Department of Endocrinology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, China.
Department of General Practice, Community Health Service Center Xiayang Street, Shanghai, China.
Front Endocrinol (Lausanne). 2024 Mar 27;15:1381949. doi: 10.3389/fendo.2024.1381949. eCollection 2024.
This study aimed to explore the association between the Chinese visceral adiposity index (CVAI) and cardiometabolic multimorbidity in middle-aged and older Chinese adults.
The data used in this study were obtained from a national cohort, the China Health and Retirement Longitudinal Study (CHARLS, 2011-2018 wave). The CVAI was measured using previously validated biomarker estimation formulas, which included sex, age, body mass index, waist circumference, triglycerides, and high-density lipoprotein cholesterol. The presence of two or more of these cardiometabolic diseases (diabetes, heart disease, and stroke) is considered as cardiometabolic multimorbidity. We used Cox proportional hazard regression models to examine the association between CVAI and cardiometabolic multimorbidity, adjusting for a set of covariates. Hazard ratios (HRs) and 95% confidence intervals (CIs) were used to show the strength of the associations. We also conducted a subgroup analysis between age and sex, as well as two sensitivity analyses. Receiver operator characteristic curves (ROC) were used to test the predictive capabilities and cutoff value of the CVAI for cardiometabolic multimorbidity.
A total of 9028 participants were included in the final analysis, with a mean age of 59.3 years (standard deviation: 9.3) and women accounting for 53.7% of the sample population. In the fully-adjusted model, compared with participants in the Q1 of CVAI, the Q3 (HR = 2.203, 95% CI = 1.039 - 3.774) and Q4 of CVAI (HR = 3.547, 95% CI = 2.100 - 5.992) were associated with an increased risk of cardiometabolic multimorbidity. There was no evidence of an interaction between the CVAI quartiles and sex or age in association with cardiometabolic multimorbidity (0.05). The results of both sensitivity analyses suggested that the association between CVAI and cardiometabolic multimorbidity was robust. In addition, the area under ROC and ideal cutoff value for CVAI prediction of cardiometabolic multimorbidity were 0.685 (95% CI = 0.649-0.722) and 121.388.
The CVAI is a valid biomarker with good predictive capability for cardiometabolic multimorbidity and can be used by primary healthcare organizations in the future for early warning, prevention, and intervention with regard to cardiometabolic multimorbidity.
本研究旨在探讨中国内脏脂肪指数（CVAI）与中老年中国人代谢相关心血管疾病多种病症的关联。
本研究使用了来自全国性队列研究——中国健康与养老追踪调查（CHARLS，2011-2018 年）的数据。CVAI 通过先前验证的生物标志物估算公式进行测量，其中包括性别、年龄、体重指数、腰围、甘油三酯和高密度脂蛋白胆固醇。存在两种或多种这些代谢相关疾病（糖尿病、心脏病和中风）被认为是代谢相关心血管疾病多种病症。我们使用 Cox 比例风险回归模型，在调整了一系列协变量后，检验 CVAI 与代谢相关心血管疾病多种病症之间的关联。风险比（HR）和 95%置信区间（CI）用于显示关联的强度。我们还进行了年龄和性别亚组分析以及两种敏感性分析。接收器操作特征曲线（ROC）用于检验 CVAI 对代谢相关心血管疾病多种病症的预测能力和截断值。
共有 9028 名参与者被纳入最终分析，平均年龄为 59.3 岁（标准差：9.3），女性占样本的 53.7%。在完全调整的模型中，与 CVAI Q1 组相比，Q3（HR=2.203，95%CI=1.039-3.774）和 Q4（HR=3.547，95%CI=2.100-5.992）组发生代谢相关心血管疾病多种病症的风险增加。CVAI 四分位数与性别或年龄之间没有证据表明存在交互作用与代谢相关心血管疾病多种病症相关（0.05）。两种敏感性分析的结果均表明，CVAI 与代谢相关心血管疾病多种病症之间的关联是稳健的。此外，ROC 曲线下面积和 CVAI 预测代谢相关心血管疾病多种病症的理想截断值分别为 0.685（95%CI=0.649-0.722）和 121.388。
CVAI 是一种有效的生物标志物，对代谢相关心血管疾病多种病症具有良好的预测能力，未来可被基层医疗机构用于代谢相关心血管疾病多种病症的早期预警、预防和干预。
