Arterial Stiffness, Biomarkers of Liver Fat, and the Development of Metabolic Dysfunction in Metabolically Healthy Population: A Prospective Study

Abstract

BackgroundMetabolic dysfunction is known to be associated with arterial stiffness. However, the risks of metabolic syndrome and diabetes due to arterial stiffness and the potential mechanism remain unclear. We aimed to investigate the association of arterial stiffness with the risk of metabolic syndrome and diabetes, and determine whether this association is mediated by liver fat.MethodsA prospective study was conducted with 4,139 Chinese adults who were metabolically healthy at baseline. Arterial stiffness was measured by brachial–ankle pulse wave velocity (baPWV). Obesity was defined as body mass index ≥25 kg/m2. The primary outcomes were incident metabolic syndrome and diabetes.ResultsDuring a median follow-up of 4.4 years, 1,022 (24.7%) and 354 (9.5%) participants developed metabolic syndrome and diabetes, respectively. Compared with those in the lowest quartile of baPWV, participants in the highest quartile had 85 and 91% higher risks of metabolic syndrome and diabetes [risk ratio (RR) 1.85, 95% confidence interval (CI) 1.41, 2.42 for metabolic syndrome; RR 1.91, 95% CI 1.16, 3.15 for diabetes]. Mediation analyses indicated that fatty liver significantly mediated the association of arterial stiffness with metabolic syndrome and diabetes risk. Specifically, 18.4% of metabolic syndrome and 12.6% of diabetes risk due to arterial stiffness were mediated through fatty liver.ConclusionsArterial stiffness was associated with higher risks of metabolic syndrome and diabetes in individuals with obesity. This association may be partially mediated by fatty liver.

Obesity dominates early effects on cardiac structure and arterial stiffness in people with type 2 diabetes

“…Our finding of elevated arterial stiffness in PWV in both the CWO and T2D groups when compared with reference control agrees with previous work finding decreased distensibility as a marker of stiffness in both the ascending and descending aorta of people with T2D and obesity [37,42]. We speculate that the greater aortic stiffness in people with relatively uncomplicated T2D and obesity is an initial marker of vascular disease in this population.…”

“…In a recent report of individuals with heart failure with preserved ejection fraction, arterial stiffness correlated with visceral adipose tissue, consistent with our observations with obesity alone [36]. A Chinese population study reported similar associations between arterial stiffness measured by brachial–ankle PWV and obesity [37]. Arterial stiffness as measured by 2D QA PC-MRI PWV in T2D and CWO significantly differed between the two study groups only in the ascending aorta.…”

“…This finding is important given the role the relatively compliant ascending aorta plays to dampen flow and pressure waveforms during contraction (via the Windkessel effect). In our previous report in youth with type 1 diabetes (T1D), we observed selected changes in PWV and wall shear stress in the descending aorta only; interestingly, these abnormalities were responsive to treatment with metformin [37]. Proximal aortic stiffness might represent a source of excess afterload and impaired cardiac perfusion, contributing to the observed cardiac function abnormalities.…”

Association between serum LDL‐C concentrations and risk of diabetes: A prospective cohort study

“…The participants were from an ongoing cohort study in Jiading District, Shanghai, China. The study design and detailed methods have been described previously 8,9 . Briefly, registered residents from two communities in Jiading District were invited to attend a comprehensive health examination, and 10 375 residents aged 40 years or older were recruited between March and August 2010.…”

“…The study design and detailed methods have been described previously. 8 , 9 Briefly, registered residents from two communities in Jiading District were invited to attend a comprehensive health examination, and 10 375 residents aged 40 years or older were recruited between March and August 2010. All the participants completed a standard questionnaire and a set of clinical measurements.…”