Impact of metabolic syndrome parameters and different fat depots on arterial stiffness in patients with abdominal obesity

Overweight is closely associated with development of cardiovascular disorders. Currently, the terms «metabolically healthy abdominal obesity» (MHAO) and «metabolically unhealthy obesity», i.e., metabolic syndrome (MS) are stated. Comparison target organs status and their link with fat depots in persons of these categories is of important scientific and practical interest. Aim. To assess arterial stiffness in young people with abdominal obesity with / without MS by various methods as well as its link with various fat stores and other metabolic factors. Materials and methods. 116 people, 18- to 45-year-old, with abdominal obesity were divided into two groups: MHAO (n=46), aged 40 [34; 43] years and MS (n=70), aged 40 [35; 44] years. The control group (CG) included 16 conditionally healthy volunteers without obesity, aged 32 [27; 35] years (p<0.01). All subjects were assessed for height, body weight, body mass index, and waist circumference. Lipid profile, glucose, 2-hour glucose tolerance test, insulin, leptin, adiponectin, HOMA-IR were determined. 24-hour blood pressure monitoring was performed. Subcutaneous, visceral, perivascular, epicardial fat volumes and, the ratio of subcutaneous fat to visceral fat were determined by computed tomography. Arterial stiffness was determined according to CAVI (Cardio-Ankle Vascular Index), brachial-ankle pulse wave velocity - baPWV (VaSera 1000), aortic pulse wave velocity - aoPWV (EnVisor ultrasound system). Results. aoPWV were significantly different between groups (p<0.01). In persons with MS: 6.6±1.1 m/s, in MHAO and CG groups: 4.3±0.9 m/s and 5.5±1.0 m/s, respectively. Significant differences in baPWV were found only in MS group 13.8±8.2 m/s (p<0.01) compared with CG and MHAO groups: 10.98±1.2 and 12.3±3.8 m/s, respectively. The CAVI index did not differ significantly between groups. There were reliable relationships between aoPWV and baPWV and almost all MS factors. The highest correlation coefficient was between aoPWV and visceral (r=0.55; p≤0.01) and epicardial (r=0.45; p≤0.01) fats. A close relationship between aoPWV and HOMA IR was revealed (r=0.42; p≤0.01). Correlation analysis showed a higher quality relationship between aoPWV and MS markers, insulin resistance, and fat depots compared to baPWV. According to multivariate regression analysis, the main contribution to the formation aoPWV is made by body mass index, systolic blood pressure, and epicardial fat. Conclusion. The most sensitive to metabolic factors and the volume of fat depots was aoPWV indicator. Significant differences on some metabolic risk factors and aoPWV between the control group and MHAO raises doubts about the correctness of the term «metabolically healthy obesity».

aortic pulse wave velocity, brachial-ankle pulse wave velocity, aortic stiffness, obesity, metabolic syndrome, fat depots, visceral fat, perivascular fat, periaortic fat

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