Body mass index influence the association between triglyceride-glucose index and atherosclerosis in community population: the cardiometabolic risk in Chinese (CRC) study

Abstract Background: Cardiovascular disease (CVD) is an universal problem in modern society. Atherosclerosis is the leading cause of CVD resulting in high rate of mortality in the population. The study aimed to examine the association of triglyceride-glucose (TyG) index, a novel marker of insulin resistance, with atherosclerosis in Chinese adults, and the effects of different body mass index (BMI) levels on this relationship.Methods: The study samples were from a community-based health examination survey in central China. A total of 4729 apparently healthy Chinese men and women were included. TyG index was calculated as ln[fasting triglycerides (mg/dL)×fasting glucose (mg/dL)/2]. Parameters of vascular damage, including carotid-femoral pulse wave velocity (cfPWV), carotid-radial pulse wave velocity (crPWV), carotid-dorsalis pedis pulse wave velocity (cdPWV) were measured.Results: After adjustment for conventional risk factors, TyG index was significantly associated with peripheral arterial stiffness (cdPWV>10.57cm/s or crPWV>11.12cm/s), however, TyG index was not associated with central arterial stiffness, measured by cfPWV. Moreover, we found significant interactions between TyG index and BMI in relation to crPWV and cdPWV. Risk for crPWV and cdPWV elevation was significantly decreased across increasing quartiles of TyG index under different BMI levels (P<0.001). There was a dose-response relationship of TyG index with crPWV and cdPWV in the normal-weight and overweight groups, with the most obvious in the normal-weight individuals. However, the dose-response relationship was not existed among the obesity group where the increase of TyG index did not significantly rise the risk of high crPWV and cdPWV.Conclusions: TyG index, a simple measure reflecting insulin resistance, might be useful to early identify individuals at a high risk of developing atherosclerosis. Increased BMI weakened the effect of TyG index on crPWV and cdPWV, indicating that the value of TyG index in assessing the risk of atherosclerosis in obese people maybe easily ignored, however, TyG index can better reflect the risk of atherosclerosis in normal-weight adults.

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Uric Acid and Vascular Damage in Essential Hypertension: Role of Insulin Resistance

Nutrients ◽

10.3390/nu12092509 ◽

2020 ◽

Vol 12 (9) ◽

pp. 2509

Author(s):

Velia Cassano ◽

Daniele Crescibene ◽

Marta Letizia Hribal ◽

Corrado Pelaia ◽

Giuseppe Armentaro ◽

...

Keyword(s):

Insulin Resistance ◽

Uric Acid ◽

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Wave Velocity ◽

Pulse Wave ◽

Vascular Damage ◽

Newly Diagnosed ◽

Hypertensive Patients

Increased levels of uric acid (UA) have been shown to be correlated with many clinical conditions. Uric acid may adversely affect the insulin signalling pathway inducing insulin resistance (IR). Several studies report the association between arterial stiffness (AS), an early indicator of atherosclerosis, and UA. The purpose of the present study was to evaluate the association between UA and AS, considering the potential role of IR. We enrolled 1114 newly diagnosed, never-treated hypertensive patients. Insulin resistance was assessed by the homeostatic model assessment (HOMA) index. Arterial stiffness was evaluated as the measurement of the carotid–femoral pulse wave velocity (PWV). The study cohort was divided into subgroups, according to increasing tertiles of UA. The mean values of UA were 5.2 ± 1.6 mg/dL in the overall population. Pulse wave velocity was linearly correlated with UA (p < 0.0001), HOMA (p < 0.0001), high sensitivity C-reactive protein (p < 0.0001), systolic blood pressure (p < 0.0001) and LDL cholesterol (p = 0.005). Uric acid was the strongest predictor of PWV and was associated with the highest risk for increased AS. The interaction analysis showed that the joint effect of increased UA and HOMA was significantly higher than that expected in the absence of interaction under the additive model, indicating that the two biomarkers synergically interacted for promoting vascular damage. Our data showed that UA interacted with IR to increase AS in a large cohort of newly diagnosed, never-treated hypertensive patients.

