Association between Arterial Stiffness and Obesity Indicators: A Comparative Study of Traditional and Novel Anthropometric Measures in Northern Chinese

Introduction: Arterial stiffness (AS) is a well-established independent predictor of cardiovascular events and all-cause mortality. However, limited studies have examined the comparative predictive performance of traditional obesity indicators (BMI, WC) versus novel indices (WWI, ABSI, BRI, CI) for AS. 

Methods: This study utilized baseline data from the Shaanxi cohort of the Regional Ethnic Cohort Study in Northwest China (RECS). Anthropometric measurements were collected to calculate obesity indicators, and estimated pulse wave velocity (ePWV) served as a surrogate for AS. Logistic regression and restricted cubic spline models assessed the associations and dose-response relationships between obesity indicators and ePWV. Receiver operating characteristic curves were used to compare the predictive performance of these indicators. 

Results: After adjusting for confounders, all obesity indices exhibited significant positive nonlinear associations with ePWV (p for nonlinearity < 0.001). Participants with overweight (OR = 1.63, 95% CI: 1.51–1.77) or obesity (OR = 2.13, 95% CI: 1.90–2.40) had a higher risk of elevated ePWV compared to those with normal BMI. Central adiposity (based on WC) was associated with a 70% increased risk (OR = 1.70, 95% CI: 1.58–1.83). Similarly, individuals in the highest quartile (Q4) of WWI, ABSI, BRI, and CI showed 1.40-, 1.14-, 2.24-, and 1.52-fold higher risks of elevated ePWV, respectively, compared to the lowest quartile (Q1). Novel obesity indices demonstrated superior predictive performance over traditional measures, with WWI exhibiting the strongest discriminative ability. Conclusions: Obesity significantly increases AS risk in Chinese adults, and novel obesity indicators (particularly WWI) could outperform BMI and WC in predicting AS. Managing abdominal obesity and reducing visceral adiposity may mitigate AS risk, thereby lowering the likelihood of cardiovascular disease.