van den Munckhof Inge C L, Holewijn Suzanne, de Graaf Jacqueline, Rutten Joost H W
aDepartment of Internal Medicine, Division of Vascular Medicine, Radboudumc, NijmegenbResearch Vascular Center Rijnstate, Arnhem, The Netherlands.
J Hypertens. 2017 Jun;35(6):1219-1225. doi: 10.1097/HJH.0000000000001297.
The increase in arterial stiffness in patients with the metabolic syndrome is strongly related to the amount of visceral adipose tissue. In clinical practice, anthropometric measurements such as BMI and waist circumference are commonly used to assess general and abdominal adiposity. Waist circumference is a composite measure of subcutaneous and visceral abdominal adipose tissue. As the distribution of intra-abdominal fat differs between men and women, we investigated the sex-specific associations between different anthropometric measures for general and abdominal obesity with arterial stiffness.
A cross-sectional descriptive study was performed in 1517 participants of the Nijmegen Biomedical Study, aged 50-70 years. After measurement of height, waist circumference and hip circumference, the following indices were calculated: BMI, waist-hip ratio and waist-height ratio (WHtR). Arterial stiffness was assessed by measurement of carotid-femoral pulse wave velocity (PWV). The association between the anthropometric indices and vascular stiffness was investigated by linear regression analysis adjusting for the traditional cardiovascular risk factors.
BMI, waist circumference, waist-hip ratio and WHtR correlated positively with PWV in univariate analysis both in men and women (all P < 0.016). Hip circumference was only associated with PWV in women (P < 0.001). After adjustment for age and heart rate, waist circumference and WHtR (standardized beta of 0.142 and 0.141, respectively, both P < 0.001) showed the strongest associations with PWV in men, whereas in women only BMI was associated with PWV (standardized beta of 0.177, P < 0.001). In men, WHtR was independently related to increased arterial stiffness, after adjustment for BMI and traditional cardiovascular risk factors. In women, in multivariate analyses, BMI remained significantly positively associated with PWV, whereas WHtR became negatively associated with PWV.
Sex-related differences in adipose tissue distribution influence the association between anthropometric measures of obesity and vascular stiffness as measured with by PWV. We found that in men, WHtR showed the strongest association with PWV, whereas in women BMI was best associated with a higher PWV.
代谢综合征患者动脉僵硬度增加与内脏脂肪组织量密切相关。在临床实践中，常用人体测量指标如体重指数（BMI）和腰围来评估总体和腹部肥胖情况。腰围是皮下和内脏腹部脂肪组织的综合测量指标。由于男性和女性腹部脂肪分布不同，我们研究了不同人体测量指标用于评估总体和腹部肥胖与动脉僵硬度之间的性别特异性关联。
对奈梅亨生物医学研究中的1517名年龄在50 - 70岁的参与者进行了横断面描述性研究。测量身高、腰围和臀围后，计算以下指标：BMI、腰臀比和腰高比（WHtR）。通过测量颈股脉搏波速度（PWV）评估动脉僵硬度。通过对传统心血管危险因素进行校正的线性回归分析，研究人体测量指标与血管僵硬度之间的关联。
在单变量分析中，男性和女性的BMI、腰围、腰臀比和WHtR均与PWV呈正相关（所有P<0.016）。臀围仅与女性的PWV相关（P<0.001）。在调整年龄和心率后，腰围和WHtR（标准化β分别为0.142和0.141，均P<0.001）在男性中与PWV的关联最强，而在女性中只有BMI与PWV相关（标准化β为0.177，P<0.001）。在男性中，调整BMI和传统心血管危险因素后，WHtR与动脉僵硬度增加独立相关。在女性中，多变量分析中，BMI仍与PWV显著正相关，而WHtR与PWV呈负相关。
脂肪组织分布的性别差异影响肥胖人体测量指标与通过PWV测量的血管僵硬度之间的关联。我们发现，在男性中，WHtR与PWV的关联最强，而在女性中，BMI与较高的PWV关联最佳。