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Increased Arterial Stiffness in Adolescents With Obesity

Global Pediatric Health ◽

10.1177/2333794x19831297 ◽

2019 ◽

Vol 6 ◽

pp. 2333794X1983129

Author(s):

Yvette E. Lentferink ◽

Lisa A. J. Kromwijk ◽

Marloes P. van der Aa ◽

Catherijne A. J. Knibbe ◽

Marja M. J. van der Vorst

Keyword(s):

Insulin Resistance ◽

Cardiovascular Disease ◽

Risk Assessment ◽

Cardiovascular Risk ◽

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Wave Velocity ◽

Pulse Wave ◽

Augmentation Index ◽

Cardiovascular Risk Assessment

Increased arterial stiffness (AS) is an early sign of cardiovascular disease. Influence of weight, puberty, and insulin resistance (IR) on AS in adolescents is unclear. Therefore, this study compared AS, assessed with pulse wave velocity (PWV) and augmentation index (AIx), of adolescents with and without obesity and evaluated the influence of puberty and IR on AS. Sixty-two lean and 61 adolescents with obesity were included. Significantly higher PWV was observed in adolescents with obesity (4.1 ms−1 [2.4 to 5.6 ms−1] vs 3.6 ms−1 [0.4 to 6.1 ms−1]; P = .01), while AIx was not significant different. However, significantly higher AIx was observed in adolescents with obesity and IR (3.0 [−17.5% to 28.5%] vs −3.0 [−19.0% to 13.0%]; P = .01). For Tanner stages, no differences were observed. The higher PWV in adolescents with obesity and higher AIx in adolescents with obesity and IR both indicate an increased AS. Consequently, measurement of AS should be considered in adolescents with obesity and IR as part of cardiovascular risk assessment.

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Body Mass Index and Arterial Stiffness Are Associated With Greater Beat-to-Beat Blood Pressure Variability After Transient Ischemic Attack or Minor Stroke

Stroke ◽

10.1161/strokeaha.120.031179 ◽

2021 ◽

Author(s):

Alastair J.S. Webb ◽

Amy Lawson ◽

Sara Mazzucco ◽

Linxin Li ◽

Peter M. Rothwell ◽

...

Keyword(s):

Blood Pressure ◽

Body Mass Index ◽

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Wave Velocity ◽

Cardiovascular Events ◽

Blood Pressure Variability ◽

Pulse Wave ◽

Ischemic Attack ◽

The Relationship

Background and Purpose: Blood pressure variability (BPV) from beat to beat is associated with an increased risk of cardiovascular events and enables rapid assessment of BPV, but the underlying causes of elevated BPV are unclear. Methods: In consecutive patients within 4 to 6 weeks of transient ischemic attack or nondisabling stroke (OXVASC [Oxford Vascular Study]), continuous noninvasive blood pressure was measured beat to beat over 5 minutes (Finometer). Arterial stiffness was measured by carotid-femoral pulse wave velocity (Sphygmocor). After automated and manual data cleaning, associations between BPV (residual coefficient of variation), demographic factors, and arterial stiffness were determined for both systolic and diastolic blood pressure, by ANOVA and linear models. Relationships between demographic factors and arterial stiffness were determined by interaction terms and mediation. Results: Among 1013 patients, 54 (5.3%) were in AF, and 51 (5%) had low-quality recordings. In a general linear model including the remaining 908 participants, systolic BPV (SBPV) was most strongly associated with age ( P =0.00003), body mass index (BMI; P =0.003), and arterial stiffness ( P =0.008), with weaker independent associations with current smoking ( P =0.01) and a low diastolic blood pressure ( P =0.046). However, while there was a linear increase in SBPV with BMI in men, in women, SBPV was lowest for a BMI in the normal range but was greater below 20 or above 30 (ANOVA, P =0.012; BMI-sex interaction, P =0.03). Although BMI and pulse wave velocity were partially independent, increased pulse wave velocity mediated ≈32% of the relationship between increased BMI and SBPV ( P <0.001). Conclusions: Vascular aging, manifest as arterial stiffness, was a strong determinant of increased SBPV and partially mediated the effect of increased BMI. However, although high BMI was independently associated with SBPV in both sexes, a low BMI was associated with increased SBPV only in women. SBPV may partially mediate the relationship between BMI and cardiovascular events, while obesity may provide a modifiable target to reduce SBPV and cardiovascular events.

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Does body mass index or waist-hip ratio correlate with arterial stiffness based on brachial-ankle pulse wave velocity in Chinese rural adults with hypertension?

BMC Cardiovascular Disorders ◽

10.1186/s12872-021-02390-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Feng Hu ◽

Rihua Yu ◽

Fengyu Han ◽

Juan Li ◽

Wei Zhou ◽

...

