{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T15:03:33Z","timestamp":1789398213932,"version":"build-2803163510"},"reference-count":70,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2022,4,29]],"date-time":"2022-04-29T00:00:00Z","timestamp":1651190400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Arterial stiffness (AS), measured by arterial stiffness index (ASI), can be considered as a major denominator in cardiovascular (CV) diseases. Thus, it remains essential to highlight the risk factors influencing its increase among healthy participants. Methods: According to European consensus, AS is defined as ASI &gt; 10 m\/s. The purpose of this study was to investigate the determinants of the arterial stiffness (ASI &gt; 10 m\/s) among UK Biobank normotensive and healthy participants without comorbidities and previous CV diseases. Thus, a cross-sectional study was conducted on 22,452 healthy participants. Results: Participants were divided into two groups, i.e., ASI &gt; 10 m\/s (n = 5782, 25.8%) and ASI &lt; 10 m\/s (n = 16,670, 74.2%). All the significant univariate covariables were included in the multivariate analysis. The remaining independent factors associated with AS were age (OR = 1.063, threshold = 53.0 years, p &lt; 0.001), BMI (OR = 1.0450, threshold = 24.9 kg\/m2, p &lt; 0.001), cystatin c (OR = 1.384, threshold = 0.85 mg\/L, p = 0.011), phosphate (OR = 2.225, threshold = 1.21 mmol\/L, p &lt; 0.001), triglycerides (OR = 1.281, threshold = 1.09 mmol\/L, p &lt; 0.001), mean BP (OR = 1.028, threshold = 91.2 mmHg, p &lt; 0.001), HR (OR = 1.007, threshold = 55 bpm, p &lt; 0.001), Alkaline phosphate (OR = 1.002, threshold = 67.9 U\/L, p = 0.004), albumin (OR = 0.973, threshold = 46.0 g\/L, p &lt; 0.001), gender (male, OR = 1.657, p &lt; 0.001) and tobacco use (current, OR = 1.871, p &lt; 0.001). Conclusion: AS is associated with multiple parameters which should be investigated in future prospective studies. Determining the markers of increased ASI among healthy participants participates in the management of future CV risk for preventive strategies.<\/jats:p>","DOI":"10.3390\/jcm11092512","type":"journal-article","created":{"date-parts":[[2022,4,30]],"date-time":"2022-04-30T05:44:07Z","timestamp":1651297447000},"page":"2512","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Arterial Stiffness Determinants for Primary Cardiovascular Prevention among Healthy Participants"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9158-4467","authenticated-orcid":false,"given":"Alexandre","family":"Vall\u00e9e","sequence":"first","affiliation":[{"name":"Department of Epidemiology-Data-Biostatistics, Delegation of Clinical Research and Innovation (DRCI), Foch Hospital, 92150 Suresnes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Vasan, R.S., Short, M.I., Niiranen, T.J., Xanthakis, V., DeCarli, C., Cheng, S., Seshadri, S., and Mitchell, G.F. (2019). Interrelations Between Arterial Stiffness, Target Organ Damage, and Cardiovascular Disease Outcomes. J. Am. Heart Assoc., 8.","DOI":"10.1161\/JAHA.119.012141"},{"key":"ref_2","first-page":"23","article-title":"Arterial Stiffness as a Noninvasive Tissue Biomarker of Cardiac Target Organ Damage","volume":"4","author":"Spartano","year":"2014","journal-title":"Curr. Biomark. Find."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2631","DOI":"10.1056\/NEJMoa055373","article-title":"Multiple Biomarkers for the Prediction of First Major Cardiovascular Events and Death","volume":"355","author":"Wang","year":"2006","journal-title":"N. Engl. J. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1161\/01.CIR.0000048894.99865.02","article-title":"Arterial and Cardiac Aging: Major Shareholders in Cardiovascular Disease Enterprises: Part III: Cellular and Molecular Clues to Heart and Arterial Aging","volume":"107","author":"Lakatta","year":"2003","journal-title":"Circulation"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1007\/s11883-007-0010-y","article-title":"Arterial Stiffness as a Risk Factor for Coronary Atherosclerosis","volume":"9","author":"Duprez","year":"2007","journal-title":"Curr. Atheroscler. Rep."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Vall\u00e9e, A., Cinaud, A., Protogerou, A., Zhang, Y., Topouchian, J., Safar, M.E., and Blacher, J. (2020). Arterial Stiffness and Coronary Ischemia: New Aspects and Paradigms. Curr. Hypertens. Rep., 22.","DOI":"10.1007\/s11906-019-1006-z"},{"key":"ref_7","first-page":"1257","article-title":"Arterial Stiffness Association with Chronic Inflammatory Disorders in the UK Biobank Study","volume":"104","author":"Dregan","year":"2018","journal-title":"Heart Br. Card. Soc."