Boy Houben

Associate professor

Alfons (Boy) Houben is Associate Professor at the Department of Internal Medicine of Maastricht UMC+. He graduated in Biology at the University of Nijmegen, and received his PhD, in Maastricht in 1993, on early microcirculatory changes in patients with type 1 diabetes. He has longstanding expertise in human (non-invasive) micro- and macrovascular function tests in combination with (pharmacological) interventions, and in the epidemiological setting (The Maastricht Study). Using this unique approach, his main research interest is on the role of microvascular dysfunction in cardiometabolic diseases. An additional focus in his present research is the effects of lifestyle modifications in order to improve microvascular function. He is Past-President of the European Society for Microcirculation, chair of the Dutch Society for Microcirculation and Vascular Biology, and member of several other international scientific societies.

The focus of my research for many years has been microvascular dysfunction (MVD) as both a cause and a consequence of (cardio)metabolic diseases. One important function of the microcirculation is to deliver oxygen/nutrients to all tissues and to remove waste products. In normal metabolism this includes the delivery of glucose, which taken up by the gut following a meal, to skeletal muscle in order to be stored as glycogen. For that, insulin plays an important role by stimulating the endothelium to produce nitric oxide (NO), which leads to recruitment of capillaries in skeletal muscle and thus an increase in exchange surface. As a result, both glucose and insulin can reach skeletal muscle cells quickly and easily in order to store glucose in the cells. In our working hypothesis, we state that MVD may disturb this insulin-mediated glucose delivery/uptake, leading to metabolic insulin resistance and contributing to the development of type 2 diabetes. Within the framework of The Maastricht Study (a population-based cohort study), we perform deep phenotyping of the microcirculation. By using this approach, we are looking for (early) determinants of MVD, and study the role of MVD in the development and progression of various diseases (e.g. (pre)diabetes, heart failure, and depression).

Department of Internal Medicine
P. Debyelaan 25, 6229 HX Maastricht 
PO Box 5800, 6202 AZ Maastricht

  • 2019
    • Rensma, S., van Sloten, T. T., Houben, A. J. H. M., van Boxtel, M. P. J., Berendschot, T. T. J. M., Jansen, J. F. A., Kroon, A. A., Koster, A., Backes, W. H., Schaper, N., Dinant, G. J., Schalkwijk, C. G., Henry, R. M. A., Wolfs, E. M. L., van Heumen, M. J. A., Schram, M. T., & Stehouwer, C. D. A. (2019). Microvascular Dysfunction Is Associated with Worse Cognitive Performance: The Maastricht Study. Journal of Vascular Research, 56(S1), 94-94.
  • 2018
    • van Agtmaal, M. J. M., Houben, A. J. H. M., de Wit, V., Henry, R. M. A., Schaper, N. C., Dagnelie, P. C., van der Kallen, C. J., Koster, A., Sep, S. J., Kroon, A. A., Jansen, J. F. A., Hofman, P. A., Backes, W. H., Schram, M. T., & Stehouwer, C. D. A. (2018). Prediabetes Is Associated With Structural Brain Abnormalities: The Maastricht Study. Diabetes Care, 41(12), 2535-2543. https://doi.org/10.2337/dc18-1132
