Abstract 3218: Adiposity Measures Predict Prevalent and Incident High Ankle Brachial Index in the Multi-Ethnic Study of Atherosclerosis Study Population
Background: An abnormally high ankle brachial index (ABI >1.4) reflects increased vascular stiffness and is associated with higher all cause and cardiovascular mortality. The goal of the present study was to investigate whether the anthropometric measures of body weight, BMI, waist circumference, and waist to hip ratio (WHR) are associated with prevalent and incident high ABI.
Methods: The Multi-Ethnic Study of Atherosclerosis included 6,814 participants free of clinical cardiovascular disease who had baseline ABI measured and fasting blood drawn; 5,885 returned 4 years later for follow up ABI measurement. For the incidence analysis, 5624 participants remained after excluding those with baseline low and high ABI. Prevalence and incidence ratios for high ABI were obtained from separate log-binomial regression models for each anthropometric measure, adjusted for demography, cardiovascular factors, inflammatory markers and the urine albumin creatinine ratio.
Results: The mean age was 62 years (SD 10.2) and 53% were female. The prevalence and incidence of a high ABI were 3.0% and 2.5%, respectively. For all anthropometric measures, a one standard deviation increment was significantly associated with a 30%– 45% higher prevalence and incidence of high ABI, with the exception of WHR and incident high ABI which was close to null. When comparing incidence ratios for the highest to lowest quartile of each measure, BMI and body weight demonstrated the strongest associations (table⇓).
Conclusions: We observed an independent, positive association of increasing adiposity to both prevalent and incident high ABI. Mechanisms thought to be induced by adiposity which may explain this association include inflammation, advanced glycation end products or leptin dysregulation. That BMI and weight were the most strongly associated with incident high ABI in this cohort may suggest a less important role of abdominal adiposity in mediating abnormal peripheral vascular properties.