Wen Song, Huang Xingjie, Huang Zehan, Zhang Xinjie, Dai Chang, Han Feihuang, Zheng Weidong, Wang Feng, Chen Shubo, Zhang Bin, Huang Yuqing
Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, 510080, Guangdong, China.
Department of Cardiology, The Second Affiliated Hospital of Guilin Medical University, Guilin, 541000, Guangxi, China.
Diabetol Metab Syndr. 2024 Sep 14;16(1):228. doi: 10.1186/s13098-024-01460-3.
The relationship between changes in Chinese visceral adiposity index (CVAI) and cardiometabolic diseases (CMD) in middle-aged and elderly individuals remains unclear. This study aimed to explore whether changes in the CVAI were associated with CMD incidence.
This study included 3,243 individuals aged over 45 years from the China Health and Retirement Longitudinal Study. The exposures were changes in the CVAI and cumulative CVAI from 2012 to 2015. Changes in the CVAI were classified using K-means clustering analysis, and the cumulative CVAI was calculated as follows: (CVAI + CVAI)/2 × time (2015-2012). Multivariable logistic regression models were used to assess the relationship between different CVAI change classes and CMD incidence. Restricted cubic splines regression was used to assess the dose-response relationship between cumulative CVAI and CMD incidence. To investigate the relationship between combined exposure to each component of CAVI and CMD incidence, a weighted quantile sum regression analysis was employed.
During the 5 years of follow-up, 776 (24%) incident CMD cases were identified. Changes in CVAI and cumulative CVAI were independently and positively associated with CMD. After adjusting for potential confounders, compared with Class 1, the adjusted ORs (95% CIs) for incident CMD were 1.18 (0.90-1.57) for Class 2, 1.40 (1.03-1.92) for Class 3, and 1.56 (1.04-2.34) for Class 4. When cumulative CVAI was categorized into quartiles, compared with Q1, the adjusted ORs (95% CIs) for incident CMD were 1.30 (1.00-1.70) for Q2, 1.34 (1.01-1.79) for Q3, and 1.63 (1.15-2.31) for Q4. In addition, cumulative CVAI in the overall population exhibited a linear association with CMD (P = 0.012, P = 0.287), diabetes (P = 0.022, P = 0.188), and stroke (P = 0.002, P = 0.978), but showed no significant association with heart disease (P = 0.619, P = 0.442).
Participants with higher baseline CVAI level and a change of elevating CVAI level may suffer an increased incidence of CMD. Furthermore, our findings elucidate the underlying mechanisms of the CVAI by highlighting TG as the primary contributor to the observed associations. Long-term CVAI monitoring is of significant importance for early identification and prevention of CMD, with significant implications for clinical practice.
中国内脏脂肪指数（CVAI）变化与中老年人心血管代谢疾病（CMD）之间的关系尚不清楚。本研究旨在探讨CVAI变化是否与CMD发病率相关。
本研究纳入了来自中国健康与养老追踪调查的3243名45岁以上个体。暴露因素为2012年至2015年期间CVAI的变化及累积CVAI。CVAI的变化采用K均值聚类分析进行分类，累积CVAI的计算方法如下：（CVAI+CVAI）/2×时间（2015 - 2012）。采用多变量逻辑回归模型评估不同CVAI变化类别与CMD发病率之间的关系。采用受限立方样条回归评估累积CVAI与CMD发病率之间的剂量反应关系。为研究CAVI各成分联合暴露与CMD发病率之间的关系，采用加权分位数和回归分析。
在5年的随访期间，共识别出776例（24%）新发CMD病例。CVAI的变化及累积CVAI与CMD独立且呈正相关。在调整潜在混杂因素后，与第1类相比，第2类、第3类和第4类新发CMD的调整后比值比（95%置信区间）分别为1.18（0.90 - 1.57）、1.40（1.03 - 1.92）和1.56（1.04 - 2.34）。当将累积CVAI分为四分位数时，与第一四分位数相比，第二、第三和第四四分位数新发CMD的调整后比值比（95%置信区间）分别为1.30（1.00 - 1.70）、1.34（1.01 - 1.79）和1.63（1.15 - 2.31）。此外，总体人群中的累积CVAI与CMD（P = 0.012，P = 0.287）、糖尿病（P = 0.022，P = 0.188）和中风（P = 0.002，P = 0.978）呈线性关联，但与心脏病无显著关联（P = 0.619，P = 0.442）。
基线CVAI水平较高且CVAI水平呈升高变化的参与者可能患CMD的风险增加。此外，我们的研究结果通过强调甘油三酯是观察到的关联的主要促成因素，阐明了CVAI的潜在机制。长期监测CVAI对于早期识别和预防CMD具有重要意义，对临床实践具有重要启示。