    • de Waard, E. A. C., de Jong, J. J. A., Koster, A., Savelberg, H. H. C. M., van Geel, T. A., Houben, A. J. H. M., Schram, M. T., Dagnelie, P. C., van der Kallen, C. J., Sep, S. J. S., Stehouwer, C. D. A., Schaper, N. C., Berendschot, T. T. J. M., Schouten, J. S. A. G., Geusens, P. P. M. M., & van den Bergh, J. P. W. (2018). The association between diabetes status, HbA1c, diabetes duration, microvascular disease, and bone quality of the distal radius and tibia as measured with high-resolution peripheral quantitative computed tomography: The Maastricht Study. Osteoporosis International, 29(12), 2725-2738. https://doi.org/10.1007/s00198-018-4678-3
    • van Twist, D. J. L., de Heer, P. W. M., Houben, A. J. H. M., de Haan, M. W., de Leeuw, P. W., & Kroon, A. A. (2018). Differences in renal hemodynamics and renin secretion between patients with unifocal and multifocal fibromuscular dysplasia. Journal of Hypertension, 36(8), 1729-1735. https://doi.org/10.1097/HJH.0000000000001755
    • Martens, R. J. H., Houben, A. J. H. M., Kooman, J. P., Berendschot, T. T. J. M., Dagnelie, P. C., van der Kallen, C. J. H., Kroon, A. A., Leunissen, K. M. L., van der Sande, F. M., Schaper, N. C., Schouten, J. S. A. G., Schram, M. T., Sep, S. J. S., Sörensen, B. M., Henry, R. M. A., & Stehouwer, C. D. A. (2018). Microvascular endothelial dysfunction is associated with albuminuria: the Maastricht Study. Journal of Hypertension, 36(5), 1178-1187. https://doi.org/10.1097/HJH.0000000000001674
    • Schutten, M. T. J., Kusters, Y. H. A. M., Houben, A. J. H. M., Scheijen, J. L. J. M., van de Waarenburg, M. P. H., Schalkwijk, C. G., Joris, P. J., Plat, J., Mensink, R. P., de Leeuw, P. W., & Stehouwer, C. D. A. (2018). Aldosterone Is Not Associated With Metabolic and Microvascular Insulin Sensitivity in Abdominally Obese Men. Journal of Clinical Endocrinology & Metabolism, 103(2), 759-767. https://doi.org/10.1210/jc.2017-01541
  • 2017
    • Houben, A. J. H. M., Martens, R. J. H., & Stehouwer, C. D. A. (2017). Assessing Microvascular Function in Humans from a Chronic Disease Perspective. Journal of the American Society of Nephrology, 28(12), 3461-3472. https://doi.org/10.1681/ASN.2017020157
    • Sörensen, B. M., Houben, A. J. H. M., Berendschot, T. T. J. M., Schouten, J. S. A. G., Kroon, A. A., van der Kallen, C. J. H., Henry, R. M. A., Koster, A., Dagnelie, P. C., Schaper, N. C., Schram, M. T., & Stehouwer, C. D. A. (2017). Cardiovascular risk factors as determinants of retinal and skin microvascular function: The Maastricht Study. PLOS ONE, 12(10), Article e0187324. https://doi.org/10.1371/journal.pone.0187324
    • Sörensen, B. M., Houben, A. J. H. M., Berendschot, T. T. J. M., Schouten, J. S. A. G., Kroon, A. A., van der Kallen, C. J. H., Henry, R. M. A., Koster, A., Reesink, K. D., Dagnelie, P. C., Schaper, N. C., Schalkwijk, C. G., Schram, M. T., & Stehouwer, C. D. A. (2017). Hyperglycemia Is the Main Mediator of Prediabetes- and Type 2 Diabetes-Associated Impairment of Microvascular Function: The Maastricht Study. Diabetes Care, 40(8), e103-e105. https://doi.org/10.2337/dc17-0574
    • van Twist, D. J. L., Houben, A. J. H. M., de Leeuw, P. W., & Kroon, A. A. (2017). Lateralization of renal blood flow and renin secretion in fibromuscular dysplasia Reply. Journal of Hypertension, 35(8), 1721-1722. https://doi.org/10.1097/HJH.0000000000001387
