Cumulative Cigarette Consumption is Associated with Cardio-Ankle Vascular Index (CAVI) Mediated by Abdominal Obesity Assessed by A Body Shape Index (ABSI): A Cross-Sectional Study

Aim: To elucidate the mechanism by which cigarette smoking causes vascular damage, we examined the relationship between cumulative cigarette consumption and abdominal obesity, and the possible mediating effect of smoking on arterial stiffness. Methods: Cross-sectional data from 19499 never smokers a...

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Bibliographic Details
Published in:	Journal of Atherosclerosis and Thrombosis p. 64221
Main Authors:	Nagayama, Daiji, Krakauer, Jesse C, Krakauer, Nir Y, Sugiura, Tomonori, Watanabe, Yasuhiro, Shimizu, Kazuhiro, Saiki, Atsuhito, Suzuki, Kenji, Fujishiro, Kentaro, Shirai, Kohl
Format:	Journal Article
Language:	English
Published:	Japan Atherosclerosis Society 2023
Subjects:	A body shape index Abdominal obesity Cardio-ankle vascular index Cigarette smoking
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Summary:	Aim: To elucidate the mechanism by which cigarette smoking causes vascular damage, we examined the relationship between cumulative cigarette consumption and abdominal obesity, and the possible mediating effect of smoking on arterial stiffness. Methods: Cross-sectional data from 19499 never smokers and 5406 current smokers receiving health screening was analyzed. Abdominal obesity was assessed by ABSI, and arterial stiffness by CAVI. High CAVI was defined as CAVI ≥ 9.0. Results: Current smoker showed higher ABSI than never smokers after propensity score matching. Cumulative cigarette consumption expressed in pack-years correlated with ABSI (Rs: 0.312 in men, 0.252 in women), and was also extracted as an independent factor associated with ABSI by multiple regression analysis. A linear relationship between pack-year and CAVI was observed (Rs: 0.544 in men, 0.423 in women). Pack-year had almost equal discriminatory power in predicting high CAVI in both sexes (C-statistic: 0.774 in men, 0.747 in women), and the best cut-offs of pack-year for high CAVI were 24.5 in men and 14.7 in women. Bivariate logistic regression models revealed that the association between pack-year higher than cut-off and high CAVI was independent of traditional risks. A mediating effect of ABSI (mediation rate: 9.9% in men and 11.2% in women), but not waist circumference (WC), on the association of pack-year with CAVI was observed, after adjusting for traditional risks. Conclusion: Cumulative cigarette smoking in pack-years was independently associated with ABSI. ABSI partially mediates the association between pack-year and CAVI, suggesting that abdominal obesity partially mediates smoking-related vascular dysfunction.
ISSN:	1340-3478 1880-3873
DOI:	10.5551/jat.64221