Obesity, weight loss, and vascular function

被引:45
作者
Brook, RD [1 ]
机构
[1] Univ Michigan, Div Cardiovasc Med, Ann Arbor, MI 48109 USA
关键词
endothelium; obesity; vascular function; cardiovascular risk;
D O I
10.1385/ENDO:29:1:21
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Obesity promotes the development of several major cardiovascular risk factors. Moreover, excess adiposity may play a direct role in initiating atherosclerosis as fat cells are capable of affecting the systemic vasculature through a variety of mechanisms. Recent studies demonstrate that obesity per se may impair vascular endothelial function. This is important as endothelial dysfunction is a key factor in the pathogenesis of atherosclerosis and in triggering acute ischemic events. At present, few studies have determined the beneficial impact of weight loss on cardiovascular outcomes and mortality. However, several experiments have demonstrated that weight loss can lead to improvements in endothelial function, a validated surrogate marker of cardiovascular risk. The mechanisms whereby weight loss restores vascular health are likely multifactorial. However, the relative importance of reduced adiposity versus the specific dietary regimens prescribed, the role of concomitant exercise, and the direct effect of medications remain unclear. Several other unresolved issues such as the longevity of improvement, the amount of weight loss required, and whether the improvement in endothelial function actually translates into a reduction in cardiovascular events also remain to be determined. Nevertheless, lifestyle changes that lead to weight reduction are able to improve vascular function in overweight adults.
引用
收藏
页码:21 / 25
页数:5
相关论文
共 33 条
[1]   Obesity is independently associated with coronary endothelial dysfunction in patients with normal or mildly diseased coronary arteries [J].
Al Suwaidi, J ;
Higano, ST ;
Holmes, DR ;
Lennon, R ;
Lerman, A .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2001, 37 (06) :1523-1528
[2]   Body fat distribution predicts the degree of endothelial dysfunction in uncomplicated obesity [J].
Arcaro, G ;
Zamboni, M ;
Rossi, L ;
Turcato, E ;
Covi, G ;
Armellini, F ;
Bosello, O ;
Lechi, A .
INTERNATIONAL JOURNAL OF OBESITY, 1999, 23 (09) :936-942
[3]   Lowering of LDL cholesterol rather than moderate weight loss improves endothelium-dependent vasodilatation in obese women with previous gestational diabetes [J].
Bergholm, R ;
Tiikkainen, M ;
Vehkavaara, S ;
Tamminen, M ;
Teramo, K ;
Rissanen, A ;
Yki-Järvinen, H .
DIABETES CARE, 2003, 26 (06) :1667-1672
[4]   Effect of short-term weight loss on the metabolic syndrome and conduit vascular endothelial function in overweight adults [J].
Brook, RD ;
Bard, RL ;
Glazewski, L ;
Kehrer, C ;
Bodary, PF ;
Eitzman, DL ;
Rajagopalan, S .
AMERICAN JOURNAL OF CARDIOLOGY, 2004, 93 (08) :1012-1016
[5]   Usefulness of visceral obesity (waist/hip ratio) in predicting vascular endothelial function in healthy overweight adults [J].
Brook, RD ;
Bard, RL ;
Rubenfire, M ;
Ridker, PM ;
Rajagopalan, S .
AMERICAN JOURNAL OF CARDIOLOGY, 2001, 88 (11) :1264-1269
[6]   Long-term consequences of body mass index for cardiovascular mortality: The Chicago Heart Association Detection Project in Industry Study [J].
Dyer, AR ;
Stamler, J ;
Garside, DB ;
Greenland, P .
ANNALS OF EPIDEMIOLOGY, 2004, 14 (02) :101-108
[7]   Association of intentional changes in body weight with coronary heart disease event rates in overweight subjects who have an additional coronary risk factor [J].
Ellat-Adar, S ;
Eldar, M ;
Goldbourt, U .
AMERICAN JOURNAL OF EPIDEMIOLOGY, 2005, 161 (04) :352-358
[8]   Effect of a Mediterranean-style diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome - A randomized trial [J].
Esposito, K ;
Marfella, R ;
Ciotola, M ;
Di Palo, C ;
Giugliano, F ;
Giugliano, G ;
D'Armiento, M ;
D'Andrea, F ;
Giugliano, D .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2004, 292 (12) :1440-1446
[9]   Early upregulation of endothelial adhesion molecules in obese hypertensive men [J].
Ferri, C ;
Desideri, G ;
Valenti, M ;
Bellini, C ;
Pasin, M ;
Santucci, A ;
De Mattia, G .
HYPERTENSION, 1999, 34 (04) :568-573
[10]   Metabolic syndrome and endothelial dysfunction [J].
Fornoni, A ;
Raij, L .
CURRENT HYPERTENSION REPORTS, 2005, 7 (02) :88-95