Association between a body shape index and abdominal aortic calcificationingeneral population: a cross-sectional study

Abstract Background: The association between a body shape index (ABSI) and abdominal aortic calcification(AAC) is still unclear, so we tried to prove the association between ABSI and AAC in the general population in this cross-sectional study. Methods: After excluding participants with missing data on height, weight, waist circumference (WC) and AAC, we finally selected 3,140 participants aged 40-80 years from the 2013-2014 National Healthand Nutrition Examination Survey. Using multivariate logistic regression and receiver operatingcharacteristic (ROC) curves to test the association between ABSI and AAC. Results: Participants (median age: 58.0 years; 48.3% men) were divided into two groups by the optimal cutoff point of ABSI: higher ABSI (> 0.84) and lower ABSI (≤ 0.84). Participants with higher ABSI showed significantly higher proportion of AAC than those with lower ABSI (39.8%vs 23.7%, P< 0.001). Participants with higher ABSI had an increased risk of developing AAC in crude model (ABSI as a continuous variable: OR = 2.485, 95% CI: 2.099-2.942, P < 0.001; as a categorical variable: OR = 2.132, 95% CI: 1.826-2.489, P < 0.001), while ABSI was still independently associated withAAC in adjusted models (all adjusted P < 0.05). Further subgroup analyses showed that higher ABSI was consistently associated with AAC in subgroups with sex, age, smoking history, hypertension, diabetes, sleep disorder, body mass index (BMI), systolic blood pressure, diastolic blood pressure, fasting plasma glucose and low-density lipoprotein cholesterol (P for interaction > 0.05). While inother subgroups, the association was no longer synchronized. The ROC showed that the area under the curve of ABSI was significantly higher than height, weight, BMI, WC and waist-to-height ratio(WHtR). Conclusions: Higher ABSI was independently associated with higher risk of AAC, anddiscriminant ability of ABSI for AAC was significantly higher than height, weight, BMI, WCand 3 WHtR.