Increased visceral fat accumulation modifies the effect of insulin resistance on arterial stiffness and hypertension risk

Autor: Neftali Eduardo Antonio-Villa, Omar Yaxmehen Bello-Chavolla, Arsenio Vargas-Vázquez, Roopa Mehta, Carlos A. Fermín-Martínez, Alexandro J. Martagón-Rosado, Daphne Abigail Barquera-Guevara, Carlos A. Aguilar-Salinas, Olimpia Arellano-Campos, Donaji V. Gómez-Velasco, Tania Viveros-Ruiz, Ivette Cruz-Bautista, Marco A. Melgarejo-Hernandez, Paloma Almeda-Valdés, Liliana Muñoz-Hernandez, Daniel Elias-Lopez, Fabiola Mabel Del Razo-Olvera, Bethsabel Rodríguez Encinas, Renán Fernando Fagoaga Ramírez, Luz E. Guillén, José de Jesús Garduño-García, Ulices Alvirde, Yukiko Ono-Yoshikawa, Ricardo Choza-Romero, Leobardo Sauque-Reyna, Ma. Eugenia Garay-Sevilla, Juan M. Malacara-Hernandez, María Teresa Tusié-Luna, Luis Miguel Gutierrez-Robledo, Francisco J. Gómez-Pérez, Rosalba Rojas
Rok vydání: 2021
Předmět:
Adult
Blood Glucose
Male
medicine.medical_specialty
Endocrinology
Diabetes and Metabolism
Medicine (miscellaneous)
Adipose tissue
030209 endocrinology & metabolism
Intra-Abdominal Fat
030204 cardiovascular system & hematology
Risk Assessment
Hypertension risk
03 medical and health sciences
Vascular Stiffness
0302 clinical medicine
Insulin resistance
Internal medicine
medicine
Humans
Insulin
Arterial Pressure
Prospective Studies
Prospective cohort study
Mexico
Adiposity
Cardiometabolic risk
Nutrition and Dietetics
business.industry
Incidence
Cardiometabolic Risk Factors
nutritional and metabolic diseases
Increased visceral fat
Middle Aged
medicine.disease
Cross-Sectional Studies
Blood pressure
Hypertension
Arterial stiffness
Cardiology
Female
Insulin Resistance
Cardiology and Cardiovascular Medicine
business
Biomarkers
Zdroj: Nutrition, Metabolism and Cardiovascular Diseases. 31:506-517
ISSN: 0939-4753
Popis: Background and aims Both insulin resistance (IR) and visceral adipose tissue (VAT) are related cardiometabolic risk factors; nevertheless, their joint effect on endothelial functionality is controversial. This study aims to evaluate the joint effect of IR and VAT on endothelial functionality using the pulse-waveform analysis and explore the mediating role of VAT on the effect of IR on arterial pressure, arterial stiffness and incident arterial hypertension. Methods and results We measured VAT (n = 586) using two methods (dual-energy X-ray absorptiometry and a clinical surrogate), arterial stiffness (with pulse-waveform velocity), and IR (using three methods: HOMA2-IR (n = 586), a frequently sampled intravenous glucose tolerance test (n = 131) and euglycemic hyperinsulinemic clamping (n = 97)) to confirm the mediator effect of IR on VAT. The incidence of arterial hypertension attributable to the mediating effect of IR related to VAT was evaluated using a prospective cohort (n = 6850). Adjusted linear regression models, causal mediation analysis, and Cox-proportional hazard risk regression models were performed to test our objective. IR and VAT led to increased arterial stiffness and increased blood pressure; the combination of both further worsened vascular parameters. Nearly, 57% (ΔE→MY 95% CI: 31.7–100.0) of the effect of IR on altered pulse-wave velocity (PWV) analysis was mediated through VAT. Moreover, VAT acts as a mediator of the effect of IR on increased mean arterial pressure (ΔE→MY 35.7%, 95% CI: 23.8–59) and increased hypertension risk (ΔE→MY 69.1%, 95% CI: 46.1–78.8). Conclusion VAT acts as a mediator of IR in promoting arterial stiffness and arterial hypertension. Both phenomena should be targeted to ameliorate the cardiometabolic risk.
Databáze: OpenAIRE
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