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上海市浦东新区社区人群中中国内脏脂肪指数与卒中发病的关联

Associations between chinese visceral adiposity index and incident stroke among community populations in Pudong New Area, Shanghai.

作者信息

Liu Qingping, Zhou Yi, Wu Kang, Song Jiahui, Ke Juzhong, Qiu Hua, Li Zhitao, Ruan Xiaonan

机构信息

Center for Disease Prevention and Control, Pudong Preventive Medicine Research Institute of Fudan University, Pudong New Area, No. 3039, Zhangyang Road, Shanghai 200136, China.

Center for Disease Prevention and Control, Pudong Preventive Medicine Research Institute of Fudan University, Pudong New Area, No. 3039, Zhangyang Road, Shanghai 200136, China.

出版信息

J Stroke Cerebrovasc Dis. 2025 Jan;34(1):108100. doi: 10.1016/j.jstrokecerebrovasdis.2024.108100. Epub 2024 Nov 8.

Abstract

BACKGROUND

To analyze the relationship between Chinese Visceral Adiposity Index (CVAI) and stroke in Pudong New Area, and to provide a scientific basis for the prevention and treatment of this condition.

MATERIALS AND METHODS

Based on the Follow-up Cohort Program of Chronic Disease Risk Factors in Pudong New Area, a total of 7,194 residents from 12 townships and 35 village committees or neighborhood committees were selected. The cohort data in 2016 served as the baseline, and a follow-up was conducted on 5462 individuals from 2019 to 2020.

RESULTS

In the analysis of stroke incidence, 5,462 subjects were included, with 616 stroke events recorded. The incidence density of stroke was 33.41 per 1000 person-years, while the China standard rate and the world standard rate were 13.78 and 12.52 per 1000 person-years, respectively. The incidence density of stroke rose with increasing quartiles of CVAI. After adjusting for potential confounders, the risk of stroke for males and females with CVAI ≥ 132.11 was 2.492 times (95% CI: 1.457 ∼ 4.260) and 1.759 times (95% CI: 1.070-2.891), respectively, compared to the groups with CVAI < 81.91. Among the eight obesity indicators, including CVAI, Visceral Adiposity Index (VAI), Body Mass Index (BMI), Waist Circumference (WC), Waist Hip Ratio (WHR), Waist Height Ratio (WHtR), Body Adiposity Index (BAI), A Body Shape Index (ABSI),and Body Roundness Index (BRI), CVAI has the highest diagnostic accuracy for female stroke using Receiver Operator Characteristic (ROC) curves (the Area under the ROC curve/AUC = 0.619). Subgroup analysis showed that smoking and dyslipidemia significantly modified the association between CVAI and stroke risk in females (interaction P < 0.05).

CONCLUSIONS

CVAI is identified as a significant risk factor for stroke and serves as a valuable predictor of stroke, particularly in females.

摘要

背景

分析中国内脏脂肪指数(CVAI)与浦东新区脑卒中的关系,为该病的防治提供科学依据。

材料与方法

基于浦东新区慢性病危险因素随访队列项目,选取了来自12个乡镇及35个村委会或居委会的7194名居民。以2016年的队列数据作为基线,并于2019年至2020年对5462名个体进行了随访。

结果

在脑卒中发病率分析中,纳入5462名受试者,记录到616例脑卒中事件。脑卒中的发病密度为每1000人年33.41例,而中国标准率和世界标准率分别为每1000人年13.78例和12.52例。脑卒中的发病密度随CVAI四分位数的增加而升高。在调整潜在混杂因素后,与CVAI<81.91的组相比,CVAI≥132.11的男性和女性发生脑卒中的风险分别为2.492倍(95%CI:1.457~4.260)和1.759倍(95%CI:1.070 - 2.891)。在包括CVAI、内脏脂肪指数(VAI)、体重指数(BMI)、腰围(WC)、腰臀比(WHR)、腰高比(WHtR)、身体脂肪指数(BAI)、身体形状指数(ABSI)和身体圆润度指数(BRI)在内的八项肥胖指标中,使用受试者工作特征(ROC)曲线分析显示,CVAI对女性脑卒中的诊断准确性最高(ROC曲线下面积/AUC = 0.619)。亚组分析表明,吸烟和血脂异常显著改变了女性中CVAI与脑卒中风险之间的关联(交互作用P<0.05)。

结论

CVAI被确定为脑卒中的重要危险因素,是脑卒中的一个有价值的预测指标,尤其是在女性中。

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