Association of Body Fluid Volumes and Body Fat Distribution with Abnormal Ankle-Brachial Index

Abstract

Background Ankle-brachial index (ABI) is a simple, non-invasive and easy-to-obtain measure for the evaluation of atherosclerotic peripheral arterial disease (PAD). This study aimed to investigate the relationships between body fluid volumes, body composition, body fat distribution and ABI at a population perspective. Results Using the US National Health and Nutrition Examination Survey Data (NHANES) during 1999–2000, 2001–2002, and 2003–2004, adults ≥ 40 years old were eligible for inclusion. Univariate and multivariable linear and logistic regression analyses were performed to determine the associations between ABI, body fluid volume and body composition assessed by bioelectrical impedance analysis (BIA), and body fat distribution assessed by dual-energy X-ray absorptiometry (DEXA). After exclusion, the final analytic sample contained 1535 participants who were representative of totally 28,572,458 subjects in the US. After adjustments for relevant confounders, estimated fat mass was significantly and inversely associated with ABI (beta: − 0.0009, 95% CI = − 0.0015, − 0.0003). Total percent fat (beta: − 0.0024, 95% CI = − 0.0033, − 0.0014), trunk percent fat (beta: − 0.0016, 95% CI = − 0.0023, − 0.0009), and percent fat at the four limbs were also significantly and inversely associated with ABI (p < 0.001). In addition, subjects with higher estimated fat mass, total percent fat, trunk percent fat and higher percent fat at the four limbs were all significantly more likely to have abnormal ABI < 0.9. No significant association between parameters of body fluid volume and abnormal ABI was observed. Conclusions Estimated fat mass, total percent fat, trunk percent fat and percent fat at the four limbs were significantly and inversely associated with ABI. Subjects with abnormal ABI are more likely to have higher total percent fat, trunk percent fat and the limb fat. These findings fill the knowledge gap on the relationships between atherosclerosis and body fat distribution. Further well-designed prospective studies are needed to confirm the present findings.