    • Houben, A. J. H. M., Berendschot, T. T. J. M., & Grassi, G. (2017). Retinal microvascular diameters: normative data and their use in clinical hypertension. Journal of Hypertension, 35(8), 1573-1574. https://doi.org/10.1097/HJH.0000000000001421
    • Kusters, Y. H. A. M., Schalkwijk, C. G., Houben, A. J. H. M., Kooi, M. E., Lindeboom, L., 't Roodt, J. O., Joris, P. J., Plat, J., Mensink, R. P., Barrett, E. J., & Stehouwer, C. D. A. (2017). Independent tissue contributors to obesity-associated insulin resistance. JCI INSIGHT, 2(13), Article e89695. https://doi.org/10.1172/jci.insight.89695
    • van Agtmaal, M. J. M., Houben, A. J. H. M., Pouwer, F., Stehouwer, C. D. A., & Schram, M. T. (2017). Association of Microvascular Dysfunction With Late-Life Depression A Systematic Review and Meta-analysis. JAMA Psychiatry, 74(7), 729-739. https://doi.org/10.1001/jamapsychiatry.2017.0984
    • Slot, M. C., Kroon, A. A., Damoiseaux, J. G. M. C., Theunissen, R., Houben, A. J. H. M., de Leeuw, P. W., & Tervaert, J. W. C. (2017). CD4+CD28null T Cells are related to previous cytomegalovirus infection but not to accelerated atherosclerosis in ANCA-associated vasculitis. Rheumatology International, 37(5), 791-798. https://doi.org/10.1007/s00296-016-3643-8
    • Snijders, T., Nederveen, J. P., Verdijk, L. B., Houben, A. J. H. M., Goossens, G. H., Parise, G., & van Loon, L. J. C. (2017). Muscle fiber capillarization as determining factor on indices of insulin sensitivity in humans. Physiological Reports, 5(10), Article e13278. https://doi.org/10.14814/phy2.13278
    • Schutten, M. T. J., Houben, A. J. H. M., de Leeuw, P. W., & Stehouwer, C. D. A. (2017). The Link Between Adipose Tissue Renin-Angiotensin- Aldosterone System Signaling and Obesity-Associated Hypertension. Physiology, 32(3), 197-209. https://doi.org/10.1152/physiol.00037.2016
    • Sorensen, B. M., Houben, A. J. H. M., Martens, R. J. H., & Stehouwer, C. D. A. (2017). Response by Sorensen et al to Letters Regarding Article, "Prediabetes and Type 2 Diabetes Are Associated With Generalized Microvascular Dysfunction": The Maastricht Study. Circulation, 135(14), E862-E863. https://doi.org/10.1161/CIRCULATIONAHA.117.027475
    • van Twist, D. J. L., Houben, A. J. H. M., de Haan, M. W., de Leeuw, P. W., & Kroon, A. A. (2017). Pathophysiological differences betweenmultifocal fibromuscular dysplasia and atherosclerotic renal artery stenosis. Journal of Hypertension, 35(4), 845-852. https://doi.org/10.1097/HJH.0000000000001243
    • Joris, P. J., Plat, J., Kusters, Y. H. A. M., Houben, A. J. H. M., Stehouwer, C. D. A., Schalkwijk, C. G., & Mensink, R. P. (2017). Diet-induced weight loss improves not only cardiometabolic risk markers but also markers of vascular function: a randomized controlled trial in abdominally obese men. American Journal of Clinical Nutrition, 105(1), 23-31. https://doi.org/10.3945/ajcn.116.143552
  • 2016
    • Martens, R. J. H., Henry, R. M. A., Houben, A. J. H. M., van der Kallen, C. J. H., Kroon, A. A., Schalkwijk, C. G., Schram, M. T., Sep, S. J. S., Schaper, N. C., Dagnelie, P. C., Muris, D. M. J., Gronenschild, E. H. B. M., van der Sande, F. M., Leunissen, K. M. L., Kooman, J. P., & Stehouwer, C. D. A. (2016). Capillary Rarefaction Associates with Albuminuria: The Maastricht Study. Journal of the American Society of Nephrology, 27(12), 3748-3757. https://doi.org/10.1681/ASN.2015111219
