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Whether the combination of inter-arm and inter-leg systolic blood pressure differences (BPDs) and ankle-brachial index is of clinical significance remains unclear. In this study, we aimed to investigate the association of the combination of inter-limb systolic BPDs with cardiovascular risk factors and hypertension-mediated organ damage (HMOD). A total of 2621 elderly subjects from the Northern Shanghai Study were divided into Group A, B, and C consisting of participants with 0, 1, and ≥2 abnormal inter-limb systolic BPDs, respectively. Comparisons of cardiovascular risk factors and parameters of cardiac, vascular, and renal damage between groups and logistic regression models were conducted. The proportions of subjects presenting 0, 1, and ≥2 abnormal inter-limb systolic BPDs were 60.9%, 25.1%, and 14.0%, respectively. Upward trends, from Group A, through Group B, to Group C, were observed for the level or prevalence of nearly all cardiovascular risk factors and HMOD (P for trend ≤0.007 for all). In multiple logistic regression, Group C showed significantly higher odds for carotid plaque (vs Group A: Odds ratio [OR] = 1.88, 95% confidence interval [CI] = 1.43-2.48; vs Group B: OR = 1.46, 95% CI = 1.08-1.97), arterial stiffness (vs Group A: OR = 1.26, 95% CI = 0.96-1.65; vs Group B: OR = 1.36, 95% CI = 1.01-1.83), and left ventricular hypertrophy (vs Group A: OR = 1.35, 95% CI = 1.04-1.76; vs Group B: OR = 1.25, 95% CI = 0.93-1.67), when compared with Group A and B. In conclusion, the combination of abnormal inter-limb systolic BPDs significantly associates with greater burden of cardiovascular risk factors and higher likelihood for HMOD, especially carotid plaque, arterial stiffness, and left ventricular hypertrophy., (©2019 Wiley Periodicals, Inc.)

Background: Carotid-femoral pulse-wave velocity (cf-PWV) and brachial-ankle PWV (ba-PWV) are the 2 most frequently applied PWV measurements. However, little is known about the comparison of hypertensive target organ damage (TOD) with cf-PWV and ba-PWV., Methods and Results: A total of 1599 community-dwelling elderly subjects (age >65 years) in northern Shanghai were recruited from June 2014 to August 2015. Both cf-PWV and ba-PWV were measured using SphygmoCor and VP1000 systems, respectively. Within the framework of comprehensive cardiovascular examinations, risk factors were assessed, and asymptomatic TOD, including left ventricular mass index, peak transmitral pulsed Doppler velocity/early diastolic tissue Doppler velocity (E/Ea), carotid intima-media thickness, arterial plaque, creatinine clearance rate, and urinary albumin-creatinine ratio were all evaluated. Both PWVs were significantly associated with male sex, age, waist/hip circumference, fasting plasma glucose, and systolic blood pressure, and ba-PWV was also significantly related to body mass index. Both PWVs were significantly correlated with most TOD. When cf-PWV and ba-PWV were both or separately put into the stepwise linear regression model together with cardiovascular risk factors and treatment, only cf-PWV, but not ba-PWV, was significantly associated with carotid intima-media thickness and creatinine clearance rate ( P <0.05). When cf-PWV and ba-PWV were both or separately put into the same full-mode model after adjustment for confounders, only cf-PWV, but not ba-PWV, showed significant association with carotid intima-media thickness and creatinine clearance rate ( P <0.05). Similar results were observed in logistic regression analysis., Conclusions: Taken together, in the community-dwelling elderly Chinese, cf-PWV seems to be more closely associated with hypertensive TOD, especially vascular and renal TOD, as compared with ba-PWV., Clinical Trial Registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT02368938., (© 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.)

