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

Figures & data

Table 1 Characteristics of male and female participants

Characteristics	All	Male	Female	P value*
Number of subjects	23,257	12,729	10,528	–
Age (years)	47.1 ± 12.5	47.0 ± 13.0	47.1 ± 12.0	0.692
Height (cm)	163 ± 9	169 ± 6	156 ± 6	<0.001
Body weight (kg)	61.6 ± 12.2	68.4 ± 10.5	53.3 ± 8.4	<0.001
BMI (kg/m^2)	22.9 ± 3.4	23.9 ± 3.2	21.7 ± 3.3	0.003
CAVI	7.84 ± 1.07	7.96 ± 1.14	7.69 ± 0.97	<0.001
sBP (mmHg)	124 ± 16	124 ± 16	123 ± 16	<0.001
dBP (mmHg)	76 ± 12	76 ± 12	75 ± 11	<0.001
γ-GTP (IU/L)	43 ± 56	43 ± 52	44 ± 60	0.415
FPG (mg/dL)	91 ± 18	91 ± 18	91 ± 18	0.465
HbA1c (NGSP, %)	5.3 ± 0.6	5.3 ± 0.6	5.3 ± 0.6	0.086
TC (mg/dL)	209 ± 37	210 ± 37	208 ± 36	0.002
TG (mg/dL)	113 ± 95	117 ± 100	108 ± 89	<0.001
HDL-C (mg/dL)	66 ± 19	65 ± 18	67 ± 19	<0.001
Non-HDL-C	144 ± 39	145 ± 39	142 ± 38	<0.001
Creatinine (mg/dL)	0.71 ± 0.15	0.80 ± 0.13	0.62 ± 0.10	0.055

Notes: Data are presented as mean ± standard deviation.

* Student’s t-test was used to compare male and female subjects.

Abbreviations: BMI, body mass index; CAVI, cardioankle vascular index; sBP, systolic blood pressure; dBP, diastolic blood pressure; γ-GTP, γ-glutamyl transpeptidase; FPG, fasting plasma glucose; HbA1c, glycosylated hemoglobin; TC, total cholesterol; TG, triglyceride; HDL-C, high-density lipoprotein-cholesterol.

Table 2 Prevalence of major cardiovascular risk factors

Variable	All (%)	Male (%)	Female (%)	P value**
Older age (age ≥65; 1, <65; 0)	9.2	9.2	6.6	<0.001
Obesity (BMI ≥25; 1, <25; 0)	24.9	32.9	15.4	<0.001
Hypertension (BP ≥140/90; 1, <140/90; 0)	15.3	16.1	14.3	<0.001
IFG (FPG ≥110; 1, <110; 0)	10.1	10.2	10.0	0.498
Low HDL-C (HDL-C <40; 1, ≥40; 0)	5.0	5.3	4.7	0.058

Note:

** Fisher’s exact test was used to compare male and female subjects.

Abbreviations: BMI, body mass index; BP, blood pressure; IFG, impaired fasting glucose; FPG, fasting plasma glucose; HDL-C, high-density lipoprotein-cholesterol.

Figure 1 Relationship between adjusted cardioankle vascular index and BMI in (A) male and (B) female subjects.

Notes: CAVI was adjusted by age, sBP, and HDL-C. Data are presented as mean ± standard deviation. A significant linear trend [F = 53.732, P < 0.001 in (A) and F = 61.386, P < 0.001 in (B)] was observed for the whole BMI distribution.
Abbreviations: BMI, body mass index; CAVI, cardioankle vascular index; sBP, systolic blood pressure; HDL-C, high-density lipoprotein-cholesterol.

Table 3 Correlation of cardioankle vascular index with clinical variables analyzed by multiple regression model

Variable	β coefficient	SE	P value
Gender (male; 1, female; 0)	0.149	0.125	<0.001
Age (years)	0.584	0.017	<0.001
BMI (kg/m^2)	−0.119	0.003	<0.001
sBP (mmHg)	0.139	17.105	<0.001
γ-GTP (IU/L)	0.004	0.538	<0.001
HbA1c (%)	−0.003	0.015	0.712
HDL-C (mg/dL)	−0.181	0.001	<0.001
Non HDL-C (mg/dL)	0.107	<0.001	0.542
Creatinine (mg/dL)	0.012	1.470	0.142

Note: Model: r² = 0.598, P < 0.001.

Abbreviations: SE, standard error; BMI, body mass index; sBP, systolic blood pressure; γ-GTP, γ-glutamyl transpeptidase; HbA1c, glycosylated hemoglobin; HDL-C, high-density lipoprotein-cholesterol.

