Body composition and fat repartition in relation to structure and function of large arteries in middle-aged adults (the SU.VI.MAX study)

Abstract

OBJECTIVE:To investigate associations of body composition assessed by bioimpedance analysis and anthropometric indicators of fat repartition with carotid structure and function. DESIGN: Cross-sectional epidemiological study. SUBJECTS: A total of 1014 middle-aged apparently healthy adults participating in the SU.VI.MAX study. MEASUREMENTS: Body composition (fat mass, fat-free mass) was assessed by bioimpedance analysis and anthropometric indicators of fat repartition (waist circumference (WC); waist-hip-ratio (WHR)) were simultaneously collected. Carotid ultrasound examination included measurements of intima-media thickness (IMT) at the common carotid arteries (CCA) and assessment of atherosclerotic plaques in extracranial carotid arteries. Carotid-femoral pulse-wave velocity (PWV) was used as a marker of aortic stiffness. RESULTS: In multivariate analyses adjusted for major known cardiovascular risk factors in addition to age, gender and height, fat-free mass, fat mass (FM), and WC were positively associated with CCA-IMT and lumen diameter. No significant association was found with occurrence of carotid plaques. PWV was only associated with WC. Associations of CCA-IMT and PWV with WC were not significant anymore after further adjustment on body mass index (BMI) or FM. CONCLUSION: WC was the only measurement positively associated with both early atherosclerosis markers such as CCA-IMT and arterial stiffness. Although this association depends on overall adiposity, as assessed by the BMI, it emphasizes the importance of WC in clinical practice and prevention programs as a screening tool for individuals at risk for cardiovascular disease.

Hypertriglyceridemic waist and 7.5-year prospective risk of cardiovascular disease in asymptomatic middle-aged men

“…1,2 Independently of overall adiposity, as defined by body mass index (BMI, kg/m 2 ), abdominal fat accumulation assessed with anthropometric indicators such as waist-hip ratio, sagittal diameter, or more simply waist circumference (WC), increases the risk for cardiovascular disease (CVD). [3][4][5][6][7] There is general agreement that increased intra-abdominal (or visceral) fat is particularly deleterious in relation with CVD risk, 8 and WC is one of the anthropometric indicators strongly correlated with this fat depot. 9 Consensus conferences have defined WC cutoffs for increased risk in women and men, respectively.…”

Obesity, Arterial Stiffness, and Cardiovascular Risk

“…However, increased aortic stiffness has been shown to be more related to body fat repartition (assessed by WC [ (11,14,17] and visceral adiposity [10,18]) than to increased BMI (10,11). More recently, total trunk fat (19) has been found to be associated adversely with PWV.…”

Macrovascular and microvascular dysfunction in the metabolic syndrome

“…[3][4][5][6][7] Indeed, previous studies report deleterious relationships between central fat accumulation and the structure and function of large arteries. [8][9][10][11] The microcirculation is generally defined as the network of small arteries, arterioles capillaries and venules that serve metabolic and other tissues. [12][13][14] Microcirculatory dysfunction has been proposed to be an additional mechanism relating obesity to CVD, through insulin resistance and hypertension.…”