Vital roles of age and metabolic syndrome-associated risk factors in sex-specific arterial stiffness across nearly lifelong ages: Possible implication of menopause and andropause.
Postmenopausal status is correlated with increased metabolic syndrome (MetS) and cardiovascular risks. However, the vital roles of age and MetS-associated risk factors in sex-specific arterial stiffness remain unclear.



In this population-based cross-sectional study of the general population, we enrolled in our Health Examination Program 9812 adult participants who were measured for brachial-ankle pulse wave velocity (baPWV) to assess arterial stiffness. Piecewise linear regression models were used to survey pre-defined ages associated with menopause and andropause in relation to arterial stiffness. Multivariate linear regression analyses were used to evaluate independent determinants.



Across gender, stepwise increases in baPWV corresponded to increased MetS-associated risk scores (MetSRS) and aging (all p for trend < 0.001), while a turning point was found at 50 years of age (50age). The incremental ratios of baPWV presented inverse U curves with aging, whereas the highest R2values and incremental ratios of baPWV were found at 50age across gender. Comparing men with women, a 1.4-fold higher incremental ratio of baPWV was observed before 50age, compared to a 1.3-fold after 50age, respectively. MetS risk group and over 50age were associated with stepwise increased baPWV across gender (both p for trend < 0.001). Before 50age, the determinants did not include hs-CRP for women compared with men, while MetSRS was lost as a determinant across gender. In contrast with men, in women after 50age, HDL-C was an additional determinant and triglyceride was not, while MetSRS remained a determinant across gender.



Arterial stiffness increased with aging across nearly lifelong ages more in women than in men. While menopause and andropause may both play a role, 50age was the most critical factor across gender. The sex-specific differences in determinants of arterial stiffness may remind us of sex-specific targets for further interventional studies associated with arterial stiffness.
Division of Endocrinology and Metabolism, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan.
Sung-Sheng
SS
Tsai
Division of Endocrinology and Metabolism, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan; Department of Cardiology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan; Healthcare Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan.
Yu-Sheng
YS
Lin
Healthcare Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan; Heart Failure Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan.
Jaw-Shan
JS
Hwang
Department of Cardiology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan; Healthcare Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan; Heart Failure Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan. Electronic address: taipei.chu@gmail.com.
Pao-Hsien
PH
Chu
D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000097:blood; D047649:Andropause; D055109:Ankle Brachial Index; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008593:Menopause / Q000097:blood; D024821:Metabolic Syndrome / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D015999:Multivariate Analysis; D063177:Pulse Wave Analysis; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors; D013624:Taiwan / Q000453:epidemiology; D059289:Vascular Stiffness; D055815:Young Adult
D015415:Biomarkers
Andropause; Arterial stiffness; Menopause; Metabolic syndrome; Sex-specific