Abstract：
Although many studies have been published on the effect of obesity on large and small arteries, there are no data in the literature regarding the effect of obesity on medium-sized arteries, and in particular of small conduit arteries. The aim of the present study was to investigate whether patients with severe obesity presented structural or functional alterations in different arterial segments.
34 patients with severe obesity (BMI≥35 kg/m2) and 34 age-and sex-matched normal weight patients were recruited as controls. Aortic stiffness (carotid-femoral pulse wave velocity) and wave reflection (augmentation index) were recorded. Ultrasound images of common carotid, radial and interdigital arteries were acquired for the assessment of wall-to-lumen ratio, wall cross-sectional area (WCSA), compliance, distensibility coefficient (DC) and Young\'s elastic modulus (Einc). Insulin sensitivity was calculated by oral glucose sensitivity index (OGIS). No differences between groups in carotid artery remodeling were found, while WCSA of the radial and interdigital arteries were higher in obese group than in controls. As regard the parameters of vascular elasticity, the DC of radial and interdigital arteries were lower (p = 0.025 and p = 0.001, respectively), as well as the Einc of radial arteries was higher (p = 0.021), in subject with obesity compared to controls. All these correlations were consistent after adjustment for the main covariates. Finally, in a multiple regression analysis OGIS was and independent determinant of interdigital artery DC (R2 = 0.29, p = 0.001).
For the first time, we describe an outward remodeling and increased stiffness in small conduit arteries in severe obesity.
34 patients with severe obesity (BMI≥35 kg/m2) and 34 age-and sex-matched normal weight patients were recruited as controls. Aortic stiffness (carotid-femoral pulse wave velocity) and wave reflection (augmentation index) were recorded. Ultrasound images of common carotid, radial and interdigital arteries were acquired for the assessment of wall-to-lumen ratio, wall cross-sectional area (WCSA), compliance, distensibility coefficient (DC) and Young\'s elastic modulus (Einc). Insulin sensitivity was calculated by oral glucose sensitivity index (OGIS). No differences between groups in carotid artery remodeling were found, while WCSA of the radial and interdigital arteries were higher in obese group than in controls. As regard the parameters of vascular elasticity, the DC of radial and interdigital arteries were lower (p = 0.025 and p = 0.001, respectively), as well as the Einc of radial arteries was higher (p = 0.021), in subject with obesity compared to controls. All these correlations were consistent after adjustment for the main covariates. Finally, in a multiple regression analysis OGIS was and independent determinant of interdigital artery DC (R2 = 0.29, p = 0.001).
For the first time, we describe an outward remodeling and increased stiffness in small conduit arteries in severe obesity.
摘要：
目的：尽管已经发表了许多关于肥胖对大动脉和小动脉的影响的研究，文献中没有关于肥胖对中型动脉的影响的数据，特别是小导管动脉。本研究的目的是调查严重肥胖患者是否在不同的动脉段出现结构或功能改变。
结果：招募了34例重度肥胖（BMI≥35kg/m2）患者和34例年龄和性别匹配的正常体重患者作为对照。记录主动脉硬度（颈动脉-股动脉脉搏波速度）和波反射（增强指数）。颈总动脉的超声图像，采集桡动脉和指间动脉用于评估壁与管腔的比值,墙横截面积(WCSA)，合规,膨胀系数(DC)和杨氏弹性模量(Einc)。通过口服葡萄糖敏感性指数（OGIS）计算胰岛素敏感性。两组在颈动脉重塑方面没有差异，肥胖组桡动脉和指间动脉的WCSA高于对照组。关于血管弹性的参数，桡动脉和指间动脉的DC较低（分别为p=0.025和p=0.001），以及桡动脉的Einc较高（p=0.021），与对照组相比，肥胖患者。在对主要协变量进行调整后，所有这些相关性都是一致的。最后,在多元回归分析中,OGIS是指动脉间DC的独立决定因素(R2=0.29,p=0.001).
结论：第一次，我们描述了严重肥胖患者小导管动脉的外向重塑和僵硬度增加.
结果：招募了34例重度肥胖（BMI≥35kg/m2）患者和34例年龄和性别匹配的正常体重患者作为对照。记录主动脉硬度（颈动脉-股动脉脉搏波速度）和波反射（增强指数）。颈总动脉的超声图像，采集桡动脉和指间动脉用于评估壁与管腔的比值,墙横截面积(WCSA)，合规,膨胀系数(DC)和杨氏弹性模量(Einc)。通过口服葡萄糖敏感性指数（OGIS）计算胰岛素敏感性。两组在颈动脉重塑方面没有差异，肥胖组桡动脉和指间动脉的WCSA高于对照组。关于血管弹性的参数，桡动脉和指间动脉的DC较低（分别为p=0.025和p=0.001），以及桡动脉的Einc较高（p=0.021），与对照组相比，肥胖患者。在对主要协变量进行调整后，所有这些相关性都是一致的。最后,在多元回归分析中,OGIS是指动脉间DC的独立决定因素(R2=0.29,p=0.001).
结论：第一次，我们描述了严重肥胖患者小导管动脉的外向重塑和僵硬度增加.
