Association Between Neck-to-Limb Length Ratio and Cardiovascular Events in a Chinese Population.

IF 3 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy Pub Date : 2025-08-13 eCollection Date: 2025-01-01 DOI:10.2147/DMSO.S543163

Xiaoya Li, Tingting Hu, Yiting Xu, Xuhong Lu, Yingying Su, Yunfeng Xiao, Yufei Wang, Xiaojing Ma, Yuqian Bao

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引用次数: 0

Abstract

Aim: Obesity contributes to cardiovascular (CV) events. This study aimed to identify the most effective anthropometric indicators that add predictive value to body mass index (BMI) for subsequent CV events in individuals without carotid plaques, improving early risk stratification in subclinical populations.

Methods: This longitudinal study enrolled 1043 participants from a community-based cohort in Shanghai (2013-2014) and followed them for CV events through 2021-2022. The CV events included ischemic heart disease (myocardial infarction, unstable angina pectoris, hospitalization for heart failure, and coronary revascularization), ischemic stroke, and CV death. Carotid plaque was excluded via ultrasound. Visceral fat area (VFA) was assessed using magnetic resonance imaging. The neck circumference (NC), neck-to-height ratio (NHtR), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), neck-to-limb length ratio (NLR), and waist-to-limb length ratios (WLR) were calculated.

Results: Multivariable linear regression analysis revealed a significant positive correlation between various obesity-related indices (BMI, waist circumference, NC, NHtR, WHtR, WHR, NLR, and WLR) and VFA (all P < 0.001). Over a mean follow-up period of 7.6 years, 97 CV events (9.3%) were recorded. Cox proportional hazards regression demonstrated that elevated NLR was significantly associated with an increased CV risk with hazard ratios of 1.28 (95% confidence interval [CI]: 1.08-1.52). Notably, the NLR significantly improved the predictive capacity of CV events (C-statistic, 0.671 [95% CI: 0.616-0.726], P = 0.002; NRI, 0.090 [95% CI: 0.003-0.177], P < 0.001; IDI, 0.007 [95% CI: 0.000-0.019], P < 0.001).

Conclusion: NLR was correlated with visceral fat content, and significantly enhanced the predictive value of BMI for CV risk in individuals without baseline carotid plaque. These findings support their use in routine clinical assessment to enhance early prevention efforts.

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中国人群颈肢长度比与心血管事件的关系

目的：肥胖与心血管（CV）事件有关。本研究旨在确定最有效的人体测量指标，为没有颈动脉斑块的个体随后的CV事件增加体重指数（BMI）的预测价值，改善亚临床人群的早期风险分层。方法：本纵向研究招募了1043名来自上海社区队列的参与者（2013-2014年），并随访了2021-2022年的CV事件。心血管事件包括缺血性心脏病（心肌梗死、不稳定型心绞痛、心力衰竭住院和冠状动脉血运重建术）、缺血性中风和心血管死亡。超声排除颈动脉斑块。采用磁共振成像技术评估内脏脂肪面积（VFA）。计算颈围（NC）、颈高比（NHtR）、腰高比（WHtR）、腰臀比（WHR）、颈肢长比（NLR）、腰肢长比（WLR）。结果：多变量线性回归分析显示，各肥胖相关指标（BMI、腰围、NC、NHtR、WHtR、WHR、NLR、WLR）与VFA呈显著正相关（P < 0.001）。在平均7.6年的随访期间，记录了97例CV事件（9.3%）。Cox比例风险回归显示，NLR升高与CV风险增加显著相关，风险比为1.28（95%可信区间[CI]: 1.08-1.52）。值得注意的是，NLR显著提高了CV事件的预测能力（C-statistic, 0.671 [95% CI: 0.616-0.726], P = 0.002； NRI, 0.090 [95% CI: 0.003-0.177], P < 0.001； IDI, 0.007 [95% CI: 0.000-0.019], P < 0.001）。结论：NLR与内脏脂肪含量相关，并且在基线无颈动脉斑块的个体中显著增强BMI对CV风险的预测价值。这些发现支持将其用于常规临床评估，以加强早期预防工作。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy Pharmacology, Toxicology and Pharmaceutics-Pharmacology

CiteScore

5.90

自引率

6.10%

发文量

431

审稿时长

16 weeks

期刊介绍： An international, peer-reviewed, open access, online journal. The journal is committed to the rapid publication of the latest laboratory and clinical findings in the fields of diabetes, metabolic syndrome and obesity research. Original research, review, case reports, hypothesis formation, expert opinion and commentaries are all considered for publication.