Adiposity measures and arterial stiffness in primary care: the MARK prospective observational study

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

Abstract

Background: The cardiovascular risk of obesity is potentially increased by arterial stiffness.

Objective: To assess the relationship of adiposity measures with arterial stiffness in Caucasian adults with intermediate cardiovascular risk.

Setting: Six Spanish health centres.

Participants: We enrolled 2354 adults (age range, 35-74 years; mean age, 61.4±7.7 years, 61.9% male).

Methods: This is a cross-sectional study that analyses data from the baseline visit of the improving interMediAte RisK management (MARK) study. The main outcome variables were body mass index (BMI), waist-to-height ratio (WHtR), Clínica Universidad de Navarra-body adiposity estimation (CUN-BAE) body fat percentage and body roundness index (BRI). Vascular function was assessed by the cardio-ankle vascular index (CAVI) with the VaSera device; brachial-ankle pulse wave velocity (baPWV) was determined using a validated equation.

Results: The mean adiposity measures were a BMI of 29.2±4.4, WHtR of 0.61±0.07, CUN-BAE of 35.7±1.7 and BRI of 5.8±1.7. The mean stiffness measures were a CAVI of 8.8±1.2 and baPWV of 14.9±2.5. In multiple linear regression analyses, all adiposity measures were negatively associated with CAVI and baPWV (p<0.01 for all) after adjustment for possible factors of confusion. The proportion of CAVI variability via the adiposity measures were 5.5% for BMI, 5.8% for CUN-BAE, 3.8% for WHtR and 3.7% for BRI. These were higher among diabetic, obese, younger (≤62 years) and non-hypertensive subjects who had similar activity and sedentary profiles.

Conclusions: Adiposity measures are negatively associated with arterial stiffness measures. The percentage of variation in CAVI explained by its relation to the different measures of adiposity ranges from 5.8% (CUN-BAE) to 3.7% (BRI). In the case of baPWV, it oscillates between 0.7% (CUN-BAE and BMI) and 0.1% (WHtR).

Trial registration number: NCT01428934.

Keywords: arterial stiffness; body mass index; body roundness index; fat mass percent; waist circumference; waist-to-height ratio.

Conflict of interest statement

Competing interests: None declared.

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Figures

Figure 1
Figure 1
Flow chart. MARK substudy. ABI, ankle-brachial index; baPWV, brachial-ankle pulse wave velocity; CAVI, cardio-ankle vascular index; WC, waist circumference.

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