Relationship between the abdominal wall fat index and blood pressure in elderly women: a comparison with the body mass index

Background and aims: Several studies have examined the associations between measurements used to assess obesity, such as the body mass index (BMI), waist circumference (WC) and intra-abdominal fat area, and cardiometabolic abnormalities. However, the application of these measures in clinical practice requires more detailed examination in older individuals. The abdominal wall fat index (AFI) is ultrasonographically determined via a vertical scan along the upper abdominal median, to measure the maximum thickness of pre-peritoneal fat at the liver surface and the minimum thickness of subcutaneous fat. Few studies, however, have compared the AFI with the BMI as a measure of obesity. Older women were examined to determine the associations among BMI, AFI and cardiometabolic variables. Methods: In 86 asymptomatic women with BMIs of 18.5–29 kg/m2 (mean age±SD 77±6 years; mean BMI±SD 22.7±2.5 kg/m2), we measured the following cardiometabolic variables: systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), plasma glucose, serum total cholesterol, triglycerides, and high-density lipoprotein cholesterol. Results: In a multiple regression analysis adjusted for all the above cardiometabolic variables, BMI showed a significant negative correlation with age alone, whereas AFI showed a significant positive correlation with DBP and PP. Conclusions: Our results suggest that, compared with BMI, AFI may be useful in identifying blood pressure-related abnormalities, which represent an atherosclerotic risk in older Japanese women.