title: Association of body mass index and left ventricular mass index with abnormally low and high ankle-brachial indices in chronic kidney disease.
abstract: Obesity, left ventricular hypertrophy (LVH) and peripheral artery disease are frequently noted in patients with chronic kidney disease (CKD), thereby suggesting a close and causal relationship among them. This study was designed to assess whether the combination of an increased body mass index (BMI) and left ventricular mass index (LVMI) are independently associated with abnormally low and high ABI in patients with CKD stages 3-5. A total of 566 patients were included in the study and were classified into four groups according to sex-specific median BMIs and LVMIs. The ABI was measured using an ABI-form device. Abnormally low and high ABI was defined as ABI <0.9 or ⩾1.3 in either leg. The combination of high BMI and LVMI (vs. the combination of low BMI and LVMI) was significantly associated with abnormally low and high ABI in an unadjusted model (odds ratio (OR), 2.107; P=0.015) and in a multivariable model after adjustment for demographic, clinical and biochemical characteristics and medications (OR, 4.219; P=0.008). In addition, the interaction between BMI and LVMI in abnormally low and high ABI was statistically significant in the unadjusted (OR, 1.002; P=0.001) and multivariate models (OR, 1.004; P=0.003). Our findings show that the combination of high BMI and LVMI was associated with abnormally low and high ABI in patients with CKD stages 3-5. Patients with high BMI and LVMI might be at a high risk of abnormally low and high ABI.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan, Republic of China.|Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Taiwan, Republic of China.|College of Medicine, Faculty of Medicine, Kaohsiung Medical University, Taiwan, Republic of China.|Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Taiwan, Republic of China.
authors.forename: Szu-Chia
authors.initials: SC
authors.lastname: Chen
authors.affiliation: Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Taiwan, Republic of China.|College of Medicine, Faculty of Medicine, Kaohsiung Medical University, Taiwan, Republic of China.|Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan, Republic of China.
authors.forename: Wen-Hsien
authors.initials: WH
authors.lastname: Lee
authors.affiliation: College of Medicine, Faculty of Medicine, Kaohsiung Medical University, Taiwan, Republic of China.|Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan, Republic of China.
authors.forename: Po-Chao
authors.initials: PC
authors.lastname: Hsu
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan, Republic of China.|Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Taiwan, Republic of China.
authors.forename: Jiun-Chi
authors.initials: JC
authors.lastname: Huang
authors.affiliation: College of Medicine, Faculty of Medicine, Kaohsiung Medical University, Taiwan, Republic of China.|Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan, Republic of China.
authors.forename: Chee-Siong
authors.initials: CS
authors.lastname: Lee
authors.affiliation: College of Medicine, Faculty of Medicine, Kaohsiung Medical University, Taiwan, Republic of China.|Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan, Republic of China.
authors.forename: Tsung-Hsien
authors.initials: TH
authors.lastname: Lin
authors.affiliation: College of Medicine, Faculty of Medicine, Kaohsiung Medical University, Taiwan, Republic of China.|Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan, Republic of China.
authors.forename: Wen-Chol
authors.initials: WC
authors.lastname: Voon
authors.affiliation: College of Medicine, Faculty of Medicine, Kaohsiung Medical University, Taiwan, Republic of China.|Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan, Republic of China.
authors.forename: Wen-Ter
authors.initials: WT
authors.lastname: Lai
authors.affiliation: College of Medicine, Faculty of Medicine, Kaohsiung Medical University, Taiwan, Republic of China.|Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan, Republic of China.
authors.forename: Sheng-Hsiung
authors.initials: SH
authors.lastname: Sheu
authors.affiliation: Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Taiwan, Republic of China.|College of Medicine, Faculty of Medicine, Kaohsiung Medical University, Taiwan, Republic of China.|Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan, Republic of China.
authors.forename: Ho-Ming
authors.initials: HM
authors.lastname: Su
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D015992:Body Mass Index; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000150:complications* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000503:physiopathology; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000503:physiopathology