Objective: To compare the epidemiological characteristics and differences in brachial-ankle pulse wave velocity (baPWV) among middle-aged residents between Shanghai and Inner Mongolia autonomous region(Inner Mongolia), and to observe the prevalence of arterial stiffness in the two populations., Methods: A total of 922 volunteers aged between 45 and 59 from Shanghai and Inner Mongolia were selected by stratified cluster random sample method. BaPWV was measured and related data were collected., Results: A total of 903 cases were enrolled in this study, including 441 from Shanghai and 462 from Inner Mongolia. The baPWV value of middle-aged residents in Inner Mongolia was higher than that in Shanghai [(1 548 ± 281) cm/s and (1 476 ± 254) cm/s, P < 0.001]. The abnormal rate of baPWV (baPWV ≥ 1 400 cm/s) in Inner Mongolia was also higher than that in Shanghai [67.5% (312) and 57.4% (253) , P < 0.001]. The baPWV value of middle-aged men in Inner Mongolia was (1 568 ± 299) cm/s, while it was (1 508 ± 260) cm/s in Shanghai, no statistical difference was found (P > 0.05). The baPWV value of middle-aged women in Inner Mongolia was (1 534 ± 268) cm/s, which was higher than that of Shanghai [(1 468 ± 252) cm/s, P < 0.01]. The abnormal rate of baPWV of middle-aged men in Inner Mongolia and Shanghai was 67.0% (126/188) and 60.8% (59/97), respectively (P > 0.05). The abnormal rate of baPWV of middle-aged women in Inner Mongolia and Shanghai was 67.9% (186/274) and 56.4% (194/344), respectively., Conclusions: The difference of baPWV value and abnormal rate of baPWV of middle-aged residents between Inner Mongolia and Shanghai exists. Middle-aged people in Inner Mongolia should be more alert to the incidence of arteriosclerosis and cardio-cerebrovascular diseases.

Background: The prevalence of metabolic syndrome (MetS) increased recently and there was still not a screening index to predict MetS. The aim of this study was to estimate whether brachial-ankle pulse wave velocity (baPWV), a novel marker for systemic arterial stiffness, could predict MetS in Chinese community population., Methods: A total of 2 191 participants were recruited and underwent medical examination including 1 455 men and 756 women from June 2011 to January 2012. MetS was diagnosed according to the criteria of the International Diabetes Federation (IDF). Multiple Logistic regressions were conducted to explore the risk factors of MetS. Receiver operating characteristic (ROC) curve was performed to estimate the ideal diagnostic cutoff point of baPWV to predict MetS., Results: The mean age was (45.35±8.27) years old. In multiple Logistic regression analysis, the gender, baPWV and smoking status were risk factors to MetS after adjusting age, gender, baPWV, walk time and sleeping time. The prevalence of MetS was 17.48% in 30-year age population in Shanghai. There were significant differences (χ(2) = 96.46, P < 0.05) between male and female participants on MetS prevalence. According to the ROC analyses, the ideal cutoff point of baPWV was 1 358.50 cm/s (AUC = 60.20%) to predict MetS among male group and 1 350.00 cm/s (AUC = 70.90%) among female group., Conclusion: BaPWV may be considered as a screening marker to predict MetS in community Chinese population and the diagnostic value of 1 350.00 cm/s was more significant for the female group.

Background: Very few studies have examined combined association of estimated glomerular filtration rate (eGFR) and ankle-brachial index (ABI) on recurrent ischemic stroke in patients with ischemic stroke in Chinese populations., Patients and Methods: A Chinese population of 1219 ischemic stroke patients was followed up in this six-year prospective study., Results: 1080 ischemic stroke patients with complete follow-up data were included in the statistical analysis. A total of 245 ischemic stroke patients (22.7 %) had recurrent ischemic stroke during follow-up. The Incidence of recurrent ischemic stroke was significantly increased with decreasing eGFR levels and that of patients with eGFR < 30 ml/min/1.73m2 was the highest. Hazard ratio (HR) of eGFR < 30 ml/min/1.73m2 to recurrent ischemic stroke was 2.633 (95 % CI: 1.653 - 4.194) compared with that of eGFR ≥ 60 ml/min/1.73m2 after adjusting for other potential confounders using Cox regression analysis. Incidence of recurrent ischemic stroke was significantly increased with simultaneously decreasing eGFR and ABI. The highest percentage (71.4 %) of patients with eGFR < 30 ml/min/1.73m2 and ABI ≤ 0.4 simultaneously had recurrent ischemic stroke during follow-up. HR of eGFR < 30 ml/min/1.73m2 and ABI ≤ 0.4 simultaneously with recurrent ischemic stroke was 9.415 (95 % CI: 3.479 - 25.483) compared with that of eGFR ≥ 60 ml/min/1.73m2 and ABI > 1.0 to ≤ 1.4 respectively, Conclusions: Low ABI and low eGFR together had synergistic effects on increasing recurrent ischemic stroke of ischemic stroke patients during a long-term follow-up.

