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中国人内脏脂肪指数与中老年人群脑卒中发病风险的前瞻性关联

Prospective Association Between Chinese Visceral Adiposity Index and Risk of Stroke Incidence in Middle-aged and Elderly Chinese Population

    摘要
  • 摘要:
    目的 利用中国健康与养老追踪调查(China Health and Retirement Longitudinal Study, CHARLS)数据，分析中国人内脏脂肪指数(Chinese visceral adiposity index, CVAI)与中老年人群(≥45岁)脑卒中发病风险的关系。
    方法 对2015年、2018年和2020年CHARLS数据库中的中老年人数据进行分析，以随访期内新发脑卒中事件(包括出血性脑卒中和缺血性脑卒中)为结局指标，同时以一般人口学特征、生活方式、健康状况和血液生物标志物作为协变量，采用Cox比例风险回归模型探索CVAI与脑卒中发病风险的剂量-反应关系。
    结果 共11 432名中老年人纳入本研究，平均年龄为(60.24±9.56)岁。其中女性6157名(53.86%)，男性5275名(46.14%)。在5年中位随访期内，共有905名(7.92%, 905/11 432)中老年人发生脑卒中，在调整一般人口学和生活方式等协变量后，CVAI每增加1个四分位数间距(interquartile range, IQR)，脑卒中发病风险增加28%(HR=1.28，95% CI: 1.20~1.36)。与第1个四分位数(Q1)组相比，Q3(HR=1.60, 95% CI: 1.30~1.97)和Q4(HR=2.02, 95% CI: 1.65~2.47)组中老年人与脑卒中发病风险增加有关; 交互作用分析显示，CVAI与性别具有交互作用(Pfor interaction＜0.001)。限制性立方样条图显示，CVAI与脑卒中发病风险呈非线性关联(Pnonlinear=0.005)。
    结论 较高水平的CVAI与脑卒中发病风险增加有关，CVAI是一种有效的生物标志物，可用于识别脑卒中高风险人群，为脑卒中的一级预防提供参考。

     

    Abstract:
    Objective To investigate the association between the Chinese visceral adiposity index(CVAI) and the risk of stroke incidence in middle-aged and older adults (≥45 years) using data from the China Health and Retirement Longitudinal Study (CHARLS).
    Methods Data from the 2015, 2018, and 2020 CHARLS surveys were analyzed, focusing on middle-aged and older adults. The primary outcome was the occurrence of new stroke events (including both hemorrhagic and ischemic strokes) during the follow-up period. Covariates included general demographic characteristics, lifestyle factors, health status, and blood biomarkers. Cox proportional hazards regression models were used to explore the dose-response relationship between CVAI and stroke risk.
    Results A total of 11 432 middle-aged and older adults were included, with a mean age of 60.24±9.56 years. Among them, 6157 (53.86%) were women and 5275(46.14%) were men. Over a median follow-up period of 5 years, 905 individuals(7.92%, 905/11 432) experienced a stroke. After adjusting for demographic and lifestyle covariates, each interquartile range (IQR) increase in CVAI was associated with a 28% higher risk of stroke (HR=1.28, 95% CI: 1.20-1.36). Compared to the first quartile (Q1), the third (Q3: HR=1.60, 95% CI: 1.30-1.97) and fourth quartiles (Q4: HR=2.02, 95% CI: 1.65-2.47) were significantly associated with an increased risk of stroke. Interaction analysis revealed a significant interaction between CVAI and gender (Pfor interaction < 0.001). Restricted cubic spline analysis demonstrated a non-linear relationship between CVAI and stroke risk (Pnonlinear=0.005).
    Conclusions Higher CVAI levels are associated with an increased risk of stroke. CVAI serves as an effective biomarker for identifying individuals at high risk of stroke and can inform primary stroke prevention strategies.

     

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