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

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.