INFLAMMATION MARKERS AS POTENTIAL MEDIATORS FOR THE ASSOCIATION BETWEEN ARTERIAL STIFFNESS AND OBESITY

Abstract

Objective: Arterial stiffness is a strong independent predictor of cardiovascular diseases. Obesity was closely associated with arterial stiffness. This study hypothesised that inflammatory markers mediated the association between obesity and arterial stiffness. Design and method: We performed a cross-sectional study in 965 Flemish individuals (mean age 49.4 ± 15.6 years, 51 % female). Carotid-femoral pulse wave velocity (PWV) was measured as indicator of arterial stiffness via application tonometry. Obesity was defined as BMI > = 30 kg/m2. Fourteen plasma inflammatory cytokines were determined, using an ELISA-based assay and composite inflammation scores were calculated using Crohnbach's alpha as an indicator of internal consistency reliability for measurement of inflammatory burden. Insulin resistance (IR) was calculated via the homeostasis model assessment (HOMA), and resistance was defined as HOMA > = 1.9. Results: An increased PWV was found in individuals with obesity, compared to those without obesity (8.1 vs. 7.4 m/s, p < 0.001). After adjusting for sex and age, the association between, PWV and obesity remained (0.35, 95% CI: 0.08 – 0.63, p = 0.011). Obesity was positively associated (p < 0.001) with CRP (0.059, 95% CI: 0.037 – 0.081), IL-6 (0.046, 95% CI: 0.023 – 0.068), leptin (0.147, 95% CI: 0.122 – 0.172) and PAI-1 (0.036, 95% CI: 0.015 – 0.058). Mediation analysis showed that the association between PWV and obesity was partially mediated by inflammatory burden scores (18.70 %, p < 0.05) and was borderline mediated by leptin (28.70 %, p = 0.060) and insulin resistance (15.44 %, p = 0.054). Conclusions: Our findings confirm the role of inflammation as major mediator in obesity associated arterial stiffness. Leptin and insulin resistance might also involve in arterial stiffness in obesity, which may provide potential treatment targets.