Endothelial dysfunction in naval personnel in military activity with obesity
DOI:
https://doi.org/10.24265/horizmed.2015.v15n4.06Keywords:
Endothelial dysfunction, Obesity, Body mass index, Flow-mediated dilationAbstract
Objective: To establish the level of endothelial dysfunction in naval personnel with obesity in military activity of the Peruvian Navy, also relating the degree of endothelial dysfunction with modifiable factors (diet and physical activity), non-modifiable factors (family history) and cardiovascular stratification. Material and Methods: Endothelial function was analyzed by vascular Doppler, where the flow mediated by dilatation in the brachial artery was evaluated in patients with type I, II and III obesity, at rest, analyzing its relationship with variables such as physical activity, type of diet, family history, age and gender; applying statistical parameters (chi-square and regression analysis) with SPSS. This was a descriptive, prospective, cross-sectional study. Results: A total of 43.4% endothelial dysfunction was found in all age groups, of which 49.3% corresponded to the male sex. Of the total of 173 patients, 56% exercised less than one hour and a total of 113 patients received diets greater than 1800 kcal, finding the presence of endothelial dysfunction in 54% of patients in this group; 65% of patients with a family history presented ED, this being a statistically significant relationship (p<0.05) as was also the case for the evaluation of age, sex and physical activity; diet being a statistically non-significant parameter in the regression analysis. Conclusion: Obese patients evaluated presented a high incidence of endothelial dysfunction, independently of the associated variable to which it was related, since obesity has a direct relationship with the alteration of endothelial function without the presence of pre-existing cardiovascular disease or previous military conditioning. In order to improve the endothelial alteration, it is suggested to perform exercises that contemplate routines longer than one (01) hour, supervised by qualified personnel. Diet, according to the results of the study, plays an important but not determinant role in the influence of endothelial dysfunction. Secondarily, the obese population has an affinity and adherence to overweight and obesity control and nutrition programs, a system that allows the realization of different activities such as physical reconditioning in high-risk patients; however, we see an inverse relationship to these programs on the part of the institution, with the increase of sedentary working conditions that do not favor the proposed exercise routines. Finally, the evaluation of dilation-mediated flow is a marker of cardiovascular disease, which should be considered within the selection techniques for control and follow-up, but above all stratification of the obese patient without cardiovascular disease.
Downloads
References
Reporte epidemiológico de la Unidad de Evaluación Psicofísica. DICEMENA/DISAMAR MGP 2014. Lima Perú.
"BMI Classification". Global Database on Body Mass Index. World Health Organization. 2006. Retrieved July 27, 2012.
Palomo G, Fuentes Q, Moore-Carrasc, González D, Rojas A. El consumo de frutas y hortalizas ayuda a prevenir el daño endotelial. Rev Chil Nutr Vol 38, No3, Set 2011.
Badimon L. Vilahur G. Padro T. Holven KB, Holm T, Nutraceuticals and Atherosclerosis: Human Trials. Cardiovasc Therapeutics 2010; 28: 202-15.
Ghisi S, Schenke W, Zalos G, Mincemoyer R, Prasad A. Exercício físico e disfuncao endotelial, Arq Bras Cardiol 2010;95(5):e130-e137.
Bruyndonckx L, Hoymans VY, De Guchtenaere A, Van Helvoirt M, Van Craenenbroeck EM, Diet, exercise and endothelial function in obese adolescents. Pediatrics 2015 Mar, 135(3); e653-61.
Badimón L, Martínez J. Disfunción endotelial. Rev Esp Cardiol Supl. 2006;6:21A-30A.
Gori T, Parker JD, Munzel T. Flow-mediated constriction: further insight into a new measure of vascular function. Eur Heart J. 2011; 32:784-7.
Toda N, Okamura T. Obesity impairs vasodilatation and blood flow increase mediated by endothelial nitric oxide: an overview J Clin Pharmacol. 2013 Dec;53(12):1228-39.
Rojas E, Rodríguez-Molina D, Bolli P. The role of adiponectin in endothelial dysfunction and hypertension. Curr Hypertens Rep. 2014 Aug;16(8):463.
prieto D, Contreras C, Sánchez A. Endothelial dysfunctio, obesity and insulin resistance. Curr Vasc Pharmacol. 2014 May; 12(3):412-26.
Lovren F, Teoh H, Verma S. Obesity and Atherosclerosis: Mechanist Insights. Canadian Journal of Cardiology. 2015 Feb; 31(2):177-183.
