Abstract：
OBJECTIVE: Visceral obesity and the lifetime risk of cardiovascular disease (CVD) have received increasing attention. However, the relationship between dynamic changes in visceral obesity and CVD has not been studied. We aimed to determine the association of visceral adiposity index (VAI) transition with CVD risk.
METHODS: A total of 5395 participants were recruited in 2011-2012 and followed up until 2018 from the China Health and Retirement Longitudinal Study. The cut-off value of the VAI was obtained by the receiver-operating characteristic curve. Participants were grouped based on VAI change patterns during the follow-up period (2011-2015): the low-low group, low-high group, high-low group, and high-high group. CVD was defined as a medical diagnosis of heart disease and/or stroke. A Cox proportional hazards model was used to evaluate the correlation between VAI transition and CVD.
RESULTS: Over a median follow-up period of 7 years, 969 participants (17.9 %) developed CVD. VAI change patterns were significantly associated with CVD risk after adjustment for demographic characteristics and risk factors. The high-high group (hazard ratio (HR): 1.65, 95 % confidence interval (CI): 1.39-1.97) and the low-high group (HR: 1.29, 95 % CI: 1.04-1.61) were associated with a higher risk of CVD after adjusting for demographic characteristics and traditional risk factors compared to the low-low group, while the effect in the high-low group was not significant.
CONCLUSIONS: VAI transition was significantly associated with the risk of CVD. Monitoring the dynamics of the VAI in public health practice would help prevent CVD.
METHODS: A total of 5395 participants were recruited in 2011-2012 and followed up until 2018 from the China Health and Retirement Longitudinal Study. The cut-off value of the VAI was obtained by the receiver-operating characteristic curve. Participants were grouped based on VAI change patterns during the follow-up period (2011-2015): the low-low group, low-high group, high-low group, and high-high group. CVD was defined as a medical diagnosis of heart disease and/or stroke. A Cox proportional hazards model was used to evaluate the correlation between VAI transition and CVD.
RESULTS: Over a median follow-up period of 7 years, 969 participants (17.9 %) developed CVD. VAI change patterns were significantly associated with CVD risk after adjustment for demographic characteristics and risk factors. The high-high group (hazard ratio (HR): 1.65, 95 % confidence interval (CI): 1.39-1.97) and the low-high group (HR: 1.29, 95 % CI: 1.04-1.61) were associated with a higher risk of CVD after adjusting for demographic characteristics and traditional risk factors compared to the low-low group, while the effect in the high-low group was not significant.
CONCLUSIONS: VAI transition was significantly associated with the risk of CVD. Monitoring the dynamics of the VAI in public health practice would help prevent CVD.
摘要：
目的：内脏肥胖和心血管疾病（CVD）的终生风险越来越受到关注。然而,内脏肥胖的动态变化与CVD之间的关系尚未研究。我们旨在确定内脏肥胖指数（VAI）转变与CVD风险的关联。
方法：2011-2012年共招募了5395名参与者，并从中国健康与退休纵向研究中随访至2018年。通过接收器工作特性曲线获得VAI的截止值。参与者根据随访期间(2011-2015年)的VAI变化模式进行分组：低-低组，低高组,高低组,高-高集团。CVD被定义为心脏病和/或中风的医学诊断。使用Cox比例风险模型来评估VAI转变与CVD之间的相关性。
结果：在7年的中位随访期内，969名参与者（17.9%）发展为CVD。在调整人口统计学特征和危险因素后，VAI变化模式与CVD风险显著相关。高-高组（风险比（HR）：1.65，95％置信区间（CI）：1.39-1.97）和低-高组（HR：1.29，95％CI：1.04-1.61）与低-低组相比，在调整人口统计学特征和传统危险因素后，CVD的风险更高。而高低组的效果不显著。
结论：VAI转变与CVD风险显著相关。在公共卫生实践中监测VAI的动态将有助于预防CVD。
方法：2011-2012年共招募了5395名参与者，并从中国健康与退休纵向研究中随访至2018年。通过接收器工作特性曲线获得VAI的截止值。参与者根据随访期间(2011-2015年)的VAI变化模式进行分组：低-低组，低高组,高低组,高-高集团。CVD被定义为心脏病和/或中风的医学诊断。使用Cox比例风险模型来评估VAI转变与CVD之间的相关性。
结果：在7年的中位随访期内，969名参与者（17.9%）发展为CVD。在调整人口统计学特征和危险因素后，VAI变化模式与CVD风险显著相关。高-高组（风险比（HR）：1.65，95％置信区间（CI）：1.39-1.97）和低-高组（HR：1.29，95％CI：1.04-1.61）与低-低组相比，在调整人口统计学特征和传统危险因素后，CVD的风险更高。而高低组的效果不显著。
结论：VAI转变与CVD风险显著相关。在公共卫生实践中监测VAI的动态将有助于预防CVD。
