Background: Obesity, particularly abdominal obesity, is a well-established risk factor for arterial stiffness (AS) and cardiovascular diseases. A Body Shape Index (ABSI) is a novel anthropometric measure designed to assess abdominal obesity, yet its association with AS remains inconclusive. This study aims to investigate the relationship between ABSI and AS indicators in a general population. Methods: This cross-sectional study included 721 participants from the general population of Dali, Yunnan Province, China. ABSI was calculated using a standardized formula. Univariate and multivariate linear regression analyses were performed to examine the associations between ABSI and AS indicators, including brachial-ankle pulse wave velocity (ba-PWV) and carotid-femoral pulse wave velocity (cf-PWV). Results: Higher ABSI tertiles were significantly associated with increased ba-PWV and cf-PWV compared to the lowest tertile (P ≤ 0.007). However, after adjusting for potential confounders, these associations became non-significant (P ≥ 0.058), suggesting that ABSI is not an independent predictor of AS. Conclusions: The initial association between ABSI and AS was attenuated after covariate adjustment, suggesting ABSI is not an independent AS marker. Further research is warranted to understand the complex interactions between ABSI and other cardiovascular risk factors and its potential role in AS risk assessment.
References
[1]
Boutouyrie, P., Chowienczyk, P., Humphrey, J.D. and Mitchell, G.F. (2021) Arterial Stiffness and Cardiovascular Risk in Hypertension. CirculationResearch, 128, 864-886. https://doi.org/10.1161/circresaha.121.318061
[2]
Agbaje, A.O. (2022) Arterial Stiffness Precedes Hypertension and Metabolic Risks in Youth: A Review. JournalofHypertension, 40, 1887-1896. https://doi.org/10.1097/hjh.0000000000003239
[3]
Wang, Y., Zhao, L., Gao, L., Pan, A. and Xue, H. (2021) Health Policy and Public Health Implications of Obesity in China. TheLancetDiabetes&Endocrinology, 9, 446-461. https://doi.org/10.1016/s2213-8587(21)00118-2
[4]
Cox, A.J., West, N.P. and Cripps, A.W. (2015) Obesity, Inflammation, and the Gut Microbiota. TheLancetDiabetes&Endocrinology, 3, 207-215. https://doi.org/10.1016/s2213-8587(14)70134-2
[5]
Koenen, M., Hill, M.A., Cohen, P. and Sowers, J.R. (2021) Obesity, Adipose Tissue and Vascular Dysfunction. CirculationResearch, 128, 951-968. https://doi.org/10.1161/circresaha.121.318093
[6]
Lastra, G., Manrique, C., Jia, G., Aroor, A.R., Hayden, M.R., Barron, B.J., et al. (2017) Xanthine Oxidase Inhibition Protects against Western Diet-Induced Aortic Stiffness and Impaired Vasorelaxation in Female Mice. AmericanJournalofPhysiology-Regulatory, IntegrativeandComparativePhysiology, 313, R67-R77. https://doi.org/10.1152/ajpregu.00483.2016
[7]
Aroor, A.R., Jia, G. and Sowers, J.R. (2018) Cellular Mechanisms Underlying Obesity-Induced Arterial Stiffness. AmericanJournalofPhysiology-Regulatory, IntegrativeandComparativePhysiology, 314, R387-R398. https://doi.org/10.1152/ajpregu.00235.2016
[8]
Britton, K.A., Massaro, J.M., Murabito, J.M., Kreger, B.E., Hoffmann, U. and Fox, C.S. (2013) Body Fat Distribution, Incident Cardiovascular Disease, Cancer, and All-Cause Mortality. JournaloftheAmericanCollegeofCardiology, 62, 921-925. https://doi.org/10.1016/j.jacc.2013.06.027
