中老年人中国内脏脂肪指数与新发脑卒中的相关性及剂量-反应关系

doi:10.12183/j.scjpm.2024.0599

摘要/Abstract

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6 902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（P_nonliner =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。

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

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 established 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 examine 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%） experienced new-onset stroke. The median CVAI at baseline was 93.26 （63.21,123.96）,and the CVAI in new-onset stroke patients was higher than that in non- new-onset stroke patients （P<0.01）. Cox regression model results showed that after adjusting 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 Q₁ 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 （P_trend < 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 linear （P_nonliner =0.53）. Subgroup analysis showed that age may have a moderating effect on the relationship between the two groups （P_interaction <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 vigilant about their risk for developing strokes.

Key words: Middle-aged and elderly, Chinese visceral adiposity index, New-onset stroke, Dose-response relationship

中图分类号:

R195.4

鲍洋, 张晶, 刘琰, 方及男, 伊朗, 富铭姝. 中老年人中国内脏脂肪指数与新发脑卒中的相关性及剂量-反应关系[J]. 华南预防医学, 2024, 50(7): 599-603.

BAO Yang, ZHANG Jing, LIU Yan, FANG Jinan, YI Lang, FU Mingshu. Correlation and dose-response relationship between Chinese visceral adiposity index and new-onset stroke in middle-aged and elderly people[J]. South China Journal of Preventive Medicine, 2024, 50(7): 599-603.

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