Impaired pulse pressure amplification, augmentation index, and arterial stiffness are associated with reduced limb lean mass in overweight and obese postmenopausal women

Abstract

Background: The age-related muscle mass loss has been associated with increased arterial stiffness (brachial-ankle pulse wave velocity, baPWV) and wave reflection (augmentation index, AIx). In healthy individuals, pulse pressure (PP) is lower in the aorta compared to the brachial artery (PP amplification, PPA). Postmenopausal women experience elevated aortic stiffness leading to increased AIx and aortic PP causing reduced PPA, an independent predictor of cardiovascular mortality. It is unknown whether appendicular skeletal muscle index (ASMI), arm (ArmLM) or leg lean mass (LegLM) are negatively associated with PPA. The purpose of this study was to investigate the associations between vascular function (PPA, AIx, and baPWV) and lean mass (ASMI, ArmLM, and LegLM) in postmenopausal women.

Methods: The study was performed in 93 postmenopausal women (48-71 years; BMI: 30 ± 7 kg/m²). PPA (brachial/aortic PP), aortic AIx, and baPWV were measured. ArmLM and LegLM were measured by dual-energy X-ray absorptiometry. ASMI was calculated as (ArmLM+LegLM)/Ht². Associations between vascular and lean mass measures were analyzed by multiple linear regression.

Results: PPA was associated with ASMI (β = 0.29, p = .016) and LegLM (β = 0.25, p = .028) after adjustment for age, height, systolic pressure, strength, and heart rate. AIx was associated with ASMI (β = -0.27, p = .011), ArmLM (β = -0.25, p = .023), and LegLM (β = -0.22, p = .026), while baPWV was associated with reduced ASMI (β = -0.23, p = .043) and ArmLM (β = -0.23, p = .045), but not with LegLM (β = -0.19, p = .074) after full adjustment.

Conclusions: Our findings indicate that impaired pulsatile hemodynamics (PPA and AIx) are negatively associated with ASMI and LegLM, while arterial stiffness is negatively associated with ASMI and ArmLM. Thus, vascular dysfunction may be implicated in muscle mass loss in overweight and obese postmenopausal women.

Keywords: Arterial stiffness; Lean mass; Pressure wave reflection; Pulse pressure amplification.