The Effect of Wrist Circumference on Vascular Stiffening Due to Body Mass Index, Weight, Body Surface Area, and Waist Circumference as Mediators

Background: Wrist circumference is emerging as a potential indicator of vascular health, but its relationship with vascular stiffening remains under explored. Objectives: This study investigates the mediating roles of Body Mass Index (BMI), weight, body surface area (BSA), and waist circumference (WC) in the association between Wrist circomfrence and vascular stiffness. Methods: This cross-sectional study was conducted to examine the mediating effects of BMI, weight, BSA, and WC on the association between wrist circumference and vascular stiffness in children and adolescents aged 5 - 18 years who referred to the pediatric clinics affiliated with Zahedan University of Medical Sciences (ZaUMS) in the years 2022 and 2023. Physical examinations and standardized measurements of wrist circumference, BMI, weight, BSA, and WC were conducted, with vascular stiffness parameters including arterial distensibility, Aortic Stiffness Beta Index, and pressure strain elastic modulus evaluated. Results: The analysis revealed that BMI, weight, BSA, and WC significantly mediated the relationship between wrist circumference and specific vascular stiffness measures, notably for Aortic Stiffness Beta Index and pressure strain elastic modulus. Sobel test results indicated significant mediation effects for BMI, BSA, and WC in both right and left wrist circumferences, though mediation was not significant for arterial strain. Conclusions: The findings underscore the importance of body composition variables in cardiovascular health assessments, suggesting that indirect effects (IDE) of wrist circumference on vascular stiffness can vary by the type of body composition metric and vascular parameter. These insights offer potential pathways for identifying at-risk populations and tailoring cardiovascular interventions based on anthropometric assessments.