Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
Clin Cardiol. 2023 Mar;46(3):310-319. doi: 10.1002/clc.23976. Epub 2023 Jan 18.
Obesity is an important risk factor for heart failure (HF).
Visceral adiposity index (VAI) is a simple metric for assessing obesity; however, the association between VAI and risk for HF has not been studied.
A cross-sectional study involving 28 764 participants ≥18 years of age from the National Health and Nutrition Examination Survey (NHANES), 2009-2018, in the United States was performed. VAI was calculated using body mass index (BMI), waist circumference (WC), triglycerides (TG), and high-density lipoprotein cholesterol. VAI was analyzed as a continuous and categorical variable to examine its association with HF. Subgroup analysis was also performed.
The highest VAI (fourth quartile [Q4]) was found among males, BMI, systolic and diastolic blood pressure, WC, hypertension, diabetes, liver disease, coronary heart disease, smoking, total cholesterol, and TG. More participants in Q4 took β-receptor blockers, angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers/angiotensin receptor-neprilysin inhibitor, calcium channel blockers, and antidiabetic and antihyperlipidemic medications. Participants with HF exhibited greater VAI. A per-unit increase in VAI resulted in a 4% increased risk for HF (odds ratio [OR] 1.04 [95% confidence interval (CI) 1.02-1.05]). After multivariable adjustment, compared with the lowest quartile, the OR for Q3 was 1.55 (95% CI 1.24-1.94). Subgroup analysis revealed no significant interactions between VAI and specific subgroups.
VAI was independently associated with the risk for HF. As a noninvasive index of visceral adiposity, VAI could be used for a "one shot" assessment of HF risk and may serve as a novel marker.
肥胖是心力衰竭(HF)的一个重要危险因素。
内脏脂肪指数(VAI)是评估肥胖的一种简单指标;然而,VAI 与 HF 风险之间的关系尚未得到研究。
在美国进行了一项横断面研究,纳入了 2009 年至 2018 年全国健康和营养检查调查(NHANES)中≥18 岁的 28764 名参与者。使用体重指数(BMI)、腰围(WC)、甘油三酯(TG)和高密度脂蛋白胆固醇计算 VAI。VAI 被分析为连续和分类变量,以检查其与 HF 的关系。还进行了亚组分析。
男性、BMI、收缩压和舒张压、WC、高血压、糖尿病、肝病、冠心病、吸烟、总胆固醇和 TG 的第四四分位数(Q4)VAI 最高。更多的 Q4 参与者服用β受体阻滞剂、血管紧张素转换酶抑制剂/血管紧张素 II 受体阻滞剂/血管紧张素受体脑啡肽酶抑制剂、钙通道阻滞剂以及抗糖尿病和抗高血脂药物。HF 患者的 VAI 更高。VAI 每增加一个单位,HF 的风险增加 4%(优势比 [OR] 1.04 [95%置信区间(CI)1.02-1.05])。在多变量调整后,与最低四分位相比,Q3 的 OR 为 1.55(95% CI 1.24-1.94)。亚组分析显示,VAI 与特定亚组之间没有显著的相互作用。
VAI 与 HF 风险独立相关。作为一种非侵入性的内脏脂肪指数,VAI 可用于 HF 风险的“一次性”评估,并且可能是一种新的标志物。