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Relations of metabolically healthy and unhealthy obesity to digital vascular function in three community-based cohorts: A meta-analysis
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نویسنده
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brant l.c.c. ,wang n. ,ojeda f.m. ,lavalley m. ,barreto s.m. ,benjamin e.j. ,mitchell g.f. ,vasan r.s. ,palmisano j.n. ,münzel t. ,blankenberg s. ,wild p.s. ,zeller t. ,ribeiro a.l.p. ,schnabel r.b. ,hamburg n.m.
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منبع
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journal of the american heart association - 2017 - دوره : 6 - شماره : 3
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چکیده
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Background-microvascular dysfunction is a marker of early vascular disease that predicts cardiovascular events. whether metabolically healthy obese individuals have impaired microvascular function remains unclear. the aim of this study was to evaluate the relation of obesity phenotypes stratified by metabolic status to microvascular function. methods and results-we meta-analyzed aggregate data from 3 large cohorts (brazilian longitudinal study of adult health,the framingham heart study,and the gutenberg heart study; n=16 830 participants,age range 19-90,51.3% men). regression slopes between cardiovascular risk factors and microvascular function,measured by peripheral arterial tonometry (pat),were calculated. individuals were classified as normal-weight,overweight,or obese by body mass index (bmi) and stratified by healthy or unhealthy metabolic status based on metabolic syndrome using the atp-iii criteria. male sex,bmi,and metabolic risk factors were associated with higher baseline pulse amplitude and lower pat ratio. there was stepwise impairment of vascular measures from normal weight to obesity in both metabolic status strata. metabolically healthy obese individuals had more impaired vascular function than metabolically healthy normal-weight individuals (baseline pulse amplitude 6.12±0.02 versus 5.61±0.01; pat ratio 0.58±0.01 versus 0.76±0.01,all p < 0.0001). metabolically unhealthy obese individuals had more impaired vascular function than metabolically healthy obese individuals (baseline pulse amplitude 6.28±0.01 versus 6.12±0.02; pat ratio 0.49±0.01 versus 0.58±0.01,all p < 0.0001). conclusions-metabolically healthy obese individuals have impaired microvascular function,though the degree of impairment is less marked than in metabolically unhealthy obese individuals. our findings suggest that obesity is detrimental to vascular health irrespective of metabolic status. © 2017 the authors.
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کلیدواژه
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Body mass index; Cardiovascular risk factors; Cohort studies; Endothelial function; Metabolic syndrome
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آدرس
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estudo longitudinal da saúde do adulto (elsa-brasil),hospital das clínicas and school of medicine,universidade federal de minas gerais,belo horizonte, Brazil, data coordinating center,boston university school of public health,boston,ma, United States, department of general and interventional cardiology,university heart center hamburg,hamburg,germany,german center for cardiovascular research (dzhk e.v.),partner site hamburg,lübeck,kiel, Germany, department of biostatistics,boston university school of public health,boston,ma, United States, estudo longitudinal da saúde do adulto (elsa-brasil),hospital das clínicas and school of medicine,universidade federal de minas gerais,belo horizonte, Brazil, department of epidemiology,boston university school of public health,boston,ma,united states,boston university's and the nhlibi's framingham heart study,framingham,ma,united states,sections of cardiology and preventive medicine,department of medicine,boston university school of medicine,boston,ma, United States, boston university's and the nhlibi's framingham heart study,framingham,ma, United States, department of epidemiology,boston university school of public health,boston,ma,united states,boston university's and the nhlibi's framingham heart study,framingham,ma,united states,sections of cardiology and preventive medicine,department of medicine,boston university school of medicine,boston,ma, United States, data coordinating center,boston university school of public health,boston,ma, United States, center for cardiology,cardiology i university medical center of the johannes gutenberg-university,mainz,germany,dzhk (german center for cardiovascular research),partner site rhinemain,mainz, Germany, department of general and interventional cardiology,university heart center hamburg,hamburg,germany,german center for cardiovascular research (dzhk e.v.),partner site hamburg,lübeck,kiel, Germany, preventive cardiology and preventive medicine,center for cardiology,university medical center of the johannes gutenberg-university,mainz,germany,center for thrombosis and hemostasis,university medical center of the johannes gutenberg-university,mainz,germany,dzhk (german center for cardiovascular research),partner site rhinemain,mainz, Germany, department of general and interventional cardiology,university heart center hamburg,hamburg,germany,german center for cardiovascular research (dzhk e.v.),partner site hamburg,lübeck,kiel, Germany, estudo longitudinal da saúde do adulto (elsa-brasil),hospital das clínicas and school of medicine,universidade federal de minas gerais,belo horizonte, Brazil, department of general and interventional cardiology,university heart center hamburg,hamburg,germany,german center for cardiovascular research (dzhk e.v.),partner site hamburg,lübeck,kiel, Germany, whitaker cardiovascular institute,school of medicine,boston university,boston,ma, United States
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Authors
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