Dose-response association between Chinese visceral adiposity index and cardiovascular disease: a national prospective cohort study.

Chinese visceral adiposity index (CVAI) is a reliable visceral obesity index, but the association between CVAI and risk of cardiovascular disease (CVD) remains unclear. We explored the associations of CVAI with incident CVD, heart disease, and stroke and compared the predictive power of CVAI with other obesity indices based on a national cohort study. The present study included 7,439 participants aged ≥45 years from China Health and Retirement Longitudinal Study (CHARLS). Cox regression models were applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Restricted cubic splines analyses were adopted to model the dose-response associations. Receiver operator characteristic (ROC) analyses were used to compare the predictive ability of different obesity indices (CVAI, visceral adiposity index [VAI], a body shape index [ABSI], conicity index [CI], waist circumference [WC], and body mass index [BMI]). During 7 years' follow-up, 1,326 incident CVD, 1,032 incident heart disease, and 399 stroke cases were identified. The HRs (95% CI) of CVD, heart disease, and stroke were 1.50 (1.25-1.79), 1.29 (1.05-1.57), and 2.45 (1.74-3.45) for quartile 4 versus quartile 1 in CVAI. Linear associations of CVAI with CVD, heart disease, and stroke were observed (P nonlinear >0.05) and per-standard deviation (SD) increase was associated with 17% (HR 1.17, 1.10-1.24), 12% (1.12, 1.04-1.20), and 31% (1.31, 1.18-1.46) increased risk, respectively. Per-SD increase in CVAI conferred higher risk in participants aged<60 years than those aged ≥60 years (P interaction<0.05). ROC analyses showed that CVAI had higher predictive value than other obesity indices (P<0.05). CVAI was linearly associated with risk of CVD, heart disease, and stroke and had best performance for predicting incident CVD. Our findings indicate CVAI as a reliable and applicable obesity index to identify higher risk of CVD.

Ren Y ，Hu Q ，Li Z ，Zhang X ，Yang L ，Kong L ... -  《Frontiers in Endocrinology》

The Chinese visceral adiposity index: a novel indicator more closely related to cardiovascular disease than other abdominal obesity indices among postmenopausal women.

Liu L ，Peng J ，Zang D ，Zhang Y ，Wu Z ，Song C ，Chen S ，Guo D ，Lu F ，Zheng T ，Yang J ... -  《Journal of Translational Medicine》

Association between Chinese visceral adiposity index and risk of stroke incidence in middle-aged and elderly Chinese population: evidence from a large national cohort study.

Abdominal obesity has long been considered as a crucial risk factor of stroke. Chinese visceral adiposity index (CVAI), a novel surrogate indicator of abdominal obesity, has been confirmed as a better predictor for coronary heart disease than other indicators in Asian population. However, the data on the relationship of CVAI with stroke is limited. The objective of our study is evaluating the relationship between CVAI and stroke incidence. In the present study, we enrolled 7242 middle-aged and elderly residents from the China Health and Retirement Longitudinal Study (CHARLS) and placed them into groups according to quartile of CVAI. The outcome of interest was stroke. Kaplan-Meier curves were used to estimate the cumulative incidences of stroke. Cox regression analyses and multivariable-adjusted restricted cubic spline (RCS) curves were performed to evaluate the relationship between CVAI and incident stroke. Multiple sensitivity analyses and subgroups analyses were performed to test the robustness of the findings. During a median 84 months of follow-up, 612 (8.45%) participants experienced incident stroke, and the incidences of stroke for participants in quartiles (Q) 1-4 of CVAI were 4.42%, 7.29%, 9.06% and 13.04%, respectively. In the fully adjusted model, per 1.0-SD increment in CVAI has a significant increased risk of incident stroke: hazard ratio (HR) [95% confidence interval (CI)] was 1.17 (1.07-1.28); compared with participants in Q1 of CVAI, the HRs (95% CI) of incident stroke among those in Q2-4 were 1.47 (1.10-1.95), 1.62 (1.22-2.15), and 1.70 (1.28-2.27), respectively. Subgroups analyses suggested the positive association was significant in male participants, without diabetes, hypertension and heart disease. The findings were robust in all the sensitivity analyses. Additional, RCS curves showed a significant dose-response relationship of CVAI with risk of incident stroke (P for non-linear trend = 0.319). Increased CVAI is significantly associated with higher risk of stroke incidence, especially in male individuals, without hypertension, diabetes and heart disease. The findings suggest that baseline CVAI is a reliable and effective biomarker for risk stratification of stroke, which has far-reaching significance for primary prevention of stroke and public health.