Keyword(s):

Body Mass Index ◽

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Body Mass ◽

Wave Velocity ◽

Central Obesity ◽

Pulse Wave ◽

Waist Hip Ratio ◽

The Relationship ◽

Rural Adults

Abstract Background The relationship between obesity indices and arterial stiffness (AS) has not been fully discovered nor has it been studied in depth in large hypertensive patient populations. The aim of this study was to explore the association between body mass index (BMI) and waist-hip ratio (WHR) levels and AS based on brachial-ankle pulse wave velocity (baPWV) in Chinese rural adults with hypertension. Methods This cross-sectional study analyzed 5049 Chinese rural adults with essential hypertension. BMI was calculated as the body weight in kilograms divided by the square of the height in meters (kg/m2). Central obesity was defined as WHR ≥ 0.9 for males and ≥ 0.85 for females. Measurement of arterial stiffness was carried out via brachial-ankle pulse wave velocity (baPWV). Results The prevalence of overweight, general obesity, central obesity and increased AS were 26.88%, 3.39%, 63.85% and 44.01%, respectively. Multivariate logistic regression analysis indicated that BMI levels were negatively associated with the prevalence of increased AS (adjusted-OR per SD increase: 0.74, 95% CI 0.67–0.81, P < 0.001). When BMI was instead treated as a categorical variable divided into tertiles, the same relationship was observed (P for trend < 0.001). Inversely, WHR levels were positively associated with the prevalence of increased AS (adjusted-OR per SD increase: 1.25, 95% CI 1.14–1.36, P < 0.001). Compared to subjects without central obesity, those with central obesity had a higher prevalence of increased AS (adjusted-OR: 1.52, 95% CI 1.28–1.81, P < 0.001). Linear regression models indicated similar results in the correlation between BMI or WHR levels and baPWV levels (adjusted-β per SD increase: − 0.57, 95% CI − 0.68 to − 0.46, P < 0.001; adjusted-β per SD increase: 4.46, 95% CI 3.04–5.88, P < 0.001). There were no interactions in terms of age and blood pressure on the relationship between BMI or WHR levels and the prevalence of increased AS or baPWV levels. Conclusion There was an inverse relationship between BMI levels and increased AS or baPWV levels, whereas WHR levels and central obesity were positively associated with increased AS or baPWV levels in Chinese rural adults with hypertension.

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Insulin resistance and arterial stiffness: impact of gestational diabetes on pulse wave velocity

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20183624 ◽

2018 ◽

Vol 6 (9) ◽

pp. 2895

Author(s):

Aissatou Seck ◽

Fatou Diallo Agne ◽

Abibatou Sall Fall ◽

Fatou Binetou Sar ◽

Valentin Ouedraogo ◽

...

Keyword(s):

Insulin Resistance ◽

Blood Pressure ◽

Arterial Stiffness ◽

Gestational Diabetes ◽

Pulse Wave Velocity ◽

Total Cholesterol ◽

Wave Velocity ◽

Ldl Cholesterol ◽

Pulse Wave ◽

History Of

Background: Gestational diabetes is an intolerance of glucose with the first appearance during the pregnancy. This hyperglycaemia status, because of the pre-existing insulin-resistance, constitute a favourable land of arterial stiffness. The aim of this study is to determine the impact of non obese gestational diabetes on arterial stiffness by measuring the pulse wave velocity (PWV).Methods: We recruited 60 pregnant women aged from 20 to 35 years old. They were between twentieth four and thirtieth five weeks of gestational age. Subjects were divided into two groups: the first group (G1), considered as control group, included 25 normoglycemic pregnant subjects without any history of illness or risk factors of gestational diabetes; the second group (G2) included 35 women with Gestational Diabetes Mellitus (GDM). All pregnant women had not history of smoking, were not taking decoction or medicine, which could disturb pregnancy evolution. Anthropo-physiological and biochemical parameters studied, were: age, body mass index (BMI), blood pressure (BP), triglyceride, cholesterol and HOMA-IR index. The PWV between finger and toe (PWVft) was measured by pOpmètre®.Results: The two groups are matched by age (G1:28±4ans; G2:29±3ans) and BMI (G1:25.6±1.27; G2:26.9±1.3). Blood pressure (BP) values are in normal interval (systolic BP: [110-132mmHg]; diastolic BP: [63-87mmHg]; mean BP: [79-103mmHg]). Total cholesterol (G1:0.95±0.08;G2:2.4±0.7; p˂0.0001), HDL cholesterol (G1:0.44±0.02; G2:0.76±0.2; p˂0.0001, LDL cholesterol (G1:0.40±0.05; G2:1.3±0.5; p˂0.0001), triglyceride (G1:0.57±0.45; G2:1.6±0.4;p˂0.0001), HOMA.IR (G1:1.31±1.05; G2:7.4±1.07; p˂0.01), PWVft (G1:5.99±1.23; G2:10.3±1.9; p˂0.0001) are significantly higher in diabetic group. PWVft is positively correlate to HOMA-IR index, total cholesterol, LDL cholesterol and triglycerides (r=0.3348, p=0.032; r=0.5275, p˂0.0001; r=0.4855,p˂0.0001; r=0.5581, p˂0.0001respectively).Conclusions: Gestational diabetes might induce an increase of pulse wave velocity expressing increment of arterial stiffness. This last constitute an early underlying cardiovascular risk.

