2023, Vol. 27 ›› Issue (26): 4223-4230

Changes in microvascular reactivity and exercise intervention in obese patients

Xiao Zhe1, Zhou Shufeng1, Zhu Huan1, Li Feng2, Hu Jiangping3   

Abstract: BACKGROUND: Microvascular dysfunction is a key factor in the occurrence and development of obesity. Aerobic exercise is not only an effective way to reduce fat and body mass, but also can improve microvascular function in obese people. However, some studies have pointed out that resistance exercise, aerobic combined resistance exercise and high-intensity intermittent exercise can also improve microvascular reactivity in obese people.
OBJECTIVE: To summarize the characteristics of microvascular reactivity in obese people and the intervention effects and main mechanisms of different exercise modes on microvascular reactivity in obese people, thereby providing a theoretical basis for improving microcirculation function in obese people.
METHODS: CNKI and PubMed were searched for relevant literature published from January 2000 to August 2022 using “obesity, microcirculation, microvessels, capillary, microvascular reactivity, microvascular vasodilatation, microvascular blood flow, exercise, training” as Chinese and English search terms. Finally, 61 articles were included for review.
RESULTS AND CONCLUSION: In the resting state, the function of microvascular endothelial cells is impaired in obese people, which leads to the decrease of microvascular reactivity. However, when oxidative stress and inflammation are not obvious in vivo, microvascular reactivity may not change significantly. During exercise, especially in the process of high-intensity exercise, the microvascular reactivity of obese people is significantly decreased, resulting in blood perfusion insufficiency. Aerobic exercise lasting 6-12 weeks, 3-5 times per week, with the exercise intensity of 65%-80% maximal heart rate can effectively improve microvascular reactivity in obese people, but the “dose-response” relationship of aerobic exercise in improving microvascular reactivity in obese people still needs to be further studied. Aerobic exercise combined with resistance exercise lasting 6-12 weeks, 3 times a week, with the exercise intensity of 65%-80% 1 repetition maximum can effectively improve microvascular reactivity in obese people, but resistance exercise alone requires longer intervention time. High-intensity intermittent exercise lasting 4-12 weeks, 2-3 times per week, with the exercise intensity of maximum aerobic intensity or above can improve microvascular reactivity in obese people. However, due to the lack of relevant studies, further studies are needed to clarify the intervention effect of high-intensity intermittent exercise on microvascular reactivity in obese people. Regulating the level of nitric oxide/endothelin-1 and the expression of vascular endothelial growth factor in different tissues may be the main mechanism by which exercise improves microvascular reactivity in obese people.

Key words: obese group, microvascular reactivity, microvascular blood flow, exercise intervention, nitric oxide, endothelin-1, vascular endothelial growth factor