Key result
Youth lean mass is linked to aortic compliance while fat mass correlates with arterial stiffness.
Why the study?
Does body composition (lean and fat mass) affect vascular structure and function in youth across varying BMI percentiles?
Cross-Sectional (n=190)
No
Does body composition (lean and fat mass) affect vascular structure and function in youth across varying BMI percentiles?
In youth, lean mass displays a protective vascular effect in the abdominal aorta, whereas fat mass is associated with greater arterial stiffness in both the carotid and abdominal aorta.
May indicate elevated aortic stiffness risk in severely obese youth; hypothesis-generating for body composition effects on vascular function, needing longitudinal data.
Objective The aim of this study was to compare and evaluate the relationship between body composition and arterial function among youth throughout a range of body mass index (BMI) percentiles. Methods Ultrasonographic measurements of the carotid artery and abdominal aorta were obtained from 190 youth (96 female, 12.9 ± 0.2years). Body composition was assessed by dual X-ray absorptiometry. Participants were stratified by BMI as normal weight (NW: <85 th percentile; n=79), overweight/obesity (OW/OB: ≥85 th to <95 th percentile; n=61), and severe obesity (SO: ≥120% of the 95 th percentile; n=50). Analysis of variance and linear regression evaluated group differences and the association of body composition variables and arterial function, respectively. Results Lean mass (NW = 32.9 ± 9.2kg. OW/OB=25.1 ± 8.8kg, SO = 44.7 ± 12.5kg; p<0.001, all). and fat mass (NW = 10.8 ± 10.5 kg. OW/OB=39.3 ± 10.8kg, SO = 48.7 ± 12.6kg) were all found to be significantly higher (p<0.001, all) across increasing BMI groups. Aortic and carotid intima-media thickness was significantly increased between groups (Aortic: NW = 0.59 ± 0.09mm, OW/OB=0.51 ± 0.17mm, SO = 0.43 ± 0.17mm; Carotid: NW = 0.54 ± 0.05mm, OW/OB=0.51 ± 0.07mm, SO = 0.48mm ± 0.11; p<0.0001 for all groups). Aortic cross-sectional distensibility was significantly (p=0.033) elevated between the SO (30.61 ± 1.48%) and NW (36.39 ± 1.49%) but not observed in the carotid artery. Aortic incremental elastic modulus (IEM) was significantly greater in the SO (1153.0 ± 70.8mmHg) group compared to OW/OB (960.4 ± 48.6mmHg) and NW (846.0 ± 40.9mmHg) groups (p<0.001). Carotid IEM was significantly greater (p=0.005) in SO (1191.07 ± 383.09mmHg) compared NW (998.91 ± 313.19mmHg). LM and LMI were similarly associated with increased compliance in the abdominal aorta, but not the carotid artery. FM and FMI were similarly associated with greater arterial stiffness in both arterial beds with absolute FM showing more consistent associations with decreased vascular function. Conclusion Vascular structure and function vary across BMI percentiles in children and adolescents. Lean mass and fat mass relate to both arterial structure and function differently in different vascular locations, especially in the abdominal aorta. Lean mass displays a protective vascular effect in the abdominal aorta more than the carotid while fat mass displays a negative effect in both arterial beds.
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Evanoff et al. (2026) conducted a cross-sectional in Obesity and varying body mass index percentiles (n=190). Severe obesity and overweight/obesity vs. Normal weight was evaluated on Arterial structure and function (intima-media thickness, distensibility, compliance, incremental elastic modulus). In youth, lean mass was associated with increased abdominal aortic compliance, whereas fat mass was associated with greater arterial stiffness in both the abdominal aorta and carotid artery.
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