Cardiovasc Diabetol: Correlation between abdominal obesity index and the risk of cardiovascular events in T2D patients in China

Waist circumference (WC), visceral fat index (VAI), fat accumulation (LAP), and Chinese visceral fat index (CVAI) are considered surrogate indicators of abdominal fat deposition, but the longitudinal association of these with cardiovascular (CV) events in adults with type 2 diabetes mellitus (T2D) is unclear
.
The study aimed to explore the correlation between abdominal obesity index and CV events in patients with T2D and to compare their predictive performance
in risk assessment.

A total of 2328 T2D patients
were enrolled in the Xinjiang multi-ethnic cohort.
Multivariate Cox regression analysis was used to assess the relationship between
abdominal obesity index and CV events.
The prediction performance
of abdominal obesity indicators was evaluated using the Harrell agreement statistic (C-statistic), the Net Reclassification Improvement Index (NRI), and the Comprehensive Discriminant Improvement Index (IDI).

Calculation formula for LAP and CVAI

At a median follow-up of 59 months, 289 patients experienced CV events
.
After multivariate adjustment, WC, VAI, LAP, and CVAI were associated with a higher risk of CV events in patients with T2D, with adjusted risk ratios (HR) of 1.
57, 1.
11, 1.
46, and 1.
78
, respectively.
In subgroup analyses, these positive associations were stronger
in patients with a body mass index (BMI) <of 25 kg/m2 than in overweight/obese patients.

The risk of CV events in patients is grouped according to different quartiles of abdominal obesity index

In terms of predictive performance, CVAI has the largest C-statistic (0.
700, 95% CI 0.
672-0.
728; all comparison p-values <0.
05)
compared to VAI, LAP, WC, and BMI 。 The CVAI index also showed the largest risk stratification increment when the abdominal obesity index was added to the underlying risk model (C-statistic 0.
751 vs 0.
701, p<0.
001; IDI: 4.
3%, p<0.
001; NRI: 26.
6%, p<0.
001).

Taken together, the study provides additional evidence that all abdominal obesity indices are associated with cardiovascular event risk in people with type 2 diabetes in China, and CVAI may be a valuable indicator
of abdominal obesity in identifying T2D patients at high CV event risk in China.
These results suggest that a positive assessment of abdominal obesity may contribute to effective clinical management
of people with diabetes.

Original source:

Qiao, T.
, Luo, T.
, Pei, H.
et al.
Association between abdominal obesity indices and risk of cardiovascular events in Chinese populations with type 2 diabetes: a prospective cohort study.
Cardiovasc Diabetol 21, 225 (2022).
https://doi.
org/10.
1186/s12933-022-01670-x