Department of Neurosurgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, 150001, China.
Lipids Health Dis. 2023 Jun 19;22(1):74. doi: 10.1186/s12944-023-01843-x.
Stroke represents the second most prevalent contributor to global mortality. The Chinese Visceral Adiposity Index (CVAI) serves as an established metric for assessing visceral adiposity in the Chinese population, exhibiting prognostic capabilities. This investigation aimed to explore the association of CVAI and new-onset stroke among middle-aged and older Chinese populations.
The study employed data from the 2011 and 2018 China Health and Retirement Longitudinal Study (CHARLS) to assess the association of CVAI and the incidence of new-onset stroke. Utilizing a directed acyclic graph (DAG), 10 potential confounders were identified. Moreover, to explore the association between CVAI and new-onset stroke, three multifactor logistic regression models were constructed, accounting for the identified confounders and mitigating their influence on the findings.
The study comprised 7070 participants, among whom 417 (5.9%) experienced new-onset strokes. After controlling for confounding variables, regression analysis suggested that the new-onset stroke's highest risk was linked to the fourth quartile (Q4) of the CVAI, with an odds ratio (OR) of 2.33 and a 95% confidence interval (CI) of 1.67-3.28. The decision tree analysis demonstrated a heightened probability of new-onset stroke among hypertensive individuals with a CVAI equal to or greater than 83, coupled with a C-reactive protein level no less than 1.1 mg/l. Age seemed to have a moderating influence on the CVAI and new-onset stroke association, exhibiting a more prominent interaction effect in participants under 60 years.
In middle-aged and older Chinese populations, a linear relationship was discerned between CVAI and the probability of new-onset stroke. CVAI provides a predictive framework for stroke incidence in this demographic, laying the groundwork for more sophisticated risk prediction models that improve the precision and specificity of stroke risk evaluations.
中风是全球第二大致死原因。中国内脏脂肪指数（CVAI）是评估中国人群内脏脂肪的既定指标，具有预后能力。本研究旨在探讨 CVAI 与中国中年及以上人群新发中风的关系。
本研究采用 2011 年和 2018 年中国健康与退休纵向研究（CHARLS）的数据，评估 CVAI 与新发中风的关系。利用有向无环图（DAG），确定了 10 个潜在的混杂因素。此外，为了探讨 CVAI 与新发中风的关系，构建了三个多因素逻辑回归模型，考虑了确定的混杂因素，并减轻了它们对结果的影响。
本研究共纳入 7070 名参与者，其中 417 名（5.9%）发生了新发中风。在校正混杂因素后，回归分析表明，CVAI 第四四分位数（Q4）与新发中风的最高风险相关，优势比（OR）为 2.33，95%置信区间（CI）为 1.67-3.28。决策树分析表明，在 CVAI 等于或大于 83 且 C-反应蛋白水平不低于 1.1mg/L 的高血压患者中，新发中风的可能性更高。年龄似乎对 CVAI 和新发中风的关系有调节作用，在 60 岁以下的参与者中表现出更明显的交互作用。
在中年及以上的中国人群中，CVAI 与新发中风的概率呈线性关系。CVAI 为该人群的中风发病率提供了预测框架，为更复杂的风险预测模型奠定了基础，提高了中风风险评估的准确性和特异性。
