Sonographic Measurement of Mesenteric Fat Thickness Is a Better Predictor of Aortic Stiffness Compared With Conventional Obesity Indexes


      Increased aortic stiffness is closely associated with central obesity whereas mesenteric fat is the key adipose tissue in central obesity. We investigated the associations of mesenteric fat thickness with aortic stiffness, with comparison to conventional obesity measures. We used ultrasound to measure mesenteric, pre-peritoneal and subcutaneous fat thickness, carotid intima–media thickness (CIMT) and carotid–femoral pulse wave velocity (c-f PWV), an index of central aortic stiffness. Anthropometric indexes, blood pressure, fasting plasma glucose and lipid profile were measured. One hundred forty-seven healthy volunteers (age [mean ± standard deviation]: 43.2 ± 13.3 y; 41.5% men) were assessed. On univariate analysis, mesenteric, preperitoneal and subcutaneous fat thickness, body mass index (BMI), waist circumference (WC), waist/hip ratio (WHR) and waist/height ratio (WHtR) were associated with c-f PWV with or without adjustment for age. The mesenteric fat thickness had the highest correlation coefficient (r = 0.48, p < 0.001) with c-f PWV among all the investigated obesity indexes. Using multiple linear regression analysis, only mesenteric fat thickness remained to be an independent determinant of c-f PWV after adjustments for other abdominal fat thickness, anthropometric and metabolic indexes and CIMT. In conclusion, mesenteric fat thickness is an independent risk factor for aortic stiffness and has a stronger association with aortic stiffness compared with conventional obesity indexes.

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        • Ahima RS
        • Flier JS.
        Adipose tissue as an endocrine organ.
        Trends Endocrinol Metab. 2000; 11: 327-332
        • Boutouyrie P
        • Tropeano AI
        • Asmar R
        • Gautier I
        • Benetos A
        • Lacolley P
        • Laurent S.
        Aortic stiffness is an independent predictor of primary coronary events in hypertensive patients: A longitudinal study.
        Hypertension. 2002; 39: 10-15
        • Cruickshank K
        • Riste L
        • Anderson SG
        • Wright JS
        • Dunn G
        • Gosling RG.
        Aortic pulse-wave velocity and its relationship to mortality in diabetes and glucose intolerance: An integrated index of vascular function?.
        Circulation. 2002; 106: 2085-2090
        • Dangardt F
        • Chen Y
        • Berggren K
        • Osika W
        • Friberg P.
        Increased rate of arterial stiffening with obesity in adolescents: A five-year follow-up study.
        PLoS One. 2013; 8: e57454
        • DeFronzo RA
        • Ferrannini E
        Insulin resistance: a multifaceted syndrome responsible for NIDDM, obesity, hypertension, dyslipidaemia and atherosclerotic cardiovascular disease.
        Diabetes Care. 1991; 14: 173-194
        • Derchi LE
        • Solbiati L
        • Rizzatto G
        • De Pra L.
        Normal anatomy and pathologic changes of the small bowel mesenteries: US appearances.
        Radiology. 1987; 164: 649-652
        • Despres JP
        • Krauss RM.
        Obesity and lipoprotein metabolism.
        in: Bray GA Bouchard C James WPT Handbook of obesity. Marcel Dekker, New York, NY1997: 6651-6675
        • Hansen TW
        • Jeppesen J
        • Rasmussen S
        • Ibsen H
        • Torp-Pedersen C.
        Relation between insulin and aortic stiffness: A population-based study.
        J Hum Hypertens. 2004; 18: 1-7
        • Janic M
        • Lunder M
        • Sabovic M.
        Arterial stiffness and cardiovascular therapy.
        Biomed Res Int. 2014; 2014621437
        • Jee SH
        • Sull JW
        • Park J
        • et al.
        Body mass index and mortality in Korean men and women.
        N Engl J Med. 2006; 355: 779-787
        • Jordan J
        • Nilsson PM
        • Kotsis V
        • Olsen MH
        • Grassi G
        • Yumuk V
        • Hauner H
        • Zahorska-Markiewicz B
        • Toplak H
        • Engeli S
        • Finer N.