Background: In a previous review, we reported that ankle brachial index (ABI) ≤ 0.90 could reliably identify patients with peripheral artery disease (PAD). Since then, more studies have been published which may extend the power of a meta-analysis of studies of diagnostic accuracy of the ABI. MEDLINE and several other databases were searched for studies on sensitivity and specificity of using ABI ≤ 0.90 for PAD diagnosis compared with angiography., Methods: Quality of each study was assessed by standards for reporting diagnostic accuracy initiative and quality assessment for studies of diagnostic accuracy tool. Heterogeneity was assessed using the Cochran Q statistic, χ(2), and inconsistency index. The area under the curve and Q* were estimated using summary receiver operator curve. The pooled diagnostic odds ratio (DOR), sensitivity, specificity, positive likelihood ratio (PLR), and negative likelihood ratio (NLR) of ABI ≤ 0.90 to diagnose PAD were estimated using Meta-DiSc software (Meta-DiSc, Madrid, Spain)., Results: Four studies comprising 569 patients (922 limbs) met inclusion criteria. Significant heterogeneity among these studies was not detected in DOR but was evident in pooled sensitivity, specificity, PLR, and NLR. The area under the curve under the summary receiver operator curve is 0.87 (standard error = 0.02) and diagnostic accuracy (Q*) is 0.80 (standard error = 0.02). Additionally, DOR was 15.33 with corresponding 95% confidence intervals of 9.39-25.02. The pooled sensitivity and specificity of ABI ≤ 0.90 for PAD diagnosis were 75% and 86% and the pooled PLR and NLR were 4.18 and 0.29, respectively., Conclusions: We conclude that test of ABI ≤ 0.90 can be a useful tool to identify PAD with serious stenosis in clinical practice., (Copyright © 2013 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.)

Objective: To investigate epidemiological characteristics and differences in ankle-brachial index (ABI) among the natural population in Shanghai and Inner Mongolia, and to observe the prevalence of lower extremity peripheral arterial disease (PAD)., Methods: A total of 2604 volunteers from Shanghai and Inner Mongolia were selected by stratified cluster random sample. ABI was measured and related data were collected., Results: The ABI value in Shanghai was 1.074 ± 0.095, while it was 1.062 ± 0.075 in Inner Mongolia (P < 0.001). The prevalence of lower extremity PAD in Shanghai was 4.2%, while it was 1.9% in Inner Mongolia (P < 0.01). For males, the ABI value in Shanghai was 1.078 ± 0.105, and it was 1.075 ± 0.080 in Inner Mongolia (P > 0.05). For females, the ABI value in Shanghai was 1.073 ± 0.089, while it was 1.052 ± 0.070 in Inner Mongolia (P < 0.001). For males, the prevalence of lower extremity PAD of the in Shanghai was 4.7%, while it was 2.0% in Inner Mongolia (P < 0.05). For females, the prevalence of lower extremity PAD of in Shanghai was 4.0%, while it was 1.8% in Inner Mongolia (P < 0.05). The ABI values in age group of < 50 years in Shanghai and Inner Mongolia were 1.037 ± 0.082 and 1.055 ± 0.068, respectively (P < 0.05). The prevalences of lower extremity PAD in age group of < 50 years in Shanghai and Inner Mongolia were 7.6% and 1.2%, respectively (P < 0.001). There were no significant differences in ABI value and the prevalence of lower extremity PAD between Shanghai and Inner Mongolia in both age group of 50 - 69 years and ≥ 70 years (all P values > 0.05)., Conclusions: The ABI value in Shanghai is higher than that in Inner Mongolia and the prevalence of lower extremity PAD in both males and females in Shanghai is significantly higher than that in Inner Mongolia. But they are lower than the level of western countries. In different age groups, the difference of the prevalence of lower extremity PAD between Shanghai and Inner Mongolia is only displayed in the age group of < 50 years, which may be related to the limited sample size. The natural population in Shanghai exposed artery atherosclerotic disease risk factors may increase and we need to pay more attention to the lower extremity PAD.

