Need another reason to work out?™ Higher central fat mass and lower peripheral lean mass are independent determinants of endothelial dysfunction in the elderly

Atherosclerosis. 2014 Jan 17;233(1):310-318. doi: 10.1016/j.atherosclerosis.2013.12.002. [Epub ahead of print]

Higher central fat mass and lower peripheral lean mass are independent determinants of endothelial dysfunction in the elderly: The Hoorn study.

Beijers HJ1, Ferreira I2, Bravenboer B3, Henry RM4, Schalkwijk CG5, Dekker JM6, Nijpels G6, Stehouwer CD5.

Author information

• 1Department of Medicine, Catharina Hospital, Postbox 1350, 5602 ZA Eindhoven, The Netherlands. Electronic address: hanneke.beijers@catharina-ziekenhuis.nl.
• 2Department of Internal Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands; Department of Clinical Epidemiology and Medical Technology Assessment, MUMC+, Maastricht, The Netherlands; Cardiovascular Research Institute Maastricht (CARIM), MUMC+, Maastricht, The Netherlands; Care and Public Health Research Institute (CAPHRI), MUMC+, Maastricht, The Netherlands.
• 3Department of Internal Medicine, University Hospital (AZVU), Brussel, Belgium.
• 4Department of Internal Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands.
• 5Department of Internal Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands; Cardiovascular Research Institute Maastricht (CARIM), MUMC+, Maastricht, The Netherlands.
• 6Institute for Research in Extramural Medicine, VU University Medical Centre, Amsterdam, The Netherlands.

Abstract

OBJECTIVE:

To investigate whether an adverse body composition is associated with endothelial dysfunction (ED) and the extent to which any such association could be explained by low-grade inflammation (LGI) and/or insulin resistance (HOMA2-IR).

METHODS:

We studied 475 individuals from the Hoorn Study [mean (range) age, 68.9 (60-87) years, 245 women). Body composition was assessed by whole body dual-energy absorptiometry. Endothelial dysfunction was measured functionally, by flow-mediated dilation (FMD) and by circulating biomarkers. Associations were examined with multiple linear regression models and mediation analyses according to the ab product of coefficients method.

RESULTS:

After adjustment for age, sex, glucose metabolism status, prior cardiovascular disease and lifestyle factors, total and central fat mass were positively associated with the ED score [β = 0.16 (95% CI 0.04-0.29) and β = 0.18 (0.05-0.31), respectively] and inversely, although not statistically significantly, with FMD. Peripheral fat mass was not associated with the ED score or FMD. There was a significant favourable association between peripheral lean mass and FMD [β = 0.13 (0.00-0.26)], but not with the ED score. The association between total and central fat mass and the ED score was, to a great extent, mediated by LGI and HOMA2-IR. In contrast, LGI or HOMA2-IR did not mediate the association between peripheral lean mass and FMD.

CONCLUSION:

Higher levels of central, but not peripheral fat mass were adversely associated with ED, which was attributable to body composition-related LGI and insulin resistance. In contrast, peripheral lean mass was beneficially associated with ED, but this seemed to be unrelated to LGI or insulin resistance.