Microvascular Differences in Individuals With Obesity At Risk of Developing Cardiovascular Disease
A new study using GlycoCheck from Microvascular Health Solutions, a BioRegenx company, reveals that individuals with obesity are at risk of developing cardiovascular disease. The senior author of the paper is Dr. Hans Vink, Chief Science Officer of GlycoCheck and Microvascular Health Solutions.
The objective was to investigate microvascular differences in individuals with obesity at risk for developing cardiovascular disease.
GlycoCheck shows that increased cardiovascular risk reduces capillary density by 49% in healthy individuals in a large obesity study, as shown in this chart.
Obesity is a well-established risk factor for developing cardiovascular disease (CVD), the leading cause of mortality worldwide. Because microvascular dysfunction is one of the first signs of CVD, the study’s researchers aimed to investigate whether individuals with obesity and a high risk for developing CVD could be characterized by microvascular changes measured with sidestream dark field (SDF) imaging.
The Framingham Risk Score was used to calculate 10-year cardiovascular risk, divided into low,intermediate, and high-risk groups. The Framingham Risk Score is a sex-specific algorithm that is widely used to assess the risk of cardiovascular events (coronary, cerebrovascular, and peripheral artery disease and heart failure) within 10 years.
Study Importance
What is already known?Microvascular changes due to endothelial dysfunction is an early step in the pathogenesis of cardiovascular disease. Sidestream dark field imaging is a noninvasive technique to detect these microvascular changes.
What does this study add?By analyzing densities of blood perfused microvessels in a diameter-dependent manner, it is demonstrated that significant reductions in the number of the smallest capillaries can be identified in individuals with obesity exposed to increased cardiovascular risk according to the Framingham Risk Score. This new analysis could be used for early detection of microvascular changes in individuals with obesity that might aid in monitoring such individuals, e.g., using various interventions.
How might your results change the direction of research or the focus of clinical practice?By adding red blood cell velocity calculations to the new sidestream dark field imaging software, a better estimate of perfused boundary regions can be implemented that can be used to detect early signs of microvascular damage. Automated imaging can be used to detect early microvascular changes and monitor clinical interventions aimed at restoring microvascular health.
Results
A total of 813 participants were included. The high-risk group (n = 168) was characterized by differences in the microvasculature compared with the low-risk group (n = 392): the high-risk group had a 49% reduction in the number of smallest capillaries and a 9.1-µm/s (95% CI: 5.2-12.9) higher red blood cell velocity in the feed vessels. No differences in velocity-corrected perfused boundary regions were found.
This study was supported by a grant (LSHM16058-SGF) for the GLYCOTREAT consortium, a collaboration project financed by the public-private partnership (PPP) allowance made available by Top Sector Life Sciences & Health to the Dutch Kidney Foundation to stimulate public private partnerships. The Netherlands Epidemiology of Obesity (NEO) study is supported by participating departments, the Division and the Board of Directors of the Leiden University Medical Center, and by the Leiden University Research Profile Area “Vascular and Regenerative Medicine.” The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
The study was conducted by Division of Nephrology, Department of Internal Medicine, The Einthoven Laboratory for Vascular and Regenerative Medicine, Leiden University Medical Center, Leiden, the Netherlands; Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands; Department of Nephrology, Nijmegen Centre for Molecular Life Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands; Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands; and the Department of Physiology, Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands.
You may read the full study here.
Read more about the GlycoCheck testing device at GlycoCheck.com.