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1161\/ATVBAHA.107.156950","article-title":"Arterial Stiffness Is Associated with Regional Ventricular Systolic and Diastolic Dysfunction: The Multi-Ethnic Study of Atherosclerosis","volume":"28","author":"Fernandes","year":"2008","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2588","DOI":"10.1093\/eurheartj\/ehl254","article-title":"Expert Consensus Document on Arterial Stiffness: Methodological Issues and Clinical Applications","volume":"27","author":"Laurent","year":"2006","journal-title":"Eur. Heart J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1318","DOI":"10.1016\/j.jacc.2009.10.061","article-title":"Prediction of Cardiovascular Events and All-Cause Mortality with Arterial Stiffness: A Systematic Review and Meta-Analysis","volume":"55","author":"Vlachopoulos","year":"2010","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2268","DOI":"10.1109\/TBME.2007.897805","article-title":"Predicting Arterial Stiffness from the Digital Volume Pulse Waveform","volume":"54","author":"Alty","year":"2007","journal-title":"IEEE Trans. Biomed. Eng."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Said, M.A., Eppinga, R.N., Lipsic, E., Verweij, N., and van der Harst, P. (2018). Relationship of Arterial Stiffness Index and Pulse Pressure With Cardiovascular Disease and Mortality. J. Am. Heart Assoc., 7.","DOI":"10.1161\/JAHA.117.007621"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Sudlow, C., Gallacher, J., Allen, N., Beral, V., Burton, P., Danesh, J., Downey, P., Elliott, P., Green, J., and Landray, M. (2015). UK Biobank: An Open Access Resource for Identifying the Causes of a Wide Range of Complex Diseases of Middle and Old Age. PLoS Med., 12.","DOI":"10.1371\/journal.pmed.1001779"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1038\/s41586-018-0579-z","article-title":"The UK Biobank Resource with Deep Phenotyping and Genomic Data","volume":"562","author":"Bycroft","year":"2018","journal-title":"Nature"},{"key":"ref_15","unstructured":"UK Biobank (2022, January 01). Arterial Pulse-Wave Velocity. Available online: https:\/\/Biobank.Ndph.Ox.Ac.Uk\/Ukb\/Ukb\/Docs\/Pulsewave.Pdf."},{"key":"ref_16","unstructured":"UK Biobank (2022, January 01). Blood Pressure. Available online: https:\/\/Biobank.Ctsu.Ox.Ac.Uk\/Crystal\/Docs\/Bloodpressure.Pdf."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1097\/01.mbp.0000189788.05736.5f","article-title":"Validation of the Omron 705IT (HEM-759-E) Oscillometric Blood Pressure Monitoring Device According to the British Hypertension Society Protocol","volume":"11","author":"Coleman","year":"2006","journal-title":"Blood Press. Monit."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1093\/aje\/kwj160","article-title":"Algorithms for Converting Random-Zero to Automated Oscillometric Blood Pressure Values, and Vice Versa","volume":"164","author":"Stang","year":"2006","journal-title":"Am. J. Epidemiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/j.amjhyper.2004.08.038","article-title":"Assessment of Central and Peripheral Arterial Stiffness: Studies Indicating the Need to Use a Combination of Techniques","volume":"18","author":"Woodman","year":"2005","journal-title":"Am. J. Hypertens."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2284","DOI":"10.1097\/HJH.0000000000001961","article-title":"2018 Practice Guidelines for the Management of Arterial Hypertension of the European Society of Hypertension and the European Society of Cardiology: ESH\/ESC Task Force for the Management of Arterial Hypertension","volume":"36","author":"Williams","year":"2018","journal-title":"J. Hypertens."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/S0933-3657(98)00062-1","article-title":"Selected Techniques for Data Mining in Medicine","volume":"16","author":"Lavrac","year":"1999","journal-title":"Artif. Intell. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1016\/j.patrec.2005.10.010","article-title":"An Introduction to ROC Analysis","volume":"27","author":"Fawcett","year":"2006","journal-title":"Pattern Recognit. Lett."