    • Sörensen, B., Houben, B., Berendschot, T. T. J. M., Schouten, J. S. A. G., Kroon, A. A., van der Kallen, C. J. H., Henry, R. M. A., Koster, A., Sep, S. J. S., Dagnelie, P. C., Schaper, N. C., Schram, M. T., & Stehouwer, C. D. A. (2016). Prediabetes and Type 2 Diabetes Are Associated With Generalized Microvascular Dysfunction The Maastricht Study. Circulation, 134(18), 1339-1352. https://doi.org/10.1161/CIRCULATIONAHA.116.023446
    • Schutten, M. T. J., Houben, A. J. H. M., Kroon, A. A., Stehouwer, C. D. A., & de Leeuw, P. W. (2016). Aldosterone-Renin Ratio and Side-Selective Renal Perfusion in Essential Hypertension. American Journal of Hypertension, 29(11), 1311-1316. https://doi.org/10.1093/ajh/hpw077
    • Montero, D., Houben, B., Koster, A., Muris, D. M. J., Schram, M. T., Gronenschild, E. H., Sep, S. J. S., Henry, R. M. A., van der Kallen, C. J. H., Schaper, N. C., Dagnelie, P. C., van Geel, T. A. C. M., Kremers, S. P. J., Savelberg, H. H. C. M., & Stehouwer, C. D. A. (2016). Physical Activity Is Associated With Glucose Tolerance Independent of Microvascular Function: The Maastricht Study. Journal of Clinical Endocrinology & Metabolism, 101(9), 3324-3332. https://doi.org/10.1210/jc.2016-1526
    • van Twist, D. J. L., Houben, B., de Haan, M. W., de Leeuw, P. W., & Kroon, A. A. (2016). Renal hemodynamics and renin-angiotensin system activity in humans with multifocal renal artery fibromuscular dysplasia. Journal of Hypertension, 34(6), 1160-1169. https://doi.org/10.1097/HJH.0000000000000917
  • 2015
    • van Sloten, T. T., Czernichow, S., Houben, A. J., Protogerou, A. D., Henry, R. M., Muris, D. M., Schram, M. T., Sep, S. J., Dagnelie, P. C., van der Kallen, C. J., Schaper, N. C., Blacher, J., Hercberg, S., Levy, B. I., & Stehouwer, C. D. (2015). Association Between Arterial Stiffness and Skin Microvascular Function: The SUVIMAX2 Study and The Maastricht Study. American Journal of Hypertension, 28(7), 868-876. https://doi.org/10.1093/ajh/hpu246
    • Touwslager, R. N. H., Houben, A. J. H. M., Tan, F. E. S., Gielen, M., Zeegers, M. P., Stehouwer, C. D. A., Gerver, W. J. M., Westerterp, K. R., Wouters, L., Blanco, C. E., Zimmermann, L. J., & Mulder, A. L. M. (2015). Growth and Endothelial Function in the First 2 Years of Life. Journal of Pediatrics, 166(3), 666-671.e1. https://doi.org/10.1016/j.jpeds.2014.11.059
    • Wijnands, J. M. A., Houben, A. J. H. M., Muris, D. M. J., Boonen, A., Schram, M. T., Sep, S. J. S., van der Kallen, C. J. H., Henry, R. M. A., Dagnelie, P. C., van der Linden, S., Schaper, N. C., Arts, I. C. W., & Stehouwer, C. D. A. (2015). Uric acid and skin microvascular function: the Maastricht study. Journal of Hypertension, 33(8), 1651-1657. https://doi.org/10.1097/HJH.0000000000000583
  • 2014
    • Muris, D. M. J., Houben, A. J. H. M., Kroon, A. A., Henry, R. M. A., van der Kallen, C. J. H., Sep, S. J. S., Koster, A., Dagnelie, P. C., Schram, M. T., & Stehouwer, C. D. A. (2014). Age, waist circumference, and blood pressure are associated with skin microvascular flow motion: The Maastricht Study. Journal of Hypertension, 32(12), 2439-2449. https://doi.org/10.1097/HJH.0000000000000348
