Associations of Body Composition Measures and C2, a Marker for Small Artery Elasticity: The Multi-Ethnic Study of Atherosclerosis

Objective—Lower C2, a continuous blood pressure waveform characteristic asserted to represent small artery elasticity, predicts future cardiovascular disease (CVD) events. We hypothesized that the paradoxical positive association between body mass index (BMI) and C2 may reflect muscle instead of excess fat. Methods—In a multi-ethnic, community living cohort of 1,960 participants, we used computed tomography (CT) scans of the abdomen to measure visceral adipose tissue (VAT) and total abdominal muscle tissue (TAMT), and used applanation tonometry of the radial arteries to assess C2. We then ascertained the period cross-sectional associations between BMI, TAMT, and VAT with C2. Results—The mean age was 62 ± 9 years and 50% male. After adjustments for age, gender, ethnicity, pack years smoking cigarettes, diabetes, hypertension, total and HDL cholesterol, higher BMI (standardized beta = 0.09, p-value < 0.01) and more TAMT (standardized beta = 0.12, pvalue < .01), were significantly associated with higher C2. In contrast, more VAT (standardized beta = -0.09, p-value < .01) was associated with lower C2. Conclusion—In multivariable analysis, VAT, in contrast to TAMT and BMI was associated with less compliant small arteries. Visceral fat may be a better marker for detrimental excess body fat than BMI.