Key result
Higher cfPWV linked to higher BP, partly mediated by lean mass and insulin resistance.
Why the study?
Arterial stiffness appears to temporally precede elevated blood pressure in adolescents, but whether insulin resistance and body composition mediate this relationship remains unknown.
Do insulin resistance and body composition mediate the association between arterial stiffness and blood pressure in adolescents?
Cross-Sectional (n=3,764)
Do insulin resistance and body composition mediate the association between arterial stiffness and blood pressure in adolescents?
Lean mass and insulin resistance, but not total fat mass, partially mediate the association between arterial stiffness and blood pressure in adolescents, suggesting that attenuating insulin resistance may help lower blood pressure driven by arterial stiffness.
Answers are grounded in this paper and cite their sources.
May support targeting insulin resistance to mitigate stiffness-driven BP in adolescents; leaves open causal confirmation and intervention trials.
Background Emerging evidence among adolescents suggests that arterial stiffness temporally precedes elevated blood pressure/hypertension in the casual pathway. It remains unknown whether insulin resistance and body composition mediate this relationship. Therefore, we examined the mediating role of total fat mass, lean mass, and insulin resistance in the association between arterial stiffness and blood pressure among adolescents. Materials and methods We studied 3,764 participants, aged 17 years from the Avon Longitudinal Study of Parents and Children (ALSPAC) United Kingdom birth cohort. Arterial stiffness accessed with Vicorder device measured carotid-femoral pulse wave velocity (cfPWV), body composition was measured by dual-energy Xray Absorptiometry, blood pressure by Omron device, and homeostatic model assessment of insulin resistance (HOMA-IR) was computed. Data were analysed with structural equation models mediation path analyses and adjusted for cardiometabolic and lifestyle factors. Results Among 1,678 [44.6%] male and 2,086 [55.4%] female participants, higher cfPWV was directly and independently associated with higher systolic and diastolic blood pressure, irrespective of the mediator [Standardized regression coefficient (β) = 0.248–0.370, p for all = 0.002]. Lean mass [β = 0.010; p = 0.026; 3.3% mediation] and HOMA-IR [β = 0.004; p = 0.033; 1.1% mediation] but not total fat mass [β < 0.0001; p = 0.615; 0% mediation] partly mediated the association of cfPWV with systolic blood pressure after full adjustments. Similarly, lean mass [β = –0.004; p = 0.021; 1.4% mediation] and HOMA-IR [β = 0.007; p = 0.039; 2.8% mediation] but not total fat mass [β = –0.002; p = 0.665; 0.7% mediation] partly mediated the association of cfPWV with diastolic blood pressure. Conclusion Attenuating insulin resistance may be a potentially valuable strategy in lowering higher blood pressure precipitated by higher arterial stiffness.
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Andrew O. Agbaje (2022) conducted a cross-sectional in Healthy adolescents (n=3,764). Carotid-femoral pulse wave velocity (cfPWV) was evaluated on Association of cfPWV with systolic and diastolic blood pressure (β 0.248-0.370, p=0.002). Higher carotid-femoral pulse wave velocity was directly associated with higher systolic and diastolic blood pressure, a relationship partly mediated by lean mass and insulin resistance but not total fat mass.
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