Avaliação da função microvascular sistêmica em indivíduos com obesidade metabolicamente saudável
Avaliação da função microvascular sistêmica em indivíduos com obesidade metabolicamente saudável
Data
2022
Autores
Araujo, Silas Escobar
Journal Title
Journal ISSN
Volume Title
Publisher
instituto Nacional de Cardiologia
Resumo
Introdução: A obesidade é considerada um dos fatores de risco para doenças
cardiovasculares. No entanto, nem todos os indivíduos com obesidade apresentam
o mesmo risco cardiovascular. Indivíduos com obesidade metabolicamente saudável
(ObMS) parecem ter risco cardiovascular intermediário entre indivíduos eutróficos
metabolicamente saudáveis (EMS) e indivíduos com obesidade metabolicamente
não saudável (ObMNS). Sabe-se que a disfunção endotelial constitui uma etapa
inicial do processo aterosclerótico. Entretanto, pouco tem sido estudado sobre
a função endotelial nos indivíduos ObMS. Objetivo: Este estudo tem por
objetivo investigar o impacto da obesidade metabolicamente saudável na
microcirculação. Métodos: Realizado estudo transversal observacional com 111
voluntários (média de idade 33,2±7,6 anos) sem doença cardiovascular prévia. Os
indivíduos foram classificados em três grupos fenotípicos: EMS (n=32), ObMS
(n=24) e ObMNS (n=55). Os dados coletados e analisados foram: informações
clínicas e demográficas; medidas antropométricas e bioimpedância; avaliação
do perfil metabólico; avaliação da densidade capilar; medida da pressão arterial;
avaliação da reatividade microvascular. O desfecho primário avaliado foi o
aumento da condutância vascular cutânea induzido por acetilcolina (CVC ACh picobasal)
que representa a vasodilatação dependente de endotélio. Resultados: A
CVC ACh pico-basal nos grupos EMS, ObMS e ObMNS foram, respectivamente:
0,24±0,17 UAP/mmHg, 0,23±0,19 UAP/mmHg e 0,30±0,20 UAP/mmHg; p=0,18. O
grupo ObMNS apresentou menor fluxo microvascular basal em relação ao grupo EMS
(CVC basal: EMS 0,33±0,12 UAP/mmHg vs. ObMS 0,30±0,10 UAP/mmHg vs. ObMNS
0,25±0,20 UAP/mmHg; p=0,005). A densidade capilar cutânea média nos grupos
EMS, ObMS e ObMNS foram, respectivamente: 70±14 capilares/mm², 73±16 capilares/mm²
e 68±19 capilares/mm²; p=0,57. Conclusões: A reatividade microvascular dependente
e independente de endotélio, assim como a densidade capilar e o recrutamento capilar
foram estatisticamente semelhantes entre os indivíduos com ObMS, com ObMNS
e EMS na população estudada. Indivíduos com ObMNS apresentaram menor fluxo
microvascular sistêmico basal em comparação com indivíduos EMS no presente estudo.
Palavras-chave: Obesidade metabolicamente benigna; Microcirculação; Rarefação
microvascular.
