title: Higher central fat mass and lower peripheral lean mass are independent determinants of endothelial dysfunction in the elderly: the Hoorn study.
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.
  
  
  CONCLUSIONS
  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.
authors: Department of Medicine, Catharina Hospital, Postbox 1350, 5602 ZA Eindhoven, The Netherlands. Electronic address: hanneke.beijers@catharina-ziekenhuis.nl.
authors: Hanneke J B H
authors: HJ
authors: Beijers
authors: Department 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.
authors: Isabel
authors: I
authors: Ferreira
authors: Department of Internal Medicine, University Hospital (AZVU), Brussel, Belgium.
authors: Bert
authors: B
authors: Bravenboer
authors: Department of Internal Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands.
authors: Ronald M A
authors: RM
authors: Henry
authors: Department of Internal Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands; Cardiovascular Research Institute Maastricht (CARIM), MUMC+, Maastricht, The Netherlands.
authors: Casper G
authors: CG
authors: Schalkwijk
authors: Institute for Research in Extramural Medicine, VU University Medical Centre, Amsterdam, The Netherlands.
authors: Jacqueline M
authors: JM
authors: Dekker
authors: Institute for Research in Extramural Medicine, VU University Medical Centre, Amsterdam, The Netherlands.
authors: Giel
authors: G
authors: Nijpels
authors: Department of Internal Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands; Cardiovascular Research Institute Maastricht (CARIM), MUMC+, Maastricht, The Netherlands.
authors: Coen D A
authors: CD
authors: Stehouwer
mesh_terms: D015502:Absorptiometry, Photon; D000273:Adipose Tissue / Q000473:pathology*; D000368:Aged; D015415:Biomarkers; D001823:Body Composition; D004727:Endothelium / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000503:physiopathology; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow; D014664:Vasodilation
chemical_list: D015415:Biomarkers
keywords: Biomarkers; Body composition; Dual-energy absorptiometry; Elderly; Endothelial dysfunction; Epidemiology; Fat mass; Flow-mediated dilation; Sarcopenia