OBJECTIVE: Arterial stiffness (ArSt) describes a loss of arterial wall elasticity and is an independent predictor of cardiovascular events. A cardiometabolic-based chronic disease model integrates concepts of adiposity-based chronic disease (ABCD), dysglycemia-based chronic disease (DBCD), and cardiovascular disease. We assessed if ABCD and DBCD models detect more people with high ArSt compared with traditional adiposity and dysglycemia classifiers using the cardio-ankle vascular index (CAVI). METHODS: We evaluated 2070 subjects aged 25 to 64 years from a random population-based sample. Those with type 1 diabetes were excluded. ABCD and DBCD were defined, and ArSt risk was stratified based on the American Association of Clinical Endocrinologists criteria. RESULTS: The highest prevalence of a high CAVI was in stage 2 ABCD (18.5%) and stage 4 DBCD (31.8%), and the lowest prevalence was in stage 0 ABCD (2.2%). In univariate analysis, stage 2 ABCD and all DBCD stages increased the risk of having a high CAVI compared with traditional classifiers. After adjusting for age and gender, only an inverse association between obesity (body mass index ≥30 kg/m2) and CAVI remained significant. Nevertheless, body mass index was responsible for only 0.3% of CAVI variability. CONCLUSION: The ABCD and DBCD models showed better performance than traditional classifiers to detect subjects with ArSt; however, the variables were not independently associated with age and gender, which might be explained by the complexity and multifactoriality of the relationship of CAVI with the ABCD and DBCD models, mediated by insulin resistance.

Department of Global Health and Population Harvard TH Chan School of Public Health Harvard University Boston Massachusetts

Department of Public Health Faculty of Medicine Masaryk University Brno Czech Republic

Division of Endocrinology Diabetes and Bone Disease Icahn School of Medicine at Mount Sinai New York New York

Division of Preventive Cardiology Department of Cardiovascular Medicine Mayo Clinic Minnesota

Faculty of Sport Studies Department of Health Support Masaryk University Brno Czech Republic

Foundation for Clinic Public Health and Epidemiology Research of Venezuela Caracas Venezuela

International Clinical Research Centre Czech Republic

LifeDoc Health Memphis Tennessee

Research Centre for Toxic Compounds in the Environment Masaryk University Brno Czech Republic

The Marie Josée and Henry R Kravis Center for Cardiovascular Health at Mount Sinai Heart Icahn School of Medicine at Mount Sinai New York New York

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