Association between visceral lipid accumulation indicators and advanced cardiovascular-kidney-metabolic syndrome: a cross-sectional study based on NHANES 1999-2018.

IF 2.9 4区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Zihan Fang, Jun Yuan, Jieshan Qiu, Qi Liu, Ran He, Danna Zheng, Juan Jin, Qiang He
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引用次数: 0

Abstract

Background A newly recognized condition, the cardiovascular-kidney-metabolic (CKM) syndrome,integrated disease spectrum encompassing interlinked renal, cardiovascular, and metabolic dysfunction. Visceral adiposity plays a pivotal role in driving this multisystem deterioration. Although surrogate markers such as the visceral adiposity index (VAI), metabolic score for visceral fat (METS-VF), body roundness index (BRI), and weight-adjusted waist index (WWI) have been proposed to estimate visceral fat burden, their relationship with advanced CKM syndrome remains poorly defined.This study sought to thoroughly examine the links between these indices and advanced CKM risk, and to evaluate their ability to predict such risk. Methods In this study, we performed a cross-sectional analysis using data from the National Health and Nutrition Examination Survey (NHANES) spanning 1999 to 2018, which included 22,019 adults aged 20 years and older. We calculated four indices of visceral fat accumulation (VAI, METS-VF, BRI, WWI) and assessed their associations with advanced CKM syndrome through weighted multivariable logistic regression, restricted cubic spline (RCS) modeling, and receiver operating characteristic (ROC) curve analysis. Subgroup analyses were also conducted to ensure the robustness of the findings, adjusting for demographic and lifestyle factors. Results Advanced CKM syndrome was present in 17.4% of participants. All four indices were significantly associated with advanced CKM (all P < 0.05), with METS-VF showing the strongest association (OR = 1.87, 95% CI: 1.51-2.30). Both METS-VF and VAI demonstrated a non-linear increase in risk for advanced CKM, whereas BRI and WWI showed a positive linear relationship with the risk. Subgroup analyses provided additional evidence, confirming that these associations remained consistent across multiple population subgroups. In ROC analysis, METS-VF demonstrated the highest predictive accuracy (AUC = 0.79), followed by WWI (AUC = 0.73), outperforming traditional markers such as body mass index (BMI) and waist circumference (WC). Conclusions Elevated VAI, METS-VF, BRI, and WWI levels have been significantly linked to advanced CKM syndrome. METS-VF and WWI, as simple and non-invasive markers, show strong predictive capacity and may serve as effective tools for early detection and intervention in clinical settings.

内脏脂质积累指标与晚期心肾代谢综合征之间的关联:基于NHANES 1999-2018的横断面研究
背景:心血管-肾-代谢综合征是一种新认识的疾病,是一种包括肾脏、心血管和代谢功能障碍在内的综合性疾病。内脏脂肪在驱动这种多系统恶化中起着关键作用。虽然已经提出了内脏脂肪指数(VAI)、内脏脂肪代谢评分(met - vf)、身体圆度指数(BRI)和体重调整腰围指数(WWI)等替代指标来评估内脏脂肪负担,但它们与晚期CKM综合征的关系仍不明确。本研究旨在彻底检查这些指标与晚期CKM风险之间的联系,并评估其预测此类风险的能力。在本研究中,我们使用1999年至2018年国家健康与营养检查调查(NHANES)的数据进行了横断面分析,其中包括22,019名20岁及以上的成年人。我们计算了4个内脏脂肪堆积指数(VAI、met - vf、BRI、WWI),并通过加权多变量logistic回归、限制性三次样条(RCS)建模和受试者工作特征(ROC)曲线分析评估了它们与晚期CKM综合征的相关性。还进行了亚组分析,以确保结果的稳健性,调整了人口统计学和生活方式因素。结果17.4%的参与者存在晚期CKM综合征。4项指标均与晚期CKM相关(均P < 0.05),其中met - vf相关性最强(OR = 1.87, 95% CI: 1.51 ~ 2.30)。met - vf和VAI都显示出晚期CKM风险的非线性增加,而BRI和WWI与风险呈正线性关系。亚组分析提供了额外的证据,证实这些关联在多个人群亚组中保持一致。在ROC分析中,METS-VF的预测准确率最高(AUC = 0.79),其次是WWI (AUC = 0.73),优于传统的身体质量指数(BMI)和腰围(WC)等指标。结论VAI、METS-VF、BRI和WWI水平升高与晚期CKM综合征显著相关。met - vf和WWI作为一种简单、无创的标志物,具有较强的预测能力,可作为临床早期发现和干预的有效工具。
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来源期刊
Cardiorenal Medicine
Cardiorenal Medicine CARDIAC & CARDIOVASCULAR SYSTEMS-UROLOGY & NEPHROLOGY
CiteScore
5.40
自引率
2.60%
发文量
25
审稿时长
>12 weeks
期刊介绍: The journal ''Cardiorenal Medicine'' explores the mechanisms by which obesity and other metabolic abnormalities promote the pathogenesis and progression of heart and kidney disease (cardiorenal metabolic syndrome). It provides an interdisciplinary platform for the advancement of research and clinical practice, focussing on translational issues.
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