title: Association of serum-free fatty acid level with reduced reflection pressure wave magnitude and central blood pressure: the Nagahama study.
abstract: Central blood pressure (BP) has been suggested to be a better predictor of cardiovascular disease risk than brachial BP. Given that central BP and arterial waveform are both influenced by insulin resistance, major initiators of insulin resistance, such as serum-free fatty acid (FFA), are suspected of potentially being involved in central hemodynamics. To confirm that insulin signaling is an important modulator of central hemodynamics, we investigated this hypothesis in a large-scale general population. Brachial BP and radial arterial waveform were measured simultaneously in 9393 middle-aged to elderly individuals. The augmentation index was calculated from the radial waveform as the ratio of the height of the late systolic peak to that of the first peak. Central systolic BP was defined as the absolute pressure of the late systolic peak of the waveform. Differences in central and brachial pulse pressure (PP) were considered to represent PP amplification. PP amplification differed significantly among serum FFA level quartiles (Q1, 7.8±5.3; Q2, 8.6±5.0; Q3, 9.3±5.7; Q4, 10.3±6.1 mm Hg; P<0.001), and the maximum difference in combination with diabetes mellitus status was 4.9 mm Hg. Multivariate analysis adjusted for major covariates indicated that higher serum FFA was an independent determinant for higher PP amplification (β=0.145, P<0.001) and lower augmentation index (β=-0.122, P<0.001) and central systolic BP (β=-0.044, P<0.001), whereas the association between FFA and PP amplification significantly decreased (β=0.022, P<0.001) after further adjustment for augmentation index. Serum FFA is an overlooked factor favorably influencing central hemodynamics. A low-magnitude reflection pressure wave might be involved in this paradoxical relationship.
authors.affiliation: From the Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan (Y.T., T.K., K.S., C.T., R.Y., F.M.); Departments of Health Informatics (Y.T., T.N.) and Medical Ethics and Medical Genetics (S.K.), Kyoto University School of Public Health, Kyoto, Japan; and Kyoto University Medical Research Support Center, Kyoto, Japan (A.S.). tabara@genome.med.kyoto-u.ac.jp.
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Tabara
authors.affiliation: From the Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan (Y.T., T.K., K.S., C.T., R.Y., F.M.); Departments of Health Informatics (Y.T., T.N.) and Medical Ethics and Medical Genetics (S.K.), Kyoto University School of Public Health, Kyoto, Japan; and Kyoto University Medical Research Support Center, Kyoto, Japan (A.S.).
authors.forename: Yoshimitsu
authors.initials: Y
authors.lastname: Takahashi
authors.affiliation: From the Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan (Y.T., T.K., K.S., C.T., R.Y., F.M.); Departments of Health Informatics (Y.T., T.N.) and Medical Ethics and Medical Genetics (S.K.), Kyoto University School of Public Health, Kyoto, Japan; and Kyoto University Medical Research Support Center, Kyoto, Japan (A.S.).
authors.forename: Takahisa
authors.initials: T
authors.lastname: Kawaguchi
authors.affiliation: From the Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan (Y.T., T.K., K.S., C.T., R.Y., F.M.); Departments of Health Informatics (Y.T., T.N.) and Medical Ethics and Medical Genetics (S.K.), Kyoto University School of Public Health, Kyoto, Japan; and Kyoto University Medical Research Support Center, Kyoto, Japan (A.S.).
authors.forename: Kazuya
authors.initials: K
authors.lastname: Setoh
authors.affiliation: From the Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan (Y.T., T.K., K.S., C.T., R.Y., F.M.); Departments of Health Informatics (Y.T., T.N.) and Medical Ethics and Medical Genetics (S.K.), Kyoto University School of Public Health, Kyoto, Japan; and Kyoto University Medical Research Support Center, Kyoto, Japan (A.S.).
authors.forename: Chikashi
authors.initials: C
authors.lastname: Terao
authors.affiliation: From the Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan (Y.T., T.K., K.S., C.T., R.Y., F.M.); Departments of Health Informatics (Y.T., T.N.) and Medical Ethics and Medical Genetics (S.K.), Kyoto University School of Public Health, Kyoto, Japan; and Kyoto University Medical Research Support Center, Kyoto, Japan (A.S.).
authors.forename: Ryo
authors.initials: R
authors.lastname: Yamada
authors.affiliation: From the Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan (Y.T., T.K., K.S., C.T., R.Y., F.M.); Departments of Health Informatics (Y.T., T.N.) and Medical Ethics and Medical Genetics (S.K.), Kyoto University School of Public Health, Kyoto, Japan; and Kyoto University Medical Research Support Center, Kyoto, Japan (A.S.).
authors.forename: Shinji
authors.initials: S
authors.lastname: Kosugi
authors.affiliation: From the Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan (Y.T., T.K., K.S., C.T., R.Y., F.M.); Departments of Health Informatics (Y.T., T.N.) and Medical Ethics and Medical Genetics (S.K.), Kyoto University School of Public Health, Kyoto, Japan; and Kyoto University Medical Research Support Center, Kyoto, Japan (A.S.).
authors.forename: Akihiro
authors.initials: A
authors.lastname: Sekine
authors.affiliation: From the Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan (Y.T., T.K., K.S., C.T., R.Y., F.M.); Departments of Health Informatics (Y.T., T.N.) and Medical Ethics and Medical Genetics (S.K.), Kyoto University School of Public Health, Kyoto, Japan; and Kyoto University Medical Research Support Center, Kyoto, Japan (A.S.).
authors.forename: Takeo
authors.initials: T
authors.lastname: Nakayama
authors.affiliation: From the Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan (Y.T., T.K., K.S., C.T., R.Y., F.M.); Departments of Health Informatics (Y.T., T.N.) and Medical Ethics and Medical Genetics (S.K.), Kyoto University School of Public Health, Kyoto, Japan; and Kyoto University Medical Research Support Center, Kyoto, Japan (A.S.).
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Matsuda
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination; D001916:Brachial Artery / Q000502:physiology; D005230:Fatty Acids, Nonesterified / Q000097:blood*; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology*; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies
chemical_list: D005230:Fatty Acids, Nonesterified
keywords: aortic blood pressure; free fatty acid; insulin resistance; pulse wave analysis