiments and morphometry. Results Leptin concentrations were higher and adiponectin concentrations were lower in subjects with AO. No differences were observed in other biochemical or clinical parameters between the groups. No correlation between waist circumference, HOMA index and inflammatory markers were observed. Endothelium-dependent relaxation to acetylcholine was lower, and contractile responses to angiotensin-II were higher in subjects with AO. These changes were not related to differences in vascular morphometry. Conclusion In subjects with severe coronary disease, the presence of AO was associated with leptin/adiponectin imbalance, decreased endothelium-dependent relaxation and an enhanced response to angiotensin-II. These changes occurred independently of other cardiovascular risk factors including insulin resistance and levels of inflammatory markers.