Korean Journal of Family Medicine (가정의학회지)

The Korean Academy of Family Medicine (대한가정의학회)
권호 표지
DOI QR코드

DOI QR Code

The Association of Body Fat and Arterial Stiffness Using the Brachial-Ankle Pulse Wave Velocity

  • Kim, Gyu Lee (Department of Family Medicine, Pusan National University Hospital) ;
  • Hwang, Hye Rim (Department of Family Medicine, Pusan National University Hospital) ;
  • Kim, Yun Jin (Department of Family Medicine, Pusan National University Hospital) ;
  • Lee, Sang Yeoup (Department of Family Medicine, Pusan National University School of Medicine) ;
  • Lee, Jeong Gyu (Department of Family Medicine, Pusan National University Hospital) ;
  • Jeong, Dong Wook (Department of Family Medicine, Pusan National University School of Medicine) ;
  • Yi, Yu Hyeon (Department of Family Medicine, Pusan National University School of Medicine) ;
  • Tak, Young Jin (Department of Family Medicine, Pusan National University Hospital) ;
  • Lee, Seung Hun (Department of Family Medicine, Pusan National University Hospital) ;
  • Park, A Rum (Department of Family Medicine, Pusan National University Hospital)
  • Received : 2017.03.16
  • Accepted : 2017.07.12
  • Published : 2018.11.20
⟨ Previous Next ⟩

Abstract

Background: BMI alone may not serve as an index of obesity because it does not reflect body composition. The present study aimed to compare arterial stiffness as assessed by the brachial-ankle pulse wave velocity (ba-PWV) among groups defined by body fat percentage (pBF) and BMI. Methods: This cross-sectional study was based on 1,700 participants (1,044 men and 656 women) who completed a health screening examination at a national hospital between January 2011 and February 2016. Participants were divided into four groups according to BMI and pBF: normal fat and normal weight (NFNW); excessive fat and normal weight (EFNW); normal fat and obese (NFO); and excessive fat and obese (EFO). The ba-PWV and other cardiometabolic factors were compared among the four groups in men and women separately. Results: For both sexes, the NFNW group had a lower metabolic risk compared to that in the other groups (EFNW, NFO, and EFO). After adjusting for multiple variables, the NFO males had a significantly lower ba-PWV compared to those in the other groups, including NFNW males. The NFO group had significantly more skeletal muscle mass and muscle mass compared the other groups (P<0.05). Among women, the NFNW group had a significantly lower ba-PWV compared the other groups, even after adjusting for multiple variables. Conclusion: Lower pBF in obese men may be associated with improved cardiovascular risk.

