Publicação
Role of adipose tissue and skeletal muscle in atherosclerotic occlusive disease (peripheral arterial disease and carotid artery disease) and in central hemodynamics
| Resumo: | Background: Skeletal muscle and adipose tissue are the two largest organs in the body with an endocrine action in several metabolic processes, including arteriosclerosis and atherosclerosis. Peripheral artery disease (PAD) and carotid artery disease are common manifestations of atherosclerosis. This study aims to clarify the characteristics of adipose tissue and skeletal muscle in patients with arteriosclerosis and atherosclerosis. Methods: An observational and prospective study, based on usual care was performed. The population studied included patients with PAD or with carotid artery stenosis or with varicose veins. The study variables (hemodynamic arterial parameters, carotid-femoral Pulse-Wave Velocity- cfPWV, blood inflammatory markers) were collected at inclusion, three, six and 12 months. The amount of adipose tissue and skeletal muscle was quantified with a CT scan protocol. Samples of adipose tissue, skeletal muscle, arteries and atherosclerotic plaques were collected from patients with indication for surgery. Results: We included 177 subjects (mean age: 67.16 ± 9.87 years-old; 80.23% males), 119 with PAD 11 patients with carotid stenosis ≥ 50% and 47 with varicose veins. In 68 patients’ samples of tissue were collected. Up to July 2023, 101 patients had completed four clinical visits and reached the end of the follow-up. Thirteen patients dropped out of the study and nine (5.08%) deaths were registered. We found that the characteristics of adipose tissue and skeletal muscle were correlated with arteriosclerosis and atherosclerosis. Skeletal muscle mass was lower in patients with higher arterial stiffness, estimated with cfPWV. Regarding the perivascular adipose tissue (PVAT) we found a significant association between peri-carotid adipose and carotid atherosclerosis. In severe forms of atherosclerosis, as in patients with chronic limb-threatening ischemia (CLTI), we observed a decrease in skeletal muscle mass and area. CLTI also displayed an inflammatory state, characterized by elevated serum markers of inflammation and the presence of inflammatory cells in the histologic analysis of skeletal muscle. After CLTI resolution, the systemic inflammatory state was partially reversed. Conclusion: The intricate relationship between adipose tissue, skeletal muscle and arteriosclerosis and atherosclerosis emphasizes the importance of considering these factors in understanding and managing cardiovascular risk. Further investigation in this field could pave the way for more personalized medicine. |
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| Autores principais: | Ferreira, Joana Margarida Magalhães |
| Assunto: | Adipose tissue Arteriosclerosis Atherosclerosis Central hemodynamic parameters Skeletal muscle Doença aterosclerótica oclusiva Músculo esquelético Parâmetros hemodinâmicos centrais Tecido adiposo |
| Ano: | 2025 |
| País: | Portugal |
| Tipo de documento: | tese de doutoramento |
| Tipo de acesso: | acesso aberto |
| Instituição associada: | Universidade do Minho |
| Idioma: | inglês |
| Origem: | RepositóriUM - Universidade do Minho |
| Resumo: | Background: Skeletal muscle and adipose tissue are the two largest organs in the body with an endocrine action in several metabolic processes, including arteriosclerosis and atherosclerosis. Peripheral artery disease (PAD) and carotid artery disease are common manifestations of atherosclerosis. This study aims to clarify the characteristics of adipose tissue and skeletal muscle in patients with arteriosclerosis and atherosclerosis. Methods: An observational and prospective study, based on usual care was performed. The population studied included patients with PAD or with carotid artery stenosis or with varicose veins. The study variables (hemodynamic arterial parameters, carotid-femoral Pulse-Wave Velocity- cfPWV, blood inflammatory markers) were collected at inclusion, three, six and 12 months. The amount of adipose tissue and skeletal muscle was quantified with a CT scan protocol. Samples of adipose tissue, skeletal muscle, arteries and atherosclerotic plaques were collected from patients with indication for surgery. Results: We included 177 subjects (mean age: 67.16 ± 9.87 years-old; 80.23% males), 119 with PAD 11 patients with carotid stenosis ≥ 50% and 47 with varicose veins. In 68 patients’ samples of tissue were collected. Up to July 2023, 101 patients had completed four clinical visits and reached the end of the follow-up. Thirteen patients dropped out of the study and nine (5.08%) deaths were registered. We found that the characteristics of adipose tissue and skeletal muscle were correlated with arteriosclerosis and atherosclerosis. Skeletal muscle mass was lower in patients with higher arterial stiffness, estimated with cfPWV. Regarding the perivascular adipose tissue (PVAT) we found a significant association between peri-carotid adipose and carotid atherosclerosis. In severe forms of atherosclerosis, as in patients with chronic limb-threatening ischemia (CLTI), we observed a decrease in skeletal muscle mass and area. CLTI also displayed an inflammatory state, characterized by elevated serum markers of inflammation and the presence of inflammatory cells in the histologic analysis of skeletal muscle. After CLTI resolution, the systemic inflammatory state was partially reversed. Conclusion: The intricate relationship between adipose tissue, skeletal muscle and arteriosclerosis and atherosclerosis emphasizes the importance of considering these factors in understanding and managing cardiovascular risk. Further investigation in this field could pave the way for more personalized medicine. |
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