Department of Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, PR China.
Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.
Diabetes Metab Res Rev. 2021 Feb;37(2):e3370. doi: 10.1002/dmrr.3370. Epub 2020 Jul 18.
The evidence of the association between Chinese visceral adiposity index (CVAI) and risk of type 2 diabetes mellitus (T2DM) is limited. We explored the association of CVAI with T2DM and directly compared with the predictive power of CVAI with other visceral obesity indices (visceral adiposity index, waist to height ratio, waist circumference and body mass index) based on a large prospective study.
We conducted a population-based study of 12 237 Chinese participants. Cox proportional-hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between CVAI and T2DM.
During follow-up (median: 6.01 years), the incidence of T2DM was 3.29, 7.34, 12.37 and 23.72 per 1000 person-years for quartiles 1, 2, 3 and 4 of CVAI, respectively. The risk of T2DM was increased with quartiles 2, 3 and 4 vs quartile 1 of CVAI (HR 2.12 [95% CI 1.50-3.00], 2.94 [2.10-4.13] and 5.01 [3.57-7.04], P < 0.001). Per-SD increase in CVAI was associated with a 72% increased risk of T2DM (HR 1.72 [95% CI 1.56-1.88]). Sensitivity analyses did not alter the association. The area under receiver operating characteristic curve was significantly higher for CVAI than other visceral obesity indices (all P <.001). Similar results were observed in stratified analyses by sex.
Our findings show a positive association between CVAI and risk of T2DM. CVAI has the best performance in predicting incident T2DM, so the index might be a reliable and applicable indicator identifying people at high risk of T2DM.
目前关于中国内脏脂肪指数（CVAI）与 2 型糖尿病（T2DM）风险之间关联的证据有限。我们基于一项大型前瞻性研究，探讨了 CVAI 与 T2DM 之间的相关性，并直接比较了 CVAI 与其他内脏肥胖指数（内脏脂肪指数、腰高比、腰围和体重指数）的预测能力。
我们对 12237 名中国参与者进行了一项基于人群的研究。使用 Cox 比例风险模型估计 CVAI 与 T2DM 之间的关联的风险比（HR）和 95%置信区间（CI）。
在随访期间（中位数：6.01 年），CVAI 四分位数 1、2、3 和 4 组的 T2DM 发生率分别为每 1000 人年 3.29、7.34、12.37 和 23.72 例。与 CVAI 四分位数 1 相比，四分位数 2、3 和 4 的 T2DM 风险增加（HR 2.12[95%CI 1.50-3.00]、2.94[2.10-4.13]和 5.01[3.57-7.04]，P<0.001）。CVAI 每增加 1 个标准差，T2DM 的风险增加 72%（HR 1.72[95%CI 1.56-1.88]）。敏感性分析并未改变这种关联。CVAI 的受试者工作特征曲线下面积明显高于其他内脏肥胖指数（均 P<0.001）。按性别分层分析也观察到了类似的结果。
我们的研究结果表明 CVAI 与 T2DM 风险之间存在正相关。CVAI 在预测 T2DM 事件方面表现最佳，因此该指数可能是识别 T2DM 高危人群的可靠且适用的指标。