        Joint scientific statement of the European Association for the study of obesity and the European Society of Hypertension: Obesity and early vascular ageing.
        J Hypertension. 2015; 33: 425-434
        • Koshizaka M
        • Ishikawa K
        • Ishibashi R
        • Maezawa Y
        • Sakamoto K
        • Uchida D
        • Nakamura S
        • Yamaga M
        • Yokoh H
        • Kobayashi A
        • Onishi S
        • Kobayashi K
        • Ogino J
        • Hashimoto N
        • Tokuyama H
        • Shimada F
        • Ohara E
        • Ishikawa T
        • Shoji M
        • Ide S
        • Ide K
        • Baba Y
        • Hattori A
        • Kitamoto T
        • Horikoshi T
        • Shimofusa R
        • Takahashi S
        • Nagashima K
        • Sato Y
        • Takemoto M
        • Newby LK.
        Comparing the effects of ipragliflozin versus metformin on visceral fat reduction and metabolic dysfunction in Japanese patients with type 2 diabetes treated sitagliptin: A prospective, multicenter, open-label, blinded end-point, randomized controlled study (PRIME-V study).
        Diabetes Obes Metab. 2019; 21: 1990-1995
        • Laurent S
        • Cockcroft J
        • Van Bortel L
        • Boutouyrie P
        • Giannattasio C
        • Hayoz D
        • Pannier B
        • Vlachopoulos C
        • Wilkinson I
        • Struijker-Boudier H
        European Network for Non-invasive Investigation of Large Arteries. Expert consensus document on arterial stiffness: Methodological issues and clinical applications.
        Eur Heart J. 2006; 27: 2588-2605
        • Laurent S
        • Boutouyriw P.
        Arterial stiffness: A new surrogate end point for cardiovascular disease?.
        J Nephrol. 2007; 20: S45-S50
        • Liu KH
        • Chan YL
        • Chan WB
        • Kong WL
        • Kong MO
        • Chan JC.
        Sonographic measurement of mesenteric fat thickness is a good correlate with cardiovascular risk factors: comparison with subcutaneous and preperitoneal fat thickness, magnetic resonance imaging and anthropometric indexes.
        Int J Obes. 2003; 27: 1267-1272
        • Liu KH
        • Chan YL
        • Chan JC
        • Chan WB.
        Association of carotid intima–media thickness with mesenteric, preperitoneal and subcutaneous fat thickness.
        Atherosclerosis. 2005; 179: 299-304
        • Liu KH
        • Chan YL
        • Chan WB
        • Chan JC
        • Chu CW.
        Mesenteric fat thickness is an independent determinant of metabolic syndrome and identified subjects with increased carotid intima-media thickness.
        Diabetes Care. 2006; 29: 379-384
        • Liu KH
        • Chan YL
        • Chan JC
        • Chan WB
        • Kong WL.
        Mesenteric fat thickness as an independent determinant of fatty liver.
        Int J Obes. 2006; 30: 787-793
        • Liu KH
        • Chu WC
        • To KW
        • Ko FWS
        • Ng SSS
        • Ngai JCL
        • Chan JWS
        • Ahuja AT
        • Hui DSC.
        Mesenteric fat thickness is associated with increased risk of obstructive sleep apnoea.
        Respirology. 2014; 19: 92-97
        • Liu KH
        • Chu WC
        • To KW
        • Ko FWS
        • Ng SSS
        • Ngai JCL
        • Chan KP
        • Yip WH
        • Ahuja WH
        • Hui DSC.
        Mesenteric fat thickness is associated with metabolic syndrome independently of apnoea–hypopnoea index in subjects with obstructive sleep apnoea.
        Respirology. 2016; 21: 533-540
        • Liu KH
        • Lee MC
        • Kong AP
        • Chen L
        • Chan JCN
        • Chu WC.
