Zhang Yangchang, He Qiang, Zhang Weihao, Xiong Yang, Shen Shisi, Yang Jialu, Ye Mengliang
School of Public Health and Management, Chongqing Medical University, Chongqing, China.
Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China.
Front Cardiovasc Med. 2022 Jun 24;9:908020. doi: 10.3389/fcvm.2022.908020. eCollection 2022.
To investigate associations between visceral adiposity index (VAI) and cardiovascular and cerebrovascular diseases (CCDs) in the American population from 1999 to 2018.
Data from the National Health and Nutrition Examination Survey (1998-2018) were analyzed in this study. Specifically, VAI scores were calculated using sex-specific equations that incorporate body mass index, waist circumference (WC), high-density lipoprotein (HDL), triglycerides (TG), and cholesterol. Weighted logistic regression analysis was conducted to assess the relationship between VAI tertile and increased risk of CCDs. Restricted cubic splines were used to evaluate the non-linear relationship between VAI and CCDs, such as heart failure, angina, heart attack, stroke, hypertension, and coronary heart disease. Sensitivity analysis was conducted, using VAI quartiles as independent variables.
A total of 22,622 subjects aged over 20 years were included. In the fully adjusted model after controlling for covariates, the third VAI tertile was more strongly associated with CCDs than the first VAI tertile, with odds ratio (OR) and 95% confidence interval (95% CI) values for angina of 2.86, 1.68-4.85; heart attack, 1.75, 1.14-2.69; stroke, 2.01, 1.23-3.26; hypertension, 2.28, 1.86-2.78; and coronary heart disease, 1.78, 1.32-2.41; but there was no significant association with heart failure ( > 0.05). Restricted cubic splines revealed parabolic relationships between VAI score and angina ( for non-linear = 0.03), coronary heart disease ( for non-linear = 0.01), and hypertension ( for non-linear < 0.001). Sensitivity analysis indicated that the fourth VAI quartile was more strongly associated with an increased risk of angina (OR = 2.92, 95% CI, 1.49-5.69), hypertension (OR = 2.37, 95% CI, 1.90-2.97), heart attack (OR = 1.77, 95% CI, 1.09-2.88), and coronary heart disease (OR = 1.89, 95% CI, 1.24-2.86) than the first VAI quartile. VAI had superior predictive power for prevalent CCDs than other independent indicators ( < 0.05).
Visceral adiposity index score is positively correlated with angina, heart attack, stroke, hypertension, and coronary heart disease, but not heart failure, and the relationships between VAI score and angina, hypertension, and coronary heart disease are non-linear.
研究1999年至2018年美国人群内脏脂肪指数（VAI）与心脑血管疾病（CCDs）之间的关联。
本研究分析了国家健康与营养检查调查（1998 - 2018年）的数据。具体而言，使用纳入体重指数、腰围（WC）、高密度脂蛋白（HDL）、甘油三酯（TG）和胆固醇的性别特异性方程计算VAI得分。进行加权逻辑回归分析以评估VAI三分位数与CCDs风险增加之间的关系。使用受限立方样条评估VAI与CCDs（如心力衰竭、心绞痛、心脏病发作、中风、高血压和冠心病）之间的非线性关系。以VAI四分位数作为自变量进行敏感性分析。
共纳入22,622名20岁以上的受试者。在控制协变量后的完全调整模型中，VAI三分位数中的第三个与CCDs的关联比第一个VAI三分位数更强，心绞痛的比值比（OR）和95%置信区间（95%CI）值为2.86，1.68 - 4.85；心脏病发作，1.75，1.14 - 2.69；中风，2.01，1.23 - 3.26；高血压，2.28，1.86 - 2.78；冠心病，1.78，1.32 - 2.41；但与心力衰竭无显著关联（>0.05）。受限立方样条显示VAI得分与心绞痛（非线性检验P = 0.03）、冠心病（非线性检验P = 0.01）和高血压（非线性检验P<0.001）之间呈抛物线关系。敏感性分析表明，VAI四分位数中的第四个与心绞痛（OR = 2.92，95%CI，1.49 - 5.69）、高血压（OR = 2.37，95%CI，1.90 - 2.97）、心脏病发作（OR = 1.77，95%CI，1.09 - 2.88）和冠心病（OR = 1.89，95%CI，1.24 - 2.86）风险增加的关联比第一个VAI四分位数更强。VAI对CCDs患病率的预测能力优于其他独立指标（P<0.05）。
内脏脂肪指数得分与心绞痛、心脏病发作、中风、高血压和冠心病呈正相关，但与心力衰竭无关，且VAI得分与心绞痛、高血压和冠心病之间的关系是非线性的。
