Current and adolescent body fatness and fat distribution: relationships with carotid intima-media thickness and large artery stiffness at the age of 36 years

Objective Body fat and its distribution are determinants of cardiovascular disease but the underlying mechanisms of these adverse effects are poorly understood. We therefore investigated (1) the cross-sectional relationship between estimates of body fatness and its distribution on the one hand and carotid atherosclerosis and stiffness of the carotid, femoral and brachial arteries and the carotido-femoral segment on the other (336 subjects, 175 women); (2) the relationship between estimates of body fatness and its distribution during adolescence (13-16 years) and the same arterial properties at age 36- prospective analyses (subpopulation of 159 subjects, 84 girls). Design Cross-sectional and prospective analyses within an ongoing observational longitudinal study: The Amsterdam Growth and Health Longitudinal Study. Methods Body fatness and its distribution were assessed by anthropometry and dual-energy X-ray absorptiometry (DXA); arterial properties were assessed non-invasively by ultrasound imaging. Results Total adiposity and, in men, truncal subcutaneous fat accumulation during adolescence, were positively and independently associated with carotid intima-media thickness at age 36, a pre-clinical indicator of atherosclerosis. Adolescent truncal subcutaneous fat accumulation but not total adiposity was associated with increased arterial stiffness at age 36. At age 36, both abdominal and truncal subcutaneous fat were independently associated with arterial stiffness, while the associations between total adiposity and arterial stiffness appeared to be mediated by other cardiovascular risk factors. Conclusions Body fatness and body fat distribution are associated with large artery structural and functional properties at age 36 and the roots of these associations may already be present in adolescence. (C) 2004 Lippincott Williams Wilkins.