Elevated Chinese visceral adiposity index increases the risk of stroke in Chinese patients with metabolic syndrome

Abstract

IntroductionPatients with Metabolic Syndrome (MetS) are considered at high-risk for incident stroke. An indicator of visceral adiposity dysfunction, the Chinese Visceral Adiposity Index (CVAI) is used to evaluate the dysfunction of visceral fat. Given the impact of visceral adiposity dysfunction on elevating cardiovascular hazards, this study aimed to examine the association between CVAI and stroke risk in MetS patients.MethodBetween November 2017 and December 2018, a total of 18,974 individuals aged ≥40 underwent standardized in-person clinical interviews in Hunan Province, with 6,732 meeting the criteria for MetS. After the baseline survey was completed, subsequent surveys were conducted biennially. The study was split into two stages performed at baseline and after two years. During the former, receiver-operating characteristic curves were used to assess the accuracy of using baseline CVAI in diagnosing MetS. After two years, we examined the association between CVAI and incident stroke in MetS patients using logistic regression, subgroup analysis, and restricted cubic spline (RCS) analysis.ResultAs evidenced by a higher AUC (AUC:0.741), CVAI demonstrated superior diagnostic performance relative to body mass index (AUC:0.631) and waist circumference (AUC:0.627) in diagnosing MetS. After a 2-year follow-up, 72 MetS patients had a stroke event. There was a robust positive correlation between incident stroke and CVAI in patients with MetS. Each 1 SD increase in CVAI was associated with a 1.52-fold higher risk of stroke after adjustment for confounding factors (aOR=1.52, 95%CI: 1.18-1.95). The RCS demonstrated a reduced risk of stroke for MetS patients when the CVAI was below 110.91. However, no significant correlation was detected between CVAI and stroke in non-MetS patients.ConclusionOur findings recommend CVAI as a superior screening tool for detecting MetS and suggest that reducing CVAI can mitigate the risk of stroke in patients with MetS.

The association between Chinese visceral adiposity index and cardiometabolic multimorbidity among Chinese middle-aged and older adults: a national cohort study

“…In a cohort study involving more than 2,000 patients with type 2 diabetes, elevated CVAI was found to increase the risk of cardiovascular events ( 28 ). Additionally, the risk of stroke in patients with metabolic syndrome increased with increased CVAI ( 29 ). A cross-sectional study of Chinese older adults showed a linear association between CVAI and the prevalence of hypertension and diabetes mellitus ( 30 ).…”

Comparison of seven surrogate insulin resistance indexes for predicting the prevalence of carotid atherosclerosis in normal-weight individuals

“…Physical inactivity refers to the absence of moderate-to-vigorous physical activity for >150 min/week or vigorous-intensity physical activity for >75 min/week ( 31 ). Diabetes was defined as a fasting plasma glucose level of ≥7.0 mmol/L, a previous diagnosis of diabetes mellitus, or the use of antidiabetic medication or insulin ( 32 ). Hypertension was defined as a blood pressure of ≥140/90 mmHg, a history of hypertension, or the use of antihypertensive medication ( 32 ).…”

“…Diabetes was defined as a fasting plasma glucose level of ≥7.0 mmol/L, a previous diagnosis of diabetes mellitus, or the use of antidiabetic medication or insulin ( 32 ). Hypertension was defined as a blood pressure of ≥140/90 mmHg, a history of hypertension, or the use of antihypertensive medication ( 32 ). Dyslipidemia was defined as serum total cholesterol (TC) concentration ≥ 6.22 mmol/L, and/or low-density lipoprotein cholesterol (LDL-C) concentration ≥ 4.14 mmol/L, and/or TG concentration ≥ 2.26 mmol/L, and/or HDL-C concentration < 1.04 mmol/L, or previous history of hyperlipidemia ( 32 ).…”

“…Hypertension was defined as a blood pressure of ≥140/90 mmHg, a history of hypertension, or the use of antihypertensive medication ( 32 ). Dyslipidemia was defined as serum total cholesterol (TC) concentration ≥ 6.22 mmol/L, and/or low-density lipoprotein cholesterol (LDL-C) concentration ≥ 4.14 mmol/L, and/or TG concentration ≥ 2.26 mmol/L, and/or HDL-C concentration < 1.04 mmol/L, or previous history of hyperlipidemia ( 32 ). The height, weight, and WC were measured twice by a qualified nurse or physician and the results were averaged.…”

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

“…To date, there are only four studies reported the higher CVAI was longitudinally associated with increased incidence of stroke [ 25 – 28 ]. However, participants of the one study were recruited from only one province of China [ 25 ], study conducted by Zhao et al only included participants from rural areas [ 26 ], another study recruited participants from community-dwelling population in Suzhou [ 27 ], while a recent study included patients from clinical interview in Hunan Province [ 28 ], which may not draw nationally representative results and affect the generalization of the findings. More importantly, the results from the four studies were inconsistent [ 25 – 28 ].…”