        Associations of renal augmented velocity index with arterial stiffness, carotid intima–media thickness and blood pressure, in comparison with renal resistive index.
        Ultrasound Med Biol. 2021; 47: 1279-1288
        • Nilsson PM
        • Khalili P
        • Franklin SS.
        Blood pressure and pulse wave velocity as metrics for evaluating pathologic ageing of the cardiovascular system.
        Blood Press. 2014; 23: 17-30
        • Rebuffe-Scrive M
        • Andersson B
        • Olbe L
        • Bjortorp P.
        Metabolism of adipose tissue in intra-abdominal depots of non-obese men and women.
        Metabolism. 1989; 38: 453-458
        • Recio-Rodriguez JL
        • Gomez-Marcos MA
        • MC Patino-Alonso
        • Agudo-Conde C
        • Rodriguez-Sanchez E
        • Garcia-Ortiz L
        • Group Vasorisk
        Abdominal obesity vs general obesity for identifying arterial stiffness, subclinical atherosclerosis and wave reflection in healthy, diabetics and hypertensive.
        BMC Cardiovascular Disord. 2012; 12: 3
        • Riksen NP
        • Bosselaar M
        • Bakker SJ
        • Heine RJ
        • Rongen GA
        • Tack CJ
        • Smits P.
        Acute elevation of plasma nonesterified fatty acids increases pulse wave velocity and induces peripheral vasodilatation in humans in vivo.
        Clin Sci (Lond). 2007; 113: 33-40
        • Rodrigues SL
        • Baldo MP
        • Lani L
        • Nogueira L
        • Mill JG
        • de Sa Cunha R.
        Body mass index is not independently associated with aortic stiffness in a Brazilian population.
        Am J Hypertens. 2012; 25: 1064-1069
        • Strasser B
        • Arvandi M
        • Pasha EP
        • Haley AP
        • Stanforth P
        • Tanaka H.
        Abdominal obesity is associated with arterial stiffness in middle-aged adults.
        Nutr Metab Cardiovasc Dis. 2015; 25: 495-502
        • Sutton-Tyrrell K
        • Newman A
        • Simonsick EM
        • Havlik R
        • Pahor M
        • Lakatta E
        • Spurgeon H
        • Vaitkevicius P.
        Aortic stiffness is associated with visceral adiposity in older adults enrolled in the study of health, aging, and body composition.
        Hypertension. 2001; 38: 429-433
        • Teoh WL
        • Price JF
        • Williamson RM
        • Payne RA
        • Van Look LAF
        • Reynolds RM
        • Frier BM
        • Wilkinson IB
        • Webb DJ
        • Strachan MWJ
        • ET2DS Investigators
        Metabolic parameters associated with arterial stiffness in older adults with type 2 diabetes: The Edinburgh type 2 diabetes study.
        J Hypertens. 2013; 31: 1010-1017
        • Tsujimoto T
        • Kajio H
        Abdominal obesity is associated with an increased risk of all-cause mortality in patients with HFpEF.
        J Am Coll Cardiol. 2017; 70: 2739-2749
        • Vlachopoulos C
        • Aznaouridis K
        • Stefanadis C
        Predication of cardiovascular events and all-cause mortality with arterial stiffness: A systematic review and meta-analysis.
        J Am Coll Cardiol. 2010; 55: 1318-1327
        • Wohlfahrt P
        • Somers VK
        • Cifkova R
        • Filipovsky J
        • Seidlerova J
        • Krajcoviechova A
        • Sochor O
        • Kullo IJ
        • Lopez-Jimenez F.
        Relationship between measures of central and general adiposity with aortic stiffness in the general population.
        Atherosclerosis. 2014; 235: 625-631
        • Zhong Q
        • Hu M
        • Cui Y
        • Liang L
        • Zhou MM
        • Yang YW
        • Huang F.
        Carotid–femoral pulse wave velocity in the prediction of cardiovascular events and mortality: An updated systematic review and meta-analysis.
        Angiology. 2018; 69: 617-629