Department of Epidemiology and Biostatistics School of Public Health Xuzhou Medical University Xuzhou Jiangsu People's Republic of China.
Department of Biostatistics and Epidemiology School of Public Health Shenzhen University Health Science Center Shenzhen Guangdong People's Republic of China.
J Am Heart Assoc. 2022 Jan 4;11(1):e022633. doi: 10.1161/JAHA.121.022633. Epub 2021 Dec 31.
Background We aimed to evaluate the association between the Chinese visceral adiposity index (CVAI) and its dynamic change and risk of carotid plaque based on a large Chinese cohort. Methods and Results This cohort included 23 522 participants aged 20 to 80 years without elevated carotid intima-media thickness and carotid plaque at baseline and who received at least 2 health checkups. CVAI was calculated at baseline and at every checkup. The dynamic change in CVAI was calculated by subtracting CVAI at baseline from that at the last follow-up. Cox proportional hazard regression model was used to estimate hazard ratios (HRs) and 95% CIs. The restricted cubic spline was applied to model the dose-response association between CVAI and carotid plaque risk. During the 82 621 person-years of follow-up, 5987 cases of carotid plaque developed (7.25/100 person-years). We observed a significant positive correlation between CVAI and carotid plaque risk (HR, 1.53; 95% CI, 1.48-1.59 [<0.001]) in a nonlinear dose-response pattern (<0.001). The sensitivity analyses further confirmed the robustness of the results. The association was significant in all subgroup analyses stratified by sex, hypertension, and fatty liver disease except for the diabetes subgroup. The association between CVAI and carotid plaque risk was much higher in men than in women. No significant association was identified between change in CVAI and carotid plaque risk. Conclusions CVAI was positively associated with carotid plaque risk in a nonlinear dose-response pattern in this study. Individuals should keep their CVAI within a normal level to prevent the development of carotid plaque.
背景 我们旨在评估基于大型中国队列的中国内脏脂肪指数（CVAI）及其动态变化与颈动脉斑块风险之间的关系。
方法和结果 该队列包括 23522 名年龄在 20 至 80 岁之间的参与者，基线时无颈动脉内膜中层增厚和颈动脉斑块，且至少接受过 2 次健康检查。在基线和每次检查时计算 CVAI。通过从最后一次随访时的 CVAI 中减去基线时的 CVAI 来计算 CVAI 的动态变化。使用 Cox 比例风险回归模型估计风险比（HR）和 95%置信区间（CI）。限制性立方样条用于构建 CVAI 与颈动脉斑块风险之间的剂量反应关系模型。在 82621 人年的随访期间，发生了 5987 例颈动脉斑块（7.25/100 人年）。我们观察到 CVAI 与颈动脉斑块风险之间存在显著的正相关关系（HR，1.53；95%CI，1.48-1.59 [<0.001]）呈非线性剂量反应模式（<0.001）。敏感性分析进一步证实了结果的稳健性。除糖尿病亚组外，在按性别、高血压和脂肪肝疾病分层的所有亚组分析中，这种相关性均具有统计学意义。在男性中，CVAI 与颈动脉斑块风险之间的相关性明显高于女性。CVAI 的变化与颈动脉斑块风险之间没有显著的关联。
结论 在本研究中，CVAI 与颈动脉斑块风险之间呈非线性剂量反应关系。个体应将 CVAI 保持在正常水平，以预防颈动脉斑块的发生。