Background: To investigate the predictive value of ankle-brachial index (ABI) for all-cause mortality and cardiovascular mortality in Chinese patients with chronic kidney disease (CKD)., Patients and Methods: 1563 CKD patients were enrolled in the cohort and were followed up for about 3 years in China. CKD was defined as an eGFR less than 60 ml/min/1.73m(2). 573 participants were diagnosed with PAD using ABI <= 0.90. Their average age was 73.4 ±8.2 years., Results: During a median follow-up of 38 months, there were 1353 CKD patients with complete data. A total of 313 patients (161 with and 152 without PAD) died during follow-up. 184 deaths (99 with and 85 without PAD) were caused by cardiovascular disease (CVD). All-cause and CVD mortality of CKD patients with PAD was increased 2.2-fold and 2.4-fold compared with CKD patients without PAD. The hazard ratio (HR) of PAD for all-cause and CVD mortality was 2.15 (95 % CI: 1.66 - 2.79) and 2.51 (95 % CI: 1.80 - 3.50) respectively. Mortality of CKD patients significantly increased with decreasing ABI. That of CKD patients with ABI <= 0.4 was the highest (42.9 % and 28.6 %, respectively) in different ABI categories. Relative risks of all-cause and CVD mortality of CKD patients with ABI <= 0.4 were increased 3.479-fold (95 % CI: 2.076 - 5.830) and 4.960-fold (95 % CI: 2.644 - 9.302) respectively compared with those of patients with ABI > 1.0 and <= 1.4. Special models to evaluate the predictive value of ABI to mortality of CKD patients suggested that addition of ABI significantly increased the predictive value of the model for 3-year mortality compared with a model including conventional risk factors alone., Conclusions: Low ankle-brachial index can predict increased mortality of chronic kidney disease patients. Addition of ankle-brachial index can significantly improve the prediction of 3-year mortality compared with conventional risk factors alone.

Objective: Peripheral arterial disease (PAD) is a common clinical manifestation of the systemic atherosclerotic process, and the ankle-brachial index (ABI) is an ideal tool to diagnose PAD. Currently, there have been few long-term follow-up studies focused on the associations of the ABI with all-cause mortality and cardiovascular disease (CVD) mortality in Chinese MetS patients. The aim of this study was to evaluate the usefulness of ABI to predict the prognosis of CVD in hospitalized Chinese patients with metabolic syndrome (MetS)., Methods: Participants from multi-center departments were followed up from November 2004 to January 2011. The study sample actually comprised 1,266 valid participants whose age was ≥35 years. Patients were separated into four groups, with an ABI ≤0.4, 0.41-0.7, 0.71-0.9 and 0.91-1.4. An ABI ≤0.9 was defined as PAD, and subjects with an ABI >1.4 were excluded because of the false negative rate. Factors related to all-cause and cardiovascular mortality were observed by Cox models and the log rank test. Potential confounding variables with values of p<0.10 were adjusted for the multivariate analysis., Results: An abnormal ABI value was strongly, independently, and inversely correlated with the all-cause and cardiovascular mortality. After adjusting for age and other covariates, Cox models revealed that an abnormal ABI value was still correlated with the all-cause mortality (relative risk/RR/=1.82, 95% confidence interval/CI/=1.45-2.34 p<0.01), and CVD mortality (RR=1.88, 95% CI=1.51-2.90 p<0.01)., Conclusion: An abnormal ABI value was not only a significant and independent risk factor for CVD, but also for the survival rate in Chinese MetS patients. Routine ABI evaluation could therefore be helpful for identifying high risk patients, especially MetS patients.

The present study was conducted to obtain reference values for brachial-ankle pulse wave velocity (baPWV) and to evaluate influencing factors of baPWV according to gender. Using automatic devices, baPWV was measured simultaneously in 2095 subjects. A total of 647 healthy subjects, none of whom presented atherosclerotic risk factors, were analyzed in the present study. Two different statistical methods were used to obtain reference values for baPWV according to subject gender and age. The association between baPWV value and gender, as well as other features, were analyzed. For male subjects, multiple stepwise analysis showed that age, systolic blood pressure (SBP), heart rate (HR), and plasma levels of triglycerides (TG) were independent predictors of baPWV. For female subjects, age, SBP, HR, and plasma levels of uric acid (UA) were independent predictors of baPWV. In male subjects, the upper limits of baPWV values were 1497.43/1425.00, 1518.67/1513.25, 1715.97/1726.50, 1925.20/1971.90, and 2310.18/2115.00 cm/s, obtained using two different statistical methods for the age ranges of 30-39, 40-49, 50-59, 60-69, and 70 and older, respectively. For females, the upper limits of baPWV values were 1426.70/1411.13, 1559.15/1498.95, 1733.50/1739.00, 1958.63/1973.78, and 2720.80/2577.00 cm/s for the age ranges of 30-39, 40-49, 50-59, 60-69, and 70 and older, respectively. Aging is the most important influencing factor for baPWV value and its effect is more prominent in females. The reference values of baPWV according to age and gender may be useful for the clinical diagnosis and preventive therapy of cardiovascular diseases.

