Metabolic indicators as mediators in the relationship between lifestyle and arterial stiffness

Previous studies have demonstrated that a healthy lifestyle can modify the risk of atherosclerosis. However, limited research has explored the association between lifestyle factors and early markers of arterial health, and the potential role of metabolic indicators remains unclear.

A prospective cohort study was conducted among 1210 Chinese participants. Participant completed a questionnaire, underwent anthropometric assessments, and received biochemical testing. Lifestyle factors and metabolic indicators were measured at baseline, and arterial stiffness (AS) was assessed at follow-up using pulse wave velocity (PWV). Multivariable linear and logistic regression examined associations between healthy lifestyle score (HLS) and AS, and causal mediation analysis assessed metabolic mediators. Higher HLS was linked to lower vascular parameters (RbaPWV, right brachial-ankle pulse wave velocity: β = -13.25; LbaPWV, left brachial-ankle pulse wave velocity: β = -13.47; AS: OR = 0.75) and a reduction in metabolic indicators, including uric acid (UA), total cholesterol (TC), triglyceride-glucose (TyG), mean arterial pressure (MAP), and metabolic score (MS) (β = -0.18, -2.11, -0.13, -1.62, and -0.44, respectively). Additionally, all metabolic indicators showed significant mediation effects between HLS and RbaPWV, LbaPWV and AS.

These findings suggest that a healthy lifestyle has beneficial effects on both metabolic and vascular health, and metabolic indicators mediate the relationship between lifestyle and vascular health, providing novel insights into lifestyle modifications for the early prevention of cardiovascular disease.