Thijssen DHJ, Black MA, Pyke KE, Padilla J, Atkinson G, Harr RA, et al. Assessmentof flow-mediated dilation in humans: methodological and physiological guideline. Am J Physiol Heart Cir Physiol. 2011.
Antonio L. Arrebola-Moreno, Martin Laclaustra y Juan Carlos Kaskia. Evaluación no invasiva de la función endotelial en la práctica clínica. Rev Esp Cardiol. 2012;65(1):80-90.
Charakida M, Masi S, Lu" scher TF, Kastelein JJP, Deanfield JE.. Assessment ofatherosclerosis: the role of flow-mediated dilatation. Eur Heart J. 2010; 31:2854-61.
World Health Organization Technical report series 894: "Obesity: preventing and managing the global epidemic." Geneva: World Health Organization, 2000. PDF. ISBN 92-4-120894-5.
lantorno M, Campia U Obesity, inflammation and endothelial dysfunction. J Biol Regul Homeost Agents. 2014 Apr-Jun;28(2):169-76
Obesidad y Sobrepeso, Nota descriptiva N° 311 WHO, 2015-01
Cardillo C. Drug treatments to restore vascular function and diabesity. Ann Pharm Fr. 2013 Jan;71(1):27-33.
Tisha Marie B. Suboc, Kodlipet Dharmashankar. Moderate obesity and endothelial dysfunction in humans: influence of gender and systemic inflammation Physiological Reports2013. Vol. 1. Iss. 3.
Celermajer DS, Sorensen KE, Gooch VM, Spiegelhalter DJ, Miller Ol, Sullivan ID, et al. Non-invasive detection of endothelial dysfunction in children and adultsat risk of atherosclerosis. Lancet. 1992.
You T, Arsenis NC, Disanzo BL, Lamonte MJ Effects of exercise training on chronic inflammation in obesity: current evidence and potential mechanisms. Sports Med. 2013 Apr; 43(4):243-56.
Tisha Marie B. Suboc, Kodlipet Dharmashankar. Moderate obesity and endothelial dysfunction in humans: influence of gender and systemic inflammation Physiological Reports2013. Vol. 1. Iss. 3.
Gu P, Xu A. Interplay between adipose tissue and blood vessels in obesity and vascular dysfunction. Rev Endocr Metab Disord. 2013 Mar;14(1):49-58.
Kim J, Montagnani M, Chandrasekran S, Quon MJ Role of lipotoxicity in endothelial dysfunction. Heart Fail Clin. 2012 Oct;8 (4):589-607.
Seligman, B.G., Polanczyk, C.A., Santos, A.S., Foppa, M., Junges, M., Bonzanini, L., Intensive practical lifestyle intervention improves endothelial function in metabolic syndrome independent of weight loss: a randomized controlled trial. Metabolism: Clin. Exp. 2011; 60:1736-1740.
Mohler, E.R. 3rd, Sibley, A.A., Stein, R., Davila-Roman, V., Wyatt, H., Badellino, K., Endothelial function and weight loss: comparison of low-carbohydrate and low-fat diets. Obes. (Silver Spring, Md). 2013; 21:504-509.
Meyers MR, Gokce N. Endothelial dysfunction in obesity: etiological role in atherosclerosis. Curr Opin Endocrinol Diabetes Obesity. 2007 Oct;14(5):365-9.
Michael D. Jensen, Donna H. Ryan, Caroline M. Apovian, Jamy D. Ard. 2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults: A Report of the American College of Cardiology/American Heart Association Task Force. Circulation. published online November 12, 2013.
Phillips SA, Mahmoud AM, Brown MD, Haus JM. Exercise interventions and peripheral arterial function: implications for cardio-metabolic disease. Prog Cardiovasc Dis. 2015 Mar-Apr;57(5):521-34.
Joris PJ, Zeegers MP, Mensink RP. Weight loss improves fasting flow mediated vasodilation in adults: A meta-analysis of intervention studies. Atherosclerosis. 2015 Mar; 239(1):21-30.
Hallmark R, Patrie JT, Liu Z, Gaesser GA, Barrett EJ, Weltman A. The effect of exercise intensity on endothelial function in physically inactive lean and obese adults PLoS One. 2014 Jan 20;9.
