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Cited by 64Cardiovascular and exercise physiologyThermoregulation and physiological responsesDiabetes, Cardiovascular Risks, and Lipoproteins

Microvascular dysfunction in healthy insulin-sensitive overweight individuals

Czernichow, Sébastien, Greenfield, Jerry R, Galan, Pilar, Bastard, Jean-Philippe, Charnaux, Nathalie, Samaras, Katherine, Safar, Michel E, Blacher, Jacques +2 more·2010·Journal of Hypertension
DOI 10.1097/hjh.0b013e328333d1fc
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Abstract

BACKGROUND: Obesity is associated with increased cardiovascular morbidity. The skin is a unique site allowing simple, noninvasive assessment of capillary density and endothelial function. In the present study, we measured skin capillary density and endothelial function in a group of normotensive overweight/obese nondiabetic individuals and healthy lean controls. METHODS AND RESULTS: We examined 120 relatively insulin-sensitive overweight individuals (BMI 27.9 +/- 2.7 kg/m, mean +/- SD) with normal blood pressure and fasting plasma glucose and 130 lean (BMI 22.4 +/- 1.7 kg/m) controls. We used video microscopy to measure skin capillary density in the resting state and during venous occlusion. Laser Doppler flowmetry, combined with iontophoresis of acetylcholine (endothelial-dependent vasodilation) and following skin heating (endothelial-independent dilation), was performed. Resting capillary density was negatively correlated with BMI (r = -0.130, P < 0.05). Resting capillary density (mean +/- SE) was lower, however nonsignificantly, in overweight as compared with the lean individuals (88.6 +/- 1.5 vs. 91.8 +/- 1.4, P = 0.117). Capillary recruitment, defined as the percentage increase in capillary density during venous congestion, was higher in overweight (9.5 +/- 1.0%) than in controls (5.4 +/- 0.9%, P = 0.003), which remained significant after adjustment for age, sex, mean arterial pressure and fasting glucose. As a consequence, capillary density during venous occlusion was similar between the groups. Endothelial-dependent and independent cutaneous vasodilation was also similar between groups. No correlations were found between capillary density and plasma markers of adiposity, inflammation or endothelial dysfunction. CONCLUSION: BMI was inversely correlated with resting capillary density. This suggests a lower baseline tissue perfusion associated with higher vasomotor tone. Despite this, capillary recruitment was higher in overweight as compared with lean individuals, resulting in similar capillary density during venous congestion. Our results suggest that skin microcirculation abnormalities, in the absence of endothelial dysfunction, may be one of the earliest detectable alterations in vascular function in overweight individuals.

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  • Publications that experimentally and explicitly demonstrate the effect of obesity or BMI on the PPG waveform are limited.

    “While, to the authors’ knowledge, publications that experimentally and explicitly demonstrate the effect of obesity or BMI on the PPG waveform are limited, we will explore works which suggest that there would be a substantial effect [56,59,60,61,62,63,64,65,66,67,68,69,70].”

    From Sources of inaccuracy in photoplethysmography for continuous cardiovascular monitoring (2021) · cites this paper as [63]

  • The majority of findings find that dermal capillary density does negatively correlate on average with increasing BMI.

    “In adults, while some studies show that at rest there is no significant change in dermal capillary density, the majority of findings find that dermal capillary density does negatively correlate on average with increasing BMI [62,63,64,65].”

    From Sources of inaccuracy in photoplethysmography for continuous cardiovascular monitoring (2021) · cites this paper as [63]

  • The effect of obesity on dermal capillary density could lead to a decrease in the dominant 'DC' component of a PPG waveform due to the increased blood volume of the obese.

    “This effect of obesity could lead to a decrease in the dominant “DC” component of a PPG waveform due to the increased blood volume of the obese [61,62,63,64].”

    From Sources of inaccuracy in photoplethysmography for continuous cardiovascular monitoring (2021) · cites this paper as [63]

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Authors
Czernichow, S., Greenfield, J. R., Galan, P., Bastard, J.-P., Charnaux, N., Samaras, K., Safar, M. E., Blacher, J., Hercberg, S., & Levy, B. I.
Affiliations
  • Conservatoire National des Arts et Métiers (FR)
  • Garvan Institute of Medical Research (AU)
  • Inserm (FR)
  • Hôpital Jean-Verdier (FR)
  • Assistance Publique – Hôpitaux de Paris (FR)
Corresponding author
Czernichow, Sébastien
ORCID
Venue
Journal of Hypertension
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2010-02
Volume
28
Issue
2
Pages
325-332
ISSN
0263-6352 (ISSN-L)
DOI
10.1097/hjh.0b013e328333d1fc
OpenAlex
W2001527395
Cited by
64
References
46
Citations by year
2026: 1 · 2025: 1 · 2024: 3 · 2023: 3 · 2022: 1 · 2021: 4 · 2020: 4 · 2019: 2 · 2018: 3 · 2017: 5 · 2016: 6 · 2015: 1 · 2014: 11 · 2013: 5 · 2012: 4
FWCI
16.25
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of Hypertension (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
  • Health Sciences › Medicine › Physiology › Thermoregulation and physiological responses
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
microvascular dysfunction, endothelial function, overweight, obesity, capillary recruitment, venous occlusion, endothelium-dependent vasodilation, endothelium-independent relaxation, tissue perfusion, vascular tone, body mass index, insulin sensitivity
MeSH terms
Aged, Blood Glucose, Capillaries, Endothelium, Vascular, Female, Hemodynamics, Humans, Insulin, Male, Microcirculation, Middle Aged, Obesity, Prospective Studies, Skin, Vasodilation, Cohort Studies, Body Mass Index, Case-Control Studies, Laser-Doppler Flowmetry, Microscopy, Video, Overweight

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