Tang Biwen, Luo Fangxiu, Zhao Jiehui, Ma Jing, Tan Isabella, Butlin Mark, Avolio Alberto, Zuo Junli
Department of Geriatric Medicine.
Department of Pathology, Shanghai Jiaotong University School of Medicine.
Medicine (Baltimore). 2020 Jan;99(3):e18793. doi: 10.1097/MD.0000000000018793.
Pulse wave velocity (PWV) is a reliable measurement of arterial stiffness. Our study assesses the association between body mass index (BMI) and brachial-ankle PWV (baPWV) in a healthy cohort and seeks to explain possible mechanisms associated with the obesity paradox.A cross-sectional study was conducted in 578 normal individuals. The mean age was 48.3 ± 14.6 years, and 468 (81.0%) were men. 288 subjects (49.8%) were overweight and obese. baPWV and ankle-brachial index (ABI) were performed to evaluate arterial stiffness and atherosclerosis respectively. Normal weight was defined as 18.5 < BMI <25 kg/m, overweight as 25 ≤ BMI < 28 kg/m and obesity as BMI ≥28 kg/m.The overweight/obese subjects had significantly higher baPWV than the normal-weight group (1490.0 ± 308.0/1445.2 ± 245.2 cm/s vs 1371.2 ± 306.4 cm/s, P < .001). For the whole cohort, baPWV showed a significant positive correlation with BMI (r = 0.205, P < .001). However, baPWV was significantly lower as BMI increased: 1490.0 ± 308.0 cm/s (overweight); 1445.2 ± 245.2 cm/s (obese); P < .001) when adjusted for age, gender, heart rate, mean blood pressure, and cardiovascular risk factors (glucose, cholesterol, triglyceride, and low-density lipoprotein). For the whole cohort BMI was negatively associated with baPWV (β = -0.06, P = .042). ABI showed no relationship with BMI. In a middle-age healthy Chinese population, arterial stiffness measured as baPWV increased with BMI.Evidence of reduced arterial stiffness with increasing BMI when accounting for all other cardiovascular risk factors may contribute to underlying factors involved in the obesity paradox that becomes more prominent with increasing age.
脉搏波速度（PWV）是动脉僵硬度的可靠测量指标。我们的研究评估了健康队列中体重指数（BMI）与臂踝脉搏波速度（baPWV）之间的关联，并试图解释与肥胖悖论相关的可能机制。
对578名正常个体进行了一项横断面研究。平均年龄为48.3±14.6岁，男性468名（81.0%）。288名受试者（49.8%）超重或肥胖。分别采用baPWV和踝臂指数（ABI）评估动脉僵硬度和动脉粥样硬化。正常体重定义为18.5＜BMI＜25kg/m²，超重定义为25≤BMI＜28kg/m²，肥胖定义为BMI≥28kg/m²。
超重/肥胖受试者的baPWV显著高于正常体重组（1490.0±308.0/1445.2±245.2cm/s对1371.2±306.4cm/s，P＜0.001）。在整个队列中，baPWV与BMI呈显著正相关（r = 0.205，P＜0.001）。然而，在调整年龄、性别、心率、平均血压和心血管危险因素（血糖、胆固醇、甘油三酯和低密度脂蛋白）后，随着BMI升高，baPWV显著降低：超重者为1490.0±308.0cm/s；肥胖者为1445.2±245.2cm/s；P＜0.001）。对于整个队列，BMI与baPWV呈负相关（β = -0.06，P = 0.042）。ABI与BMI无关。
在中年健康中国人群中，以baPWV衡量的动脉僵硬度随BMI升高而增加。在考虑所有其他心血管危险因素时，随着BMI升高动脉僵硬度降低的证据可能有助于解释肥胖悖论中随着年龄增长而变得更加突出的潜在因素。
