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Original Article
- Diabetes, obesity and metabolism
- Association of Abdominal Myosteatosis and Visceral Fat Obesity with Arterial Stiffness
- Min Jung Lee, Hong-Kyu Kim, Eun Hee Kim, Sung Jin Bae, Hyo-Jung Nam, Sang Hoon Lee, Chang Hee Jung, Woo Je Lee
- Endocrinol Metab. 2026;41(4):543-557. Published online April 8, 2026
- DOI: https://doi.org/10.3803/EnM.2025.2734
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Abstract
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Supplementary Material
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ePub - Background
Arterial stiffness with aging predicts cardiovascular diseases (CVDs) and target organ damage. While sarcopenia has been linked to arterial stiffness, the association of myosteatosis and visceral adiposity with arterial stiffness remains underexplored. As age-related fat redistribution, including myosteatosis and visceral obesity, often precedes overt sarcopenia, their early evaluation may be beneficial in preventing arterial stiffness. Therefore, this cross-sectional study aimed to assess whether myosteatosis and visceral obesity are associated with increased arterial stiffness.
Methods
A total of 6,004 subjects without CVD who underwent abdominal computed tomography and brachial-ankle pulse wave velocity (baPWV) between 2012 and 2013 during health examinations were included. Visceral fat area and total abdominal muscle area (TAMA) were measured at the L3 vertebral level. Muscle quality was assessed using the normal attenuation muscle area (NAMA)/TAMA index, where a lower value indicates a reduced proportion of healthy muscle (NAMA) and a higher presence of myosteatosis.
Results
After adjusting for multiple cardiovascular risk factors, including myosteatosis, visceral obesity was significantly associated with elevated baPWV in men (odds ratio [OR]=1.32; 95% confidence interval [CI]=1.10 to 1.60; P=0.004). In contrast, in women, myosteatosis was significantly associated with elevated baPWV in a fully adjusted model that included visceral obesity (OR=3.26; 95% CI=1.13 to 9.44; P=0.029).
Conclusion
Ectopic fat infiltration, including visceral obesity and myosteatosis, was significantly associated with increased arterial stiffness. Notably, visceral obesity was significantly associated with elevated baPWV in men, while myosteatosis was significantly associated with elevated baPWV in women after adjustment.
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