The presence of abdominal obesity is associated with changes in vascular function independently of other cardiovascular risk factors

Published:October 15, 2008DOI:



      Because of the strong association between abdominal obesity (AO) and other cardiovascular risk factors, it has been difficult to determine which changes in vascular function are directly related to this condition. Our objective was to evaluate the changes in ex-vivo vascular reactivity, circulating levels of adipokines and inflammatory markers associated with the presence of AO in subjects who underwent coronary artery bypass graft (CABG) controlling by the presence of other cardiovascular risk factors.


      Subjects scheduled for a CABG with (n=17) and without (n=17) AO (defined as a waist circumference ≥90 cm for male or ≥80 cm for female) whom were matched by several cardiovascular risk factors, were included in the study. Lipid profile and plasma levels of glucose, insulin, leptin, adiponectin and inflammatory markers were measured. Internal mammary artery segments were used for ex-vivo vascular reactivity experiments and morphometry.


      Leptin concentrations were higher and adiponectin concentrations were lower in subjects with AO. No differences were observed in other biochemical or clinical parameters between the groups. No correlation between waist circumference, HOMA index and inflammatory markers were observed. Endothelium-dependent relaxation to acetylcholine was lower, and contractile responses to angiotensin-II were higher in subjects with AO. These changes were not related to differences in vascular morphometry.


      In subjects with severe coronary disease, the presence of AO was associated with leptin/adiponectin imbalance, decreased endothelium-dependent relaxation and an enhanced response to angiotensin-II. These changes occurred independently of other cardiovascular risk factors including insulin resistance and levels of inflammatory markers.


