The continuums of impairment in vascular reactivity across the spectrum of cardiometabolic health: A systematic review and network meta‐analysis

摘要: This study aimed to assess, for the first time, change in vascular reactivity across full spectrum of cardiometabolic health. Systematic searches were conducted MEDLINE and EMBASE databases from their inception March 13, 2017, including studies that assessed basal two or more following health groups (aged ≥18 years old): healthy, overweight, obesity, impaired glucose tolerance, metabolic syndrome, type 2 diabetes with without complications. Direct indirect comparisons combined using a network meta-analysis. Comparing data 193 articles (7226 healthy subjects 19344 patients), meta-analyses revealed progressive impairment (flow-mediated dilation data) clinical onset an overweight status (-0.41%, 95% CI, -0.98 0.15) through development complications those (-4.26%, -4.97 -3.54). Meta-regressions every 1 mmol/l increase fasting blood concentration, flow-mediated decreased by 0.52%. Acknowledging time course disease may vary between patients, this demonstrates multiple continuums dysfunction where severity progressively increases throughout pathogenesis obesity and/or insulin resistance, providing information is important enhancing timing effectiveness strategies aim improve cardiovascular outcomes.