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Wang X, Si Z, Wang H, Meng R, Lu H, Zhao Z, Hu J, Wang H, Chen J, Zheng Y, Zheng Z, Chen Y, Yang Y, Li X, Xue L, Sun J, Wu J. Association of Chinese Visceral Adiposity Index and Carotid Atherosclerosis in Steelworkers: A Cross-Sectional Study. Nutrients 2023; 15:nu15041023. [PMID: 36839381 PMCID: PMC9964603 DOI: 10.3390/nu15041023] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 02/16/2023] [Accepted: 02/17/2023] [Indexed: 02/22/2023] Open
Abstract
The Chinese Visceral Adiposity Index (CVAI) is an indicator of visceral adiposity dysfunction used to evaluate the metabolic health of the Chinese population. Steelworkers are more likely to be obese due to their exposure to special occupational factors, and have a higher prevalence of carotid atherosclerosis (CAS). This study aimed to analyze the special relationship between CVAI and CAS among steelworkers. A total of 4075 subjects from a northern steel company were involved in the cross-sectional study. Four logistic regression models were developed to analyze the correlation between CVAI and CAS. In addition, the restricted cubic spline was applied to fit the dose-response association between CVAI and CAS risk. In the study, the prevalence of CAS was approximately 25.94%. After adjustment for potential confounders, we observed a positive correlation between CVAI and CAS risk. Compared to the first CVAI quartile, the effect value odds ratio (OR) and 95% CI in the second, third, and fourth CVAI quartile were 1.523 (1.159-2.000), 2.708 (2.076-3.533), and 4.101 (3.131-5.372), respectively. Additionally, this positive correlation was stable in all subgroups except for female. Furthermore, we also found a non-linear relationship between CVAI and CAS risk (p nonlinear < 0.05). Notably, CVAI could increase the risk of CAS when higher than 106. In conclusion, our study showed that CVAI might be a reliable indicator to identify high-risk populations of CAS among steelworkers.
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Affiliation(s)
- Xuelin Wang
- Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, No. 21 Bohai Avenue, Caofeidian New Town, Tangshan 063210, China
| | - Zhikang Si
- Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, No. 21 Bohai Avenue, Caofeidian New Town, Tangshan 063210, China
| | - Hui Wang
- Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, No. 21 Bohai Avenue, Caofeidian New Town, Tangshan 063210, China
| | - Rui Meng
- Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, No. 21 Bohai Avenue, Caofeidian New Town, Tangshan 063210, China
| | - Haipeng Lu
- Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, No. 21 Bohai Avenue, Caofeidian New Town, Tangshan 063210, China
| | - Zekun Zhao
- Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, No. 21 Bohai Avenue, Caofeidian New Town, Tangshan 063210, China
| | - Jiaqi Hu
- Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, No. 21 Bohai Avenue, Caofeidian New Town, Tangshan 063210, China
| | - Huan Wang
- Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, No. 21 Bohai Avenue, Caofeidian New Town, Tangshan 063210, China
| | - Jiaqi Chen
- Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, No. 21 Bohai Avenue, Caofeidian New Town, Tangshan 063210, China
| | - Yizhan Zheng
- Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, No. 21 Bohai Avenue, Caofeidian New Town, Tangshan 063210, China
| | - Ziwei Zheng
- Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, No. 21 Bohai Avenue, Caofeidian New Town, Tangshan 063210, China
| | - Yuanyu Chen
- Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, No. 21 Bohai Avenue, Caofeidian New Town, Tangshan 063210, China
| | - Yongzhong Yang
- Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, No. 21 Bohai Avenue, Caofeidian New Town, Tangshan 063210, China
| | - Xiaoming Li
- Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, No. 21 Bohai Avenue, Caofeidian New Town, Tangshan 063210, China
| | - Ling Xue
- Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, No. 21 Bohai Avenue, Caofeidian New Town, Tangshan 063210, China
| | - Jian Sun
- Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, No. 21 Bohai Avenue, Caofeidian New Town, Tangshan 063210, China
- Correspondence: (J.S.); (J.W.)
| | - Jianhui Wu
- Key Laboratory of Coal Mine Health and Safety of Hebei Province, School of Public Health, North China University of Science and Technology, No. 21 Bohai Avenue, Caofeidian New Town, Tangshan 063210, China
- Correspondence: (J.S.); (J.W.)
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Associations of the Cardiometabolic Index with the Risk of Cardiovascular Disease in Patients with Hypertension and Obstructive Sleep Apnea: Results of a Longitudinal Cohort Study. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:4914791. [PMID: 35783191 PMCID: PMC9246614 DOI: 10.1155/2022/4914791] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/08/2022] [Accepted: 05/25/2022] [Indexed: 11/22/2022]
Abstract
Purpose We aimed to explore the relationship between the cardiometabolic index (CMI) and cardiovascular disease (CVD) and its subtypes (coronary artery disease and stroke) in patients with hypertension and obstructive sleep apnea (OSA). Methods We conducted a retrospective cohort study enrolling 2067 participants from the Urumqi Research on Sleep Apnea and Hypertension study. The CMI was calculated as triglyceride to high‐density lipoprotein cholesterol ratio × waist‐to‐height ratio. Participants were divided into three groups (T1, T2, and T3) according to the tertile of CMI. The Kaplan-Meier method helped to calculate the cumulative incidence of CVD in different groups. We assessed the association of CMI with the risk of CVD and CVD subtypes by estimating hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox models. Results During a median follow-up of 6.83 years (interquartile range: 5.92-8.00 years), 326 incident CVD were identified, including 121 incident stroke and 205 incident coronary heart disease (CHD). Overall, after adjusting for confounding variables, CMI was positively associated with the risk of new-onset CVD (per SD increment, adjusted HR: 1.31; 95% CI: 1.20, 1.43), new-onset CHD (per SD increment, adjusted HR: 1.33; 95% CI: 1.20, 1.48), and new-onset stroke (per SD increment, adjusted HR: 1.27; 95% CI: 1.10, 1.47). Similar results were obtained in various subgroup and sensitivity analyses. Adding CMI to the baseline risk model for CVD improved the C-index (P < 0.001), continuous net reclassification improvement (P < 0.001), and integrated discrimination index (P < 0.001). Similar results were observed for CHD and stroke. Conclusion There was a positive association between CMI levels and the risk of new-onset CVD in patients with hypertension and OSA. This finding suggests that CMI may help identify people at high risk of developing CVD.
