Visceral adiposity index and sex differences in relation to peripheral artery disease in normal-weight adults with hypertension

Abstract Background Previous studies on the relationship between the visceral adiposity index (VAI) and peripheral arterial disease (PAD) are limited. Therefore, this study explored the relationship between VAI and PAD in normal-weight patients with hypertension. Methods A total of 6615 normal-weight patients with hypertension were included in the current study. The VAI, a simple index calculated using blood lipid and waist circumference (WC), can be used as a simple biomarker of body fat distribution. The outcome was PAD, which was defined as present when each side’s ankle–brachial index (ABI) was ≤ 0.90. Results A significant positive association was observed between VAI and PAD prevalence. For per unit increment in LnVAI, the adjusted odds ratios (ORs) of PAD for the total participants and males were 1.55 (95% CI 1.15–2.10) and 2.12 (95% CI 1.46–3.07), respectively. However, the VAI was not associated with PAD in female patients with hypertension (OR 1.28; 95% confidence interval [CI] 0.85–1.95). There was no interaction between sex and VAI ( P for interaction = 0.128). Accordingly, in total participants, when VAI was assessed in quartiles and compared with quartile 1 (< 0.84), the PAD prevalence was higher than that of quartiles 2 (0.84 to < 1.36: OR 1.49; 95% CI 0.92–2.44), 3 (1.36 to < 2.25: OR 1.95; 95% CI 1.14–3.32), and 4 (≥ 2.25: OR 1.93; 95% CI 1.04–3.57). There were no significant interactions with the other confounders. Conclusion This study showed a positive association between VAI and PAD in normal-weight adults with hypertension among men but not among women.