Aims: Whether a low ankle-brachial index can improve the prediction of all-cause and cardiovascular mortality on top of conventional risk factors remains unclear among patients with ischemic heart disease. The present study aimed to assess the association between the ankle-brachial index and mortality in Chinese patients., Methods: This was an observational prospective study and 1,800 Chinese patients aged > or =35 years were followed-up from 2004 to 2007-2008., Results: There were 280 deaths, of which 165 were attributable to cardiovascular disease. Compared with patients with an ankle-brachial index > or =1.1, the risk of mortality increased linearly in lower ankle-brachial index categories: patients with an ankle-brachial index of 0.9 to 1.1, 0.7 to 0.9, <0.7 had hazard ratios of 1.60, 2.07, and 3.08 for all-cause mortality and 1.89, 2.33, and 4.09 for cardiovascular mortality (p for trend <0.001), respectively. Addition of the ankle-brachial index significantly (p<0.001) increased the predictive value of the model for 3-year deaths compared with a model including risk factors alone. Comparison of areas under receiver operator characteristics curves confirmed that a model including the ankle-brachial index discriminated better than without., Conclusion: There was an inverse association between the ankle-brachial index and mortality. Addition of the ankle-brachial index significantly improved the prediction of 3-year mortality over and above that of conventional risk factors. We recommend that the ankle-brachial index be incorporated into prognostic assessment for patients with ischemic heart disease.

The purpose of this study was to investigate the association between chronic kidney disease (CKD) and peripheral arterial disease (PAD) and examine the combined effect of CKD and PAD on all-cause and cardiovascular disease (CVD) mortality. The Chinese Ankle Brachial Index Cohort consisted of 3732 adults aged 35 years or older enrolled in 2004 and followed-up in 2007. Complete baseline data were compiled on 3610 people which were examined in the final analysis. Mortality surveillance was completed from December 2007 to February 2008. Survival analysis was used to compare the survival rate in different CKD/PAD groups. The relative risks (RR) of death from all-cause and CVD were compared using a Cox regression model. It was found that the prevalence of PAD in patients with and without CKD was 41.9% and 22.3%, respectively (p < 0.001). The survival rate for the CKD and PAD group was significantly lower than that for any single disease, for both all-cause and CVD mortality (log-rank: p < 0.001). In conclusion, CKD is a risk factor for PAD. The combined CKD and PAD patients had the highest risk for all-cause and CVD mortality. Early recognition of risk can be made by taking an ankle-brachial index measurement of PAD; a corresponding laboratory assessment should be used as a measurement of renal function for PAD patients.

Objective: To investigate the association between glucose metabolism status and brachial-ankle pulse wave velocity (baPWV) in Chinese patients with coronary artery disease (CAD)., Methods: baPWV values were measured in 198 CAD patients. Plasma glucose, serum lipids, hsCRP and other baseline data were obtained in all the patients. According to the glucose level, the participants were divided into 3 groups: normal glucose tolerance (NGT) group, impaired glucose regulation (IGR) group and diabetes mellitus (DM) group., Results: baPWV values in the DM group (1807 +/- 381) cm/s were significantly higher than those in the NGT group [(1615 +/- 248) cm/s, P = 0.000] and IGR group [(1674 +/- 277) cm/s, P = 0.035]. Multiple stepwise linear regression analyses indicated that higher baPWV values were associated with aging and hsCRP levels in 198 patients. In DM group, higher baPWV values were independently associated with aging and HbA1c levels., Conclusions: In patients with coronary artery disease, baPWV values increase with different glucose metabolism status from NGT to IGR then DM. baPWV values in the patients with DM were significantly higher than those in the other two groups. Glycemic control may ameliorate arterial stiffness.

Objective: To evaluate the value of measuring ankle brachial index (ABI) for diagnosing peripheral arterial disease(PAD) compared with conventional digital subtraction angiography (DSA) as the reference standard., Methods: A total of 383 consecutive inpatients (245 male, mean age 64.1 +/- 11.7 years) underwent both conventional DSA and ABI measurements., Results: The rate of statin intervention was 90.9%, ACEI 69.2%, antiplatelet 96.6% and beta-blockers 67.9%. The intravascular stenosis was classified into six degrees: normal, < 30%, 30% - 49%, 50% - 69%, 70% - 89% and > or = 90%. Compared to the traditional gold standard (DSA) in diagnosis PDA, the ABI value decreased in proportion to the severity of PAD (the ABI value was 1.08 +/- 0.11, 1.05 +/- 0.16, 0.99 +/- 0.17, 0.66 +/- 0.24, 0.55 +/- 0.28 and 0.54 +/- 0.00 respectively in the six ranks). There was a significant correlation between DSA and ABI in diagnosis PAD., Conclusion: ABI measurement is an accurate and reliable non-invasive alternative to conventional DSA in the assessment of lower extremity arteries in patients with peripheral arterial disease.

