中青年原发性高血压患者中国内脏脂肪指数与颈动脉粥样硬化的相关性

Correlation between Chinese visceral adiposity index and carotid atherosclerosis in young and middle-aged patients with essential hypertension

    摘要
  • 摘要:
    目的 探讨中青年原发性高血压患者中国内脏脂肪指数（CVAI）与颈动脉粥样硬化（CAS）的相关性。
    方法 连续入选2023年2—9月收住新疆医科大学第五附属医院高血压科的18～64岁原发性高血压患者761例，收集患者的人口学资料、生化指标等结果，基于年龄、体重指数（BMI）、腰围、甘油三酯和高密度脂蛋白胆固醇（HDL-C）计算CVAI，根据CVAI四分位数分为4组：第1四分位组（CVAI＜102.115）、第2四分位组（CVAI 102.115～＜130.860）、第3四分位组（CVAI 130.860～＜153.891）、第4四分位组（CVAI≥153.891）。采用点二列相关分析方法分析CVAI与CAS的相关性。采用多因素logistic回归分析方法分析中青年原发性高血压患者CVAI与CAS之间的关系。按性别、年龄、吸烟、饮酒、冠心病、糖尿病、服降压药分组进行亚组分析。计算受试者操作特征（ROC）曲线的曲线下面积（AUC），比较CVAI、BMI和腰围对CAS的诊断能力。
    结果 从CVAI第1四分位组到第4四分位组，CAS患病率逐渐增大29.5%（56/190）比46.6%（89/191）比52.1%（99/190）比64.2%（122/190），χ2=47.554，P＜0.001。点二列相关分析显示CVAI与CAS呈正相关（r=0.282，P＜0.001）。多因素logistic回归分析显示，校正相关混杂因素后，CVAI与CAS风险呈正相关（OR=1.016，95%CI 1.010～1.021，P＜0.001），与CVAI第1四分位组相比，第4四分位组的CAS风险增加（OR=3.648，95%CI 2.197～6.057，P＜0.001）。亚组分析显示，CVAI与CAS之间的关系在所有亚组中都是稳定的。ROC曲线分析显示，CVAI的AUC为0.645，高于BMI（AUC=0.545，Z=6.628，P＜0.001）和腰围（AUC=0.605，Z=4.961，P＜0.001）。
    结论 中青年原发性高血压患者中，CVAI与CAS风险呈正相关，可能有助于CAS高危人群的识别。

     

    Abstract:
    Objective To investigate the relationship between Chinese visceral adiposity index (CVAI) and carotid atherosclerosis (CAS) in young and middle-aged patients with essential hypertension (EH).
    Methods A total of 761 patients with EH aged 18–64 years admitted to the Department of Hypertension of the Fifth Affiliated Hospital of Xinjiang Medical University from February 2023 to September 2023 were consecutively enrolled. The demographic data and biochemical index of the patients were collected, and the CVAI was calculated based on age, body mass index (BMI), waist circumference, triglycerides, and high density lipoprotein cholesterol (HDL-C). The patients were categorized into 4 groups according to the quartiles of CVAI: Q1 (CVAI＜102.115), Q2 (CVAI 102.115–＜130.860), Q3 (CVAI 130.860–＜153.891), and Q4 (CVAI≥153.891). Point-biserial correlation was used to analyze the correlation between CVAI and CAS. Multivariate logistic regression analysis was used to analyze the relationship between CVAI and CAS in young and middle-aged patients with EH. Subgroup analyses were conducted by grouping according to gender, age, smoking, alcohol consumption, coronary heart disease, diabetes, and taking antihypertensive medication, respectively. Receiver operating characteristic (ROC) curve analysis was conducted and the area under the curve (AUC) was calculated to compare the diagnostic power of CVAI, BMI, and waist circumference for CAS.
    Results The prevalence of CAS showed a progressive increase from the first quartile group to the fourth quartile group 29.5% (56/190) vs 46.6% (89/191) vs 52.1% (99/190) vs 64.2% (122/190), χ2=47.554, P＜0.001. Point-Biserial correlation analysis showed that CVAI was positively correlated with CAS (r=0.282, P＜0.001). Multivariate logistic regression analysis showed that CVAI was positively associated with CAS risk (OR=1.016, 95%CI 1.010–1.021, P＜0.001), after adjustment for relevant confounders, the risk of CAS was significantly increased in Q4 group compared to Q1 group (OR=3.648, 95%CI 2.197–6.057, P＜0.001). Subgroup analyses showed that the relationship between CVAI and CAS was persisted across all subgroups. ROC analysis showed that the AUC of CVAI was 0.645, higher than that of BMI (AUC=0.545, Z=6.628, P＜0.001) and waist circumference (AUC=0.605, Z=4.961, P＜0.001).
    Conclusions CVAI is positively associated with CAS in young and middle-aged patients with EH, and it may be helpful for the identification of high-risk groups for CAS.

     

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