Arterial Stiffness, Biomarkers of Liver Fat, and the Development of Metabolic Dysfunction in Metabolically Healthy Population: A Prospective Study

Lin Lin; Long Wang; Rui Du; Chunyan Hu; Jieli Lu; Tiange Wang; Mian Li; Zhiyun Zhao; Yu Xu; Min Xu; Yufang Bi; Weiqing Wang; Guang Ning; Yuhong Chen

doi:10.3389/fcvm.2022.928782

Arterial Stiffness, Biomarkers of Liver Fat, and the Development of Metabolic Dysfunction in Metabolically Healthy Population: A Prospective Study

Front Cardiovasc Med. 2022 Jun 9:9:928782. doi: 10.3389/fcvm.2022.928782. eCollection 2022.

Authors

Lin Lin^{1

2}, Long Wang^{1

2}, Rui Du^{1

2}, Chunyan Hu^{1

2}, Jieli Lu^{1

2}, Tiange Wang^{1

2}, Mian Li^{1

2}, Zhiyun Zhao^{1

2}, Yu Xu^{1

2}, Min Xu^{1

2}, Yufang Bi^{1

2}, Weiqing Wang^{1

2}, Guang Ning^{1

2}, Yuhong Chen^{1

2}

Affiliations

¹ Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
² Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Abstract

Background: Metabolic dysfunction is known to be associated with arterial stiffness. However, the risks of metabolic syndrome and diabetes due to arterial stiffness and the potential mechanism remain unclear. We aimed to investigate the association of arterial stiffness with the risk of metabolic syndrome and diabetes, and determine whether this association is mediated by liver fat.

Methods: A prospective study was conducted with 4,139 Chinese adults who were metabolically healthy at baseline. Arterial stiffness was measured by brachial-ankle pulse wave velocity (baPWV). Obesity was defined as body mass index ≥25 kg/m². The primary outcomes were incident metabolic syndrome and diabetes.

Results: During a median follow-up of 4.4 years, 1,022 (24.7%) and 354 (9.5%) participants developed metabolic syndrome and diabetes, respectively. Compared with those in the lowest quartile of baPWV, participants in the highest quartile had 85 and 91% higher risks of metabolic syndrome and diabetes [risk ratio (RR) 1.85, 95% confidence interval (CI) 1.41, 2.42 for metabolic syndrome; RR 1.91, 95% CI 1.16, 3.15 for diabetes]. Mediation analyses indicated that fatty liver significantly mediated the association of arterial stiffness with metabolic syndrome and diabetes risk. Specifically, 18.4% of metabolic syndrome and 12.6% of diabetes risk due to arterial stiffness were mediated through fatty liver.

Conclusions: Arterial stiffness was associated with higher risks of metabolic syndrome and diabetes in individuals with obesity. This association may be partially mediated by fatty liver.

Keywords: arterial stiffness; diabetes; fatty liver; metabolic syndrome; obesity.