Zhang Z ，Zhao L ，Lu Y ，Meng X ，Zhou X ... -  《Journal of Translational Medicine》

Linear associations of Chinese visceral adiposity index and its change with hyperuricemia: A prospective cohort study.

This study aims to investigate the association of Chinese visceral adiposity index (CVAI) with incident hyperuricemia (HUA). We included 5186 adults aged ≥45 years from China Health and Retirement Longitudinal Study. Modified Poisson regression model was used to estimate the relative risks (RRs) of incident HUA associated with baseline CVAI, and logistic model was used to estimate the odds ratios (ORs) of HUA for CVAI change. Restricted cubic splines analysis was adopted to model the dose-response associations. The area under the receiver operating characteristic curve (AUC) analysis was used to evaluate the predictive value of CVAI. During 4-year follow-up, a total of 510 (9.8%) HUA cases were identified. The RRs (95%CIs) of incident HUA were 3.75 (2.85-4.93) for quartile 4 versus quartile 1 and 1.56 (1.45-1.69) for per-standard deviation increase in baseline CVAI. For the analyses of CVAI change, compared with stable group, participants in decreased group had 34% lower risk (OR 0.66, 95%CI 0.49-0.87) and those in increased group had 35% (1.35, 1.03-1.78) higher risk of HUA. Linear associations of baseline CVAI and its change with HUA were observed (Pnonlinear >0.05). Besides, the AUC value for HUA was 0.654 (0.629-0.679), which was higher than other five obesity indices. Our study found linear associations between baseline CVAI and its change and risk of HUA. CVAI had the best predictive performance in predicting incident HUA. These findings suggest CVAI as a reliable obesity index to identify individuals with higher HUA risk.

Chen J ，Liu X ，Lu S ，Man S ，Zhang L ，Xu X ，Deng W ，Jiang X ... -  《-》

Visceral adiposity measures are strongly associated with cardiovascular disease among female participants in Southwest China: A population-based prospective study.

Controversy remains regarding the prediction effects of different adiposity measure indicators for the risk of cardiovascular disease (CVD). Our study aimed to assess the associations of three traditional anthropometric indicators, namely, waist circumference (WC), waist-to-height ratio (WHtR), and body mass index (BMI) as well as three non-traditional anthropometric indicators, namely, the Chinese visceral adiposity index (CVAI), lipid accumulation product (LAP), and body shape index (ABSI), with the risk of CVD among Southwest Chinese population. Our study was based on the Guizhou Population Health Cohort Study (GPHCS) conducted from 2010 to 2020. A total of 9,280 participants were recruited from 12 areas in Guizhou Province, China, from November 2010 to December 2012, and followed up for major chronic diseases until December 2020. A total of 7,837 individuals with valid data were included in this analysis. The gender-specific associations of WC, WHtR, BMI, CVAI, LAP, and ABSI with CVD were evaluated using Cox proportional hazards models. Receiver operating characteristic (ROC) curve analysis was used to estimate the prediction powers of different indicators for CVD. No association of six indicators with CVD was observed among male participants. Female participants with either WC-based central obesity (HR: 1.82, 95% CI: 1.12-2.97) or WHtR-based central obesity (HR: 1.68, 95% CI: 1.07-2.64) had a higher risk of CVD, after adjusted for age, area, ethnic group, smoking, alcohol drinking, MET, previous history of diabetes, hypertension and dyslipidemia, medication use, and nutraceutical intake. Compared with female participants in the lowest quartile (Q1), those in the highest quartile (Q4) of WHtR (HR: 2.24, 95% CI: 1.17-4.27), CVAI (HR: 3.98, 95% CI: 1.87-8.49), and ABSI (HR: 1.94, 95% CI: 1.06-3.52) had an increased risk for incident CVD. CAVI showed the maximum predictive power of CVD with the biggest AUC of 0.687 (95% CI: 0.654-0.720) compared to other indicators in female participants. Visceral adiposity measures, especially CVAI, are stronger predictive indicators of CVD among female and not male participants in Southwest China. Different anthropometric indexes need to be combined to comprehensively assess health risks.

Wang Y ，Zhao X ，Chen Y ，Yao Y ，Zhang Y ，Wang N ，Liu T ，Fu C ... -  《Frontiers in Endocrinology》