[9]
Bawadi, H., Abouwatfa, M., Alsaeed, S., Kerkadi, A. and Shi, Z. (2019) Body Shape Index Is a Stronger Predictor of Diabetes. Nutrients, 11. https://doi.org/10.3390/nu11051018
[10]
Li, G., Yao, T., Wu, X., Cao, Z., Tu, Y., Ma, Y., et al. (2020) Novel and Traditional Anthropometric Indices for Identifying Arterial Stiffness in Overweight and Obese Adults. ClinicalNutrition, 39, 893-900. https://doi.org/10.1016/j.clnu.2019.03.029
[11]
Thomas, D.M., Bredlau, C., Bosy-Westphal, A., Mueller, M., Shen, W., Gallagher, D., et al. (2013) Relationships between Body Roundness with Body Fat and Visceral Adipose Tissue Emerging from a New Geometrical Model. Obesity, 21, 2264-2271. https://doi.org/10.1002/oby.20408
[12]
Tang, J., Zhao, S., Yu, S., Chi, C., Ji, H., Xiong, J., et al. (2021) Association between Hypertension-Mediated Organ Damage and Obesity Defined by Novel Anthropometric Indices in Community-Dwelling Elderly Individuals. ClinicalNutrition, 40, 4473-4480. https://doi.org/10.1016/j.clnu.2020.12.035
[13]
Krakauer, N.Y. and Krakauer, J.C. (2012) A New Body Shape Index Predicts Mortality Hazard Independently of Body Mass Index. PLOSONE, 7, e39504. https://doi.org/10.1371/journal.pone.0039504
[14]
Sugiura, T., Dohi, Y., Takagi, Y., Yokochi, T., Yoshikane, N., Suzuki, K., et al. (2021) A Body Shape Index Could Serve to Identify Individuals with Metabolic Syndrome and Increased Arterial Stiffness in the Middle-Aged Population. ClinicalNutritionESPEN, 46, 251-258. https://doi.org/10.1016/j.clnesp.2021.10.001
[15]
Zhang, Y., Gao, W., Li, B., Liu, Y., Chen, K., Wang, A., et al. (2022) The Association between a Body Shape Index and Elevated Urinary Albumin-Creatinine Ratio in Chinese Community Adults. FrontiersinEndocrinology, 13, Article 955241. https://doi.org/10.3389/fendo.2022.955241
[16]
Lotfi, K., Hassanzadeh Keshteli, A., Saneei, P., Afshar, H., Esmaillzadeh, A. and Adibi, P. (2022) A Body Shape Index and Body Roundness Index in Relation to Anxiety, Depression, and Psychological Distress in Adults. FrontiersinNutrition, 9, Article 843155. https://doi.org/10.3389/fnut.2022.843155
[17]
Choi, H.S., Cho, Y.H., Lee, S.Y., Park, E.J., Kim, Y.J., Lee, J.G., et al. (2019) Association between New Anthropometric Parameters and Arterial Stiffness Based on Brachial-Ankle Pulse Wave Velocity. Diabetes, MetabolicSyndromeandObesity: TargetsandTherapy, 12, 1727-1733. https://doi.org/10.2147/dmso.s211542
[18]
Ishida, A., Taira, H., Shinzato, T. and Ohya, Y. (2023) Association between Visceral Fat Mass and Arterial Stiffness among Community-Based Screening Participants. HypertensionResearch, 46, 2488-2496. https://doi.org/10.1038/s41440-023-01350-7
[19]
Ataee, Z., Aghaee, A., Sobhani, S.R., Ebrahimi Miandehi, E., Pirzadeh, P., Alinezhad-Namaghi, M., et al. (2023) Evaluation of Arterial Stiffness and Its Relation to Innovative Anthropometric Indices in Persian Adults. InternationalJournalofHypertension, 2023, Article ID: 2180923. https://doi.org/10.1155/2023/2180923
[20]
Zhang, J., Fang, L., Qiu, L., Huang, L., Zhu, W. and Yu, Y. (2017) Comparison of the Ability to Identify Arterial Stiffness between Two New Anthropometric Indices and Classical Obesity Indices in Chinese Adults. Atherosclerosis, 263, 263-271. https://doi.org/10.1016/j.atherosclerosis.2017.06.031
