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Central Fat Mass Versus Peripheral Fat and Lean Mass: Opposite (Adverse Versus Favorable) Associations with Arterial Stiffness? The Amsterdam Growth and Health Longitudinal Study

Institute for Research in Extramural Medicine (I.F., M.B.S., J.W.R.T., W.v.M., H.C.G.K., J.C.S., C.D.A.S.), Department of Clinical Epidemiology and Biostatistics (J.W.R.T.), Department of Social Medicine and Body@Work Research Centre for Physical Activity, Work and Health TNO-VU (W.v.M.),, and Department of Internal Medicine and the Institute for Cardiovascular Research (C.D.A.S.), VU University Medical Center, 1081 HV Amsterdam, The Netherlands; and Department for Nutrition and Health (J.C.S.), Faculty of Earth and Life Sciences, Vrije Universiteit, 1081 HV Amsterdam, The Netherlands

Address all correspondence and requests for reprints to: Professor Dr. Coen D. A. Stehouwer, Department of Internal Medicine, VU University Medical Center, De Boelelaan 1117, P.O. Box 7057, 1081 HV Amsterdam, The Netherlands. E-mail: cda.stehouwer{at}vumc.nl.

Central and peripheral fatness seem to confer opposite (i.e. adverse vs. protective) effects on cardiovascular risk, but how this occurs is not clear. In addition, the role of peripheral lean mass needs to be elucidated. We therefore investigated, in 336 (175 women) 36-yr-old and apparently healthy adults, the relationship between trunk fat, peripheral fat, and peripheral lean mass on the one hand, and estimates of stiffness of three large arteries on the other. Body composition was assessed by dual-energy x-ray absorptiometry. Arterial properties were assessed by ultrasound imaging. We found that 1) trunk fat was positively (i.e. adversely) associated with stiffness of the carotid and femoral arteries, whereas peripheral fat was inversely (i.e. favorably) associated with stiffness of the brachial and the carotido-femoral segment; 2) peripheral lean mass was positively associated with arterial diameter and carotid compliance and inversely associated with stiffness of the carotido-femoral segment; and 3) after adjustment for the other body composition variables, the above-mentioned associations remained, but peripheral fat in addition became, if anything, favorably associated with stiffness of the femoral artery. We conclude that trunk fat is adversely associated with large artery stiffness, whereas some degree of protection is conferred by peripheral fat and lean mass.

I.F. was supported by a research grant from the Foundation for Science and Technology—State Secretary of Science and Technology of Portugal, and the European Social Fund, within the Third European Community Framework Program (Grant PRAXIS XXI/BD/19760/99). The AGAHLS has, since 1974, been supported by major grants from the Foundation for Educational Research; the Dutch Prevention Fund; The Netherlands Heart Foundation; the Dutch Ministry of Public Health, Well Being and Sport; the Dairy Foundation on Nutrition and Health; The Netherlands Olympic Committee/Netherlands Sports Federation; Heineken BV; and Scientific Board of Smoking and Health.

Abbreviations: AGAHLS, Amsterdam Growth and Health Longitudinal Study; ß, standardized regression coefficient; BMI, body mass index; DXA, dual-energy x-ray absorptiometry; FFA, free fatty acids; HbA_1c, glycated hemoglobin; HDL, high-density lipoprotein; IMT, intima-media thickness; PWV, pulse wave velocity.

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