Research Article: Exploring the role of body mass index in relationship of serum nitric oxide and advanced glycation end products in apparently healthy subjects

Date Published: March 11, 2019

Publisher: Public Library of Science

Author(s): Elaheh Foroumandi, Mohammad Alizadeh, Sorayya Kheirouri, Mohammad Asghari Jafarabadi, Ming-Chang Chiang.


This study aimed to identify any association of serum nitric oxide (NO) and advanced glycation end products (AGEs) with body mass index (BMI) in apparently healthy subjects. In this cross-sectional study, participants were 90 apparently healthy subjects, categorized into three BMI groups as follows: BMI≤19.5 (n = 21), 19.6≤BMI≤24.9 (n = 35), and BMI≥25 (n = 34). Serum levels of NO were measured by griess reaction method. Determination of serum pentosidine and carboxymethyllysine (CML) was done using ELISA. Median (95% confidence interval [CI]: lower- upper) of serum NO in subjects with BMI≥25 were 68.94 (CI: 55.01–70.56) μmol/L, which was higher compared with 19.6≤BMI≤24.9 and BMI≤19.5 groups (22.65 (CI: 19.29–28.17) μmol/L and 8.00 (CI: 9.12–29.58) μmol/L, respectively). Serum NO positively correlated with BMI in total subjects (r = 0.585, p<0.001), which this correlation was significant in both male and female groups (r = 0.735, p<0.001 and r = 0.476, p = 0.001, respectively). Serum pentosidine and CML were significantly lower in subjects with higher BMI. Further, BMI showed negative correlations with pentosidine and CML (r = -0.363, p<0.001 and r = -0.484, p<0.001, respectively). There were not any significant differences in serum NO, pentosidine, and CML levels between sex groups. After adjusting the effects of confounders (BMI, sex, age, and waist to hip ratio), serum NO significantly correlated with serum pentosidine and CML (r = -0.319, p = 0.003 and r = -0.433, p<0.001, respectively). It is concluded that higher BMI is accompanied by increased serum NO and suppressed pentosidine and CML.

Partial Text

Obesity is a multifactorial disorder which defined as an excessive fat accumulation that may impair health [1]. According to the World Health Organization in 2016, 39% and 13% of adults aged 18 years and over in the world were overweight and obese, respectively [2]. The obesity is a main risk factor for cardiovascular diseases, musculoskeletal disorders, diabetes mellitus and some cancers [3, 4]. Obesity is associated with inflammation due to the activation of pro-inflammatory signaling pathways, and expression of tumor-necrosis factor (TNF-alpha) in adipose tissue. There is evidence that obesity is associated with chronic inflammation, endothelial cell dysfunction and increased oxidative stress, which may affect nitric oxide (NO) production and activation [5].

A total of 90 (n = 45 for each sex group) apparently healthy subjects were recruited in current study. The characteristics of the participants based on the gender and BMI are shown in Table 1. The mean± SEM age of total participants was 44.82±2.11. The mean of BMI in three BMI groups (BMI≤19.5, 19.6≤BMI≤24.9, and BMI≥25) were 18.22±0.37, 22.72±0.25 and 29.32±0.41 kg/m2, respectively. There was a significant difference between WHR of sex groups (p<0.05). In this cross-sectional study, we measured the serum levels of NO, pentosidine and CML with regard to BMI in apparently healthy subjects. The major findings of the present study are (1) serum levels of NO strongly correlated with BMI, which is raised by increasing BMI, (2) the serum levels of pentosidine and CML inversely associated with BMI, as they were higher in subjects with lower BMI, and (3) serum NO levels is inversely correlated with levels of pentosidine and CML. It is concluded that serum NO levels were positively correlated with BMI in both male and female participants. Further, higher BMI contributed to attenuation of serum pentosidine and CML levels. Gender did not affect the variables. Serum levels of NO inversely associated with glycated products. More studies are needed to investigate the mechanisms involved in this relationship.   Source:


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