1.
Cardiometabolic Risk and Female Sexuality: Focus on Clitoral Vascular Resistance.
Maseroli, E, Fanni, E, Cipriani, S, Scavello, I, Pampaloni, F, Battaglia, C, Fambrini, M, Mannucci, E, Jannini, EA, Maggi, M, et al
The journal of sexual medicine. 2016;(11):1651-1661
Abstract
INTRODUCTION The relation between sexual and cardiovascular health in women is not well defined. Clitoral color Doppler ultrasound (CDU) with assessment of the pulsatility index (PI), reflecting resistance to blood flow, has been proposed as an objective measurement of sexual functioning. AIM: To investigate associations between clitoral PI and cardiometabolic risk factors, sexual and intrapsychic parameters, and self-perception of body image. METHODS Seventy-one adult heterosexual women in a stable relationship attending our clinic for sexual dysfunction were consecutively recruited. MAIN OUTCOME MEASURES Patients underwent physical, laboratory, and clitoral color Doppler ultrasound examinations and completed the Female Sexual Function Index, the Middlesex Hospital Questionnaire, and the Body Uneasiness Test (BUT). RESULTS Clitoral PI was positively correlated with body mass index (r = 0.441, P < .0001), waist circumference (r = 0.474, P < .0001), glycemia (r = 0.300, P = .029), insulin (r = 0.628, P = .002), homeostatic model assessment index (r = 0.605, P = .005), triglycerides (r = 0.340, P = .011), total cholesterol (r = 0.346, P = .010), and low-density lipoprotein cholesterol (r = 0.334, P = .016). All relations, with the exception of glycemia, retained statistical significance after adjusting for age, smoking habit, and years since menopause (P < .0001 for body mass index, waist circumference, and triglycerides; P < .05 for all other associations). Analysis of covariance, after adjusting for confounders, showed that women with obesity or metabolic syndrome (MetS) showed significantly higher PI values (obesity: F = 17.79, P = .001; MetS: F = 7.37, P = .019). In particular, a stepwise increase of PI was found as a function of increasing MetS components (β = 0.434, P = .007). Clitoral PI was negatively associated with Female Sexual Function Index arousal (β = -0.321, P = .014) and satisfaction (β = -0.289, P = .026) scores and positively associated with Middlesex Hospital Questionnaire somatized anxiety symptoms, even after adjusting for age, smoking habit, years since menopause, and current use of psychiatric medication (β = 0.354, P = .011). A positive association also was observed between PI and the BUT positive symptom distress index (β = 0.322, P = .039) and BUT for dislike of the womb, genitals, and breast (β = 0.538, P < .0001; β = 0.642, P < .0001; β = 0.549, P < .0001, respectively). After introducing waist circumference as another covariate, the associations between clitoral PI and the BUT positive symptom distress index and BUT dislike of the womb, genitals, and breast retained statistical significance (P = .038 for positive symptom distress index; P < .0001 for dislike of womb, genitals, and breast). CONCLUSION Clitoral vascular resistance is positively associated with MetS (in particular insulin resistance), decreased sexual arousal, body image concerns, and increased somatized anxiety symptoms. Further studies are needed to establish whether treatment of metabolic abnormalities might improve clitoral color Doppler ultrasound indices and sexual outcomes.
2.
Low-intensity resistance training with slow movement and tonic force generation increases basal limb blood flow.
Tanimoto, M, Kawano, H, Gando, Y, Sanada, K, Yamamoto, K, Ishii, N, Tabata, I, Miyachi, M
Clinical physiology and functional imaging. 2009;(2):128-35
Abstract
Metabolic syndrome is associated with reductions in basal limb blood flow. Resistance training increasing muscle mass and strength increases basal limb blood flow. Low-intensity resistance exercise with slow movement and tonic force generation (LST) has been proposed as one of the effective methods of resistance training increasing muscle mass and strength. The hypothesis that LST training increases basal femoral blood flow as well as traditional high-intensity resistance training at normal speed (HN) was examined. Thirty-six healthy young men without a history of regular resistance training were randomly assigned to the LST [approximately 55-60% one repetition maximum (1RM) load, 3 s lifting and 3 s lowering with no relaxation phase, n = 12], HN (approximately 85-90% 1RM, 1 s lifting and 1 s lowering with 1 s relaxation, n = 12) or sedentary control (CON, n = 12) groups. Participants in the training groups underwent two whole-body training sessions per week for 13 weeks. Basal femoral blood flow increased significantly by +18% in LST and +35% in HN (both P<0.05), while there was no such change in CON. There were no significant differences between these increases induced by LST and HN, although the increase in LST corresponded to about half that in HN. In conclusion, not only resistance training in HN but in LST as well, were effective for increasing basal limb blood flow, and that this effect was evident even in healthy young men.