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        • Barton M.
        • Carmona R.
        • Ortmann J.
        • Krieger J.E.
        • Traupe T.
        Obesity-associated activation of angiotensin and endothelin in the cardiovascular system.
        Int J Biochem Cell Biol. 2003; 35: 826-837
        • Meyers M.R.
        • Gokce N.
        Endothelial dysfunction in obesity: etiological role in atherosclerosis.
        Curr Opin Endocrinol Diabetes Obes. 2007; 14: 365-369
        • Poirier P.
        • Giles T.D.
        • Bray G.A.
        • et al.
        Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss.
        Arterioscler Thromb Vasc Biol. 2006; 26: 968-976
        • Scaglione R.
        • Argano C.
        • Di Chiara T.
        • Licata G.
        Obesity and cardiovascular risk: the new public health problem of worldwide proportions.
        Expert Rev Cardiovasc Ther. 2004; 2: 203-212
        • International Diabetes Federation
        The IDF consensus worldwide definition of the metabolic syndrome [article online].
        2005 (Available from 2005)
        • Kahn R.
        • Buse J.
        • Ferrannini E.
        • Stern M.
        American Diabetes Association; European Association for the Study of Diabetes. The metabolic syndrome: time for a critical appraisal: joint statement from the American Diabetes Association and the European Association for the Study of Diabetes.
        Diabetes Care. 2005; 28: 2289-2304
        • Reaven G.M.
        The metabolic syndrome: is this diagnosis necessary?.
        Am J Clin Nutr. 2006; 83: 1237-1245
        • Yusuf S.
        • Hawken S.
        • Ounpuu S.
        • Bautista L.
        • Franzosi M.G.
        • Commerford P.
        Obesity and the risk of myocardial infarction in 27,000 participants from 52 countries: a case–control study.
        Lancet. 2005; 366: 1640-1649
        • Despres J.P.
        Health consequences of visceral obesity.
        Ann Med. 2001; 33: 534-541
        • Abbasi F.
        • Brown Jr., B.W.
        • Lamendola C.
        • McLaughlin T.
        • Reaven G.M.
        Relationship between obesity, insulin resistance, and coronary heart disease risk.
        J Am Coll Cardiol. 2002; 40: 937-943
        • McLaughlin T.
        • Allison G.
        • Abbasi F.
        • Lamendola C.
        • Reaven G.
        Prevalence of insulin resistance and associated cardiovascular disease risk factors among normal weight, overweight, and obese individuals.
        Metabolism. 2004; 53: 495-499
        • Despres J.P.
        • Lemieux I.
        Abdominal obesity and metabolic syndrome.
        Nature. 2006; 444: 881-887
        • Klein S.
        • Allison D.B.
        • Heymsfield S.B.
        • et al.
        Waist circumference and cardiometabolic risk: a consensus statement from shaping America's health: Association for Weight Management and Obesity Prevention; NAASO, the Obesity Society; the American Society for Nutrition; and the American Diabetes Association.
        Diabetes Care. 2007; 30: 1647-1652
        • Grundy S.M.
        • Cleeman J.I.
        • Daniels S.R.
        • et al.
        Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute scientific statement.
        Curr Opin Cardiol. 2006; 21: 1-6
        • Perez M.
        • Casas J.P.
        • Cubillos-Garzon L.A.
        • et al.
        Using waist circumference as a screening tool to identify Colombian subjects at cardiovascular risk.
        Eur J Cardiovasc Prev Rehabil. 2003; 10: 328-335
        • Garcia R.G.
        • Cifuentes A.E.
        • Caballero R.S.
        • Sanchez L.
        • Lopez-Jaramillo P.
        A proposal for an appropriate central obesity diagnosis in Latin American population.
        Int J Cardiol. 2006; 110: 263-264
        • Lopez-Jaramillo P.
        • Rueda-Clausen C.F.
        • Silva F.A.
        The utility of different definitions of metabolic syndrome in Andean population.
        Int J Cardiol. 2007; 116: 421-422
        • Lohman T.
        • Roche A.
        • Martorel R.
        Standarisation of antropometric measurements.
        in: The airline (VA) Concensus Conference ChampaingIII: Human Kinetics. 1988
        • Furuhashi M.
        • Ura N.
        • Higashiura K.
        • et al.
        Blockade of the renin-angiotensin system increases adiponectin concentrations in patients with essential hypertension.
        Hypertension. 2003; 42: 76-81
        • Oubina M.P.
        • de las H.N.
        • Cediel E.
        • et al.
        Synergistic effect of angiotensin-converting enzyme (ACE) and 3-hydroxy-3-methylglutaryl-CoA (HMG-CoA) reductase inhibition on inflammatory markers in atherosclerotic rabbits.
        Clin Sci (Lond). 2003; 105: 655-662
        • Despres J.P.
        Is visceral obesity the cause of the metabolic syndrome?.
        Ann Med. 2006; 38: 52-63
        • Banerji M.A.
        • Lebowitz J.
        • Chaiken R.L.
        • Gordon D.
        • Kral J.G.
        • Lebovitz H.E.
        Relationship of visceral adipose tissue and glucose disposal is independent of sex in black NIDDM subjects.
        Am J Physiol. 1997; 273: E425-E432
        • Chandalia M.
        • Abate N.
        • Garg A.
        • Stray-Gundersen A.
        • Grundy S.M.
        Relationship between generalized and upper body obesity to insulin resistance in Asian Indian men.
        J Clin Endocrinol Metab. 1999; 84: 2329-2335
        • Moncada S.
        • Higgs E.A.
        • Hodson H.F.
        • et al.
        The L-arginine: nitric oxide pathway.
        J Cardiovasc Pharmacol. 1991; 17: S1-S9
        • Steinberg H.O.
        • Chaker H.
        • Leamin R.
        Obesity/insulin resistance is associated with endothelial dysfunction.
        J Clin Invest. 1996; 97: 2601-2610
        • Lakka T.A.
        • Lakka H.M.
        • Salonen R.
        • Kaplan G.A.
        • Salonen J.T.
        Abdominal obesity is associated with accelerated progression of carotid atherosclerosis in men.
        Atherosclerosis. 2001; 154: 497-504
        • Wei W.
        • Zhi-Wu C.
        • Qin Y.
        • et al.
        Vasorelaxation induced by vascular endothelial growth factor in the human internal mammary artery and radial artery.
        Vasc Pharmacol. 2007; 46: 253-259
        • Meyer A.A.
        • Kundt G.
        • Steiner M.
        • Schuff-Werner P.
        • Kienast W.
        Impaired flow-mediated vasodilation, carotid artery intima-media thickening, and elevated endothelial plasma markers in obese children: the impact of cardiovascular risk factors.
        Pediatrics. 2006; 117: 1560-1567
        • Siddiqui A.H.
        • Hussain T.
        Enhanced AT1 receptor-mediated vasocontractile response to ANG II in endothelium-denuded aorta of obese Zucker rats.
        Am J Physiol Heart Circ Physiol. 2007; 292: H1722-H1727
        • Ahima R.S.
        Adipose tissue as an endocrine organ.
        Obesity. 2006; 5: 242S-249S
        • Rondinone C.M.
        Adipocyte-derived hormones, cytokines, and mediators.
        Endocrine. 2006; 29: 81-90
        • Rahmouni K.
        • Correia M.L.
        • Haynes W.G.
        • Mark A.L.
        Obesity-associated hypertension: new insights into mechanisms.
        Hypertension. 2005; 49: 9-14
        • Kumada M.
        • Kihara S.
        • Sumitsuji S.
        • et al.
        Association of hypoadiponectinemia with coronary artery disease in men.
        Arterioscler Thromb Vasc Biol. 2003; 23: 85-89
        • Beltowski J.
        Leptin and atherosclerosis.
        Atherosclerosis. 2006; 189: 47-60
        • Oda A.
        • Taniguchi T.
        • Yokoyama M.
        Leptin stimulates rat aortic smooth muscle cell proliferation and migration.
        Kobe J Med Sci. 2001; 147: 141-150
        • Ustundag B.
        • Gungor S.
        • Aygun A.D.
        • Turgut M.
        • Yilmaz E.
        Oxidative status and serum leptin levels in obese prepubertal children.
        Cell Biochem Funct. 2007; 25: 479-483
        • Zeidan A.
        • Purdham D.M.
        • Rajapurohitam V.
        • Javadov S.
        • Chakrabarti S.
        • Karmazyn M.
        Leptin induces vascular smooth muscle cell hypertrophy through angiotensin II- and endothelin-1-dependent mechanisms and mediates stretch-induced hypertrophy.
        J Pharmacol Exp Ther. 2005; 315: 1075-1084
        • Cabrera M.A.
        • Gebara O.C.
        • Diament J.
        • Nussbacher A.
        • Rosano G.
        • Wajngarten M.
        Metabolic syndrome, abdominal obesity, and cardiovascular risk in elderly women.
        Int J Cardiol. 2007; 114: 224-229
        • Campia U.
        • Choucair W.K.
        • Bryant M.B.
        • Quyyumi A.A.
        • Cardillo C.
        • Panza J.A.
        Role of cyclooxygenase products in the regulation of vascular tone and in the endothelial vasodilator function of normal, hypertensive and hypercholesterolemic humans.
        Am J Cardiol. 2002; 89: 286-290
        • Bulut D.
        • Liaghat S.
        • Hanefeld C.
        • Koll R.
        • Miebach T.
        • Mugge A.
        Selective cyclo-oxygenase-2 inhibition with parecoxib acutely impairs endothelium-dependent vasodilatation in patients with essential hypertension.
        J Hypertens. 2003; 21: 1663-1667
        • Coats A.J.
        Ethical authorship and publishing.
        Int J Cardiol. 2009; 131: 149-150