},{"key":"ref_23","first-page":"39","article-title":"Pharmacogenomics of Drug Efficacy in the Interferon Treatment of Chronic Hepatitis C Using Classification Algorithms","volume":"3","author":"Ke","year":"2010","journal-title":"Adv. Appl. Bioinforma. Chem. AABC"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1237","DOI":"10.1016\/j.jacc.2019.07.012","article-title":"Large Artery Stiffness in Health and Disease: JACC State-of-the-Art Review","volume":"74","author":"Chirinos","year":"2019","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Seeland, U., Brecht, A., Nauman, A.T., Oertelt-Prigione, S., Ruecke, M., Knebel, F., Stangl, V., and Regitz-Zagrosek, V. (2016). Prevalence of Arterial Stiffness and the Risk of Myocardial Diastolic Dysfunction in Women. Biosci. Rep., 36.","DOI":"10.1042\/BSR20160276"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1038\/sj.jhh.1002120","article-title":"Relationship between Blood Pressure Parameters and Pulse Wave Velocity in Normotensive and Hypertensive Subjects: Invasive Study","volume":"21","author":"Kim","year":"2007","journal-title":"J. Hum. Hypertens."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2161","DOI":"10.1097\/HJH.0000000000002564","article-title":"Mean Arterial Pressure Estimated by Brachial Pulse Wave Analysis and Comparison with Currently Used Algorithms","volume":"38","author":"Grillo","year":"2020","journal-title":"J. Hypertens."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"4208","DOI":"10.1111\/bph.14624","article-title":"Sex Differences in Mechanisms of Arterial Stiffness","volume":"176","author":"DuPont","year":"2019","journal-title":"Br. J. Pharmacol."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Tsamis, A., Krawiec, J.T., and Vorp, D.A. (2013). Elastin and Collagen Fibre Microstructure of the Human Aorta in Ageing and Disease: A Review. J. R. Soc. Interface, 10.","DOI":"10.1098\/rsif.2012.1004"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2382","DOI":"10.1097\/HJH.0000000000002603","article-title":"Impact of Heart Rate on Arterial Stiffness: Virtual vs. Real Assessment","volume":"38","author":"Grassi","year":"2020","journal-title":"J. Hypertens."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1194","DOI":"10.1152\/japplphysiol.00670.2017","article-title":"Mitochondria-Targeted Antioxidant Therapy with MitoQ Ameliorates Aortic Stiffening in Old Mice","volume":"124","author":"Battson","year":"2018","journal-title":"J. Appl. Physiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1159\/000365267","article-title":"Gender Difference in Arterial Stiffness in a Multicenter Cross-Sectional Study: The Korean Arterial Aging Study (KAAS)","volume":"2","author":"Kim","year":"2014","journal-title":"Pulse"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1161\/ATVBAHA.119.313622","article-title":"Arterial Stiffness Accelerates Within 1 Year of the Final Menstrual Period","volume":"40","author":"Samargandy","year":"2020","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"107","DOI":"10.2174\/1573402113666170724100418","article-title":"Effect of Heart Rate on Arterial Stiffness as Assessed by Pulse Wave Velocity","volume":"14","author":"Tan","year":"2018","journal-title":"Curr. Hypertens. Rev."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1097\/HJH.0000000000002608","article-title":"Heart Rate and Blood Pressure Dependence of Aortic Distensibility in Rats: Comparison of Measured and Calculated Pulse Wave Velocity","volume":"39","author":"Spronck","year":"2021","journal-title":"J. Hypertens."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Sang, Y., Cao, M., Wu, X., Ruan, L., and Zhang, C. (2021). Use of Lipid Parameters to Identify Apparently Healthy Men at High Risk of Arterial Stiffness Progression. BMC Cardiovasc. Disord., 21.","DOI":"10.1186\/s12872-020-01846-x"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/j.atherosclerosis.2017.06.031","article-title":"Comparison of the Ability to Identify Arterial Stiffness between Two New Anthropometric Indices and Classical Obesity Indices in Chinese Adults","volume":"263","author":"Zhang","year":"2017","journal-title":"Atherosclerosis"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/S0091-7435(03)00097-5","article-title":"Environmental Tobacco Smoke and Carotid Arterial Stiffness","volume":"37","author":"Mack","year":"2003","journal-title":"Prev. Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2149","DOI":"10.1161\/01.CIR.88.5.2149","article-title":"Cigarette Smoking Is Associated with Dose-Related and Potentially Reversible Impairment of Endothelium-Dependent Dilation in Healthy Young Adults","volume":"88","author":"Celermajer","year":"1993","journal-title":"Circulation"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1159\/000507510","article-title":"Relation between Tobacco Smoking\/Electronic Smoking and Albuminuria\/Vascular Stiffness in Young People without Cardiovascular Diseases","volume":"45","author":"Podzolkov","year":"2020","journal-title":"Kidney Blood Press. Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1484","DOI":"10.1111\/jch.13662","article-title":"Application of a Decision Tree to Establish Factors Associated with a Nomogram of Aortic Stiffness","volume":"21","author":"Safar","year":"2019","journal-title":"J. Clin. Hypertens."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1097\/HJH.0000000000002228","article-title":"Relationship between BMI and Aortic Stiffness: Influence of Anthropometric Indices in Hypertensive Men and Women","volume":"38","author":"Lelong","year":"2020","journal-title":"J. Hypertens."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1093\/ajh\/hpt152","article-title":"Obesity and Overweight Associated with Increased Carotid Diameter and Decreased Arterial Function in Young Otherwise Healthy Men","volume":"27","author":"Kappus","year":"2014","journal-title":"Am. J. Hypertens."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1441","DOI":"10.1016\/j.amjcard.2009.07.009","article-title":"Impact of Excess Body Weight on Arterial Structure, Function, and Blood Pressure in Firefighters","volume":"104","author":"Fahs","year":"2009","journal-title":"Am. J. Cardiol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"609","DOI":"10.2215\/CJN.04100808","article-title":"Serum Phosphorus Concentrations and Arterial Stiffness among Individuals with Normal Kidney Function to Moderate Kidney Disease in MESA","volume":"4","author":"Ix","year":"2009","journal-title":"Clin. J. Am. Soc. Nephrol. CJASN"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1016\/j.amjcard.2010.03.070","article-title":"Relation of Serum Phosphorus Levels to Ankle Brachial Pressure Index (from the Third National Health and Nutrition Examination Survey)","volume":"106","author":"Kendrick","year":"2010","journal-title":"Am. J. Cardiol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"826","DOI":"10.1053\/j.ajkd.2011.07.020","article-title":"The Role of Phosphorus in the Development and Progression of Vascular Calcification","volume":"58","author":"Kendrick","year":"2011","journal-title":"Am. J. Kidney Dis."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.jvn.2017.01.003","article-title":"Effects of Serum Phosphorus on Vascular Calcification in a Healthy, Adult Population: A Systematic Review","volume":"35","author":"Sheridan","year":"2017","journal-title":"J. Vasc. Nurs."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1681\/ASN.2007080854","article-title":"Mechanisms of Vascular Calcification in Chronic Kidney Disease","volume":"19","author":"Moe","year":"2008","journal-title":"J. Am. Soc. Nephrol. JASN"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"2857","DOI":"10.1097\/01.ASN.0000141960.01035.28","article-title":"Human Vascular Smooth Muscle Cells Undergo Vesicle-Mediated Calcification in Response to Changes in Extracellular Calcium and Phosphate Concentrations: A Potential Mechanism for Accelerated Vascular Calcification in ESRD","volume":"15","author":"Reynolds","year":"2004","journal-title":"J. Am. Soc. Nephrol. JASN"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1755","DOI":"10.1161\/01.CIR.96.6.1755","article-title":"Active Serum Vitamin D Levels Are Inversely Correlated with Coronary Calcification","volume":"96","author":"Watson","year":"1997","journal-title":"Circulation"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"203","DOI":"10.5551\/jat.RV17045","article-title":"Phosphate as a Pathogen of Arteriosclerosis and Aging","volume":"28","year":"2021","journal-title":"J. Atheroscler. Thromb."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1159\/000505717","article-title":"Aortic Calcification and Arterial Stiffness Burden in a Chronic Kidney Disease Cohort with High Cardiovascular Risk: Baseline Characteristics of the Impact of Phosphate Reduction on Vascular End-Points in Chronic Kidney Disease Trial","volume":"51","author":"Lioufas","year":"2020","journal-title":"Am. J. Nephrol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1145","DOI":"10.1016\/j.jacc.2021.06.049","article-title":"Medial Arterial Calcification: JACC State-of-the-Art Review","volume":"78","author":"Lanzer","year":"2021","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/j.jjcc.2014.05.009","article-title":"The Effects of Metabolic Syndrome and Its Components on Arterial Stiffness in Relation to Gender","volume":"65","author":"Kim","year":"2015","journal-title":"J. Cardiol."