title: Regional body composition as a determinant of arterial stiffness in the elderly: The Hoorn Study.
abstract: OBJECTIVE
  To estimate the relation of precisely measured regional body composition with peripheral and central arterial stiffness in the elderly.
  
  
  METHODS
  We investigated 648 participants (mean age 69.0 +/- 6.0 years) of the Hoorn Study, a population-based cohort study. Trunk fat, leg fat, trunk lean and leg lean mass were distinguished by dual-energy X-ray absorptiometry. We used ultrasound to measure the distensibility and compliance of the carotid, femoral and brachial arteries, and carotid Young's elastic modulus, as estimates of peripheral stiffness. As estimates of central stiffness we measured carotid-femoral transit time, aortic augmentation index and systemic arterial compliance.
  
  
  RESULTS
  After adjustment for sex, age, height, mean arterial pressure, leg lean and leg fat mass, a larger trunk fat mass was consistently associated with higher peripheral arterial stiffness (standardized beta (beta) of mean Z-scores of all three large arteries -0.24, P < 0.001). In contrast, larger leg fat mass (beta = 0.15, P = 0.009) and leg lean mass (beta = 0.09, P = 0.20) were associated with lower peripheral arterial stiffness. Trunk or leg fat mass were not associated with central arterial stiffness. Leg lean mass, however, was consistently associated with lower central arterial stiffness (beta = 0.29, P < 0.001).
  
  
  CONCLUSIONS
  Trunk fat mass may have adverse effects on peripheral, but not on central arterial stiffness, while leg fat was not harmful and may have a slight protective effect. Larger leg lean mass was the most important determinant of lower central arterial stiffness. These results provide a pathophysiological framework to explain not only the higher cardiovascular risk in individuals with larger trunk fat mass, but also the reduced cardiovascular risk in individuals with larger leg lean and fat mass.
authors.affiliation: Institute for Research in Extramural Medicine, VU University Medical Center, Amsterdam, The Netherlands. marieke.snijder@falw.vu.nl
authors.forename: Marieke B
authors.initials: MB
authors.lastname: Snijder
authors.forename: Ronald M A
authors.initials: RM
authors.lastname: Henry
authors.forename: Marjolein
authors.initials: M
authors.lastname: Visser
authors.forename: Jacqueline M
authors.initials: JM
authors.lastname: Dekker
authors.forename: Jacob C
authors.initials: JC
authors.lastname: Seidell
authors.forename: Isabel
authors.initials: I
authors.lastname: Ferreira
authors.forename: Lex M
authors.initials: LM
authors.lastname: Bouter
authors.forename: John S
authors.initials: JS
authors.lastname: Yudkin
authors.forename: Nico
authors.initials: N
authors.lastname: Westerhof
authors.forename: Coen D A
authors.initials: CD
authors.lastname: Stehouwer
mesh_terms: D000005:Abdomen; D015502:Absorptiometry, Photon; D000368:Aged; D000375:Aging; D001011:Aorta / Q000000981:diagnostic imaging / Q000503:physiopathology; D001158:Arteries / Q000503:physiopathology*; D001775:Blood Circulation; D001823:Body Composition; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000209:etiology; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology; D015331:Cohort Studies; D003187:Compliance; D004548:Elasticity; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D007866:Leg; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013909:Thorax; D013997:Time Factors; D014463:Ultrasonography