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We examined the association of visceral fat area (VFA) as an obesity measurement with arterial stiffness in seven ideal cardiovascular health metrics (ICVHMs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 29\u2009048 patients were included in the analysis from June 2017 to April 2021 in 10 sites of National Metabolic Management Centers. ICVHMs were modified from the recommendations of the American Heart Association. Brachial\u2010ankle pulse wave velocity (BaPWV)\u2009\u2265\u20091400\u2009cm\/s was employed to evaluate increased arterial stiffness. Multivariate regression models were used to compare the different effects of BMI and VFA on arterial stiffness.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Lower VFA was more strongly associated with low BaPWV than lower BMI when other ICVHMs were included (adjusted odds ratio [OR], 0.85 [95% confidence interval [CI], 0.80\u20130.90] vs OR 1.08 [95% CI, 1.00\u20131.17]). Multivariable\u2010adjusted ORs for arterial stiffness were highest in patients with the VAT area VFA in the range of 150\u2010200\u2009cm<jats:sup>2<\/jats:sup> (adjusted OR, 1.26 [95% CI 1.12\u20131.41]). Compared with participants with VAT VFA\u2009&lt;\u2009100\u2009cm<jats:sup>2<\/jats:sup>, among participants with higher VAT VFA, the OR for arterial stiffness decreased gradually from 1.89 (95% CI, 1.73\u20132.07) in patients who had \u22641 ICVHM to 0.39 (95% CI, 0.25\u20130.62) in patients who had \u22655 ICVHMs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In patients with T2DM, using VAT for anthropometric measures of obesity, VFA was more relevant to cardiovascular risk than BMI in the seven ICVHMs. For anthropometric measures of obesity in the ICVHMs to describe cardiovascular risk VFA would be more optimal than BMI.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1753-0407.13463","type":"journal-article","created":{"date-parts":[[2023,9,8]],"date-time":"2023-09-08T07:06:16Z","timestamp":1694156776000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Association of visceral fat area or <scp>BMI<\/scp> with arterial stiffness in ideal cardiovascular health metrics among <scp>T2DM<\/scp> patients"],"prefix":"10.1111","volume":"16","author":[{"given":"Ling","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Endocrinology The Second Affiliated Hospital of Kunming Medical University  Kunming China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiangming","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Endocrinology The Second Affiliated Hospital of Kunming Medical University  Kunming China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4023-2861","authenticated-orcid":false,"given":"Yufei","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Endocrine and Metabolic Diseases Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine  Shanghai China"},{"name":"Shanghai National Clinical Research Center for metabolic Diseases Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor\uff0cState Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qijuan","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Endocrinology People's Hospital of Zhengzhou Affiliated Henan University of Chinese Medicine  zhengzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qidong","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine The Second People's Hospital of Yuhuan  Yuhuan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yufan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Ningbo First Hospital  Ningbo China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9847-5439","authenticated-orcid":false,"given":"Dong","family":"Zhao","sequence":"additional","affiliation":[{"name":"Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital Capital Medical University  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bangqun","family":"Ji","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Xingyi People's Hospital  Xingyi China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fengmei","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism Hebi Coal (group). 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