A body shape index and vascular structure and function in Spanish adults (MARK study): A cross-sectional study

Manuel A Gomez-Marcos, Leticia Gomez-Sanchez, Maria Carmen Patino-Alonso, Jose I Recio-Rodriguez, Marta Gomez-Sanchez, Fernando Rigo, Ruth Marti, Cristina Agudo-Conde, Rafel Ramos, Emiliano Rodriguez-Sanchez, Jose A Maderuelo-Fernandez, Luis Garcia-Ortiz, MARK Group, Manuel A Gomez-Marcos, Leticia Gomez-Sanchez, Maria Carmen Patino-Alonso, Jose I Recio-Rodriguez, Marta Gomez-Sanchez, Fernando Rigo, Ruth Marti, Cristina Agudo-Conde, Rafel Ramos, Emiliano Rodriguez-Sanchez, Jose A Maderuelo-Fernandez, Luis Garcia-Ortiz, MARK Group

Abstract

A body shape index (ABSI) has been introduced as a marker of the relationship between body composition and all-cause mortality. However, until now, the relationships between ABSI and vascular structure and function have not been evaluated. The aim of this study was to investigate the association of ABSI with vascular structure and function in Spanish adults with intermediate cardiovascular risk. This cross-sectional study analyzed the data of 2354 subjects [age, 35-74 years (median, 62.0 years [range, 56.0-67.0 years]), 61.9% men] enrolled into the MediAte Risk management (MARK) study. ABSI was calculated by using the following formula: ABSI = waist circumference (m)/[body mass index × height (m))]. Vascular function was assessed by measuring cardio-ankle vascular index (CAVI) with the VaSera device and brachial ankle pulse wave velocity (baPWV) by using a validated equation. Vascular structure was assessed by measuring carotid intima-media thickness (IMT) by ultrasonography. Median value of ABSI was 0.083 (range, 0.081-0.090), mean CAVI was (8.5 ± 1.2), and median IMT was 0.727 (range, 0.672-0.799). The values of ABSI and CAVI were higher in men. After adjusting for confounders, ABSI was positively associated with CAVI, baPWV, and average mean IMT. Thus, for each unit increase in ABSI, CAVI increased by 0.16 units, baPWV by 0.25 m/s, and IMT by 0.033 mm. In the logistic regression analysis, the odds ratio of ABSI was > 1 for high CAVI ≥ 9, baPWV ≥ 15 m/s, and IMT ≥ 0.90 mm in the overall subject group, and in the sex- and age-specific (> 62 years, ≤ 62 years) subgroups, after adjusting for confounders. The area under the receiver-operating characteristic curve of the ABSI was 0.631 (95% confidence interval [CI], 0.608-0.654) for CAVI ≥ 9, and 0.617 (95% CI, 0.593-0.641) for high baPWV ≥ 15 m/s. ABSI showed a positive association with vascular structure and function, independent of other confounders that might influence weight and fat mass distribution in Spanish subjects at intermediate cardiovascular risk.Trial Registration: ClinicalTrials.gov Identifier: NCT01428934 (registered: September 2, 2011; last updated: September 8, 2016).

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Flow chart of this MARK substudy. N = number, CAVI = cardio-ankle vascular index, baPWV = brachial-ankle pulse wave velocity, ABI = ankle-brachial index, WC = waist circumference.
Figure 2
Figure 2
Logistic regression analysis showing unadjusted overall, sex-specific, and age-specific (≤62 and >62 years) OR of ABSI according to CAVI (A), baPWV (B), and average mean IMT (C). OR = odds ratio, CI = confidence interval, CAVI = cardio-ankle vascular index, baPWV = brachial-ankle pulse wave velocity, IMT = intima media thickness.
Figure 3
Figure 3
Logistic regression analysis showing, overall, sex-specific, and age-specific (≤62 and >62 years) adjusted OR of ABSI according to CAVI (A), baPWV (B), and average mean IMT (C). Adjustment was performed for age (years), sex (0 = male and 1 = female), smoking (0 = No and 1 = Yes), amount of alcohol intake (g/wk), physical activity (METs/h/wk), diet quality index, BMI, mean blood pressure, glycosylated hemoglobin level, heart rate and atherogenic index, and use of antihypertensive drugs (0 = No and 1 = Yes), lipid lowering drugs (0 = No and 1 = Yes), and antidiabetic drugs (0 = No and 1 = Yes). OR = odds ratio, CI = confidence interval, CAVI = cardio-ankle vascular index, baPWV = brachial-ankle pulse wave velocity, IMT = intima media thickness.

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