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Association Between Two Novel Visceral Obesity Indicators and Heart Failure Among US Adults: A Cross-Sectional Study
Xi Luo1, Bin Cai2,3, Weiwei Jin1
1Department of Clinical Nutrition, Tongde Hospital of Zhejiang Province, Hangzhou, China.
Insights
Cardiometabolic index (CMI) and visceral adiposity index (VAI) and their age-adjusted versions are linked to heart failure (HF) risk. CMI-age demonstrated superior predictive ability for early HF identification compared to other indicators.
Area of Science:
- Cardiology
- Metabolic Health
- Public Health
Background:
- Visceral obesity is a significant risk factor for cardiovascular diseases, including heart failure (HF).
- Novel anthropometric indices like cardiometabolic index (CMI) and visceral adiposity index (VAI) are being explored for their association with metabolic dysfunction and cardiovascular risk.
- The predictive value of these indices, particularly their age-adjusted forms (CMI-age, VAI-age), for early HF detection requires further investigation.
Purpose of the Study:
- To investigate the association between CMI, CMI-age, VAI, and VAI-age with the prevalence of heart failure (HF).
- To compare the predictive performance of these four visceral obesity indicators in identifying individuals at risk for HF.
- To provide insights into potential biomarkers for early HF detection and management.
Main Methods:
- A cross-sectional study utilizing data from 8999 participants in the National Health and Nutrition Examination Survey (NHANES) from 2011-2018.
- Multivariable regression analysis was employed to assess the association between CMI, CMI-age, VAI, VAI-age, and HF.
- Receiver operating characteristic (ROC) curve analysis was used to evaluate and compare the predictive accuracy of the indices for HF.
Main Results:
- CMI, CMI-age, VAI, and VAI-age all showed significant positive correlations with HF risk in both crude and adjusted models.
- Higher quartiles of CMI, CMI-age, VAI, and VAI-age were associated with a significantly increased risk of HF compared to the lowest quartile.
- CMI-age exhibited the highest area under the ROC curve (0.700), indicating superior predictive ability for HF compared to CMI (0.610), VAI (0.593), and VAI-age (0.689).
Conclusions:
- CMI, CMI-age, VAI, and VAI-age are independently associated with an increased risk of heart failure.
- CMI-age emerges as a more effective indicator than CMI, VAI, and VAI-age for the early prediction of HF.
- These findings highlight the potential utility of CMI-age in clinical practice for identifying individuals at high risk of HF, aiding in prevention and management strategies.
Abstract:
This study aimed to explore the association of cardiometabolic index (CMI), CMI-age, visceral adiposity index (VAI), and VAI-age with heart failure (HF) and to compare those indicators for early identification of HF. Drawing from the National Health and Nutrition Examination Survey (NHANES) for 2011-2018, we enrolled 8999 participants in a cross-sectional study. The association of different visceral obesity indicators (CMI, CMI-age, VAI, and VAI-age) with HF was estimated by multivariable regression analysis. Receiver operating characteristic (ROC) curves were used to examine the predictive ability of CMI, CMI-age, VAI, and VAI-age on patients with HF. CMI, CMI-age, VAI and VAI-age showed positive correlations with HF. When indicators were analyzed as continuous variables, CMI, CMI-age, VAI, and VAI-age showed positive correlations with HF in both the crude and adjusted models (all P < 0.05). When indicators were analyzed as categorical variables, it was found that in all four models, the ORs of group Q4 was significantly different compared to Q1 (all P < 0.05), suggesting the risk of HF is significantly increased with higher CMI, CMI-age, VAI, or VAI-age. The association between those indicators (CMI, CMI-age, VAI, and VAI-age) and HF was similar in all stratified populations (P for interaction >0.05).The areas under the ROC curve (AUCs) of four indicators in predicting HF were significantly different (CMI: 0.610, 95% CI, 0.578-0.643; CMI-age: 0.700, 95% CI, 0.669-0.726; VAI: 0.593, 95% CI, 0.561-0.626; VAI-age: 0.689, 95% CI, 0.661-0.718), suggesting that CMI-age was significantly better than the other three indicators in predicting HF (P < 0.001). CMI, CMI-age, VAI, and VAI-age were all independently correlated with the risk of HF. In four indicators, the CMI-age was significantly better than the other three indicators in predicting HF, which provides new insights into the prevention and management of HF.
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