AUTHOR=Zhang Yangchang , He Qiang , Zhang Weihao , Xiong Yang , Shen Shisi , Yang Jialu , Ye Mengliang 

TITLE=Non-linear Associations Between Visceral Adiposity Index and Cardiovascular and Cerebrovascular Diseases: Results From the NHANES (1999–2018)

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.908020

DOI=10.3389/fcvm.2022.908020

ISSN=2297-055X

ABSTRACT=Objective: To investigate the association between visceral adiposity index (VAI) and cardiovascular &. cerebrovascular diseases (CCDs) in American population from 1999 to 2018.
Methods: The data from NHANES (1998-2018) were analysed in this study. To be specific, VAI scores were calculated using the sex-independent equation that incorporates body mass index (BMI), waist circumference (WC), high-density lipoprotein (HDL), triglycerides (TG), and cholesterol; Weighted logistic regression was used to assess the VAI tertiles and the increased risk of CCDs, respectively; Restricted cubic splines were used to evaluate the nonlinear relationship between VAI and CCDs including heart failure, angina, heart attack, stroke, hypertension, and coronary heart disease; Sensitivity analysis was adopted using the VAI quartiles as independent variable. 
Results: A total of 22,622 subjects aged over 20 years were included. In the full model after controlling covariates, the third VAI tertile was more associated, than the first VAI tertile, with higher odds ratio of angina (OR=2.86, 95% CI:1.68,4.85), heart attack (OR=1.75, 95% CI:1.14, 2.69), stroke (OR=2.01, 95% CI:1.23, 3.26), hypertension (OR=2.28, 95% CI:1.86, 2.78), and coronary heart disease (OR=1.78, 95% CI:1.32, 2.41), but it was not the same case with heart failure (P> 0.05). Restricted cubic splines presented a parabolic relationship of the VAI scores with angina (P for non-linear=0.03), coronary heart disease (P for non-linear =0.01), and hypertension (P for non-linear <0.001). The sensitivity analysis indicated that the fourth VAI quartiles was more associated with an increased risk in angina (OR=2.92, 95% CI:1.49, 5.69), hypertension (OR=2.37, 95% CI:1.90, 2.97), heart attack (OR=1.77, 95% CI:1.09, 2.88), and coronary heart disease (OR=1.89, 95% CI:1.24, 2.86) than the first VAI quartile.
Conclusion: The VAI score was positively correlated with heart angina, heart attack, stroke, hypertension, and coronary heart disease rather than heart failure, and a nonlinear relationship was found in the VAI score with angina, hypertension, and coronary heart disease.