Journal
GEROSCIENCE
Volume 40, Issue 3, Pages 337-346Publisher
SPRINGER
DOI: 10.1007/s11357-018-0028-9
Keywords
Weight loss; Obesity; Endothelial function; Aging
Categories
Funding
- National Institutes of Health (NIH) [R01-AT-006526, R01-AG047879, R01-AG038747, R01-NS056218]
- Geroscience Training Program in Oklahoma (NIH Grant) [T32-AG-052363]
- Oklahoina Nathan Shock Center (NIH Grant) [3-P30-AG050911-02S1]
- Oklahoma Shared Clinical and Translational Resources (NIH Grant) [U54-GM-104938]
- Oklahoma Center for the Advancement of Science and Technology [HR17-070]
- College of Medicine Alumni Association
- Presbyterian Health Foundation
- EU [EFOP-3.6.1-16-2016-00008]
- NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES [U54GM104938] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE [R01NS100782] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE ON AGING [R01AG055395] Funding Source: NIH RePORTER
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Obesity is one of the major risk factors for cardiovascular diseases and its prevalence is increasing in all age groups, with the biggest impact observed in middle-aged and older adults. A critical mechanism by which obesity promotes vascular pathologies in these patients involves impairment of endothelial function. While endothelial dysfunction in large vessels promotes atherogenesis, obesity-induced microvascular endothelial dysfunction impairs organ perfusion and thereby is causally related to the pathogenesis of ischemic heart disease, chronic kidney disease, intermittent claudication, exercise intolerance, and exacerbates cognitive decline in aging. Reduction of weight via calorie-based diet and exercise in animal models of obesity results in significant improvement of endothelial function both in large vessels and in the microcirculation, primarily due to attenuation of oxidative stress and inflammation. Clinical data on the protective effects of weight loss on endothelial function is limited to studies of flow-mediated dilation assessed in brachial arteries. Currently, there is no guideline on testing the effects of different weight management strategies on microvascular endothelial function in obese patients. Here, we provide proof-of-concept that weight loss-induced improvement of microvascular endothelial function can be reliably assessed in the setting of a geriatric outpatient clinic using a fast, reproducible, non-invasive method: laser speckle contrast imaging-based measurement of endothelium-dependent microvascular responses during post-occlusive reactive hyperemia tests. Our study also provides initial evidence that short-term weight loss induced by consumption of a low-carbohydrate low-calorie diet can reverse microvascular endothelial dysfunction associated with obesity.
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