Keywords

References

  1. Haslam DW, James WP. Obesity. Lancet 2005;366:1197-209. https://doi.org/10.1016/S0140-6736(05)67483-1
  2. Daviglus ML, Liu K, Yan LL, Pirzada A, Manheim L, Manning W, et al. Relation of body mass index in young adulthood and middle age to Medicare expenditures in older age. JAMA 2004;292:2743-9. https://doi.org/10.1001/jama.292.22.2743
  3. Flegal KM, Carroll MD, Kuczmarski RJ, Johnson CL. Overweight and obesity in the United States: prevalence and trends, 1960-1994. Int J Obes Relat Metab Disord 1998;22:39-47. https://doi.org/10.1038/sj.ijo.0800541
  4. World Health Organization, International Diabetes Institute, International Association for the Study of Obesity, International Obesity Task Force. The Asia-Pacific perspective: redefining obesity and its treatment. Sydney: Health Communications Australia; 2000.
  5. Pischon T, Boeing H, Hoffmann K, Bergmann M, Schulze MB, Overvad K, et al. General and abdominal adiposity and risk of death in Europe. N Engl J Med 2008;359:2105-20. https://doi.org/10.1056/NEJMoa0801891
  6. Dervaux N, Wubuli M, Megnien JL, Chironi G, Simon A. Comparative associations of adiposity measures with cardiometabolic risk burden in asymptomatic subjects. Atherosclerosis 2008;201:413-7. https://doi.org/10.1016/j.atherosclerosis.2007.11.032
  7. Ochi M, Kohara K, Tabara Y, Kido T, Uetani E, Ochi N, et al. Arterial stiffness is associated with low thigh muscle mass in middle-aged to elderly men. Atherosclerosis 2010;212:327-32. https://doi.org/10.1016/j.atherosclerosis.2010.05.026
  8. Kishimoto N, Okita K, Takada S, Sakuma I, Saijo Y, Chiba H, et al. Lipoprotein metabolism, insulin resistance, and adipocytokine levels in Japanese female adolescents with a normal body mass index and high body fat mass. Circ J 2009;73:534-9. https://doi.org/10.1253/circj.CJ-08-0381
  9. Laurent S, Boutouyrie P, Asmar R, Gautier I, Laloux B, Guize L, et al. Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients. Hypertension 2001;37:1236-41. https://doi.org/10.1161/01.HYP.37.5.1236
  10. Emerging Risk Factors Collaboration, Wormser D, Kaptoge S, Di Angelantonio E, Wood AM, Pennells L, et al. Separate and combined associations of body-mass index and abdominal adiposity with cardiovascular disease: collaborative analysis of 58 prospective studies. Lancet 2011;377:1085-95. https://doi.org/10.1016/S0140-6736(11)60105-0
  11. Van Popele NM, Grobbee DE, Bots ML, Asmar R, Topouchian J, Reneman RS, et al. Association between arterial stiffness and atherosclerosis: the Rotterdam Study. Stroke 2001;32:454-60. https://doi.org/10.1161/01.STR.32.2.454
  12. Munakata M, Ito N, Nunokawa T, Yoshinaga K. Utility of automated brachial ankle pulse wave velocity measurements in hypertensive patients. Am J Hypertens 2003;16:653-7. https://doi.org/10.1016/S0895-7061(03)00918-X
  13. Kim MK, Han K, Kwon HS, Song KH, Yim HW, Lee WC, et al. Normal weight obesity in Korean adults. Clin Endocrinol (Oxf) 2014;80:214-20. https://doi.org/10.1111/cen.12162
  14. Bowman SA, Clemens JC, Friday JE, Thoerig RC, Moshfegh AJ. Food patterns equivalents database 2011-2012: methodology and user guide [Internet]. Beltsville (MD): The Agricultural Research Service, U.S. Department of Agriculture; 2014 [cited 2015 Nov 3]. Available from: http://www.ars.usda.gov/nea/bhnrc/fsrg.
  15. Eckel RH, Jakicic JM, Ard JD, de Jesus JM, Houston Miller N, Hubbard VS, et al. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2014;63(25 Pt B):2960-84. https://doi.org/10.1016/j.jacc.2013.11.003
  16. Yamashina A, Tomiyama H, Takeda K, Tsuda H, Arai T, Hirose K, et al. Validity, reproducibility, and clinical significance of noninvasive brachial-ankle pulse wave velocity measurement. Hypertens Res 2002;25:359-64. https://doi.org/10.1291/hypres.25.359
  17. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985;28:412-9. https://doi.org/10.1007/BF00280883
  18. Jensky NE, Allison MA, Loomba R, Carnethon MR, de Boer IH, Budoff MJ, et al. Null association between abdominal muscle and calcified atherosclerosis in community-living persons without clinical cardiovascular disease: the multi-ethnic study of atherosclerosis. Metabolism 2013;62:1562-9. https://doi.org/10.1016/j.metabol.2013.06.001
  19. Qiu S, Mintz JD, Salet CD, Han W, Giannis A, Chen F, et al. Increasing muscle mass improves vascular function in obese (db/db) mice. J Am Heart Assoc 2014;3:e000854.
  20. Virdis A, Neves MF, Duranti E, Bernini G, Taddei S. Microvascular endothelial dysfunction in obesity and hypertension. Curr Pharm Des 2013;19:2382-9. https://doi.org/10.2174/1381612811319130006
  21. Zebekakis PE, Nawrot T, Thijs L, Balkestein EJ, van der Heijden-Spek J, van Bortel LM, et al. Obesity is associated with increased arterial stiffness from adolescence until old age. J Hypertens 2005;23:1839-46. https://doi.org/10.1097/01.hjh.0000179511.93889.e9
  22. Desamericq G, Tissot CM, Akakpo S, Tropeano AI, Millasseau S, Macquin- Mavier I. Carotid-femoral pulse wave velocity is not increased in obesity. Am J Hypertens 2015;28:546-51. https://doi.org/10.1093/ajh/hpu190
  23. Lee JW, Lee HR, Shim JY, Im JA, Kim SH, Choi H, et al. Viscerally obese women with normal body weight have greater brachial-ankle pulse wave velocity than nonviscerally obese women with excessive body weight. Clin Endocrinol (Oxf) 2007;66:572-8.
  24. Carey VJ, Walters EE, Colditz GA, Solomon CG, Willett WC, Rosner BA, et al. Body fat distribution and risk of non-insulin-dependent diabetes mellitus in women: the Nurses' Health Study. Am J Epidemiol 1997;145:614-9. https://doi.org/10.1093/oxfordjournals.aje.a009158
  25. Blackman MR, Sorkin JD, Munzer T, Bellantoni MF, Busby-Whitehead J, Stevens TE, et al. Growth hormone and sex steroid administration in healthy aged women and men: a randomized controlled trial. JAMA 2002;288:2282-92. https://doi.org/10.1001/jama.288.18.2282
  26. Wang D, Wang C, Wu X, Zheng W, Sandberg K, Ji H, et al. Endothelial dysfunction and enhanced contractility in microvessels from ovariectomized rats: roles of oxidative stress and perivascular adipose tissue. Hypertension 2014;63:1063-9. https://doi.org/10.1161/HYPERTENSIONAHA.113.02284
  27. Khan D, Ansar Ahmed S. The immune system is a natural target for estrogen action: opposing effects of estrogen in two prototypical autoimmune diseases. Front Immunol 2016;6:635.
  28. Lavie CJ, Milani RV, Ventura HO. Obesity and cardiovascular disease: risk factor, paradox, and impact of weight loss. J Am Coll Cardiol 2009;53:1925-32. https://doi.org/10.1016/j.jacc.2008.12.068