Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada.
Endocrinol Diabetes Metab. 2022 Mar;5(2):e00317. doi: 10.1002/edm2.317. Epub 2021 Dec 26.
Sex influences the cardiovascular risk associated with body mass index (BMI) in older adults. Whether this risk differs by sex in younger adults is unknown. We aimed to evaluate the association between measures of adiposity and arterial stiffness and reninangiotensin-aldosterone system (RAAS) activity in younger adults, stratified by sex.
Body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and fat mass% (FM%) were measured in healthy participants in a fasting, high-salt state. Arterial stiffness [pulse wave velocity (PWV) and aortic augmentation index (AIx)] were measured at baseline and in response to angiotensin II challenge, a validated marker of RAAS activity. Associations were evaluated using linear regression analysis and stratified by sex.
Ninety-five healthy, normotensive, non-diabetic females (n = 67, 37 ± 2 y, BMI 25 ± 1 kg/m ) and males (n = 28, 39 ± 3 y, BMI 27 ± 1 kg/m ) participated in the study. No association was observed between any measure of adiposity and PWV, either at baseline or in response to angiotensin II challenge in premenopausal females. In contrast, all measures of adiposity except HC were associated with PWV at baseline (BMI r = 0.32; WC r = 0.18; WHtR r = 0.34; FM r = 0.21; all values p < .05) and in response to AngII (BMI r = -0.39; WC r = -0.42; WHR r = -0.39; and WHtR r = -0.55) in males. Most adiposity measures were positively associated with baseline AIx (BMI r = 0.33; WC r = 0.27; WHtR r = 0.35; FM% r = 0.25; p < .05) in females, while only WHtR was associated with baseline AIx (r = 0.39; p = .04) in males. All measures of adiposity were positively associated with a blunted Aix response to Ang II (all values p < .001) in females. BMI, WC, WHR and WHtR were associated with a blunted AIx response to Ang II (ΔAIx: BMI r = -0.37; WC r = -0.31; WHR r = -0.16; and WHtR r = -0.22; all values p < .05) in males.
The associations between adiposity measures and cardiovascular risk differ by sex in a young population. These factors should be considered when managing cardiovascular risk.
性别会影响与老年人身体质量指数（BMI）相关的心血管风险。在年轻人中，这种风险是否因性别而异尚不清楚。我们旨在评估在年轻成年人中，以性别分层，衡量肥胖和动脉僵硬与肾素血管紧张素醛固酮系统（RAAS）活性之间的关联。
在禁食高盐状态下，对健康参与者进行体重指数（BMI）、腰围（WC）、臀围（HC）、腰臀比（WHR）、腰高比（WHtR）和脂肪量%（FM%）的测量。在基线和血管紧张素 II 刺激时测量动脉僵硬[脉搏波速度（PWV）和主动脉增强指数（AIx）]，血管紧张素 II 刺激是 RAAS 活性的有效标志物。使用线性回归分析评估关联，并按性别分层。
95 名健康、血压正常、非糖尿病的女性（n=67，37±2 岁，BMI 25±1kg/m ）和男性（n=28，39±3 岁，BMI 27±1kg/m ）参加了这项研究。在绝经前女性中，没有观察到任何肥胖指标与 PWV 之间存在关联，无论是在基线还是在血管紧张素 II 刺激时。相比之下，除了 HC 以外，所有肥胖指标都与基线 PWV 相关（BMI r=0.32；WC r=0.18；WHtR r=0.34；FM r=0.21；所有 p 值均<0.05）和对 AngII 的反应（BMI r=-0.39；WC r=-0.42；WHR r=-0.39；WHtR r=-0.55）在男性中。在女性中，大多数肥胖指标与基线 AIx 呈正相关（BMI r=0.33；WC r=0.27；WHtR r=0.35；FM% r=0.25；p<0.05），而在男性中只有 WHtR 与基线 AIx 相关（r=0.39；p=0.04）。所有肥胖指标与 Ang II 刺激后 AIx 反应减弱呈正相关（所有 p 值均<0.001）在女性中。在男性中，BMI、WC、WHR 和 WHtR 与 Ang II 刺激后 AIx 反应减弱相关（ΔAIx：BMI r=-0.37；WC r=-0.31；WHR r=-0.16；WHtR r=-0.22；所有 p 值均<0.05）。
在年轻人群中，肥胖指标与心血管风险之间的关联因性别而异。在管理心血管风险时应考虑这些因素。
