Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
Am J Cardiol. 2011 May 1;107(9):1386-91. doi: 10.1016/j.amjcard.2010.12.050. Epub 2011 Mar 4.
An abnormally high ankle-brachial index (ABI) is associated with increased all-cause and cardiovascular mortality. The relation of obesity to incident high ABI has not been characterized. The aim of this study was to investigate the hypothesis that increased obesity-quantified by body weight, body mass index, waist circumference, and waist-to-hip-ratio-is positively associated with a high ABI (≥1.3) and with mean ABI increases over a 4-year follow-up. Prevalence and incidence ratios for a high ABI were obtained for 6,540 and 5,045 participants, respectively, in the Multi-Ethnic Study of Atherosclerosis (MESA), using log-binomial regression models adjusted for demographic, cardiovascular, and inflammatory and novel risk factors. Linear regression was used to analyze mean ABI change. The prevalence and incidence of a high ABI were significantly higher for the highest compared to the lowest quartile of every baseline measure of obesity, with weight and body mass index demonstrating the highest incidence ratios (2.7 and 2.4, respectively). All prevalence and incidence ratios were positive and graded across obesity quartiles and were persistent in the subpopulation without diabetes. In those with normal baseline ABI values, 1 MESA standard deviation increase in every baseline measure of obesity was associated with significant increases in mean ABI values. In conclusion, independent, positive, and graded associations of increasing obesity with prevalent and incident high ABI and with mean increases in ABI values over time were found. Weight and body mass index seemed to be at least as strongly, if not more strongly, associated with a high ABI than were measures of abdominal obesity.
踝臂指数（ABI）异常升高与全因和心血管死亡率增加相关。肥胖与新发高 ABI 的关系尚未明确。本研究旨在验证下述假说，即肥胖程度（通过体重、体重指数、腰围和腰臀比来量化）增加与高 ABI（≥1.3）及 ABI 均值随时间增加呈正相关。在多民族动脉粥样硬化研究（MESA）中，我们分别使用对数二项式回归模型，对参与者的人口统计学、心血管、炎症和新型危险因素进行了调整，以获得 6540 名和 5045 名参与者的高 ABI 患病率和发病率比。线性回归用于分析 ABI 均值变化。与肥胖最低四分位数相比，各肥胖基线测量指标的最高四分位数与高 ABI 的患病率和发病率显著升高，体重和体重指数显示出最高的发病率比（分别为 2.7 和 2.4）。所有的患病率和发病率比均为正且呈四分位递增，且在无糖尿病的亚人群中持续存在。在基线 ABI 值正常的人群中，每增加一个 MESA 标准差的肥胖基线测量指标，ABI 均值会显著增加。总之，我们发现肥胖程度与高 ABI 的现患率和发病率以及 ABI 均值随时间的增加呈独立、正相关和分级相关。体重和体重指数与高 ABI 的相关性至少与腹部肥胖指标一样强，如果不是更强的话。