    • Muris, D. M. J., Gronenschild, E. H. B. M., Schram, M. T., Karaca, U., Stehouwer, C. D. A., & Houben, A. J. H. M. (2014). Response to comment on: Semi-automatic assessment of skin capillary density: Proof of principle and validation. Microvascular Research, 94, 7-8. https://doi.org/10.1016/j.mvr.2014.04.006
    • Karaca, U., Schram, M. T., Houben, A. J. H. M., Muris, D. M. J., & Stehouwer, C. D. A. (2014). Microvascular dysfunction as a link between obesity, insulin resistance and hypertension. Diabetes Research and Clinical Practice, 103(3), 382-387. https://doi.org/10.1016/j.diabres.2013.12.012
    • Montero, D., Walther, G., Stehouwer, C. D. A., Houben, A. J. H. M., Beckman, J. A., & Vinet, A. (2014). Effect of antioxidant vitamin supplementation on endothelial function in type 2 diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials. Obesity Reviews, 15(2), 107-116. https://doi.org/10.1111/obr.12114
  • 2013
    • Gronenschild, E. H. B. M., Muris, D. M. J., Schram, M. T., Karaca, U., Stehouwer, C. D. A., & Houben, A. J. H. M. (2013). Semi-automatic assessment of skin capillary density: Proof of principle and validation. Microvascular Research, 90, 192-198. https://doi.org/10.1016/j.mvr.2013.08.003
    • Touwslager, R. N., Gielen, M., Tan, F. E. S., Mulder, A. L., Gerver, W. J., Zimmermann, L. J., Houben, A. J. H. M., Zeegers, M. P., Derom, C., Vlietinck, R., Maes, H. H., Stehouwer, C. D. A., & Thomis, M. (2013). Genetic, Maternal and Placental Factors in the Association between Birth Weight and Physical Fitness: A Longitudinal Twin Study. PLOS ONE, 8(10), Article 76423. https://doi.org/10.1371/journal.pone.0076423
    • Touwslager, R. N., Gielen, M., Mulder, A. L. M., Gerver, W. J. M., Zimmermann, L. J., Dagnelie, P. C., Houben, A. J. H. M., Stehouwer, C. D. A., Derom, C., Vlietinck, R., Loos, R. J. F., & Zeegers, M. P. (2013). Genetic and environmental factors in associations between infant growth and adult cardiometabolic risk profile in twins. American Journal of Clinical Nutrition, 98(4), 994-1001. https://doi.org/10.3945/ajcn.112.039131
  • 2012
    • Hanssen, S. J. P., van de Poll, M. C. G., Houben, A. J., Vermeulen Windsant, I. C., Snoeijs, M. G., Bekers, O., Buurman, W. A., & Jacobs, M. J. H. M. (2012). Hemolysis compromises nitric oxide-dependent vasodilatory responses in patients undergoing major cardiovascular surgery.Thoracic and Cardiovascular Surgeon, 60(4), 255-261. https://doi.org/10.1055/s-0031-1299571
    • Touwslager, R. N., Houben, A. J., Gielen, M. J. F., Zeegers, M. P. A., Stehouwer, C. D. A., Zimmermann, L. J. I., Kessels, A. G., Gerver, W. J. M., Blanco, C. E., & Mulder, A. L. M. (2012). Endothelial vasodilatation in newborns is related to body size and maternal hypertension.Journal of Hypertension, 30(1), 124-131. https://doi.org/10.1097/HJH.0b013e32834d75c6
    • Touwslager, R. N. H., Gerver, W. J. M., Tan, F. E. S., Gielen, M., Zeegers, M. P., Zimmermann, L. J., Houben, A. J. H. M., Blanco, C. E., Stehouwer, C. D. A., & Mulder, A. L. M. (2012). Influence of Growth During Infancy on Endothelium-Dependent Vasodilatation at the Age of 6 Months. Hypertension, 60(5), 1294-1300. https://doi.org/10.1161/HYPERTENSIONAHA.112.199125
  • 2011
