Visceral fat and its dynamic changes are associated with incident stroke: evidence from the China Health and Retirement Longitudinal Study.

Abstract

Background and aims: Central obesity demonstrated an association with stroke, while the association between visceral fat accumulation and stroke required further investigation. We aimed to evaluate the association of Chinese visceral adiposity index (CVAI) and its dynamic change patterns with stroke risk.

Methods and results: A total of 9052 individuals from a nationally representative cohort were included. The main outcome was a self-reported physician's diagnosis of stroke. Multivariable Cox and logistic regression models were employed to evaluate the association of the exposure with stroke. The shape of the association was explored using restricted cubic splines. The mean age of the study population was 60.0 ± 9.5 years, and the median follow-up period was 7 years. A linear dose-response association between baseline CVAI and stroke risk was observed. Compared with the lowest CVAI quartile, those in the second, third, and fourth quartiles had 1.62, 1.72, and 2.08 times higher risk, respectively. Additionally, each standard deviation increase in CVAI induced 23 % increased risk of stroke. Among the five CVAI change patterns, the low-stable pattern carried a greatest protective effect against stroke (OR = 0.35, 95 % CI: 0.21-0.58); the decreasing pattern exhibited greater risk reduction compared to the moderate and the increasing patterns (with reference to the persistent-high pattern). In terms of identifying high-risk individuals of stroke, CVAI outperformed other obesity indices.

Conclusion: Higher baseline CVAI and a persistent-high pattern were associated with increased risk of incident stroke. Maintaining a low level of CVAI or reducing it may have potential benefits for stroke prevention.