Chi Yi, Zhang Yiqing, Lin Huang, Zhou Shanshan, Jia Genlin, Wen Wei
Department of Integrative Medicine (Geriatrics), The People's Hospital Medical Group of Xiangzhou, Zhuhai, China.
Department of Spleen and Gastroenteritis, Heilongjiang University of Chinese Medicine, Harbin, China.
Front Epidemiol. 2025 Feb 4;4:1503261. doi: 10.3389/fepid.2024.1503261. eCollection 2024.
Obesity is closely associated with lipid metabolism, and the accumulation of lipids leads to low-level inflammation in the body, which can trigger cardiovascular disease. This study aimed to explore the association between a novel marker of lipid accumulation, the abdominal volume index (AVI), inflammatory parameters, and mortality.
This study enrolled 2,109 older adult senior citizens (aged over 60 years) with hypertension from the National Health and Nutrition Examination Survey. The primary endpoints included all-cause mortality and cardiovascular mortality, which were assessed by linking the data to the National Death Index records. Cox regression model and subgroup analysis were constructed to investigate the associations between AVI and both all-cause and cardiovascular mortality. Restricted cubic splines were employed to further explore the relationships among AVI, inflammatory parameters, and mortality. By considering inflammatory factors as mediators, we investigate the mediating effects of AVI on mortality.
After a median follow-up of 69 months, there were 1,260 deaths, with 337 attributed to cardiovascular causes within the older adult population studied. In the multivariable-adjusted model, AVI was positively associated with both all-cause and cardiovascular mortality [Hazard Ratio (HR) = 1.09, 95% CI = 1.06-1.11 for all-cause mortality; HR = 1.07, 95% CI = 1.03-1.12 for cardiovascular mortality]. Kaplan-Meier survival plots indicated an overall median survival time of 144 months. Mediation analysis revealed that Systemic Inflammatory Response Index (SIRI), Monocyte-to-HDL ratio (MHR), and Neutrophil-to-Lymphocyte ratio (NLR) mediated 27.15%, 35.15%, and 16.55%, respectively, of the association between AVI and all-cause mortality.
AVI is positively associated with all-cause mortality in older adults with hypertension, and this association appears to be partially mediated by inflammatory parameters.
肥胖与脂质代谢密切相关，脂质的积累会导致体内低度炎症，进而引发心血管疾病。本研究旨在探讨一种新的脂质积累标志物——腹部容积指数（AVI）、炎症参数与死亡率之间的关联。
本研究纳入了来自美国国家健康与营养检查调查的2109名60岁以上患有高血压的老年公民。主要终点包括全因死亡率和心血管死亡率，通过将数据与国家死亡指数记录相链接来进行评估。构建Cox回归模型和亚组分析，以研究AVI与全因死亡率和心血管死亡率之间的关联。采用限制立方样条进一步探讨AVI、炎症参数与死亡率之间的关系。通过将炎症因子视为中介变量，我们研究了AVI对死亡率的中介作用。
在中位随访69个月后，在所研究的老年人群中有1260人死亡，其中337人死于心血管疾病。在多变量调整模型中，AVI与全因死亡率和心血管死亡率均呈正相关[全因死亡率的风险比（HR）=1.09，95%置信区间（CI）=1.06-1.11；心血管死亡率的HR=1.07，95%CI=1.03-1.12]。Kaplan-Meier生存曲线显示总体中位生存时间为144个月。中介分析显示，全身炎症反应指数（SIRI）、单核细胞与高密度脂蛋白比值（MHR）和中性粒细胞与淋巴细胞比值（NLR）分别介导了AVI与全因死亡率之间关联的27.15%、35.15%和16.55%。
AVI与患有高血压的老年人的全因死亡率呈正相关，且这种关联似乎部分由炎症参数介导。
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