Ades, P.A., Savage, P.D., Lischke, S., Toth, M.J., Harvey-Berino, J., Bunn, J.Y., The effect of weight loss and exercise training on flow mediated dilatation in coronary heart disease: a randomized trial. Chest. 2011; 140: 1420-1427.
Green, D.J., Maiorana, A., O'Driscoll, G., Taylor, R. Effect of exercise training on endothelium-derived nitric oxide function in humans. J. Physiol. 2004; 561:1-25.
Dod, H.S., Bhardwaj, R., Sajja, V., Weidner, G., Hobbs, G.R., Konat, G.W. et al, Effect of Intensive lifestyle changes on endothelial function and on inflammatory markers of atherosclerosis. Am. J. Cardiol. 2010;105:362-367.
Montero, D., Walther, G., Perez-Martin, A., Roche, E., Vinet, A. Endothelial dysfunction, inflammation, and oxidative stress in obese children and adolescents: markers and effect of lifestyle intervention. Obes. Rev. Off. J. Int. Assoc. Study Obes. 2012;1 3:441-455.
Andrés E, León M, Cordero A, Magallón R. Factores de riesgo cardiovascular y estilo de vida asociados a la aparición prematural de infarto agudo de miocardio Rev Esp Cardiol. 2011; 64:527-9. Vol. 64 Núm.06.
Sankhla M., Sharma T.K., Mathur K., Rathor J.S., Butolia V., Relationship of oxidative stress with obesity and its role in obesity induced metabolic syndrome. Clin. Lab. 2012;58:385-392.
Thomazella, M.C., Goes, M.F., Andrade, C.R., Debbas, V., Barbeiro, D.F., Correia, R.L. Effects of high adherence to mediterranean or low-fat diets in medicated secondary prevention patients. Am. J.. Cardiol. 2011;108:1523-1529
Buscemi, S., Cosentino, L., Rosafio, G., Morgana, M., Mattina, A., Sprini, D. Effects of hypocaloric diets with different glycemic indexes on endothelial function and glycemic variability in overweight and in obese adult patients at increased cardiovascular risk. Clin. Nutr. Edinb. Scotl. 2013; 32:346-352.
Nagamia, S., Pandian, A., Cheema, F., Natarajan, R., Khan, Q.A., Patel, A.D.I, The role of quinapril in the presence of a weight loss regimen: endothelial function and markers of obesity in patients with the metabolic syndrome. Prev. Cardiol. 2007; 10:204–209.
Tuan M, Pham I, Valensi P, Rousseau H. Flow-mediated paradoxical vasoconstriction is independently associated with asymptomatic myocardial ischemia and coronary artery disease in type 2 diabetic patients. Cardiovascular Diabetology 2014, 13:20.
Lee HY, Sakuma I, Ihm SH, Goh CW, Koh KK. Statins and renin angiotensin system inhibitor combination treatment to prevent cardiovascular disease Circ J. 2014;78 (2):281-7.
Angelico, F., Loffredo, L., Pignatelli, P., Augelletti, T., Carnevale, R., Pacella, A., Weight loss is associated with improved endothelial dysfunction via NOX2-generated oxidative stress down-regulation in patients with the metabolic syndrome. Intern. Emerg. Med. 2012; 7:219-227.
Bigornia, S.J., Mott, M.M., Hess, D.T., Apovian, C.M., McDonnell, M.E., Duess, M.A., Long-term successful weight loss improves vascular endothelial function in severely obese individuals. Obes. (Silver Spring, Md).2010; 18:754-759.
Ras, R.T., Streppel, M.T., Draijer, R., Zock, P.L. Flow-mediated dilation and cardiovascular risk prediction: a systematic review with meta-analysis. Int. J. Cardiol. 2013; 168:344-351.
Gu, P., Xu, A.M. Interplay between adipose tissue and blood vessels in obesity and vascular dysfunction. Rev. Endocr. Metab. Dis. 2013; 14:49-58.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2015 Horizonte Médico (Lima)
This work is licensed under a Creative Commons Attribution 4.0 International License.
Horizonte Médico (Lima) (Horiz. Med.) journal’s research outputs are published free of charge and are freely available to download under the open access model, aimed at disseminating works and experiences developed in biomedical and public health areas, both nationally and internationally, and promoting research in the different fields of human medicine. All manuscripts accepted and published in the journal are distributed free of charge under the terms of a Creative Commons license – Attribution 4.0 International (CC BY 4.0).