[21]
Chinese Diabetes Society and National Office for Primary Diabetes Care (2022) National Handbook for the Prevention and Control of Diabetes in Primary Care (2022). Chinese Journal of Internal Medicine, 61, 717-748. https://doi.org/10.3760/cma.j.cn112138-20220509-00350
[22]
Chang, Y., Guo, X., Chen, Y., Guo, L., Li, Z., Yu, S., et al. (2015) A Body Shape Index and Body Roundness Index: Two New Body Indices to Identify Diabetes Mellitus among Rural Populations in Northeast China. BMCPublicHealth, 15, Article No. 794. https://doi.org/10.1186/s12889-015-2150-2
[23]
Bergman, R.N., Stefanovski, D., Buchanan, T.A., Sumner, A.E., Reynolds, J.C., Sebring, N.G., et al. (2011) A Better Index of Body Adiposity. Obesity, 19, 1083-1089. https://doi.org/10.1038/oby.2011.38
[24]
Fedewa, M.V., Nickerson, B.S. and Esco, M.R. (2019) Associations of Body Adiposity Index, Waist Circumference, and Body Mass Index in Young Adults. ClinicalNutrition, 38, 715-720. https://doi.org/10.1016/j.clnu.2018.03.014
[25]
Amato, M.C., Giordano, C., Galia, M., Criscimanna, A., Vitabile, S., Midiri, M., et al. (2010) Visceral Adiposity Index: A Reliable Indicator of Visceral Fat Function Associated with Cardiometabolic Risk. DiabetesCare, 33, 920-922. https://doi.org/10.2337/dc09-1825
[26]
Zhang, A., Li, Y., Ma, S., Bao, Q., Sun, J., Cai, S., et al. (2022) Conicity-index Predicts All-Cause Mortality in Chinese Older People: A 10-Year Community Follow-Up. BMCGeriatrics, 22, Article No. 971. https://doi.org/10.1186/s12877-022-03664-6
[27]
Williams, B., Mancia, G., Spiering, W., Agabiti Rosei, E., Azizi, M., Burnier, M., et al. (2018) 2018 ESC/ESH Guidelines for the Management of Arterial Hypertension. EuropeanHeartJournal, 39, 3021-3104. https://doi.org/10.1093/eurheartj/ehy339
[28]
Chinese Medical Association, Chinese Medical Journals Publishing House, Chinese Society of General Practice, et al. (2020) Guideline for Primary Care of Obesity (2019). Chinese Journal of General Practice, 19, 95-101. https://doi.org/10.3760/cma.j.issn.1671-7368.2020.02.002
[29]
Zheng, M., Zhang, X., Chen, S., Song, Y., Zhao, Q., Gao, X., et al. (2020) Arterial Stiffness Preceding Diabetes: A Longitudinal Study. CirculationResearch, 127, 1491-1498. https://doi.org/10.1161/circresaha.120.317950
[30]
Tian, X., Zuo, Y., Chen, S., Zhang, Y., Zhang, X., Xu, Q., et al. (2022) Hypertension, Arterial Stiffness, and Diabetes: A Prospective Cohort Study. Hypertension, 79, 1487-1496. https://doi.org/10.1161/hypertensionaha.122.19256
[31]
Cardoso, C.R.L., Salles, G.C. and Salles, G.F. (2019) Prognostic Impact of Aortic Stiffness in Patients with Resistant Hypertension. Hypertension, 73, 728-735. https://doi.org/10.1161/hypertensionaha.118.12367
[32]
Cote, A.T., Phillips, A.A., Harris, K.C., Sandor, G.G.S., Panagiotopoulos, C. and Devlin, A.M. (2015) Obesity and Arterial Stiffness in Children: Systematic Review and Meta-Analysis. Arteriosclerosis, Thrombosis, andVascularBiology, 35, 1038-1044. https://doi.org/10.1161/atvbaha.114.305062
[33]
Li, P., Wang, L. and Liu, C. (2016) Overweightness, Obesity and Arterial Stiffness in Healthy Subjects: A Systematic Review and Meta-Analysis of Literature Studies. PostgraduateMedicine, 129, 224-230. https://doi.org/10.1080/00325481.2017.1268903