3.
[Microalbuminuria, a marker of artery rigidity and cardiac dysfunction].
Brahimi, M, Le Clésiau, H, Ouazen, Z, Soufi, K, Michault, A, Pariès, J, Cosson, E, Valensi, P
Archives des maladies du coeur et des vaisseaux. 2007;(8):673-6
Abstract
INTRODUCTION Microalbuminuria is considered as a marker of endothelial dysfunction and is associated with an increase in cardiovascular risk. The aim of this study was to evaluate this parameter as a potential marker of artery rigidity and left ventricle (LV) function. SUBJECTS AND METHODS We included 375 subjects referred to a health assessment center. They were 228 men and 147 women aged in means of 52.7 and 53.1 years, respectively. Among this population, 57 had type 2 diabetes, 28 of them with hypertension, 65 were hypertensive but free of diabetes, and 39 were free of diabetes but exhibited a metabolic syndrome (NCEP-ATP III). Urinary albumin excretion rate (UAER) was determined. Artery rigidity was evaluated by pulse pressure of the brachial artery (plethysmographic method), pulse pressure of the radial artery and aorta and pulse wave velocity (PWV) measured by aplanation tonometry (SphygmoCor). LV afterload was appreciated by LV telesystolic pressure and coronary perfusion by the diastolic area/systolic area ratio for aortic pressure curve (Buckberg index). RESULTS UAER correlated with PWV in the overall population (p<0.0001) and in the diabetic sub-group (p<0.001). In the overall population UAER correlated with LV telesystolic pressure (p=0.006) but not with Buckberg index. In the overall population and the diabetic subgroup, the artery rigidity indexes correlated strongly with LV telesystolic pressure, and radial and aortic pulse pressure correlated negatively with Buckberg index. CONCLUSION These data suggest that 1) microalbuminuria may be considered as a marker of artery rigidity, in line with experimental data which indicate the deleterious role of endothelial dysfunction on artery compliance; 2) artery rigidity is a potent determinant of LV afterload and coronary perfusion, in particular in diabetic patients.
4.
Relationship between arterial stiffness and glucose metabolism in women with metabolic syndrome.
Nestel, P
Clinical and experimental pharmacology & physiology. 2006;(9):883-6
Abstract
1. Cardiovascular risk factors associated with the metabolic syndrome affect vascular functions adversely. The aim of the present study was to assess the relationship between parameters of glucose homeostasis and arterial stiffness in women with characteristics of the metabolic syndrome. 2. Twenty post-menopausal women participated in a cross-sectional study in which systemic arterial compliance (SAC) and plasma glucose, lipids and glycosylated haemoglobin (HbA1c) were measured while subjects were maintained on a diet high in fibre, raised in protein and reduced in saturated fat. 3. Regression analysis suggested that mean ( +/-SD) fasting glucose of 5.9 +/- 1.7 mmol/L, glucose levels 2 h after a 75 g glucose load of 6.8 +/- 3.6 mmol/L, systolic blood pressure of 131 +/- 12 mmHg and HbA1c of 5.3 +/- 1.7% predicted SAC negatively. The following correlations were obtained between SAC and: (i) fasting glucose: R = -0.49, P = 0.028; (ii) 2 h glucose level post-glucose load: R = -0.42, P = 0.064; (iii) HbA1c: R = -0.42, P = 0.056; and (iv) systolic blood pressure: R = -0.55, P = 0.012. 4. Relationships between SAC and fasting glucose and systolic blood pressure were significantly independent of each other. There was no evidence of relationships between SAC and any plasma lipid parameter (other than a trend in relation to plasma triglyceride), bodyweight or waist circumference. 5. In conclusion, in post-menopausal women with metabolic syndrome, fasting plasma glucose and systolic blood pressure, and possibly HbA1c and the 2 h glucose post-glucose load, predicted increased arterial stiffness.