Association Of Chinese Visceral Adiposity Index And Hypertension In Rural Population Of Liaoning Province

Objective: The visceral adiposity index(VAI)has been proven to assess the risk of diseases such as hypertension,coronary heart disease and diabetes mellitus,but as an index created for caucasians,its application in Asian populations,especially Chinese populations,has been limited.The Chinese visceral Fat Index(CVAI)is an indicator of cardiovascular health created for the Chinese population,but its correlation with hypertension needs to be further confirmed.The aim of this study was to explore whether CVAI level is related to the risk of hypertension,and to compare the ability of CVAI,VAI and traditional anthropometric indicators to evaluate the risk of prehypertension and hypertension.Methods: A cross-sectional study was conducted among 9249 participants(4273 males and 4976 females)who participated in the Northeast China Rural Cardiovascular Health Study(NCRCHS)from January 2012 to August 2013 in rural areas of Liaoning Province and were successfully followed up in 2015 using a multi-stage randomized cluster sampling method.All participants completed a questionnaire carefully taken by specialists.Blood routine,liver and kidney function,blood sugar,blood lipids and other biochemical indicators were tested.A full physical examination was performed to obtain anthropometric indices such as height,weight,waist circumference and hip circumference.Then body mass index and waist-hip ratio can be calculated.Physical examination such as blood pressure,electrocardiogram and echocardiogram will be improved.Binary and multiple logistic regression analyses were used to evaluate the correlation between WHR,BMI,VAI and CVAI with prehypertension and hypertension,and ROC curves of 4 body measures and hypertension were plotted.Results: The age,WHR,BMI,VAI and CVAI of both men and women increased with the increase of blood pressure classification.Age,WHR,BMI,VAI,SBP,DBP increased with the increase of CVAI quartile grade.Binary logistic regression analysis was performed on CVAI.After adjusting for confounding factors such as education level,activity level,smoking,alcohol consumption,blood lipids and diabetes,it showed that the higher the group of CVAI quanta in men and women,the higher the risk of hypertension.In model 4,the largest values of OR was male(OR: 3.810,95%CI:3.128-4.640,P<0.001)and female(OR: 5.738,95%CI: 4.677-7.039,P<0.001).Multivariate logistic regression analysis showed that with the first quartile array as the reference,the odds ratio(OR)values of the four physical measures related to blood pressure increased with the increase of the quartile level,and the CVAI group had the largest values of OR,In the male population,prehypertensive CVAI(OR: 3.243,95%confidence interval [CI]: 2.260-4.653,P<0.001),hypertensive CVAI(OR: 9.074,95%CI: 6.406-12.854,P<0.001),in the female population,prehypertensive CVAI(OR:2.717,95%CI: 2.031-3.635,P<0.001),hypertensive CVAI(OR: 10.257,95%CI:7.761-13.556,P<0.001).ROC curve analysis showed that CVAI had the highest AUC(male C-statistic: 0.666,95%CI: 0.650-0.683,P<0.001,female C-statistic: 0.726,95%CI:0.712-0.739,P<0.001)compared with other anthropometric indicators in both males and females.In males,the optimal cut-off value was 103.31,the sensitivity was 0.621,and the specificity was 0.642.In females,the optimal cut-off value was 89.46,the sensitivity was 0.748,and the specificity was 0.588.Conclusion: This study found that CVAI was an independent risk factor for hypertension.WHR,BMI,VAI and CVAI were all positively correlated with the risk of prehypertension and hypertension,and CVAI had the strongest correlation,which was more suitable for evaluating and identifying the risk of hypertension in Chinese population.