The effects of venous hemodynamics on angiogenesis in morbid obese

Article type: Research Article

Authors: Wiewiora, Maciej^{a; *} | Mertas, Anna^b | Nowowiejska–Wiewiora, Alicja^c | Kozlowski, Andrzej^a | Czuba, Zenon^b | Piecuch, Jerzy^a

Affiliations: [a] Department of General and Bariatric Surgery and Emergency Medicine, School of Medicine, Division of Dentistry, Zabrze, Medical University of Silesia, Katowice, Poland | [b] Department of Microbiology and Immunology, School of Medicine, Division of Dentistry, Zabrze, Medical University of Silesia, Katowice, Poland | [c] Third Department of Cardiology, Silesian Centre for Heart Disease, Zabrze, Poland

Correspondence: [*] Corresponding author: Maciej Wiewiora, ul. Sklodowskiej-Curie10, 41-800 Zabrze, Poland. Tel.: +48 32 3732381; Fax: +48 32 2716335; E-mail: m-wiewiora@tlen.pl.

Abstract: BACKGROUND:It is known that obesity is associated with alterations in blood rheology and venous hemodynamics. Another recent study has confirmed that adipose tissue is actively involved in angiogenesis through secretion of biologically active substances. OBJECTIVE:The aim of this study was to investigate the impact on the venous haemodynamics of the femoral vein on angiogenesis status in morbidly obese patients. METHODS:We studied venous haemodynamics and angiogenesis in a prospective study of obese and non-obese individuals. The venous wall shear stress (WSS) was calculated from the blood viscosity and the shear rate was calculated assuming Newton’s law. Angiogenesis was detected using Bio-Plex Pro Human Angiogenesis Multiplex Assays (Bio-Plex 200 Systems). RESULTS:The shear rate (P < 0.000005) and the wall shear stress (P < 0.01) were significantly lower in the obese patients compared with the control subjects. All angiogenesis biomarkers were significantly higher in obese patients compared to the control group. Multivariate analyses identified waist circumference as an independent predictor for PECAM-1 (β = – 0.69, P < 0.0001) and for VEGF (β = – 0.60, P < 0.001); analyses identified WSS as an independent predictor for follistatin (β = – 0.59, P < 0.001), for PECAM-1 (β = – 036, P < 0.05) and for VEGF (β = – 0.42, P < 0.05). For angiopoietin 2 (β = – 0.35, P = 0.064) and HGF (β = – 0.31, P = 0.074), WSS tended to be a significant predictor. CONCLUSIONS:The results indicated that obesity-associated decreases in shear stress of the venous system lead to upregulation of angiogenesis, expressed by increased levels of endogenous positive regulators of angiogenesis.

Keywords: Obesity, angiogenesis, vascular disease

DOI: 10.3233/CH-180414

Journal: Clinical Hemorheology and Microcirculation, vol. 71, no. 3, pp. 347-356, 2019