Association of emerging anthropometric ratios with arterial stiffness risk measured by pulse wave velocity: insights from a middle-eastern population

Arterial stiffness (AS), a strong risk factor for atherosclerosis and coronary artery disease (CAD), is typically assessed using pulse wave velocity (PWV). This study takes a unique approach by exploring the relationship between novel anthropometric indices and AS in a large cohort study.

This cross-sectional study was conducted during Phase II of the Mashhad Stroke and Heart Atherosclerotic Disorders (MASHAD) study, a 10-year cohort (2010-2020). Out of the original 9704 participants at the beginning of the MASHAD cohort study, 310 healthy participants, 206 individuals without confirmed cardiovascular disease (CVD), and 307 individuals with confirmed major cardiovascular events were randomly selected. PWV test was conducted using a specialized SphygmoCor XCEL System, and participants were grouped into two CVD and two non-CVD groups based on the median PWV < 6.9 or ≥ 6.9.

A total of 823 individuals took part in the study. The CVD group with PWV ≥ 6.9 m/s had the highest mean age of 51.37 ± 7.07 years. Multinomial logistic regression analysis revealed that with each unit increase in weight-adjusted waist index (WWI) and visceral adiposity index (VAI), the odds of AS increased by 25.7% [OR: 1.257 (1.002-1.576)] and 13.9% [OR: 1.139 (1.022-1.271)] (P-value = 0.048 and 0.019, respectively). Additionally, as lipid accumulation product (LAP) increased, the AS decreased by 0.4% [OR: 0.996 (0.993-0.999)] (P-value = 0.01). Moreover, height and arm-to-height ratio (AHR) resulted in a 3.7% [OR: 1.037 (1.003-1.073)] and 6.4% [OR: 1.064 (1.002-1.131)] increase in PWV risk (P-value = 0.034 and 0.044). In the CVD-, PWV ≥ 6.9 group, VAI posed a 16.4% [OR: 1.164 (1.051-1.289)] (P-value = 0.004) increase in AS with a one-unit increment.

WWI and VAI showed significant associations with AS in CVD patients. VAI was also linked to AS in non-CVD patients, with a stronger association than height and AHR. This contributes significantly to our understanding of vascular health. Equally noteworthy is the protective association of LAP against AS in non-CVD individuals.