Clinical Significance of the Cardio-Ankle Vascular Index as a Cardiovascular Disease Risk Factor in Japanese Elderly
1Hitsumoto Medical Clinic, Shimonoseki City, Yamaguchi 750-0025, Japan.
Insights
Cardio-ankle vascular index (CAVI) predicts cardiovascular disease (CVD) in obese elderly Japanese. High CAVI is linked to visceral fat, insulin resistance, and oxidative stress, indicating increased CVD risk.
Area of Science:
- Cardiology
- Gerontology
- Metabolic Syndrome
Background:
- The cardio-ankle vascular index (CAVI) is a marker of arterial stiffness and a predictor of cardiovascular disease (CVD).
- Limited research exists on CAVI's clinical significance in elderly individuals with obesity.
Purpose of the Study:
- To determine the clinical significance of CAVI as a CVD risk factor in Japanese elderly patients with obesity.
- To investigate the association between CAVI, visceral fat, and other CVD risk factors in this population.
Main Methods:
- A prospective study of 402 Japanese elderly patients with obesity (mean age 72 years) and no prior CVD events.
- Patients were categorized into high CAVI (n=193) and low CAVI (n=209) groups (cut-off: 9.0).
- Comparison of background factors, biomarkers (HOMA-IR, pre-LPL mass, U-8-iso-PGF2α), and CVD event incidence over a median 100-month follow-up.
Main Results:
- The high CAVI group exhibited significantly higher visceral fat area, HOMA-IR, lower pre-LPL mass, and higher U-8-iso-PGF2α compared to the low CAVI group.
- Multiple Cox regression analysis revealed that high CAVI was a significant predictor of primary CVD events (HR: 2.40; 95% CI: 1.37-4.24; P=0.002).
- High HOMA-IR, low pre-LPL mass, and high U-8-iso-PGF2α were also identified as significant predictors of CVD events.
Conclusions:
- CAVI increases with visceral fat accumulation and is associated with insulin resistance, low pre-LPL mass, and oxidative stress in obese elderly Japanese.
- Elevated CAVI serves as a valuable predictor of primary CVD events in this specific patient group.
- These findings highlight CAVI's potential role in risk stratification for cardiovascular disease in elderly individuals with obesity.
Background:
The cardio-ankle vascular index (CAVI) is a physiological marker that indicates systemic arterial stiffness, and several reports have demonstrated its usefulness as a predictor of cardiovascular disease (CVD). However, there have been no studies examining the clinical significance of CAVI limited to elderly patients with obesity. This prospective study aimed to determine the clinical significance of CAVI as a CVD risk factor in Japanese elderly patients with obesity.
Methods:
This study included a total of 402 Japanese elderly patients with obesity (mean age ± standard deviation: 72 ± 5 years; mean body mass index ± standard deviation: 27.6 ± 2.2 kg/m2) and no history of CVD events. The patients were divided into two groups: the high CAVI group (group H: n = 193) and the low CAVI group (group L: n = 209) (cut-off value: 9.0). The patients' background factors were compared between groups, and the usefulness of the CAVI as a predictor of primary CVD events was assessed.
Results:
Group H showed a significantly higher visceral fat area, as measured by abdominal computed tomography, compared to group L. A significant relation with biomarkers, such as homeostasis model assessment of insulin resistance (HOMA-IR); preheparin serum lipoprotein lipase mass (pre-LPL mass) concentration, one of the coronary risk factors; and urinary 8-iso-prostaglandinF2α (U-8-iso-PGF2α) concentration, an indicator of oxidative stress in vivo, was observed. The multiple Cox proportional hazards regression analysis for the incidence of primary CVD events (median follow-up period: 100 months) indicated that group H had a significantly higher risk of developing primary CVD events than group L (hazard ratio: 2.40; 95% confidence interval: 1.37 - 4.24; P = 0.002). However, high HOMA-IR, low pre-LPL mass, and high U-8-iso-PGF2α were also selected as significant predictors of primary CVD events.
Conclusions:
The results of this study indicated that the CAVI increases in the presence of visceral fat accumulation and is significantly associated with key CVD risk factors, such as insulin resistance, low pre-LPL mass, and elevated oxidative stress in Japanese elderly patients with obesity. Furthermore, high CAVI is considered a useful predictor of primary CVD events in such patients.
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