Table 4 Characteristics of male and female participants stratified by tertile of body mass index

Variable	Tertile of body mass index			P for trend
	Lower (T1)	Middle (T2)	Upper (T3)
Male subjects
Number of subjects	4,181	4,365	4,183
Age (years)	45.2 ± 13.8	48.4 ± 12.6	47.4 ± 12.3	<0.001
Height (cm)	169 ± 6	169 ± 6	169 ± 6	<0.001
Body weight (kg)	59.2 ± 9.6	67.6 ± 5.3	78.5 ± 9.4	<0.001
BMI (kg/m^2)	20.5 ± 1.3 (≤22.2)	23.6 ± 0.8 (22.3–24.9)	23.9 ± 3.2 (≥25.0)	<0.001
CAVI	7.99 ± 1.13	8.06 ± 1.12	7.84 ± 1.15	<0.001
Adjusted CAVI***	8.16 ± 0.87	7.97 ± 0.84	7.76 ± 0.87	<0.001
sBP (mmHg)	123 ± 15	127 ± 15	131 ± 15	<0.001
dBP (mmHg)	75 ± 11	79 ± 11	82 ± 11	<0.001
γ-GTP (IU/L)	47 ± 68	58 ± 69	69 ± 66	<0.001
FPG (mg/dL)	91 ± 18	94 ± 21	95 ± 22	<0.001
HbA1c (%)	5.6 ± 0.6	5.7 ± 0.7	5.8 ± 0.8	<0.001
TC (mg/dL)	197 ± 34	209 ± 36	214 ± 35	<0.001
TG (mg/dL)	103 ± 79	138 ± 109	169 ± 135	<0.001
HDL-C (mg/dL)	65 ± 17	58 ± 15	53 ± 13	<0.001
Non HDL-C (mg/dL)	132 ± 35	151 ± 37	162 ± 36	<0.001
Creatinine (mg/dL)	0.79 ± 0.11	0.82 ± 0.29	0.82 ± 0.13	<0.001
Female subjects
Number of subjects	3,585	3,462	3,481
Age (years)	43.1 ± 12.0	47.4 ± 11.4	50.9 ± 11.2	<0.001
Height (cm)	157.7 ± 5.4	156.4 ± 5.5	155.3 ± 5.6	<0.001
Body weight (kg)	46.5 ± 4.1	52.1 ± 3.9	61.6 ± 7.9	<0.001
BMI (kg/m^2)	18.6 ± 1.1 (≤20.0)	21.2 ± 0.7 (20.1–22.5)	25.5 ± 2.7 (≥22.6)	<0.001
CAVI	7.61 ± 0.94	7.70 ± 0.96	7.76 ± 1.01	<0.001
Adjusted CAVI***	7.89 ± 0.76	7.70 ± 0.71	7.50 ± 0.76	<0.001
sBP (mmHg)	114 ± 14	119 ± 15	127 ± 17	<0.001
dBP (mmHg)	68 ± 10	71 ± 10	76 ± 11	<0.001
γ-GTP (IU/L)	21 ± 18	24 ± 25	31 ± 29	<0.001
FPG (mg/dL)	84 ± 8	86 ± 9	90 ± 16	<0.001
HbA1c (%)	5.6 ± 0.4	5.6 ± 0.5	5.8 ± 0.6	<0.001
TC (mg/dL)	202 ± 36	212 ± 37	226 ± 37	<0.001
TG (mg/dL)	65 ± 34	80 ± 52	107 ± 63	<0.001
HDL-C (mg/dL)	80 ± 18	75 ± 17	67 ± 16	<0.001
Non HDL-C (mg/dL)	122 ± 33	137 ± 37	156 ± 37	<0.001
Creatinine (mg/dL)	0.61 ± 0.14	0.61 ± 0.08	0.61 ± 0.10	0.006

Notes:

*** CAVI was adjusted by age, sBP, and HDL-C. Data are presented as mean ± standard deviation, P value for trend by ANOVA.

Abbreviations: BMI, body mass index; CAVI, cardioankle vascular index; sBP, systolic blood pressure; dBP, diastolic blood pressure; γ-GTP, γ-glutamyl transpeptidase; FPG, fasting plasma glucose; HbA1c, glycosylated hemoglobin; TC, total cholesterol; TG, triglyceride; HDL-C, high-density lipoprotein-cholesterol; ANOVA, analysis of variance.

Table 5 OR (95% CI) for high cardioankle vascular index (≥90th percentile)

Variable	OR	95% CI	P value
Gender (male; 1, female; 0)	2.26	2.03–2.51	<0.001
Older age, years (age ≥65; 1, <65; 0)	15.6	14.0–17.4	<0.001
Obesity (BMI ≥25; 1, <25; 0)	0.804	0.720–0.899	<0.001
Hypertension (+; 1, -; 0)	2.28	2.06–2.54	<0.001
IFG (FPG ≥110; 1, <110; 0)	1.17	1.01–1.37	0.0428
Low HDL-C (HDL-C <40; 1, ≥40; 0)	0.843	0.669–1.06	0.145

Note: Akaike’s Information Criterion: 12,166, residual deviance: 12,152, P < 0.0001.

Abbreviations: CI, confidence interval; BMI, body mass index; IFG, impaired fasting glucose; FPG, fasting plasma glucose; HDL-C, high-density lipoprotein-cholesterol; OR, odds ratio.