Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory, Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Xinjiang Hypertension Institute., Urumqi, China.
Front Endocrinol (Lausanne). 2022 Jul 14;13:910329. doi: 10.3389/fendo.2022.910329. eCollection 2022.
To evaluate the association between Chinese visceral adiposity index (CVAI) and incident renal damage and compared its predictive power with that of other visceral obesity indices in patients with hypertension and abnormal glucose metabolism (AGM).
This retrospective cohort consecutively included patients with hypertension and AGM who did not have renal damage at baseline. Renal damage was defined using the estimated glomerular filtration rate (eGFR) and urine protein. Multivariable Cox regression analysis was used to evaluate the association between CVAI and incident renal damage. Restricted cubic splines were used to determine the shape of the association. The predictive power of the CVAI was examined and directly compared with other indices, including the VAI, body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR), using the area under the receiver operating characteristic curve (AUC) and C-index.
In total, 2,033 patients with hypertension and AGM were included. During a median follow-up of 2.6 years, the incidence of renal damage was 31.5, 48.9, 56.8, and 67.5/1,000 person-years across the quartiles of CVAI. Compared with the first quartile, the risk of renal damage was higher in the second (hazard ratio (HR) = 1.36 [95% CI: 0.93-1.97]), third (HR = 1.57 [95% CI: 1.09-2.27]), and fourth (HR = 1.65 [95% CI: 1.11-2.44]) quartiles ( for trend = 0.011). A linear dose-response association was observed. Sensitivity and subgroup analyses confirmed the robustness and consistency of the results. In terms of predictive power, the CVAI had the highest AUC and C-index values.
CVAI is positively associated with renal damage risk in a linear dose-response pattern and has the best performance in predicting incident renal damage in patients with hypertension and AGM. The CVAI may serve as a reliable indicator for identifying patients at a high risk of renal damage.
评估中国内脏脂肪指数（CVAI）与肾脏损害事件的相关性，并将其预测能力与高血压和糖代谢异常（AGM）患者中其他内脏肥胖指数进行比较。
本回顾性队列研究连续纳入基线时无肾脏损害的高血压和 AGM 患者。肾脏损害定义为估算肾小球滤过率（eGFR）和尿蛋白。多变量 Cox 回归分析用于评估 CVAI 与肾脏损害事件的相关性。限制性立方样条用于确定相关性的形状。使用接受者操作特征曲线（AUC）和 C 指数来评估 CVAI 的预测能力，并直接与其他指数（包括 VAI、体重指数（BMI）、腰围（WC）和腰高比（WHtR））进行比较。
共纳入 2033 例高血压和 AGM 患者。在中位随访 2.6 年期间，CVAI 四分位数的肾脏损害发生率分别为 31.5、48.9、56.8 和 67.5/1000 人年。与第一四分位数相比，第二（风险比（HR）=1.36[95%CI：0.93-1.97]）、第三（HR=1.57[95%CI：1.09-2.27]）和第四（HR=1.65[95%CI：1.11-2.44]）四分位数的肾脏损害风险更高（趋势=0.011）。观察到线性剂量-反应关系。敏感性和亚组分析证实了结果的稳健性和一致性。在预测能力方面，CVAI 具有最高的 AUC 和 C 指数值。
CVAI 与肾脏损害风险呈线性剂量-反应关系，在预测高血压和 AGM 患者肾脏损害事件方面具有最佳表现。CVAI 可能是识别肾脏损害风险较高患者的可靠指标。
