title: Adiposity, obesity, and arterial aging: longitudinal study of aortic stiffness in the Whitehall II cohort.
abstract: We sought to determine whether adiposity in later midlife is an independent predictor of accelerated stiffening of the aorta. Whitehall II study participants (3789 men; 1383 women) underwent carotid-femoral applanation tonometry at the mean age of 66 and again 4 years later. General adiposity by body mass index, central adiposity by waist circumference and waist:hip ratio, and fat mass percent by body impedance were assessed 5 years before and at baseline. In linear mixed models adjusted for age, sex, ethnicity, and mean arterial pressure, all adiposity measures were associated with aortic stiffening measured as increase in pulse wave velocity (PWV) between baseline and follow-up. The associations were similar in the metabolically healthy and unhealthy, according to Adult Treatment Panel-III criteria excluding waist circumference. C-reactive protein and interleukin-6 levels accounted for part of the longitudinal association between adiposity and PWV change. Adjusting for chronic disease, antihypertensive medication and risk factors, standardized effects of general and central adiposity and fat mass percent on PWV increase (m/s) were similar (0.14, 95% confidence interval: 0.05-0.24, P=0.003; 0.17, 0.08-0.27, P<0.001; 0.14, 0.05-0.22, P=0.002, respectively). Previous adiposity was associated with aortic stiffening independent of change in adiposity, glycaemia, and lipid levels across PWV assessments. We estimated that the body mass index-linked PWV increase will account for 12% of the projected increase in cardiovascular risk because of high body mass index. General and central adiposity in later midlife were strong independent predictors of aortic stiffening. Our findings suggest that adiposity is an important and potentially modifiable determinant of arterial aging.
authors.affiliation: From the UCL Research Department of Epidemiology and Public Health, London, United Kingdom (E.J.B., M.J.S., S.A.-A., A.G.T., C.M.M., M.G.M., A.S.-M., M.K.); Semmelweis University Faculty of Medicine, 1st Department of Medicine, Budapest, Hungary (A.G.T.); Clinical Pharmacology Unit, Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, United Kingdom (C.M.M., J.B.W.); INSERM, Centre for Research in Epidemiology & Public Health, Hôpital Paul Brousse, Bâtiment, France (A.S.-M.). e.brunner@ucl.ac.uk.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Brunner
authors.affiliation: From the UCL Research Department of Epidemiology and Public Health, London, United Kingdom (E.J.B., M.J.S., S.A.-A., A.G.T., C.M.M., M.G.M., A.S.-M., M.K.); Semmelweis University Faculty of Medicine, 1st Department of Medicine, Budapest, Hungary (A.G.T.); Clinical Pharmacology Unit, Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, United Kingdom (C.M.M., J.B.W.); INSERM, Centre for Research in Epidemiology & Public Health, Hôpital Paul Brousse, Bâtiment, France (A.S.-M.).
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Shipley
authors.affiliation: From the UCL Research Department of Epidemiology and Public Health, London, United Kingdom (E.J.B., M.J.S., S.A.-A., A.G.T., C.M.M., M.G.M., A.S.-M., M.K.); Semmelweis University Faculty of Medicine, 1st Department of Medicine, Budapest, Hungary (A.G.T.); Clinical Pharmacology Unit, Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, United Kingdom (C.M.M., J.B.W.); INSERM, Centre for Research in Epidemiology & Public Health, Hôpital Paul Brousse, Bâtiment, France (A.S.-M.).
authors.forename: Sara
authors.initials: S
authors.lastname: Ahmadi-Abhari
authors.affiliation: From the UCL Research Department of Epidemiology and Public Health, London, United Kingdom (E.J.B., M.J.S., S.A.-A., A.G.T., C.M.M., M.G.M., A.S.-M., M.K.); Semmelweis University Faculty of Medicine, 1st Department of Medicine, Budapest, Hungary (A.G.T.); Clinical Pharmacology Unit, Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, United Kingdom (C.M.M., J.B.W.); INSERM, Centre for Research in Epidemiology & Public Health, Hôpital Paul Brousse, Bâtiment, France (A.S.-M.).