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Transitions in Metabolic Health and Associations With Arterial Stiffness Progression Across Body Mass Index Categories

Hypertension ◽

10.1161/hypertensionaha.121.17735 ◽

2021 ◽

Vol 78 (5) ◽

pp. 1270-1277

Author(s):

Shouling Wu ◽

Lulu Song ◽

Lulin Wang ◽

Shuohua Chen ◽

Mingyang Wu ◽

...

Keyword(s):

Cardiovascular Disease ◽

Body Mass Index ◽

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Body Mass ◽

Wave Velocity ◽

Pulse Wave ◽

Metabolic Health ◽

Metabolically Healthy Obese ◽

Metabolically Healthy

Metabolically healthy obesity is an unstable state and its transition to a metabolically unhealthy phenotype confers an increased risk of cardiovascular disease. However, it remains unclear whether changes in metabolic health over time are associated with arterial stiffness progression, a key player in the pathophysiology of cardiovascular disease. We aimed to investigate the associations of changes in metabolic health across body mass index categories with arterial stiffness and its progression. This study included 22 153 participants without cardiovascular disease or cancer at baseline from the Kailuan Study. Arterial stiffness was assessed using brachial-ankle pulse wave velocity at baseline and repeated after a mean follow-up of 3.1 years. Changes in metabolic health across body mass index categories were evaluated between the first survey (2006–2007) and the first brachial-ankle pulse wave velocity measurement. Multivariate linear regression models were used. Among initial metabolically healthy obese individuals, 53.4% (n=928) converted to a metabolically unhealthy phenotype. Compared with metabolically healthy normal-weight individuals who remained metabolically healthy, metabolically healthy obese individuals who converted to a metabolically unhealthy phenotype showed a 110.7 (95% CI, 90.8–130.6) cm/s higher increase in baseline brachial-ankle pulse wave velocity and a 22.8 (95% CI, 12.4–33.2) cm/s per year higher acceleration in arterial stiffness progression. Individuals who were initially metabolically unhealthy or converted so during follow-up across body mass index categories had higher baseline brachial-ankle pulse wave velocity and arterial stiffness progression than those who remained metabolically healthy. These data suggest that metabolically healthy individuals who develop an unhealthy phenotype across all body mass index categories are at increased risks of arterial stiffness and its progression.

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Association Between White Blood Cell Counts and Brachial-Ankle Pulse Wave Velocity in Chinese Hypertensive Adults: A Cross-Sectional Study

Angiology ◽

10.1177/00033197211021199 ◽

2021 ◽

pp. 000331972110211

Author(s):

Buyun Jia ◽

Chongfei Jiang ◽

Yun Song ◽

Chenfangyuan Duan ◽

Lishun Liu ◽

...

Keyword(s):

Arterial Stiffness ◽

Blood Cell ◽

Pulse Wave Velocity ◽

Wave Velocity ◽

White Blood Cell ◽

Pulse Wave ◽

Final Analysis ◽

Cross Sectional ◽

Cell Counts ◽

Wbc Count

Increased arterial stiffness is highly prevalent in patients with hypertension and is associated with cardiovascular (CV) risk. Increased white blood cell (WBC) counts may also be an independent risk factor for arterial stiffness and CV events. The aim of the study was to investigate the relationship between differential WBC counts and brachial-ankle pulse wave velocity (baPWV) in hypertensive adults. A total of 14 390 participants were included in the final analysis. A multivariate linear regression model was applied for the correlation analysis of WBC count and baPWV. Higher WBC counts were associated with a greater baPWV: adjusted β = 10 (95% CI, 8-13, P < .001). The same significant association was also found when WBC count was assessed as categories or quartiles. In addition, the effect of differential WBC subtypes, including neutrophil count and lymphocyte count on baPWV, showed the similar results. These findings showed that baPWV has positive associations with differential WBC counts in hypertensive adults.

