期刊
HYPERTENSION
卷 66, 期 2, 页码 294-300出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1161/HYPERTENSIONAHA.115.05494
关键词
aging; arterial stiffness; epidemiology; obesity; longitudinal studies
资金
- British Heart Foundation [RG/13/2/30098]
- British Medical Research Council [K013351]
- British Health and Safety Executive
- British Department of Health
- British Stroke Association [TSA 2008/05]
- US National Heart, Lung, and Blood Institute [R01HL036310]
- US National Institute on Aging [R01AG013196, R01AG034454]
- Economic and Social Research Council
- Cambridge National Institute for Health Research Biomedical Research Centre
- British Heart Foundation [RG/07/008/23674, PG/11/63/29011, RG/13/2/30098, FS/12/8/29377] Funding Source: researchfish
- Economic and Social Research Council [ES/J023299/1, ES/F02679X/1] Funding Source: researchfish
- Medical Research Council [G19/35, MR/K013351/1, G0701830, G0601647, G8802774, G0902037, G0100222, G1000616] Funding Source: researchfish
- ESRC [ES/J023299/1, ES/F02679X/1] Funding Source: UKRI
- MRC [G0601647, G1000616, G0701830, MR/K013351/1, G0902037] Funding Source: UKRI
We sought to determine whether adiposity in later midlife is an independent predictor of accelerated stiffening of the aorta. Whitehall II study participants (3789 men; 1383 women) underwent carotid-femoral applanation tonometry at the mean age of 66 and again 4 years later. General adiposity by body mass index, central adiposity by waist circumference and waist:hip ratio, and fat mass percent by body impedance were assessed 5 years before and at baseline. In linear mixed models adjusted for age, sex, ethnicity, and mean arterial pressure, all adiposity measures were associated with aortic stiffening measured as increase in pulse wave velocity (PWV) between baseline and follow-up. The associations were similar in the metabolically healthy and unhealthy, according to Adult Treatment Panel-III criteria excluding waist circumference. C-reactive protein and interleukin-6 levels accounted for part of the longitudinal association between adiposity and PWV change. Adjusting for chronic disease, antihypertensive medication and risk factors, standardized effects of general and central adiposity and fat mass percent on PWV increase (m/s) were similar (0.14, 95% confidence interval: 0.05-0.24, P=0.003; 0.17, 0.08-0.27, P<0.001; 0.14, 0.05-0.22, P=0.002, respectively). Previous adiposity was associated with aortic stiffening independent of change in adiposity, glycaemia, and lipid levels across PWV assessments. We estimated that the body mass index-linked PWV increase will account for 12% of the projected increase in cardiovascular risk because of high body mass index. General and central adiposity in later midlife were strong independent predictors of aortic stiffening. Our findings suggest that adiposity is an important and potentially modifiable determinant of arterial aging.
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