Pathophysiology of the microcirculatory bed in obesity

Abstract

A total of 207 patients with alimentary constitutional and hypothalamic obesity were examined in order to assess the status of the microcirculatory bed, including the status of capillary walls, hemocirculation, transcapillary metabolism, oxygen delivery to tissues in patients with various forms of obesity. Bulbobiomicroscopy, assessment of capillary wall permeability by the hydrostatic test, polarographic study of oxygen tension in the skin using oxygen and ischemic test were employed. Obese patients were found to develop appreciable microcirculatory disorders (vascular, intravascular, extravascular); capillary walls became better penetrable for liquid and proteins and the adaptation reserve of these vessels decreased, with the substrate movement from blood to tissues predominating. A correlation has been traced between the status of the circulation and capillary walls, and extravascular shifts, on the one hand, and capillary permeability, on the other. Oxygen delivery to tissues was disordered in obese patients, this manifesting by deterioration of both oxygen delivery and consumption. The degree of impairment of various components of microcirculation and oxygen supply of tissues augmented with body mass increase.