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Elevated levels of urine isocitrate, hydroxymethylglutarate, and formiminoglutamate are associated with arterial stiffness in Korean adults

Scientific Reports ◽

10.1038/s41598-021-89639-w ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Ji-Hee Haam ◽

Young-Sang Kim ◽

Doo-Yeoun Cho ◽

Hyejin Chun ◽

Sang-Woon Choi ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Cardiovascular Risk Factors ◽

Wave Velocity ◽

Pulse Wave ◽

Urinary Metabolites ◽

Metabolic Disturbances ◽

Liquid Chromatograph

AbstractRecent evidence suggests that cellular perturbations play an important role in the pathogenesis of cardiovascular diseases. Therefore, we analyzed the association between the levels of urinary metabolites and arterial stiffness. Our cross-sectional study included 330 Korean men and women. The brachial-ankle pulse wave velocity was measured as a marker of arterial stiffness. Urinary metabolites were evaluated using a high-performance liquid chromatograph-mass spectrometer. The brachial-ankle pulse wave velocity was found to be positively correlated with l-lactate, citrate, isocitrate, succinate, malate, hydroxymethylglutarate, α-ketoisovalerate, α-keto-β-methylvalerate, methylmalonate, and formiminoglutamate among men. Whereas, among women, the brachial-ankle pulse wave velocity was positively correlated with cis-aconitate, isocitrate, hydroxymethylglutarate, and formiminoglutamate. In the multivariable regression models adjusted for conventional cardiovascular risk factors, three metabolite concentrations (urine isocitrate, hydroxymethylglutarate, and formiminoglutamate) were independently and positively associated with brachial-ankle pulse wave velocity. Increased urine isocitrate, hydroxymethylglutarate, and formiminoglutamate concentrations were associated with brachial-ankle pulse wave velocity and independent of conventional cardiovascular risk factors. Our findings suggest that metabolic disturbances in cells may be related to arterial stiffness.

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Gut microbiota composition and arterial stiffness measured by pulse wave velocity: case–control study protocol (MIVAS study)

BMJ Open ◽

10.1136/bmjopen-2020-038933 ◽

2021 ◽

Vol 11 (2) ◽

pp. e038933

Author(s):

Rita Salvado ◽

Sandra Santos-Minguez ◽

Cristina Agudo-Conde ◽

Cristina Lugones-Sanchez ◽

Angela Cabo-Laso ◽

...

Keyword(s):

Arterial Stiffness ◽

Gut Microbiota ◽

Pulse Wave Velocity ◽

Wave Velocity ◽

Intestinal Microbiota ◽

Pulse Wave ◽

Case Control Study ◽

Case Control ◽

Microbiota Composition ◽

Control Study

IntroductionIntestinal microbiota is arising as a new element in the physiopathology of cardiovascular diseases. A healthy microbiota includes a balanced representation of bacteria with health promotion functions (symbiotes). The aim of this study is to analyse the relationship between intestinal microbiota composition and arterial stiffness.Methods and analysisAn observational case—control study will be developed. Cases will be defined by the presence of at least one of the following: carotid-femoral pulse wave velocity (cf-PWV), Cardio-Ankle Vascular Index (CAVI), brachial ankle pulse wave velocity (ba or ba-PWV) above the 90th percentile, for age and sex, of the reference population. Controls will be selected from the same population as cases. The study will be developed in Primary Healthcare Centres. We will select 500 subjects (250 cases and 250 controls), between 45 and 74 years of age. Cases will be selected from a database that combines data from EVA study (Spain) and Guimarães/Vizela study (Portugal). Measurements: cf-PWV will be measured using the SphygmoCor system, CAVI, ba-PWV and Ankle-Brachial Index will be determined using VaSera device. Gut microbiome composition in faecal samples will be determined by 16S ribosomal RNA sequencing. Lifestyle will be assessed by food frequency questionnaire, adherence to the Mediterranean diet and IPAQ (International Physical Activity Questionnaire). Body composition will be evaluated by bioimpedance.Ethics and disseminationThe study has been approved by ‘Committee of ethics of research with medicines of the health area of Salamanca’ on 14 December 2018 (cod. 2018-11-136) and the ’Ethics committee for health of Guimaraes’ (Portugal) on 15 October 2019 (ref: 67/2019). All study participants will sign an informed consent form agreeing to participate in the study, in compliance with the Declaration of Helsinki and the WHO standards for observational studies. The results of this study will allow a better description of gut microbiota in patients with arterial stiffness.Trial registration detailsClinicalTrials.gov, identifier NCT03900338

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