Objective: To evaluate the risk factors for peripheral arterial disease (PAD) and the relationship of low ankle brachial index (ABI) to all-cause and cardiovascular disease (CVD) mortality in Chinese male patients with hypertension., Methods: The data of 1606 male participants with hypertension from the eight hospitals in Beijing and Shanghai were analyzed. ABI was ascertained at baseline by measuring the systolic pressures on bilateral brachial and tibial arteries. ABI < or = 0.9 was used as the diagnostic criteria for PAD identification. The follow-up survey was conducted from November 2005 to January 2006., Results: Of 1606 male participants with hypertension at baseline, 406 (25.3% ) were in low-ABI group and 1200 (74.7%) were in normal-ABI group. Older age, TC, history of diabetes, history of smoking and 2-grade hypertension were associated with low ABI in male patients with hypertension. During the (12.87 +/- 2.94) months follow-up, there were 153 deaths. Of which, 62 were attributable to CVD. Low ABI was associated with adjusted all-cause and CVD mortality risk of 1.728 (1.223-2.441) and 2.388 (1.409-4.046) respectively in Cox regression models. Rate of survival for the low-ABI group was significantly worse than for the normal-ABI group. The risk of all-cause and CVD mortality was increased with the decline of ABI., Conclusion: Low ABI is independently associated with the high risks of all-cause and CVD mortality in Chinese male patients with hypertension. The utility of ABI as a tool for predicting mortality in the patients with hypertension should be popularized.

Background: The associations between obesity and abnormalities of upper and lower extremity arteries remain to be elucidated. This study is aimed to investigate whether general obesity and abdominal obesity are associated with upper and lower extremity artery diseases in a Chinese community population. Methods: This cross-sectional study included 13,144 participants in a Chinese community population. The associations between obesity parameters and abnormalities of upper and lower extremity arteries were evaluated. Multiple logistic regression analysis was used to assess the independence of associations between obesity indicators and abnormalities of peripheral arteries. Nonlinear relationship between body mass index (BMI) and risk of ankle-brachial index (ABI) ≤ 0.9 was evaluated using a restricted cubic spline model. Results: The prevalence of ABI ≤ 0.9 and interarm blood pressure difference (IABPD) ≥ 15 mmHg in the subjects was 1.9% and 1.4% respectively. Waist circumference (WC) was independently associated with ABI ≤ 0.9 (OR 1.014, 95% CI 1.002–1.026, P = 0.017). Nevertheless, BMI was not independently associated with ABI ≤ 0.9 using linear statistical models. Meanwhile, BMI and WC were independently associated with IABPD ≥ 15 mmHg respectively (OR 1.139, 95% CI 1.100–1.181, P < 0.001, and OR 1.058, 95% CI 1.044–1.072, P < 0.001). Furthermore, prevalence of ABI ≤ 0.9 was displayed with a U-shaped pattern according to different BMI (< 20, 20 to < 25, 25 to < 30, and ≥ 30). Compared with BMI 20 to < 25, risk of ABI ≤ 0.9 was significantly increased when BMI < 20 or ≥ 30 respectively (OR 2.595, 95% CI 1.745–3.858, P < 0.001, or OR 1.618, 95% CI 1.087–2.410, P = 0.018). Restricted cubic spline analysis indicated a significant U-shaped relationship between BMI and risk of ABI ≤ 0.9 (P for non-linearity < 0.001). However, prevalence of IABPD ≥ 15 mmHg was significantly increased with incremental BMI (P for trend < 0.001). Compared with BMI 20 to < 25, the risk of IABPD ≥ 15 mmHg was significantly increased when BMI ≥ 30 (OR 3.218, 95% CI 2.133–4.855, P < 0.001). Conclusions: Abdominal obesity is an independent risk factor for upper and lower extremity artery diseases. Meanwhile, general obesity is also independently associated with upper extremity artery disease. However, the association between general obesity and lower extremity artery disease is displayed with a U-shaped pattern. [ABSTRACT FROM AUTHOR]