[34]
Lee, M., Wu, Y. and Fried, S.K. (2013) Adipose Tissue Heterogeneity: Implication of Depot Differences in Adipose Tissue for Obesity Complications. MolecularAspectsofMedicine, 34, 1-11. https://doi.org/10.1016/j.mam.2012.10.001
[35]
Yadav, A., Kataria, M.A., Saini, V. and Yadav, A. (2013) Role of Leptin and Adiponectin in Insulin Resistance. ClinicaChimicaActa, 417, 80-84. https://doi.org/10.1016/j.cca.2012.12.007
[36]
Chen, X.Q. and Li, L.H. (2024) Advancements in the Association Between a Body Shape Index and Atherosclerosis. Chinese General Practice, 27, 1899-1903. https://doi.org/10.12114/j.issn.1007-9572.2023.0506
[37]
Sun, M., Gao, L., Bai, H., Hu, W., Zhang, X., Xiao, J., et al. (2023) Association between Visceral Fat, Blood Pressure and Arterial Stiffness in Patients with HFPEF: A Mediation Analysis. Diabetes, MetabolicSyndromeandObesity, 16, 653-662. https://doi.org/10.2147/dmso.s399928
[38]
Haraguchi, N., Koyama, T., Kuriyama, N., Ozaki, E., Matsui, D., Watanabe, I., et al. (2019) Assessment of Anthropometric Indices Other than BMI to Evaluate Arterial Stiffness. HypertensionResearch, 42, 1599-1605. https://doi.org/10.1038/s41440-019-0264-0
[39]
Low Wang, C.C., Hess, C.N., Hiatt, W.R. and Goldfine, A.B. (2016) Clinical Update: Cardiovascular Disease in Diabetes Mellitus: Atherosclerotic Cardiovascular Disease and Heart Failure in Type 2 Diabetes Mellitus-Mechanisms, Management, and Clinical Considerations. Circulation, 133, 2459-2502. https://doi.org/10.1161/circulationaha.116.022194
[40]
Tomoda, K., Yoshikawa, M., Itoh, T., Tamaki, S., Fukuoka, A., Komeda, K., et al. (2007) Elevated Circulating Plasma Adiponectin in Underweight Patients with COPD. Chest, 132, 135-140. https://doi.org/10.1378/chest.07-0227
[41]
Fricke, C. and Voderholzer, U. (2023) Endocrinology of Underweight and Anorexia Nervosa. Nutrients, 15, Article 3509. https://doi.org/10.3390/nu15163509
[42]
Maloberti, A., Vallerio, P., Triglione, N., Occhi, L., Panzeri, F., Bassi, I., et al. (2019) Vascular Aging and Disease of the Large Vessels: Role of Inflammation. HighBloodPressure&CardiovascularPrevention, 26, 175-182. https://doi.org/10.1007/s40292-019-00318-4
[43]
Alonso-Domínguez, R., Sánchez-Aguadero, N., Patino-Alonso, M.C., Agudo-Conde, C., de Cabo-Laso, Á., Gómez-Sánchez, M., et al. (2021) Association between Measurements of Arterial Stiffness and Target Organ Damage in a General Spanish Population. AnnalsofMedicine, 53, 345-356. https://doi.org/10.1080/07853890.2021.1881812
[44]
Bhasin, N. and Scott, D.J.A. (2007) Ankle Brachial Pressure Index: Identifying Cardiovascular Risk and Improving Diagnostic Accuracy. JournaloftheRoyalSocietyofMedicine, 100, 4-5. https://doi.org/10.1177/014107680710000103
[45]
Ato, D. (2018) Pitfalls in the Ankle-Brachial Index and Brachial-Ankle Pulse Wave Velocity. VascularHealthandRiskManagement, 14, 41-62. https://doi.org/10.2147/vhrm.s159437
[46]
Expert Consensus Drafting Group, Branch of Resistant Hypertension and Peripheral Arterial Disease, China International Exchange and Promotion Association for Medical and Healthcare (2020) 2020 Chinese Expert Consensus on Clinical Application of Simultaneous Measurement of Four-Limb Blood Pressure and Brachial-Ankle Pulse Wave Velocity. Chinese Circulation Journal, 35, 521-528.
