Relationship between trajectory of Chinese visceral adiposity index and risk of type 2 diabetes mellitus: Evidence from the China-PAR project

Xueru Fu; Yang Zhao; Yuying Wu; Liuding Wen; Weifeng Huo; Dongdong Zhang; Yanyan Zhang; Jianxin Li; Xiangfeng Lu; Fulan Hu; Ming Zhang; Dongsheng Hu

doi:10.1111/dom.16074

Relationship between trajectory of Chinese visceral adiposity index and risk of type 2 diabetes mellitus: Evidence from the China-PAR project

Diabetes Obes Metab. 2024 Nov 19. doi: 10.1111/dom.16074. Online ahead of print.

Authors

Xueru Fu^{1

2}, Yang Zhao^{3

4}, Yuying Wu⁴, Liuding Wen⁴, Weifeng Huo⁴, Dongdong Zhang^{3

4}, Yanyan Zhang^{5

6

7}, Jianxin Li^{6

7}, Xiangfeng Lu^{6

7}, Fulan Hu⁸, Ming Zhang⁸, Dongsheng Hu^{1

2}

Affiliations

¹ Department of Cardiovascular Medicine, The Seventh People's Hospital of Zhengzhou, Zhengzhou, China.
² Henan Provincial Key Laboratory of Cardiac Remodeling and Transplantation, Zhengzhou, China.
³ Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, China.
⁴ Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China.
⁵ Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China.
⁶ Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing, China.
⁷ Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
⁸ Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen University, Shenzhen, China.

PMID: 39562295
DOI: 10.1111/dom.16074

Abstract

Aims: This study aimed to identify the distinct change trajectories of the Chinese visceral adiposity index (CVAI) over time and to investigate their associations with risk of type 2 diabetes mellitus (T2DM).

Materials and methods: This study included 52 394 participants from the prospective project, the Prediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR). The CVAI was calculated using measures of age, body mass index, waist circumference, triglycerides and high-density lipoprotein cholesterol. Latent mixture modelling was conducted to fit distinct trajectory patterns. The logistic regression model was applied to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the risk of T2DM with various CVAI trajectory patterns.

Results: Four distinct CVAI trajectory patterns were identified: low-increasing, moderate-increasing, moderate high-increasing and high-increasing. Compared with low-increasing CVAI, participants with moderate-increasing (OR 1.73, 95% CI 1.49-2.00), moderate high-increasing (3.48, 3.01-4.03) and high-increasing CVAI (5.50, 4.67-6.47) had a significantly increased risk of T2DM. Similar trajectory patterns were identified in both men and women. The ORs (95% CI) for moderate-increasing, moderate high-increasing and high-increasing groups were 3.28 (2.56-4.19), 7.85 (6.09-10.13) and 13.21 (9.98-17.49) in women respectively, and 1.20 (0.99-1.45), 2.18 (1.82-2.62) and 3.60 (2.93-4.43) in men respectively, when compared to the low-increasing CVAI group. Further, significant effect modifications for age, smoking and physical activity (all P_interaction <0.05) were observed in the relationship between CVAI trajectory patterns and T2DM.

Conclusions: Initially high and persistently elevated CVAI is significantly associated with an increased risk of T2DM, with a particular focus on women, younger people, nonsmokers and physically inactive individuals. Continuous monitoring of CVAI levels will benefit effective identification, early intervention and management of individuals at high risk of T2DM.

Keywords: Chinese visceral adiposity index; obesity; prospective cohort; trajectory; type 2 diabetes mellitus.

Abstract

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