Western Diet Linked to Diabetes in Women

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de Jongh RT, Serne EH, IJzerman RG, et al.: Impaired microvascular function in obesity: Implications for obesity-associated microangiopathy, hypertension, and insulin resistance. Circulation 109:2529-2535, 2004.

What is the problem, and what is known about it so far?

Obesity makes people more likely to get heart and blood vessel problems. This is true for diseases that affect large arteries, such as heart attack and stroke, but also for diseases that affect very small blood vessels.

It is not well known how obesity causes these diseases.

The researchers wanted to test their idea that obesity may cause small blood vessels to stop functioning correctly. Problems with the small blood vessels in turn could cause other problems linked with obesity, such as small blood vessel disease, high blood pressure, and decreased insulin sensitivity (a measure of a person’s risk for heart disease). In general, the more sensitive to insulin one is, the lower the risk for heart problems.

Who was studied?

The study included 16 lean women and 12 obese women. The women were healthy and did not have diabetes, high blood pressure, or take any medications.

How was the study done?

The researchers measured the women's insulin sensitivity, the function of small blood vessels in their skin, and blood pressure. They also collected blood samples to measure cholesterol, fat in the blood, and blood glucose levels. Then they compared the measures of the obese women to the measures of the lean women.

What did the researchers find?

Obese women's small blood vessels didn't work as well as lean women's. In addition, poorly functioning small blood vessels are linked to lower insulin sensitivity and higher blood pressure in both obese and lean women.

What were the limitations of the study?

The study did not check to see if problems with the workings of small blood vessels could be caused by small increases in high blood pressure.

It also is possible that there are other factors that the researchers did not measure, such as exercise or what a person eats, that could help explain the link between obesity and poorly functioning small blood vessels. These possibilities need to be studied.

What are the implications of the study?

Losing weight could help obese women prevent high blood pressure, insulin resistance, and small blood vessel disease that's related to obesity.