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Cai X, Li N, Hu J, Wen W, Yao X, Zhu Q, Heizhati M, Hong J, Sun L, Tuerxun G, Zhang D, Luo Q. Nonlinear Relationship Between Chinese Visceral Adiposity Index and New-Onset Myocardial Infarction in Patients with Hypertension and Obstructive Sleep Apnoea: Insights from a Cohort Study. J Inflamm Res 2022; 15:687-700. [PMID: 35140499 PMCID: PMC8819537 DOI: 10.2147/jir.s351238] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 01/15/2022] [Indexed: 12/13/2022] Open
Abstract
Purpose We aimed to investigate the relationship between the Chinese visceral adiposity index (CVAI) and the risk of new-onset myocardial infarction (MI) in patients with hypertension and obstructive sleep apnoea (OSA) and to inspect possible modifiers of the effect. Methods The Cox regression model was used to evaluate the relationship between baseline CVAI and risk of new-onset MI. A generalized additive model was used to identify the nonlinear relationship. Besides, we conducted subgroup analyses and interaction tests. Results A total of 2177 patients with hypertension and OSA undergoing polysomnography were enrolled in this study. During a median follow-up period of 87 months, 82 participants developed new-onset MI. Overall, CVAI was positively related to the risk of new-onset MI (per 1 SD increase; HR = 1.54, 95% CI: 1.28–1.85). In multivariable-adjusted models, the risk of new-onset MI increased with quartiles of CVAI, with an HR of 3.64 (95% CI: 1.94–6.83) for quartile 4 compared with quartile 1. The generalized additive model and smoothed curve fit revealed a nonlinear relationship between CVAI and risk of new-onset MI with an inflection point of approximately 112. None of the stratification variables had a significant effect on the relationship between CVAI and new-onset MI. Similar outcomes were observed in the sensitivity analysis. The addition of CVAI significantly improved reclassification and discrimination over the conventional model, with a category-free NRI of 0.132 (95% CI 0.021 to 0.236, P = 0.021) and an IDI of 0.012 (95% CI 0.005 to 0.023, P < 0.001). Conclusion This study demonstrated a nonlinear relationship between CVAI and the risk of new-onset MI in patients with hypertension and OSA. Higher CVAI was significantly associated with the risk of new-onset MI when CVAI was ≥112.
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Affiliation(s)
- Xintian Cai
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
- Graduate School, Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
| | - Nanfang Li
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
- Correspondence: Nanfang Li, Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China, Email
| | - Junli Hu
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
| | - Wen Wen
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
- Graduate School, Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
| | - Xiaoguang Yao
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
| | - Qing Zhu
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
- Graduate School, Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
| | - Mulalibieke Heizhati
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
| | - Jing Hong
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
| | - Le Sun
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
| | - Guzailinuer Tuerxun
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
| | - Delian Zhang
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
| | - Qin Luo
- Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People’s Republic of China
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Lin M, Li N, Heizhati M, Gan L, Zhu Q, Yao L, Li M, Yang W. Chinese Visceral Adiposity Index Is Associated With Incident Renal Damage in Patients With Hypertension and Abnormal Glucose Metabolism: A Longitudinal Study. Front Endocrinol (Lausanne) 2022; 13:910329. [PMID: 35909550 PMCID: PMC9329673 DOI: 10.3389/fendo.2022.910329] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 06/15/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To evaluate the association between Chinese visceral adiposity index (CVAI) and incident renal damage and compared its predictive power with that of other visceral obesity indices in patients with hypertension and abnormal glucose metabolism (AGM). METHODS This retrospective cohort consecutively included patients with hypertension and AGM who did not have renal damage at baseline. Renal damage was defined using the estimated glomerular filtration rate (eGFR) and urine protein. Multivariable Cox regression analysis was used to evaluate the association between CVAI and incident renal damage. Restricted cubic splines were used to determine the shape of the association. The predictive power of the CVAI was examined and directly compared with other indices, including the VAI, body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR), using the area under the receiver operating characteristic curve (AUC) and C-index. RESULTS In total, 2,033 patients with hypertension and AGM were included. During a median follow-up of 2.6 years, the incidence of renal damage was 31.5, 48.9, 56.8, and 67.5/1,000 person-years across the quartiles of CVAI. Compared with the first quartile, the risk of renal damage was higher in the second (hazard ratio (HR) = 1.36 [95% CI: 0.93-1.97]), third (HR = 1.57 [95% CI: 1.09-2.27]), and fourth (HR = 1.65 [95% CI: 1.11-2.44]) quartiles (p for trend = 0.011). A linear dose-response association was observed. Sensitivity and subgroup analyses confirmed the robustness and consistency of the results. In terms of predictive power, the CVAI had the highest AUC and C-index values. CONCLUSIONS CVAI is positively associated with renal damage risk in a linear dose-response pattern and has the best performance in predicting incident renal damage in patients with hypertension and AGM. The CVAI may serve as a reliable indicator for identifying patients at a high risk of renal damage.
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