心血管风险分层的内脏脂肪阈值：一个简化的生物标志物驱动模型。

IF 4.7 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Obesity Pub Date : 2025-08-18 DOI:10.1002/oby.24367

Tangmeng Guo, Ping He, Weilin Lu, Lili Huang, Chengyun Liu, Bei Cheng, Yuanyuan Zhang, Qi Zhang, Yanxu Chen, Minghao Liu, Peien Zhou, Junxi Liu, Xinchun Gu, Zhengyang Sun, Qiang Zhang, Sihao Xiao

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引用次数: 0

摘要

目的：VAT体积是心脏代谢风险的关键决定因素，但特定人群的阈值和可获得的预测工具仍未定义。方法：使用美国国家健康与营养检查调查（NHANES）数据，我们分析了双能x线吸收仪（DXA）衍生的VAT体积。阈值效应和性别/种族相互作用通过多变量回归进行评估，而LASSO正则化和ROC分析确定了简化的预测模型。结果：VAT容积阈值为327.0 cm3分层CVD风险，将代偿性肥胖与病理性肥胖区分开来。高增值组表现出心血管疾病患病率升高（2.41% vs. 1.12%, p = 0.016）、代谢失调和社会经济差异。男性的危险阈值高于女性（387.5 vs. 312.0 cm3， p交互作用= 0.029）。非西班牙裔白人参与者和多种族组的风险突然上升至399.5和270.0 cm3以上（aOR = 1.08-1.12, p）。结论：本研究首次建立了CVD风险分层的性别特异性和种族特异性VAT阈值，并为内脏脂肪筛查提供了临床可操作的工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Visceral Adiposity Thresholds for Cardiovascular Risk Stratification: A Simplified Biomarker-Driven Model

查看原文本刊更多论文

Visceral Adiposity Thresholds for Cardiovascular Risk Stratification: A Simplified Biomarker-Driven Model

Objective

VAT volume is a critical determinant of cardiometabolic risk, yet population-specific thresholds and accessible predictive tools remain undefined.

Methods

Using US National Health and Nutrition Examination Survey (NHANES) data, we analyzed dual-energy x-ray absorptiometry (DXA)-derived VAT volume. Threshold effects and sex/ethnicity interactions were evaluated via multivariable regression, while LASSO regularization and ROC analyses identified a simplified predictive model.

Results

A VAT volume threshold of 327.0 cm³ stratified CVD risk, distinguishing compensatory from pathological adiposity. The high-VAT group exhibited elevated CVD prevalence (2.41% vs. 1.12%, p = 0.016), metabolic dysregulation, and socioeconomic disparities. Males showed higher risk thresholds than females (387.5 vs. 312.0 cm³, p-interaction = 0.029). Non-Hispanic White participants and multiracial groups exhibited abrupt risk escalation above 399.5 and 270.0 cm³ (aOR = 1.08–1.12, p < 0.001), absent in non-Hispanic Black individuals and Hispanic individuals. A tri-biomarker model (waist circumference + triglycerides + apolipoprotein B) achieved near-equivalent accuracy to DXA-based VAT quantification (AUC = 0.821 vs. 0.819, p = 0.66), with high sensitivity (80.95% vs. 69.05%) and cost-effectiveness.

Conclusions

This study establishes the first sex-specific and ethnicity-specific VAT thresholds for CVD risk stratification and provides a clinically actionable tool for visceral adiposity screening.

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来源期刊

Obesity 医学-内分泌学与代谢

CiteScore

11.70

自引率

1.40%

发文量

261

审稿时长

2-4 weeks

期刊介绍： Obesity is the official journal of The Obesity Society and is the premier source of information for increasing knowledge, fostering translational research from basic to population science, and promoting better treatment for people with obesity. Obesity publishes important peer-reviewed research and cutting-edge reviews, commentaries, and public health and medical developments.