title: 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).
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Center of Endocrinology and Metabolism, Shin-Oyama City Hospital, Oyama-City; Center of Diabetes, Endocrinology and Metabolism.
authors.forename: Daiji
authors.initials: D
authors.lastname: Nagayama
authors.affiliation: Center of Diabetes, Endocrinology and Metabolism.
authors.forename: Haruki
authors.initials: H
authors.lastname: Imamura
authors.affiliation: Center of Diabetes, Endocrinology and Metabolism.
authors.forename: Yuta
authors.initials: Y
authors.lastname: Sato
authors.affiliation: Center of Diabetes, Endocrinology and Metabolism.
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamaguchi
authors.affiliation: Center of Diabetes, Endocrinology and Metabolism.
authors.forename: Noriko
authors.initials: N
authors.lastname: Ban
authors.affiliation: Center of Diabetes, Endocrinology and Metabolism.
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Kawana
authors.affiliation: Center of Diabetes, Endocrinology and Metabolism.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ohira
authors.affiliation: Center of Diabetes, Endocrinology and Metabolism.
authors.forename: Atsuhito
authors.initials: A
authors.lastname: Saiki
authors.affiliation: Department of Vascular Function, Sakura Medical Center, Toho University, Sakura-City, Japan.
authors.forename: Kohji
authors.initials: K
authors.lastname: Shirai
authors.affiliation: Center of Diabetes, Endocrinology and Metabolism.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Tatsuno
mesh_terms: D050154:Adiposity; D000328:Adult; D055109:Ankle Brachial Index; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D005260:Female; D006305:Health Status Indicators; D064368:Healthy Volunteers; D006801:Humans; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D016017:Odds Ratio; D011237:Predictive Value of Tests; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D059289:Vascular Stiffness
keywords: BMI; arterial stiffness; cardioankle vascular index