Metabolic disturbances linked to obesity: the role of impaired tissue perfusion Alterações metabólicas associadas à obesidade: o papel da disfunção da microcirculação tecidual

Associated with elevated risk of cardiovascular events and cancer, obesity is a worldwide pro- blem affecting developed and developing countries. Microcirculatory vessels, represented by arterioles, capillaries and venules (mean internal diameter < 100 µm), are the place where blood/tissue nutrition and exchange effectively take place. Microvascular dysfunction is an ear- ly event in obesity probably secondary to endothelial dysfunction and capillaries rarefaction. New research techniques allow the investigation of the microcirculation in different vascular beds in humans. Studies suggest a link between endothelial dysfunction and visceral obesity. Oxidative stress, inflammation and rennin-angiotensin system are among factors considered to be involved on microvascular dysfunction in obesity. Microcirculatory impairment present in obesity suggests that it could be an important causal factor in obesity-related disorders such as insulin resistance and hypertension. Arq Bras Endocrinol Metab. 2009;53(2):238-245.