Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/20517
Title: The continuums of impairment in vascular reactivity across the spectrum of cardiometabolic health: A systematic review and network meta-analysis.
Austin Authors: Loader, Jordan;Khouri, Charles;Taylor, Frances;Stewart, Simon;Lorenzen, Christian;Cracowski, Jean-Luc;Walther, Guillaume;Roustit, Matthieu
Affiliation: Hatter Institute for Reducing Cardiovascular Disease in Africa, The University of Cape Town, Cape Town, South Africa
Inserm U1042, Université Grenoble Alpes, Grenoble, France
Clinical Pharmacology, Grenoble Alpes University Hospital, Grenoble, France
LAPEC EA4278, Avignon Université, Avignon, France
School of Exercise Science, Australian Catholic University, Melbourne, Australia
Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
Department of Medicine, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australia
LAPEC EA4278, Avignon Université, Avignon, France
Issue Date: Jun-2019
metadata.dc.date: 2019-03-18
Publication information: Obesity reviews 2019; 20(6): 906-920
Abstract: This study aimed to assess, for the first time, the change in vascular reactivity across the full spectrum of cardiometabolic health. Systematic searches were conducted in MEDLINE and EMBASE databases from their inception to March 13, 2017, including studies that assessed basal vascular reactivity in two or more of the following health groups (aged ≥18 years old): healthy, overweight, obesity, impaired glucose tolerance, metabolic syndrome, or type 2 diabetes with or without complications. Direct and indirect comparisons of vascular reactivity were combined using a network meta-analysis. Comparing data from 193 articles (7226 healthy subjects and 19344 patients), the network meta-analyses revealed a progressive impairment in vascular reactivity (flow-mediated dilation data) from the clinical onset of an overweight status (-0.41%, 95% CI, -0.98 to 0.15) through to the development of vascular complications in those with type 2 diabetes (-4.26%, 95% CI, -4.97 to -3.54). Meta-regressions revealed that for every 1 mmol/l increase in fasting blood glucose concentration, flow-mediated dilation decreased by 0.52%. Acknowledging that the time course of disease may vary between patients, this study demonstrates multiple continuums of vascular dysfunction where the severity of impairment in vascular reactivity progressively increases throughout the pathogenesis of obesity and/or insulin resistance, providing information that is important to enhancing the timing and effectiveness of strategies that aim to improve cardiovascular outcomes.
URI: http://ahro.austin.org.au/austinjspui/handle/1/20517
DOI: 10.1111/obr.12831
ORCID: 0000-0001-5623-7478
PubMed URL: 30887713
Type: Journal Article
Subjects: endothelial dysfunction
insulin resistance
obesity
vascular function
Appears in Collections:Journal articles

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