Correlation and dose-response relationship between Chinese visceral adiposity index and new-onset stroke in middle-aged and elderly people
鲍洋 1张晶 1刘琰 1方及男 1伊朗 1富铭姝1
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作者信息
1. 中国医科大学附属第一医院,辽宁沈阳 110001
折叠
摘要
目的 基于大样本队列探讨中老年人中国内脏脂肪指数(Chinese visceral adiposity index,CVAI)与新发脑卒中的关系.方法 以2011-2018年中国健康与养老追踪调查(China Health and Retirement Longitudinal Study,CHARLS)数据建立Cox回归模型,探究CVAI与新发脑卒中的关联.采用限制性立方样条检查可能的非线性关联,使用亚组分析探究社会人口特征和健康行为的调节作用.结果 共纳入中国6902名中老年人,其中新发脑卒中患者398例(5.76％).基线CVAI中位数为93.26(63.21,123.96),新发脑卒中患者的CVAI高于非新发脑卒中患者(P＜0.01).Cox回归模型结果显示,调整协变量后发现,CVAI每上升1个四分位数间距(60.75),新脑卒中的发生风险增加 67.2％(P＜0.01).与 CVAI Q1组(＜63.21)相比,CVAI Q2、Q3、Q4 组(63.21～＜93.26、93.26～＜123.96、≥123.96)新发生脑卒中的风险分别增加78.5％、96.7％、184.2％(均P＜0.01),新发脑卒中风险随着CVAI的增加而增加(P趋势＜0.001).限制性立方样条回归分析显示,CVAI指数与新发脑卒中存在剂量—反应关系(P＜0.01),且为线性关系(Pnonliner=0.53).亚组分析显示,年龄对两者的关系可能存在调节作用(P交互＜0.05),年龄较低的人群受到的影响更大.结论 CVAI指数与新发脑卒中患病率密切相关,两者存在剂量-反应关系,低龄且高CVAI的人群需要更加警惕脑卒中的发生风险.
Abstract
Objective To explore the relationship between Chinese visceral adiposity index(CVAI)and new-onset stroke in a large sample cohort of middle-aged and elderly individuals.Methods A Cox regression model was estab-lished using data from the China Health and Retirement Longitudinal Study(CHARLS)conducted between 2011 and 2018,to investigate the relationship between CVAI and new-onset stroke.Restricted cubic spline model was used to exam-ine potential non-linear relationships,while subgroup analyses explored the moderating effects of social,demographic,and economic factors.Results A total of 6 902 participants were included in this study,among whom 398(5.76％)experi-enced new-onset stroke.The median CVAI at baseline was 93.26(63.21,123.96),and the CVAI in new-onset stroke pa-tients was higher than that in non-new-onset stroke patients(P＜0.01).Cox regression model results showed that after ad-justing covariates,the risk of new-onset stroke increased by 67.2％for every one quartile increase of CVAI(60.75)(P＜0.01).Compared with CVAI Q,group(＜63.21),CVAI Q2,Q3,and Q4 groups(63.21-＜93.26,93.26-＜123.96,and ≥123.96)had an increased risk of new-onset stroke by 78.5％,96.7％,and 184.2％,respectively(all P＜0.01).The risk of new-onset stroke increased with increasing CVAI(Ptrend＜0.001).Restricted cubic spline regression analysis showed that there was a dose-response relationship between CVAI and new-onset stroke(P＜0.01),and the relationship was lin-ear(Pnonliner=0.53).Subgroup analysis showed that age may have a moderating effect on the relationship between the two groups(Pinteraction＜0.05),and the lower age group was more affected.Conclusions The CVAI is closely associated with new-onset stroke,showing a dose-response relationship.Younger individuals with high CVAI should be particularly vigi-lant about their risk for developing strokes.
关键词
中老年人/中国内脏脂肪指数/新发脑卒中/剂量-反应关系
Key words
Middle-aged and elderly/Chinese visceral adiposity index/New-onset stroke/Dose-response relationship
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