Metabolic Determinants of Proximal Aortic Stiffness among Healthy People with Abdominal Obesity - The 68th Annual Conference of the Israel Heart Society in association with the Israel Society of Cardiothoracic Surgery

Gal Tsaban ^1,2 Aryeh Shalev ² Anat Yaskolka-Meir ¹ Ehud Rinott ¹ Hila Zelicha ¹ Alon Kaplan ¹ Amos Katz ¹ Matthias Bluher ³ Meir J Stampfer ^4,5 Iris Shai ^1,4

¹Public Health, Ben Gurion University of the Negev, Israel
²Department of Cardiology, Soroka University Medical Center, Israel
³Department of Medicine, University of Leipzig, Germany
⁴T.H. Chan School of Public Health, Harvard University , ,, USA
⁵Channing Division of Network Medicine, Brigham and Women’s Hospital, USA

Background: Increased proximal aortic stiffness (PAS) is directly associated with cardiovascular risk. Likewise, metabolic syndrome (MS) and abdominal obesity are associated with cardiovascular risk. The association between MS determinants and PAS among a healthy population with abdominal obesity remains unclear. We aimed to examine the association between MS determinants and PAS among otherwise healthy participants with abdominal obesity.
Methods: We utilized the cross-sectional baseline data of the DIRECT-PLUS study (clinicaltrials.gov NCT03020186), where we recruited healthy participants with abdominal obesity/dyslipidemia. Along with anthropometric measurements and blood tests, all participants underwent magnetic-resonance-imaging from which PAS we assessed by calculating the aortic arch pulse-wave-velocity (from the ascending to the descending aorta). We defined MS according to the NCEP-ATP-III criteria.
Results: Of 282 participants who had a valid PAS estimation [mean-age: 51.0, 88.3% male, mean-body-mass-index: 31.2kg/m2, mean-waist circumference (WC): 109.5cm] 171 (60.9%) had MS. PAS was mainly associated with age (r=0.735, p<0.001). PAS was associated with an increased 10-year Framingham Risk Score (β=0.165,p=0.008 after adjustment for age and gender). Participants with MS had higher PAS than non-MS participants (6.6m/sec vs. 5.4m/sec, p=0.002 after adjusting for age and gender). In multivariate models, adjusted for gender, age, and dichotomous-components of the MS, worse PAS remained significantly associated with high-density lipoprotein cholesterol (HDL-c; β=0.-116,p=0.007) and increased blood-pressure (β=0.165,p<0.001), but not with fasting-glucose, waist-circumference or plasma-triglycerides (p>0.05 for all). In models adjusted for age, gender, and continuous determinants of MS, worse PAS remained associated with mean-arterial pressure (β=0.218,p<0.001) and HDL-c (β=0.-126,p=0.004).
Conclusions: Among a healthy population with abdominal obesity, reduced HDL-c levels and increased blood pressure might be the more dominant predictors of poor PAS state, out of the MS components.