Objective To investigate whether the Chinese visceral adiposity index(CVAI)can serve as a reliable assessment index for people with coronary heart disease combined with metabolic syndrome.Methods A retrospective study was conducted to consecutively enroll 424 patients with coronary artery disease who completed coronary angiography in the Department of Cardiology of the Affiliated Hospital of Jiangnan University from August 2022 to March 2023.These patients were divided into two groups:coronary artery disease combined with metabolic syndrome(220 patients)and coronary artery disease without metabolic syndrome(204 patients).Waist circumference of the patients was measured on admission,and general clinical data and laboratory findings were collected.CVAI was calculated and compared with other visceral obesity indicators(waist circumference,body mass index)in its ability to assess patients with coronary heart disease combined with metabolic syndrome.The 286 patients with coronary artery disease who underwent percutaneous coronary intervention(PCI)after admission to the hospital were followed up for major adverse cardiovascular events 12 months after the procedure.Results The overall CVAI in the coronary heart disease population was normally distributed,with a mean of 122.49±40.45.Patients with coronary heart disease combined with metabolic syndrome had higher proportions of body mass index,triacylglycerol,fasting glucose,blood uric acid,estimated glomerular filtration rate(eGFR),Gensini score,waist circumference,CVAI,combined stroke,diabetes mellitus,and hypertension than those without metabolic syndrome,whereas had lower albumin and high-density lipoprotein cholesterol levels than those without metabolic syndrome.All differences were statistically significant(all P<0.05).Multifactorial logistic regression analysis showed that blood uric acid(OR=1.005,95%CI:1.001-1.009,P=0.009),eGFR(OR=1.011,95%CI:1.000-1.023,P=0.045)and CVAI(OR=1.031,95%CI:1.020-1.043,P<0.001)were all risk factors for combined metabolic syndrome in patients with coronary artery disease,while albumin(OR=0.890,95%CI:0.815-0.972,P=0.010)was a protective factor for combined metabolic syndrome in patients with coronary artery disease.Compared with waist circumference,body mass index and Gensini score,CVAI diagnosed combined metabolic syndrome in coronary artery disease with the largest area under the curve(AUC)of receiver operating characteristic(ROC)(AUC=0.798,95%CI:0.736-0.859),the best diagnostic locus of 109.389,with a sensitivity of 89.1%and a specificity of 64.7%.Kaplan-Meier survival analysis showed that the rate of major adverse cardiovascular events within 12 months after PCI was higher in the high CVAI group of coronary artery disease patients(CVAI>124.41,136 patients)than in the low CVAI group(CVAI≤124.41,150 patients)[Log-rank(Mantel-Cox),χ2=4.872,P=0.027].Conclusions CVAI has a certain diagnostic value for coronary heart disease combined with metabolic syndrome and also shows a certain predictive value for prognosis after PCI.Moreover,it can be used as a reliable assessment index for patients with coronary heart disease combined with metabolic syndrome.
关键词
中国内脏脂肪指数/腰围/体质指数/冠心病/代谢综合征/主要不良心血管事件
Key words
Chinese visceral adipose index/Waist circumference/Body mass index/Coronary heart disease/Metabolic syndrome/Major adverse cardiovascular events
万方数据