ObjectivesThe visceral adiposity index (VAI), an indirect marker of visceral adipose tissue, serves as a model associated with cardiometabolic risk, but has limitations regarding the Asian population. We sought to develop a new VAI (NVAI) for the Korean population and compare it to VAI for prediction of atherosclerotic cardiovascular disease (ASCVD) risk and development of major cardiovascular diseases (CVD) and stroke.MethodsPatients (969) who underwent visceral fat area measurement were analyzed. After exclusion, 539 patients (142 men, 397 women) were randomly divided into internal (n = 374) and external validation (n = 165) data set. The NVAI was developed using univariate and multivariate logistic regression with backward selection of predictors. Receiver operating characteristic (ROC) curve analysis and comparison of the area under the curve (AUC) verified the better predictor of ASCVD risk score. Additionally, nationwide population-based cross-sectional survey data (Korean National Health and Nutrition Examination Survey [KNHANES] 2008–2010, n = 29,235) was used to validate the NVAI’s ability to predict ASCVD risk and major CVD and stroke.ResultsThe NVAI better reflected visceral fat area in internal and external data sets, with AUCs of 0.911 (95% confidence interval [CI]: 0.882–0.940) and 0.879 (95% CI: 0.828–0.931), respectively. NVAI better discriminated for ASCVD risk (AUC = 0.892, 95% CI: 0.846–0.938) compared to VAI (0.559, 95% CI: 0.439–0.679). The NVAI also better predicted MI or angina, and stroke with AUCs of 0.771 (95% CI: 0.752–0.789), and 0.812 (95% CI: 0.794–0.830), respectively, compared with waist circumference (WC), body mass index (BMI), TG to HDL ratio, and VAI via KNHANES, in a statistically significant manner.ConclusionsThe NVAI has advantages as a predictor of visceral obesity and is significantly associated with ASCVD risks and development of major CVD and stroke in the Korean population. The NVAI could be a screening tool for improved risk estimation related to visceral obesity.
We investigated the relationship between the basal metabolic rate (BMR) and muscle strength through measurement of handgrip strength. We conducted a cross-sectional study of a population representative of older Korean from the 2014–2016 Korean National Health and Nutrition Examination Survey. A total of 2512 community-dwelling men and women aged 65 years and older were included. The BMR was calculated with the Singapore equation and handgrip strength was measured using a digital dynamometer. The patients were categorized into handgrip strength quartiles and a weighted one-way analysis of variance (ANOVA) for continuous variables and a weighted chi-squared test for categorical variables were performed. Pearson, Spearman correlation analysis, univariate, and multivariate linear regression were performed. Analysis of covariance (ANCOVA) was also performed to determine the association between basal metabolic rate and handgrip strength quartiles after adjusting for confounding factors. The BMR increased according to handgrip strength quartile after adjusting for age, BMI, relative fat mass, comorbidity number, resistance exercise, aerobic physical activity, household income, educational level, smoking status, and alcohol ingestion in both sexes (p < 0.001). Handgrip strength has a positive association with the BMR in older Korean people. Therefore, muscle strength exercises should be considered for regulating the BMR in the older people.
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