Abstract 14115: Changes in Body Fat Distribution Predict Arterial Health
Introduction: Truncal obesity is associated with insulin resistance, dyslipidemia, hypertension and ultimately to cardiovascular risk. Arterial stiffness and endothelial dysfunction are markers of cardiovascular health and outcomes. Although vascular health is influenced by weight, it is not known whether the distribution of fat and its change with time modulates arterial function.
Hypothesis: Changes in truncal (android) fat predict increased arterial stiffness and endothelial dysfunction.
Methods: 711 healthy volunteers (235 males, age 48±11) were recruited into the Emory Predictive Health Study; 498 returned at one year for repeat testing. Measurements included anthropometric, lipid and chemistry panels, android and gynoid fat mass using dual energy X-ray absorptiometry, arterial stiffness indices [pulse wave velocity (PWV), augmentation index (AIx), and subendocardial viability ratio (SEVR)] using the Sphygmocor device, endothelial function using brachial artery flow-mediated dilation (FMD) and reactive hyperemia index (RHI, Endo-PAT). Uni- and multivariate regression models were conducted adjusting for relevant variables.
Results: At baseline, measures of body mass correlated with PWV, AIx, SEVR, and FMD. After multivariable analysis including all risk factors and fat distribution, android fat mass remained an independent predictor of PWV and SEVR. In a model including BMI, waist circumference, waist:hip ratio, android and gynoid fat mass, android fat mass remained an independent predictor of PWV (β= .40, p <.001), AIx (β= .23, p= .023), and SEVR (β= -.41, p <.001). The one-year change in android fat correlated negatively with the change in SEVR (β= -.13, p= .005) and FMD (β= -.13, p= .006) after adjustment for change in gynoid fat.
Conclusions: Body fat, particularly android fat, is a determinant of arterial stiffness, independent of traditional cardiovascular risk factors and other measures of weight. Moreover, changes in android fat over time are associated with simultaneous changes in vascular function, indicating the critical impact of visceral fat on vascular health.
- Endothelial function
- Pulse wave velocity (PWV)
- Body mass index (BMI) and waist circumference
- Follow-up studies
- Cardiometabolic health
Author Disclosures: F.E. Corrigan: None. H.M. Kelli: None. D.S. Dhindsa: None. R.E. Heinl: None. I. Al Mheid: None. M. Hammadah: None. S.S. Hayek: None. S. Sher: None. D.J. Eapen: None. G.S. Martin: None. A.A. Quyyumi: None.
- © 2016 by American Heart Association, Inc.