A quick look at the noteworthy articles in bariatric and metabolic research
THIS MONTH’S TOPIC: Obesity and Cardiovascular Health
Long-term effects of bariatric surgery on peripheral endothelial function and coronary microvascular function.
Tarzia P, Lanza GA, Sestito A, et al. Obes Res Clin Pract. 2017 Jan 2. [Epub ahead of print]
Synopsis: In this study, the authors assessed whether bariatric surgery maintains its beneficial effect at long-term follow up. They studied 19 patients with morbid obesity (age 43±9 years, 12 women) without any evidence of cardiovascular disease who underwent bariatric surgery, evaluating them before surgery, at three months postoperative, and at 4.0±1.5 years follow up.
They found that peripheral vascular function was assessed by flow-mediated dilation (FMD) and nitrate-mediated dilation (NMD), i.e., brachial artery diameter changes in response to post-ischemic forearm hyperhaemia and to nitroglycerin administration, respectively. Coronary microvascular function was assessed by measuring coronary blood flow (CBF) response to intravenous adenosine and to cold pressor test (CPT) in the left anterior descending coronary artery.
The authors concluded the data show that, in patients with morbid obesity, bariatric surgery exerts beneficial and long lasting effects on peripheral endothelial function and on coronary microvascular dilator function.
The rs7044343 polymorphism of the interleukin 33 gene is associated with decreased risk of developing premature coronary artery disease and central obesity, and could be involved in regulating the production of IL-33.
Angeles-Martínez J, Posadas-Sánchez R, Llorente L, et al. PLoS One. 2017;12(1):e0168828.
Synopsis: The effect of interleukin 33 (IL-33) in the inflammatory process generates significant interest in the potential significance of IL-33 as a biomarker for coronary artery disease (CAD). The researchers sought to analyze whether IL-33 gene polymorphisms are associated with premature CAD in a case-control association study.
They found that the rs7044343 T allele was significantly associated with a diminished risk of premature CAD and central obesity, respectively. When patients were divided into groups with and without type 2 diabetes mellitus (T2DM), the rs7044343 T allele was associated with a reduced risk of premature CAD in patients without and with T2DM.
They concluded that the IL-33 rs7044343 T allele could be a susceptibility marker for premature CAD and central obesity. The rs7044343 polymorphism could be involved in regulating the production of IL-33. PMID: 28045954
Impact of physical activity on cardiovascular status in obesity.
Lind L, Carlsson AC, Siegbahn A, et al. Eur J Clin Invest. 2016 Dec 30. [Epub ahead of print]
Synopsis: The authors have recently shown that being physically active (PA) counteracts, but not eliminates the increased risk of future cardiovascular disease in over-weight and obese subjects. To investigate this further, they studied the impact of having normal weight, overweight, and obese on multiple markers of subclinical cardiovascular disease in relation to physical activity.
At age 70, 1,016 subjects were investigated in the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study. Being PA was defined as performing regular heavy exercise (self-reported). According to body mass index (BMI)/PA-groups, the participants were categorized as PA/normal weight (BMI <25 kg/m2, n=104), non-PA/normal weight (n=234), PA/overweight (BMI 25-29.9 kg/m2 , n=133), non-PA/overweight (n=295), PA/obese (BMI ≥30 kg/m2 , n=54), and non-PA/obese (n=169). Several different measurements of endothelial reactivity and arterial compliance (plethysmography and ultrasound), cartotid artery atherosclerosis and echocardiography were performed and seven markers of coagulation/fibrinolysis were measured.
They found that physically active subjects with obesity showed impaired vasoreactivity in the forearm resistance vessels, increased left ventricular mass and impaired left ventricular systolic and diastolic function, together with impaired coagulation/fibrinolysis when compared to PA/normal weight subjects (p<0.05- <0.001). The majority of these disturbances were seen also in PA/overweight subjects when compared to PA/normal weight subjects (p<0.05- <0.001).
They concluded that their data provide additional support for the notion that an increased level of self-reported physical activity does not fully eliminate the deleterious cardiovascular consequences associated with overweight and obesity.
Is there any relationship between different phenotypes of metabolic syndrome and cardiovascular mortality rate?
Khosravi A, Ahmadzadeh S, Gharipour M, et al. Adv Biomed Res. 2016;5:185.
Synopsis: In this article, the researchers aimed to focus on different phenotypes of metabolic syndrome (MetS) and their impact on the cardiovascular disease (CVD) events among a sample of the Iranian population.
The Isfahan cohort study is a population-based, on-going longitudinal study of adults aged 35 years old or more, living in urban and rural areas of three counties in central Iran namely Isfahan, Najafabad and Arak. Participants were selected by multistage random sampling and were recruited to reflect the age, sex and urban/rural distribution of the community. The sample was restricted to subjects with MetS based on the National Cholesterol Education Program Adult Treatment Panel III criteria and no history of coronary heart disease, stroke, or cancer at the time of the baseline clinical examination.
Among different phenotypes of MetS components, clustering of high triglycerides (TGs), low high-density lipoprotein (HDL) and abdominal obesity (ABO) was the most related to the all-cause mortality among women and followed in order by high TGs, hypertension (HTN) and ABO. In men, the highest rate of all-cause mortality was related to high TGs, low HDL, and HTN. Clustering of four components (high TGs, low HDL and HTN and obesity) is the most related to all-cause mortality in the both sexes (12.1% in men, and 21.5% in women).
They concluded that their study showed different phenotypes of MetS related with all-cause mortality rate and existing HTN in the phenotype of MetS increased the incidence of CVD mortality.
Cardiovascular disease risk in obese adults assessed using established values for cardiorespiratory fitness.
Bostad W, Ricketts TA, Stotz PJ, Ross R. Appl Physiol Nutr Metab. 2017;42(1):93–95.
Synopsis: The present study was designed to assess the risk of cardiovascular disease as determined by cardiorespiratory fitness (CRF) in a large sample of inactive, adults with obesity. Cardiovascular disease risk was determined using published age- and sex-adjusted values for low, moderate, and high CRF from the Aerobics Center Longitudinal Study (ACLS). They found that contrary to expectations, ACLS-CRF classifications identified approximately 60 percent of inactive, obese adults as having moderate or high CRF and hence, low cardiovascular disease risk.