Endothelial Function in Distinct Phenotypes of Obesity

ABSTRACT

Purpose: In our study, we aimed to determine whether metabolically healthy subjects with obesity would show endothelial dysfunction (ED) when compared with insulin-resistant subjects with obesity.
Material and Method: We enrolled 231 subjects with obesity (83% female) in this cross-sectional study. Brachial artery flow-mediated dilation was performed by Doppler ultrasonography and a standard 75-g oral glucose tolerance test were carried out in all participants. The subjects were stratified into tertiles based on their insulin sensitivity index values and defined as having insulin-resistant obesity if the values were in the lower tertile (n=77) or metabolically healthy obesity if the values were in the upper tertile (n=77). ED was defined as Δ flow-mediated dilation <4.5%.
Results: Metabolically healthy obesity and insulin-resistant obesity groups had similar ages (39±9 vs. 40±10 years; p=0.59) and body mass index (38±5 vs. 39±5 kg/m2; p=0.09). Waist circumference (101±11 vs. 106±13 cm; p=0.01), fasting blood glucose (87±9 vs. 97±13 mg/dL; p<0.001), diastolic blood pressure (79±11 vs. 82±12 mmHg; p=0.04) and uric acid levels (4.6±1.0 vs. 5.3±1.3 mg/dL; p<0.001) were lower in metabolically healthy obesity subjects, however, the incidence of ED was similar in both metabolically healthy obesity and insulin-resistant obesity subjects (80% vs. 71%; p=0.25, respectively).
Discussion: The incidence of ED, assessed by flow-mediated dilation, was similar both in metabolically healthy obesity and insulin-resistant obesity subjects. In this study, we showed that subjects with obesity as defined as metabolically healthy obesity might also show ED.