    • Touwslager, R. N., Gielen, M. J. F., Mulder, A. L. M., Gerver, W. J. M., Zimmermann, L. J. I., Fowler, T., Houben, A. J., Stehouwer, C. D. A., Derom, C., Vlietinck, R., Loos, R. J., & Zeegers, M. P. A. (2011). Changes in genetic and environmental effects on growth during infancy. American Journal of Clinical Nutrition, 94(6), 1568-1574. https://doi.org/10.3945/ajcn.111.012757
    • Jonk, A. M., Houben, A. J., Schaper, N. C., de Leeuw, P. W., Serne, E. H., Smulders, Y. M., & Stehouwer, C. D. A. (2011). Obesity is associated with impaired endothelial function in the postprandial state.Microvascular Research, 82(3), 423-429. https://doi.org/10.1016/j.mvr.2011.08.006
    • Jonk, A. M., Houben, A. J., Schaper, N. C., de Leeuw, P., Serne, E. H., Smulders, Y. M., & Stehouwer, C. D. A. (2011). Meal-related increases in microvascular vasomotion are impaired in obese individuals: a potential mechanism in the pathogenesis of obesity-related insulin resistance. Diabetes Care, 34 Suppl 2(SUPPL. 2), S342-S348. https://doi.org/10.2337/dc11-s240
    • Jonk, A. M., Houben, A. J., Schaper, N. C., de Leeuw, P. W., Serne, E. H., Smulders, Y. M., & Stehouwer, C. D. A. (2011). Acute angiotensin II receptor blockade improves insulin-induced microvascular function in hypertensive individuals. Microvascular Research, 82(1), 77-83. https://doi.org/10.1016/j.mvr.2011.04.002
  • 2010
    • Jonk, A. M., Houben, A. J., Schaper, N. C., de Leeuw, P., Serne, E. H., Smulders, Y. M., & Stehouwer, C. D. (2010). Angiotensin II Enhances Insulin-Stimulated Whole-Body Glucose Disposal but Impairs Insulin-Induced Capillary Recruitment in Healthy Volunteers. Journal of Clinical Endocrinology & Metabolism, 95(8), 3901-3908. https://doi.org/10.1210/jc.2009-2587
    • Ronden, R. A., Houben, A. J. H. M., Kessels, A. G. H., Stehouwer, C. D. A., de Leeuw, P. W., & Kroon, A. A. (2010). Predictors of clinical outcome after stent placement in atherosclerotic renal artery stenosis: a systematic review and meta-analysis of prospective studies.Journal of Hypertension, 28(12), 2370-2377. https://doi.org/10.1097/HJH.0b013e32833ec392
  • 2004
    • van Onna, M. J. H., Kroon, A. A., Houben, A. J. H. M., Koster, D., Zeegers, M. P. A., Henskens, L. H. G., Plat, A. W., Stoffers, H. E. J. H., & de Leeuw, P. W. (2004). Genetic risk of atherosclerotic renal artery disease: the candidate gene approach in a renal angiography cohort. Hypertension, 44(4), 448-453. https://doi.org/10.1161/01.HYP.0000141440.02210.da
  • 2002
    • Keulen, E. T. P., Wyse, D. G., Houben, A. J. H. M., van Lin, J. M., Lutgens, L. C. H. W., Rijkers, K., Dallinga-Thie, G. M., & de Bruin, T. W. A. (2002). Reduced structural and functional skin capillaries in familial combined hyperlipidemia affected men, associated with increased remnant-like lipoprotein cholesterol levels. Atherosclerosis, 163(2), 355-362. https://doi.org/10.1016/S0021-9150(02)00021-7
  • 1999
    • Huvers, F. C., de Leeuw, P. W., Houben, A. J. H. M., de Haan, C. H. A., Hamulyak, K., Schouten, H. J. A., Wolffenbuttel, B. H. R., Wyse, D. G., & Schaper , NC. (1999). Endothelium-dependent vasodilatation, plasma markers of endothelial function, and adrenergic vasoconstrictor responses in type 1 diabetes under near-normoglycemic conditions.Diabetes, 48(6), 1300-1307. https://doi.org/10.2337/diabetes.48.6.1300