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Wang, X., Ye, P., Cao, R., Yang, X., Xiao, W., Zhang, Y., Bai, Y., and Wu, H. (2016). Triglycerides Are a Predictive Factor for Arterial Stiffness: A Community-Based 4.8-Year Prospective Study. Lipids Health Dis., 15.","DOI":"10.1186\/s12944-016-0266-8"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1016\/j.jacc.2007.10.038","article-title":"Impact of Triglyceride Levels beyond Low-Density Lipoprotein Cholesterol after Acute Coronary Syndrome in the PROVE IT-TIMI 22 Trial","volume":"51","author":"Miller","year":"2008","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"4804","DOI":"10.1074\/jbc.M008725200","article-title":"Elevated Triglyceride Content Diminishes the Capacity of High Density Lipoprotein to Deliver Cholesteryl Esters via the Scavenger Receptor Class B Type I (SR-BI)","volume":"276","author":"Greene","year":"2001","journal-title":"J. Biol. Chem."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"D332","DOI":"10.2741\/Yu","article-title":"Postprandial Lipoproteins and Atherosclerosis","volume":"6","author":"Yu","year":"2001","journal-title":"Front. Biosci. J. Virtual Libr."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"2946","DOI":"10.1210\/jc.2003-031977","article-title":"Lipoprotein Remnants and Endothelial Dysfunction in the Postprandial Phase","volume":"89","author":"Maggi","year":"2004","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"86","DOI":"10.5414\/CN108525","article-title":"Diagnostic Accuracy of Serum Cystatin C in Chronic Kidney Disease: A Meta-Analysis","volume":"84","author":"Wei","year":"2015","journal-title":"Clin. Nephrol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"9207","DOI":"10.12659\/MSM.916630","article-title":"Serum Cystatin C and Arterial Stiffness in Middle-Aged and Elderly Adults without Chronic Kidney Disease: A Population-Based Study","volume":"25","author":"Huang","year":"2019","journal-title":"Med. Sci. Monit."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1038\/ajh.2010.100","article-title":"Association of Serum Cystatin C with Pulse Wave Velocity, but Not Pressure Wave Reflection, in Subjects with Normal Renal Function or Mild Chronic Kidney Disease","volume":"23","author":"Odaira","year":"2010","journal-title":"Am. J. Hypertens."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1080\/10641963.2016.1248769","article-title":"Relation between Serum Cystatin C Level and Brachial-Ankle Pulse Wave Velocity in Chinese General Population","volume":"40","author":"Yang","year":"2018","journal-title":"Clin. Exp. Hypertens."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1161\/CIRCULATIONAHA.109.886655","article-title":"Arterial Stiffness and Cardiovascular Events: The Framingham Heart Study","volume":"121","author":"Mitchell","year":"2010","journal-title":"Circulation"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"824","DOI":"10.1002\/jbmr.2420","article-title":"Pathophysiological Role of Vascular Smooth Muscle Alkaline Phosphatase in Medial Artery Calcification","volume":"30","author":"Sheen","year":"2015","journal-title":"J. Bone Miner. Res."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1434","DOI":"10.1038\/labinvest.2011.83","article-title":"Cell-Specific Effects of TNF-\u03b1 and IL-1\u03b2 on Alkaline Phosphatase: Implication for Syndesmophyte Formation and Vascular Calcification","volume":"91","author":"Lencel","year":"2011","journal-title":"Lab. Investig. J. Tech. Methods Pathol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"184","DOI":"10.2215\/CJN.03340807","article-title":"Vascular Stiffness: Its Measurement and Significance for Epidemiologic and Outcome Studies","volume":"3","author":"DeLoach","year":"2008","journal-title":"Clin. J. Am. Soc. Nephrol. CJASN"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1018","DOI":"10.1093\/ije\/dyt103","article-title":"Commentary: Representativeness Is Usually Not Necessary and Often Should Be Avoided","volume":"42","author":"Richiardi","year":"2013","journal-title":"Int. J. Epidemiol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1093\/ije\/dys223","article-title":"Why Representativeness Should Be Avoided","volume":"42","author":"Rothman","year":"2013","journal-title":"Int. J. Epidemiol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/9\/2512\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:04:31Z","timestamp":1760137471000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/9\/2512"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,29]]},"references-count":70,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2022,5]]}},"alternative-id":["jcm11092512"],"URL":"https:\/\/doi.org\/10.3390\/jcm11092512","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,29]]}}}