Skin microcirculatory dilatation to mental stress in obese human subjects is impaired. This may be implicated as a pathophysiologic mechanism for the known greater pressor response to chronic psychosocial stress in obesity and contribute to the cardiovascular complications of obesity.
Microcirculation: The smallest blood vessels, including arterioles, capillaries and venules, serving to control peripheral resistance to blood flow, tissue perfusion, and blood-tissue exchange.
Vasodilatation: Increase in diameter of blood vessel as a result of vascular smooth muscle relaxation, leading to an increase in blood flow through the vessel.
1. Mahler, F., Muheim, M., Intaglietta, M., Bollinger, A., and Anliker, M. (1979). Blood pressure fluctuations in human nailfold capillaries. Am. J. Physiol. 236, H888-H893.
2. Fagrell, B., Jorneskog, G., and Intaglietta, M. (1999). Disturbed microvascular reactivity and shunting: a major cause for diabetic complications. Vasc. Med. 4, 125-127.
3. Bernardi, L., Rossi, M., Fratino, P., Finardi, G., Mevio, E., and Orlandi, C. (1989). Relationship between phasic changes in human skin blood flow and autonomic tone. Microvasc. Res. 37, 16-27.
4. Algotsson, A. (1996). Serum lipids and lipoproteins are correlated to skin vessel reactivity in healthy women. Journal of Internal Medicine 239, 147-152.
5. Vinik, A., Erbas, T., Park, T., Pierce, K., and Stansberry, K. (2001). Methods for evaluation of peripheral neurovascular dysfunction. Diabetes Technol. Ther. 3, 29-50.
6. Blaak, E., van Baak, M., Kemerink, G., Pakbiers, M., Heidendal, G., and Saris, W. (1995). Beta-adrenergic stimulation and abdominal subcutaneous fat blood flow in lean, obese, and reduced-obese subjects. Metabolism. 44, 183-187.
7. Prasad, A., Dunhill, G., Mortimer, P., and MacGregor, G. (1995). Capillary rarefaction in the forearm skin in essential hypertension. Journal of Hypertension 13, 265-268.
8. Gasser, P., and Buhler, F. R. (1992). Nailfold microcirculation in nor-motensive and essential hypertensive subjects, as assessed by video-microscopy. Journal of Hypertension 10, 83-86.
9. Serne, E., Stehouwer, C., Maaten, J., Wee, P., Rauwerda, J., Donker, A., and Gans, R. (1999). Microvascular function relates to insulin sensitivity and blood pressure in normal subjects. Circulation 99, 896-902.
10. Smagghue, O., Velayoudon, P., Paries, J., Attali, J., and Valensi, P. (1996). The Laser-Doppler microcirculation technique in the study of the orthosympathetic system in obese and non-insulin-dependent diabetic patients. Journal des Maladies Vasculaires 21, 299-302.
11. Chin, L., Huang, T., Yu, C., Wu, C., Hsu, C., and Yu, H. (1999). Increased cutaneous blood flow but impaired post-ischemic response of nutritional flow in obese children. Atherosclerosis 146, 179-185.
12. Jaap, A., Shore, A., and Tooke, J. (1997). Relationship of insulin resistance to microvascular dysfunction in subjects with fasting hypergly-caemia. Diabetologia 40, 238-243.
13. Caballero, A., Arora, S., Saouaf , R., Lim, S., Smakowski, P., Park, J., King, J., LoGerfo, F., Horton, E., and Veves, A. (1999). Microvascular and macrovascular reactivity is reduced in subjects at risk for type 2 diabetes. Diabetes 48, 1856-1862.
14. Ballard , K. (1977). Functional characteristics of the microcirculation in white adipose tissue. Microvasc. Res. 16, 1-18.
15. Steinberg, H., Tarshoby, M., Monestel, R., Hook, G., Cronin, J., Johnson, A., Bayazeed, B., and Baron, A. (1997). Elevated circulating free fatty acid levels impair endothelium-dependent vasodilation. Journal ofClinical Investigation 100, 1230-1239.
16. Stepniakowski, K., Goodfriend, T., and Egan, B. (1995). Fatty acids enhance vascular alpha-adrenergic sensitivity. Hypertension 25, 774-778.
17. Tur, E., Politi, Y., and Rubinstein, A. (1994). Cutaneous blood flow abnormalities in hypertriglyceridemia. J. Invest. Dermatol. 103, 597-600.
Agapitov, A., Correia, M., Sinkey, C., Dopp, J., and Haynes, W. (2002). Impaired skeletal muscle and skin microcirculatory function in human obesity. J. Hypertens. 20, 1401-1405. This recent article provides insights into the role of the skin microvasculature in the pathophysiol-ogy of obesity-induced hypertension. Braverman, I. (2000). The cutaneous microcirculation. J Invest Dermatol. Symp. Proc. 5, 3-9. A recent review on anatomy and physiology of skin microcirculation.
Grandall, D., Hausman, G., and Kral, J. (1997). A review of the microcirculation of adipose tissue: Anatomic, metabolic, and angiogenic perspectives. Microcirculation 4, 211-232. A recent comprehensive review of adipose tissue microcirculation. Narkiewicz, K. (2002). Obesity-related hypertension: Relevance of vascular responses to mental stress. J. Hypertens. 20, 1277-1278. A recent article discussing the relevance of stress-induced microvascular responses to obesity-related hypertension. Rosell, S., and Belfrage, E. (1979). Blood circulation in adipose tissue. Physiol. Rev. 59, 1078-1104.
Alexei Agapitov, M. D., received his research training at the University of Iowa. His research interests include the sympathetic nervous system, obesity, and hypertension.
Dr. William Haynes received his medical education at the University of Sheffield, England. In 1995, Dr. Haynes moved to the University of Iowa, where he now holds a position as Professor of Internal Medicine in the Divisions of Cardiovascular Diseases and Clinical Pharmacology. He is Program Director of the NIH-funded Clinical Research Center at the University. Dr. Haynes is also Associate Editor of the journal Arteriosclerosis, Thrombosis and Vascular Biology. His research is focused on mechanisms of vascular dysfunction in obesity, hypertension, and atherosclerosis.
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