Clinical research: atherosclerosis risk
Low body mass index is a risk factor forimpaired endothelium-dependent vasodilation in humans: role of nitric oxide and oxidative stress

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Abstract

Objectives

The purpose of this study was to evaluate the relationship between body mass index (BMI), including low BMIs, and endothelial function.

Background

Epidemiologic study has demonstrated that not only obesity but also a low BMI may be a risk factor for cardiovascular disease.

Methods

The forearm blood flow (FBF) response to acetylcholine (ACh) and isosorbide dinitrate (ISDN) was measured in 87 healthy young men (15 low BMI, 51 normal, 14 obese, and 7 extremely obese).

Results

Plasma concentrations of 8-hydroxy-2′-deoxyguanosine and serum concentrations of malondialdehyde-modified low-density lipoprotein were higher in low BMI, obese, and extremely obese subjects than in normal subjects and were similar among the low BMI, obese, and extremely obese groups. The FBF response to ACh was greater in the normal group than in the other groups (p < 0.001), and was lower in the extremely obese group as compared with the other groups (p < 0.001). The ACh-stimulated vasodilation was similar between the low BMI group and the obese group. The ISDN-stimulated vasodilation was similar in all four groups. There were no significant differences in ACh-stimulated vasodilation between the four groups after the nitric oxide (NO) synthase inhibitor NG-monomethyl-L-arginine infusion. Co-infusion of vitamin C augmented the FBF response to ACh in low BMI, obese, and extremely obese groups—but not in normal BMI group.

Conclusions

These findings suggest that not only obesity but also a low BMI may be a risk factor for impaired endothelium-dependent vasodilation through the increased oxidative stress, leading to the reduced bioavailability of NO.

Abbreviations

ACh
acetylcholine
BMI
body mass index
BP
blood pressure
DNA
deoxyribonucleic acid
FBF
forearm blood flow
HOMA
homeostatic model assessment
ISDN
isosorbide dinitrate
L-NMMA
NG-monomethyl-L-arginine
MDA-LDL
malondialdehyde-modified low-density lipoprotein
NO
nitric oxide
NOx
nitrate/nitrite
8-OHdG
8-hydroxy-2′-deoxyguanosine

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Supported, in part, by a Grant-in-Aid for Scientific Research from the Ministry of Education, Science and Culture of Japan and Japan Heart Foundation Grant for Research on Hypertension and Metabolism, a Grant for Research on Autonomic Nervous System and Hypertension from Kimura Memorial Heart Foundation/Pfizer Pharmaceuticals Inc., and Foundation for Total Health Promotion.