authors.forename: Adam G
authors.initials: AG
authors.lastname: Tabak
authors.affiliation: From the UCL Research Department of Epidemiology and Public Health, London, United Kingdom (E.J.B., M.J.S., S.A.-A., A.G.T., C.M.M., M.G.M., A.S.-M., M.K.); Semmelweis University Faculty of Medicine, 1st Department of Medicine, Budapest, Hungary (A.G.T.); Clinical Pharmacology Unit, Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, United Kingdom (C.M.M., J.B.W.); INSERM, Centre for Research in Epidemiology & Public Health, Hôpital Paul Brousse, Bâtiment, France (A.S.-M.).
authors.forename: Carmel M
authors.initials: CM
authors.lastname: McEniery
authors.affiliation: From the UCL Research Department of Epidemiology and Public Health, London, United Kingdom (E.J.B., M.J.S., S.A.-A., A.G.T., C.M.M., M.G.M., A.S.-M., M.K.); Semmelweis University Faculty of Medicine, 1st Department of Medicine, Budapest, Hungary (A.G.T.); Clinical Pharmacology Unit, Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, United Kingdom (C.M.M., J.B.W.); INSERM, Centre for Research in Epidemiology & Public Health, Hôpital Paul Brousse, Bâtiment, France (A.S.-M.).
authors.forename: Ian B
authors.initials: IB
authors.lastname: Wilkinson
authors.affiliation: From the UCL Research Department of Epidemiology and Public Health, London, United Kingdom (E.J.B., M.J.S., S.A.-A., A.G.T., C.M.M., M.G.M., A.S.-M., M.K.); Semmelweis University Faculty of Medicine, 1st Department of Medicine, Budapest, Hungary (A.G.T.); Clinical Pharmacology Unit, Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, United Kingdom (C.M.M., J.B.W.); INSERM, Centre for Research in Epidemiology & Public Health, Hôpital Paul Brousse, Bâtiment, France (A.S.-M.).
authors.forename: Michael G
authors.initials: MG
authors.lastname: Marmot
authors.affiliation: From the UCL Research Department of Epidemiology and Public Health, London, United Kingdom (E.J.B., M.J.S., S.A.-A., A.G.T., C.M.M., M.G.M., A.S.-M., M.K.); Semmelweis University Faculty of Medicine, 1st Department of Medicine, Budapest, Hungary (A.G.T.); Clinical Pharmacology Unit, Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, United Kingdom (C.M.M., J.B.W.); INSERM, Centre for Research in Epidemiology & Public Health, Hôpital Paul Brousse, Bâtiment, France (A.S.-M.).
authors.forename: Archana
authors.initials: A
authors.lastname: Singh-Manoux
authors.affiliation: From the UCL Research Department of Epidemiology and Public Health, London, United Kingdom (E.J.B., M.J.S., S.A.-A., A.G.T., C.M.M., M.G.M., A.S.-M., M.K.); Semmelweis University Faculty of Medicine, 1st Department of Medicine, Budapest, Hungary (A.G.T.); Clinical Pharmacology Unit, Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, United Kingdom (C.M.M., J.B.W.); INSERM, Centre for Research in Epidemiology & Public Health, Hôpital Paul Brousse, Bâtiment, France (A.S.-M.).
authors.forename: Mika
authors.initials: M
authors.lastname: Kivimaki
mesh_terms: D050154:Adiposity / Q000502:physiology*; D000328:Adult; D000375:Aging / Q000097:blood / Q000502:physiology*; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008131:London; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications* / Q000503:physiopathology*; D011237:Predictive Value of Tests; D063177:Pulse Wave Analysis; D059289:Vascular Stiffness / Q000502:physiology*; D055105:Waist Circumference / Q000502:physiology; D049629:Waist-Hip Ratio
chemical_list: D015850:Interleukin-6; D002097:C-Reactive Protein
keywords: aging; arterial stiffness; epidemiology; longitudinal studies; obesity