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 |
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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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