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Evaluation of Systemic Microvascular Endothelial Function in Metabolically Healthy Obesity

Not Applicable
Completed
Conditions
Dyslipidemias
Obesity
Interventions
Diagnostic Test: Evaluation of systemic skin microvascular endothelial function
Registration Number
NCT04233528
Lead Sponsor
National Institute of Cardiology, Laranjeiras, Brazil
Brief Summary

Obesity is known to be a risk factor for cardiovascular disease (CVD), type 2 diabetes mellitus, gastrointestinal tract disease, respiratory problems (such as obstructive sleep apnea), joint and muscle problems, reproductive disorders, depression and cancer.

However, recently a new classification has emerged about obesity, the metabolically healthy obesity (MHO). According to the definition of the term, MHO represents obesity that occurs segregated from the metabolic syndrome criteria defined by the International Diabetes Federation (IDF). However, as there is still disagreement about the definition of MHO, the cardiovascular risk of these individuals is also uncertain. This phenotype may present as an intermediate risk between metabolically healthy normal-weight individuals and metabolically unhealthy obese individuals (MUO) or as a transition stage of the disease; when evolving to MUO, represents a higher risk of developing CVDs.

The hypothesis of the present study is that obese individuals classified as metabolically healthy have worse vascular endothelial function when compared to non-obese individuals, demonstrating increased cardiovascular risk even in this subgroup considered "low risk". The detection of endothelial dysfunction in metabolically healthy obese may help in the prevention, treatment and follow-up of these individuals, aiming to reduce the development and morbidity and mortality of CVD.

In the present study, the investigators will use a laser-based method for evaluating non-invasive, operator-independent systemic microvascular function that detects microvascular flow in the skin for the evaluation of systemic vascular endothelial function.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
112
Inclusion Criteria

• obese individuals (BMI ≥ 30.0 kg / m2) meeting the criteria for metabolically healthy obesity

Exclusion Criteria
  • Pregnancy or lactation.
  • Endocrine disorders except diabetes, cardiovascular disease except systemic arterial hypertension, autoimmune diseases, malignant neoplasms.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
healthy volunteersEvaluation of systemic skin microvascular endothelial functionmetabolically healthy eutrophic individuals (BMI ≥18.5 and \<25 kg / m2) without any IDF criteria for metabolic syndrome
metabolically unhealthy obesityEvaluation of systemic skin microvascular endothelial functionvolunteers diagnosed with metabolically unhealthy obesity
metabolically healthy obesityEvaluation of systemic skin microvascular endothelial functionobese individuals (BMI ≥ 30.0 kg / m2) meeting the criteria for metabolically healthy obesity
Primary Outcome Measures
NameTimeMethod
Baseline and post-iontophoresis of acetylcholine endothelium-dependent skin microvascular reactivityMicrovascular reactivity will be evaluated after a 20-minute rest in the supine position in a temperature-controlled room.

Evaluation of systemic microvascular reactivity induced by endothelium-dependent agents. Microvascular reactivity will be evaluated using a non-invasive and operator -independent methodology, named laser speckle contrast imaging, coupled with skin iontophoresis of vasodilator agents. Cutaneous microvascular flow will be measured in arbitrary perfusion units, divided by mean arterial pressure, to yield cutaneous vascular conductance.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

National Institute of Cardiology

🇧🇷

Rio de Janeiro, Brazil

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