Increases in central fat mass and decreases in peripheral fat mass are associated with accelerated arterial stiffening in healthy adults: the Amsterdam Growth and Health Longitudinal Study1234

Background: Central fatness is associated with higher arterial stiffness, a mechanism that may explain adiposity-related increases in cardiovascular disease risk. In contrast, peripheral fat and lean masses may counteract such adverse effects, but evidence of this contention, as derived from longitudinal studies at the general population level, is lacking. Objective: The objective was to investigate the associations between changes in central (ie, trunk) fat mass, peripheral (ie, limbs) fat mass, and lean masses with changes in arterial stiffness. Design: A longitudinal study in 277 (145 women) healthy adults was conducted. Body composition (dual-energy X-ray absorptiometry) and arterial stiffness estimates (ultrasound imaging) were measured repeatedly at the ages of 36 and 42 y. Results: Changes (per 10 kg) in trunk fat mass were positively associated and changes in peripheral fat mass were inversely associated with carotid Young’s elastic modulus (in 103 ⋅ kPa) [β = 0.14 (95% CI: 0.02, 0.25) and −0.16 (−0.30, −0.01), respectively] and carotid-femoral pulse wave velocity (in m/s) [β = 1.54 (0.02, 3.07) and −1.46 (−3.48, 0.56), respectively]. Individuals in whom trunk fat increased and peripheral fat decreased over the 6-y follow-up (33% of the study population) had the steepest increases in these stiffness estimates. Notably, these changes were accompanied by minor increases in body weight, which remained within the limits of the normal range throughout. Conclusions: Increases in trunk mass and decreases in peripheral fat mass are associated with accelerated arterial stiffening. These findings emphasize the importance of assessing regional changes in body composition, because it may enable identification of individuals with an unrecognized increased cardiovascular disease risk.