Background: Obesity is considered one of the risk factors for cardiovascular disease. However, not all individuals with obesity have the same cardiovascular risk. Individuals with metabolically healthy obesity (MHO) appear to have an intermediate cardiovascular risk between metabolically healthy normal weight (MHNW) and metabolically unhealthy obese individuals (MUO). It is known that endothelial dysfunction constitutes an initial stage of the atherosclerotic process. However, little has been studied about endothelial function in MHO individuals. Objective: This study aims to investigate the impact of metabolically healthy obesity on microcirculation. Methods: An observational cross-sectional study was carried out with 111 volunteers (mean age 33.2±7.6 years) without previous cardiovascular disease. Individuals were classified into three phenotypic groups: MHNW (n=32), MHO (n=24) and MUO (n=55). The data collected and analyzed were: clinical and demographic information; anthropometric measurements and bioimpedance; assessment of the metabolic profile; evaluation of capillary density; blood pressure measurement; assessment of microvascular reactivity. The primary endpoint assessed was acetylcholine-induced increase in cutaneous vascular conductance (peak-basal CVC ACh) which represents endothelium-dependent vasodilation. Results: The peak-basal CVC ACh in the MHNW, MHO and MUO groups were respectively: 0.24±0.17 AUP/mmHg, 0.23±0.19 AUP/mmHg and 0.30±0.20 AUP/mmHg; p=0.18. The MUO group had lower baseline microvascular flow compared to the MHNW group (baseline CVC: MHNW 0.33±0.12 AUP/mmHg vs. MHO 0.30±0.10 AUP/mmHg vs. MUO 0.25±0.20 AUP/mmHg; p=0.005). The mean cutaneous capillary density in the MHNW, MHO and MUO groups were respectively: 70±14 capillaries/mm², 73±16 capillaries/mm² and 68±19 capillaries/mm²; p=0.57. Conclusions: Endothelium-dependent and endothelium-independent microvascular reactivity, as well as capillary density and capillary recruitment were statistically similar between subjects with MHO, with MUO and with MHNW in the study population. Subjects with MUO had lower baseline systemic microvascular flow compared with subjects MHNW in the present study. Keywords: Obesity, metabolically benign; Microcirculation; Microvascular rarefaction.
Background: Obesity is considered one of the risk factors for cardiovascular disease. However, not all individuals with obesity have the same cardiovascular risk. Individuals with metabolically healthy obesity (MHO) appear to have an intermediate cardiovascular risk between metabolically healthy normal weight (MHNW) and metabolically unhealthy obese individuals (MUO). It is known that endothelial dysfunction constitutes an initial stage of the atherosclerotic process. However, little has been studied about endothelial function in MHO individuals. Objective: This study aims to investigate the impact of metabolically healthy obesity on microcirculation. Methods: An observational cross-sectional study was carried out with 111 volunteers (mean age 33.2±7.6 years) without previous cardiovascular disease. Individuals were classified into three phenotypic groups: MHNW (n=32), MHO (n=24) and MUO (n=55). The data collected and analyzed were: clinical and demographic information; anthropometric measurements and bioimpedance; assessment of the metabolic profile; evaluation of capillary density; blood pressure measurement; assessment of microvascular reactivity. The primary endpoint assessed was acetylcholine-induced increase in cutaneous vascular conductance (peak-basal CVC ACh) which represents endothelium-dependent vasodilation. Results: The peak-basal CVC ACh in the MHNW, MHO and MUO groups were respectively: 0.24±0.17 AUP/mmHg, 0.23±0.19 AUP/mmHg and 0.30±0.20 AUP/mmHg; p=0.18. The MUO group had lower baseline microvascular flow compared to the MHNW group (baseline CVC: MHNW 0.33±0.12 AUP/mmHg vs. MHO 0.30±0.10 AUP/mmHg vs. MUO 0.25±0.20 AUP/mmHg; p=0.005). The mean cutaneous capillary density in the MHNW, MHO and MUO groups were respectively: 70±14 capillaries/mm², 73±16 capillaries/mm² and 68±19 capillaries/mm²; p=0.57. Conclusions: Endothelium-dependent and endothelium-independent microvascular reactivity, as well as capillary density and capillary recruitment were statistically similar between subjects with MHO, with MUO and with MHNW in the study population. Subjects with MUO had lower baseline systemic microvascular flow compared with subjects MHNW in the present study. Keywords: Obesity, metabolically benign; Microcirculation; Microvascular rarefaction.
Description
Palavras-chave
Obesidade metabolicamente benigna, Microcirculação, Rarefação
microvascular, Obesity, metabolically benign, Microcirculation, Microvascular rarefaction
Citação
Araujo SE. Avaliação da função microvascular sistêmica em indivíduos com obesidade metabolicamnete saudável. Dissertação [Mestrado Profissional em Ciências Cardiovasculares]. Instituto Nacional de Cardiologia; 2022.