Dangardt, F;
Charakida, M;
Georgiopoulos, G;
Chiesa, S;
Rapala, A;
Wade, K;
Hughes, A;
... Deanfield, J; + view all
(2019)
Association between fat mass through adolescence and arterial stiffness: A population-based study from The Avon Longitudinal Study of Parents and Children (ALSPAC).
The Lancet Child and Adolescent Health
, 3
(7)
pp. 474-481.
10.1016/S2352-4642(19)30105-1.
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Abstract
Background: The link between adiposity, metabolic abnormalities and arterial disease progression in the young remains poorly defined. Methods: From the Avon Longitudinal Study of Parents and Children (ALSPAC), we studied 3,423 participants (1,866 females) who had longitudinal adiposity measures (e.g. body mass index (BMI), fat mass index (FMI) collected between 9-17 years) to investigate their associations with arterial stiffness (carotid to femoral pulse wave velocity (PWV)) measured at 17 years. Findings: Total fat mass was positively associated with PWV at 17 years (0·004 m/s per kg, 95% CI 0·001- 0·006, p=0·0081). Persistent high total fat mass indexed to height2 (FMI) (0·15 m/s per kg/m2, 95% CI 0·05- 0·24, p=0·0044) and trunk FMI (0·15 m/s per kg/m2, 95% CI 0·06- 0·25, p=0·0021) between ages 9-17 years were related to greater PWV in comparison to lower FMI. Metabolic abnormalities, defined as 3 or more of the following risk factors: systolic blood pressure (SBP) >75th centile, HDL<25th centile, triglycerides >75th centile and glucose >75th centile, amplified the adverse effect of total FMI on arterial stiffness (PWV: 6·2 and 6·0 m/s, 95% CI 5·9- 6·4 and 5·9- 6·0, for high FMI metabolically unhealthy and healthy, respectively). Participants who restored normal total FMI in adolescence (PWV: 5·8 and 5·9 m/s, 95% CI 5·7- 5·9 and 5·6- 6·1 for metabolic healthy and unhealthy, respectively) had comparable PWV to those who had normal FMI throughout (PWV: 5·7 and 5·9 m/s, 95% CI 5·7- 5·8 and 5·8- 5·9 for metabolic healthy and unhealthy, respectively). Interpretation: Persistent high fat mass during adolescence was associated with greater arterial stiffness and was further aggravated by an unfavourable metabolic profile. Reverting to normal FMI in adolescence was associated with normal PWV. These findings have important public health implications and provide opportunities for interventions to tackle obesity in the young to maximise long-term vascular health.
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