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The impairment of flow-mediated vasodilatation in obese men with visceral fat accumulation

Abstract

BACKGROUND: Obesity has been reported to be associated with coronary artery disease and other atherosclerotic diseases. Recently, evidence has accumulated indicating that intra-abdominal visceral fat accumulation contributes to atherogenesis; however, the mechanism underlying this remains to be determined. This study was undertaken to elucidate whether intra-abdominal visceral fat accumulation impairs vascular endothelial function in obese men.

METHODS AND RESULTS: Thirty-eight obese men (body mass index (BMI)≥26.0), aged 19–64 y (mean age 37.6±1.8 y) and 23 age-matched non-obese subjects were examined. According to the ratio of the maximum thickness of preperitoneal fat to the minimum thickness of subcutaneous fat (Pmax/Smin) obtained by longitudinal ultrasound scanning in the subxiphoid region in obese men, we divided obese subjects into two categories; visceral (Pmax/Smin≥1; n=23) and subcutaneous type (Pmax/Smin<1; n=15). To investigate endothelial function, we performed ultrasound measurement of the brachial artery diameter non-invasively both at rest and during reactive hyperaemia in the muscle distal to the brachial artery which causes endothelium-dependent vasodilatation. The brachial diameter change was also measured after sublingual administration of nitroglycerin, which causes endothelium-independent vasodilatation. Flow-mediated diameter (D) increase (%FMD; ΔD/D×100), in the subjects with visceral type obesity (3.09±0.43%) was significantly lower than those of the subjects with subcutaneous type obesity and non-obese subjects (7.90±0.51%, 8.91±0.44%, respectively, P<0.01). The magnitude of endothelium-independent vasodilatation by nitroglycerin was similar in all groups. On multiple regression analysis, the Pmax/Smin showed a significant inverse correlation with %FMD.

CONCLUSIONS: The subjects with visceral type obesity, rather than those with the subcutaneous type, are associated with impaired flow-mediated endothelium-dependent vasodilatation of the brachial artery.

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Hashimoto, M., Akishita, M., Eto, M. et al. The impairment of flow-mediated vasodilatation in obese men with visceral fat accumulation. Int J Obes 22, 477–484 (1998). https://doi.org/10.1038/sj.ijo.0800620

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  • DOI: https://doi.org/10.1038/sj.ijo.0800620

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