Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China; Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, People's Republic of China.
Department of Biostatistics and Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
Nutr Metab Cardiovasc Dis. 2024 Sep;34(9):2065-2074. doi: 10.1016/j.numecd.2024.05.001. Epub 2024 May 6.
Few researchers have compared the effectiveness of traditional and novel obesity indicators in predicting stroke incidence. We aimed to evaluate the associations between six obesity indices and stroke risk, and to further identify the optimal indicator.
A total of 14,539 individuals from the Rural Chinese Cohort Study were included in the analyses. We used the Cox proportional hazards regression models to evaluate the association between six obesity indices (including body mass index [BMI], waist circumference [WC], conicity index [C-index], lipid accumulation product [LAP], visceral adiposity index [VAI], and Chinese visceral adiposity index [CVAI]) and stroke risk. Receiver operating characteristic curves were employed to compare their predictive ability on stroke risk. During a median follow-up period of 11.13 years, a total of 1257 cases of stroke occurred. In the multiple-adjusted Cox regression model, WC, BMI, C-index, and CVAI were positively associated with ischemic stroke (P < 0.01) rather than hemorrhagic stroke risk. Dose-response analyses showed a linear correlation of WC, BMI, C-index, and LAP (P <0.05, and P >0.05), but a non-linear correlation of CVAI (P <0.05, and P <0.05) with the risk of ischemic stroke. CVAI demonstrates the highest areas under the curves (AUC: 0.661, 95% CI: 0.653-0.668), indicating a superior predictive ability for ischemic stroke occurrence compared to other five indices (P < 0.001).
WC, BMI, C-index, LAP, and CVAI were all positively related to the risk of ischemic stroke, among which CVAI exhibited stronger predictive ability for ischemic stroke.
很少有研究比较传统和新型肥胖指标在预测卒中发病方面的有效性。本研究旨在评估六种肥胖指数与卒中风险的相关性,并进一步确定最佳指标。
本研究共纳入了来自农村中国队列研究的 14539 名参与者。我们使用 Cox 比例风险回归模型评估了六种肥胖指数(包括体重指数[BMI]、腰围[WC]、锥形指数[C-index]、脂质蓄积产物[LAP]、内脏脂肪指数[VAI]和中国内脏脂肪指数[CVAI])与卒中风险之间的关系。采用受试者工作特征曲线比较了它们对卒中风险的预测能力。在中位随访 11.13 年期间,共发生 1257 例卒中。在多因素校正的 Cox 回归模型中,WC、BMI、C-index 和 CVAI 与缺血性卒中(P<0.01)而非出血性卒中风险呈正相关。剂量反应分析显示,WC、BMI、C-index 和 LAP 呈线性相关(P<0.05,P>0.05),而 CVAI 呈非线性相关(P<0.05,P<0.05)与缺血性卒中风险相关。CVAI 曲线下面积(AUC)最高(0.661,95%CI:0.653-0.668),表明其对缺血性卒中发生的预测能力优于其他五种指数(P<0.001)。
WC、BMI、C-index、LAP 和 CVAI 均与缺血性卒中风险呈正相关,其中 CVAI 对缺血性卒中的预测能力最强。