Department of Medicine, Catharina Hospital, Postbox 1350, 5602 ZA Eindhoven, The Netherlands.
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.
Atherosclerosis. 2014 Mar;233(1):310-8. doi: 10.1016/j.atherosclerosis.2013.12.002. Epub 2014 Jan 17.
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).
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.
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.
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.
研究不良的身体成分是否与内皮功能障碍（ED）有关，以及这种关联在多大程度上可以通过低度炎症（LGI）和/或胰岛素抵抗（HOMA2-IR）来解释。
我们研究了来自霍恩研究的 475 名个体[平均（范围）年龄，68.9（60-87）岁，245 名女性）。身体成分通过全身双能吸收仪进行评估。内皮功能通过血流介导的扩张（FMD）和循环生物标志物进行功能测量。使用多元线性回归模型和根据 ab 乘积系数法的中介分析来检查关联。
调整年龄、性别、葡萄糖代谢状态、既往心血管疾病和生活方式因素后，总脂肪量和中心脂肪量与 ED 评分呈正相关[β=0.16（95%置信区间 0.04-0.29）和β=0.18（0.05-0.31）]，而 FMD 呈负相关，但无统计学意义。外周脂肪量与 ED 评分或 FMD 无关。外周瘦体重与 FMD 呈显著正相关[β=0.13（0.00-0.26）]，但与 ED 评分无关。总脂肪量和中心脂肪量与 ED 评分之间的关联在很大程度上可通过 LGI 和 HOMA2-IR 来解释。相比之下，LGI 或 HOMA2-IR 不能解释外周瘦体重与 FMD 之间的关联。
较高的中心脂肪量，而不是外周脂肪量，与 ED 呈负相关，这归因于与身体成分相关的 LGI 和胰岛素抵抗。相反，外周瘦体重与 ED 呈正相关，但这似乎与 LGI 或胰岛素抵抗无关。
