Inverse relationship of cardioankle vascular index with BMI in healthy Japanese subjects: a cross-sectional study

Abstract

Objective

The objective of this study is to investigate the association of body mass index (BMI) with arterial stiffness assessed by cardioankle vascular index (CAVI).

Subjects and methods

A retrospective cross-sectional study was conducted in 23,257 healthy Japanese subjects (12,729 men and 10,528 women, aged 47.1 ± 12.5 years, BMI 22.9 ± 3.4 kg/m²) who underwent health screening between 2004 and 2006 in Japan. Exclusion criteria were current medication use and a past history of cardiovascular disease, hypertension, stroke, diabetes, and nephritis.

Results

Male subjects showed significantly higher BMI, CAVI, and triglycerides and lower high-density lipoprotein (HDL)-cholesterol compared with female subjects. Next, the subjects were divided into tertiles of BMI: lower, middle, and upper, in a gender-specific manner. After adjusting for confounders including age, systolic blood pressure, and HDL-cholesterol identified by multiple regression analysis, the mean CAVI decreased progressively as BMI tertile increased in both genders. Furthermore, a negative inverse relationship between BMI and adjusted CAVI was observed throughout the BMI distribution. Multivariate logistic regression model for contributors of high CAVI (≥90th percentile) identified obesity (odds ratios (95% confidence interval): 0.804 (0.720–0.899)], older age [15.6 (14.0–17.4)], male gender [2.26 (2.03–2.51)], hypertension [2.28 (2.06–2.54)], impaired fasting glucose [1.17 (1.01–1.37)], and low HDL-cholesterol [0.843 (0.669–1.06)] as independent factors.

Conclusion

We demonstrated an inverse relationship between CAVI and BMI in healthy Japanese subjects, suggesting that systemic accumulation of adipose tissue per se may lead to a linear decrease of arterial stiffness in nonobese and obese subjects without metabolic disorders.

Keywords:

• BMI
• cardioankle vascular index
• arterial stiffness

Acknowledgments

We are grateful to Dr. Kenji Suzuki, Japan Health Promotion Foundation, for making enormous contribution in this study, and we gratefully acknowledge the investigators, their coinvestigators, study coordinators, and the patients who participated in this study.

Author contributions

Kohji Shirai contributed to concept/design. Daiji Nagayama contributed to data analysis and interpretation. Ichiro Tatsuno contributed to critical revision of article. Haruki Imamura, Yuta Sato, Takashi Yamaguchi, Noriko Ban, Hidetoshi Kawana, Masahiro Ohira, and Atsuhito Saiki contributed to data interpretation. All authors contributed toward data analysis, drafting and critically revising the paper and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.