Higher visceral adiposity index is associated with increased likelihood of abdominal aortic calcification

Qin, Zheng; Jiang, Luojia; Sun, Jiantong; Geng, Jiwen; Chen, Shanshan; Yang, Qinbo; Su, Baihai; Liao, Ruoxi

doi:10.1016/j.clinsp.2022.100114

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Original articles • Clinics 77 • 2022 • https://doi.org/10.1016/j.clinsp.2022.100114 copy

Higher visceral adiposity index is associated with increased likelihood of abdominal aortic calcification

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Background:

The negative effects of visceral adiposity accumulation on cardiovascular health have drawn much attention. However, the association between the Visceral Adiposity Index (VAI) and Abdominal Aortic Calcification (AAC) has never been reported before. The authors aimed to investigate the association between the VAI and AAC in US adults.

Methods:

Cross-sectional data were derived from the 2013 to 2014 National Health and Nutrition Examination Survey (NHANES) of participants with complete data of VAI and AAC scores. Weighted multivariable regression and logistic regression analysis were conducted to explore the independent relationship between VAI and AAC. Subgroup analysis and interaction tests were also performed.

Results:

A total of 2958 participants were enrolled and participants in the higher VAI tertile tended to have a higher mean AAC score and prevalence of severe AAC. In the fully adjusted model, a positive association between VAI and AAC score and severe AAC was observed (β = 0.04, 95% CI 0.01‒0.08; OR = 1.04, 95% CI 1.01‒1.07). Participants in the highest VAI tertile had a 0.41-unit higher AAC score (β = 0.41, 95% CI 0.08‒0.73) and a significantly 68% higher risk of severe AAC than those in the lowest VAI tertile (OR = 1.68, 95% CI 1.04‒2.71). Subgroup analysis and interaction tests indicated that there was no dependence for the association of VAI and AAC.

Conclusion:

Visceral adiposity accumulation evaluated by the VAI was associated with a higher AAC score and an increased likelihood of severe AAC.

Keywords:
Visceral adiposity index; Abdominal aortic calcification; Vascular calcification; Cross-sectional study

HIGHLIGHTS

Higher Adiposity Index (VAI) tertile shows higher rates of Abdominal Aortic Calcification (AAC).

Each unit increase in VAI was associated with 4% higher likelihood of severe AAC.

Increased visceral adiposity evaluating by VAI associated with a higher AAC score.

This positive relationship was more significant in normal weight population.

Visceral Adiposity Index	Overall	Tertile 1 (0.12‒1.25)	Tertile 2 (1.25‒2.60)	Tertile 3 (2.60‒130.87)	p-value
Age (year)	57.41 ± 0.29	56.82 ± 0.62	57.95 ± 0.45	57.48 ± 0.33	0.2916
Gender (%)
Male	48.55 ± 0.86	48.84 ± 1.58	46.18 ± 1.59	50.60 ± 2.14	0.2650
Female	51.45 ± 0.86	51.16 ± 1.58	53.82 ± 1.59	49.40 ± 2.14
Race (%)
Mexican American	6.97 ± 1.63	4.55 ± 1.15	8.02 ± 1.87	8.34 ± 2.01	< 0.0001
Other Hispanic	4.68 ± 0.86	3.71 ± 0.89	5.05 ± 1.01	5.29 ± 0.89
Non-Hispanic White	71.34 ± 3.10	71.09 ± 2.80	69.60 ± 3.59	73.31 ± 3.44
Non-Hispanic Black	9.82 ± 1.34	14.11 ± 1.80	10.18 ± 1.59	5.19 ± 0.88
Other Races	7.18 ± 0.77	6.54 ± 0.84	7.14 ± 1.00	7.87 ± 1.26
Education level (%)
Less than high school	5.02 ± 1.82	12.55 ± 1.36	14.50 ± 1.94	18.68 ± 2.76	< 0.0001
High school or GED	32.06 ± 1.44	19.11 ± 2.13	19.64 ± 1.05	26.70 ± 2.89
Above high school	62.92 ± 2.63	68.32 ± 2.85	65.84 ± 2.54	54.61 ± 3.79
Unknown	0.02 ± 0.01	0.03 ± 0.02	0.02 ± 0.02	0.00 ± 0.00
Smoking status (%)
Never	54.29 ± 1.72	60.18 ± 2.75	54.21 ± 2.21	48.49 ± 2.05	0.0001
Ever	28.41 ± 1.27	26.25 ± 2.13	29.48 ± 1.89	29.50 ± 2.04
Current	17.30 ± 1.59	13.54 ± 2.06	16.31 ± 2.20	22.01 ± 1.50
Unknown	0.01 ± 0.01	0.03 ± 0.03	0.00 ± 0.00	0.00 ± 0.00
BMI (kg/m²)	28.53 ± 0.17	26.19 ± 0.17	28.98 ± 0.28	30.41 ± 0.24	< 0.0001
Diabetes (%)	12.94 ± 0.80	6.63 ± 0.89	11.74 ± 1.12	20.41 ± 1.55	< 0.0001
Hypertension (%)	43.58 ± 1.15	32.13 ± 2.39	45.16 ± 1.85	53.46 ± 1.70	< 0.0001
Serum creatinine (mg/dL)	0.93 ± 0.01	0.92 ± 0.01	0.92 ± 0.01	0.94 ± 0.01	0.2574
Serum uric acid (μmoL/L)	321.59 ± 1.87	301.43 ± 2.32	320.40 ± 2.07	342.89 ± 4.68	< 0.0001
Serum calcium (mmoL/L)	2.36 ± 0.00	2.36 ± 0.00	2.36 ± 0.01	2.37 ± 0.01	0.0210
Serum phosphorus (mmoL/L)	1.23 ± 0.01	1.22 ± 0.01	1.22 ± 0.01	1.23 ± 0.01	0.6103
Total cholesterol (mmoL/L)	5.05 ± 0.01	4.91 ± 0.04	4.98 ± 0.04	5.27 ± 0.03	0.0001
HDL-C (mmoL/L)	1.42 ± 0.01	1.77 ± 0.02	1.39 ± 0.02	1.08 ± 0.01	< 0.0001
Waist circumference (cm)	99.82 ± 13.57	93.16 ± 0.53	100.61 ± 0.56	105.69 ± 0.46	< 0.0001
Triglycerides (mmoL/L)	1.81 ± 0.04	0.83 ± 0.01	1.48 ± 0.02	3.11 ± 0.07	< 0.0001
AAC score	1.47 ± 0.11	1.19 ± 0.15	1.44 ± 0.11	1.77 ± 0.20	0.0047
Severe AAC (%)	7.85 ± 0.75	6.29 ± 1.04	7.43 ± 0.79	9.81 ± 1.38	0.0300

Visceral adiposity index groups	AAC Score	Severe AAC
	β (95% CI)	OR (95% CI)
Crude model (Model 1)
Continuous	0.04 (-0.01, 0.09)	1.02 (1.00, 1.05)
Categories
Tertile 1	Reference	Reference
Tertile 2	0.25 (-0.13, 0.63)	1.20 (0.83, 1.72)
Tertile 3	0.57 (0.24, 0.91)	1.62 (1.11, 2.37)
p for trend	0.0047	0.0271
Minimally adjusted model (Model 2)
Continuous	0.05 (0.00, 0.09)	1.04 (1.02, 1.06)
Categories
Tertile 1	Reference	Reference
Tertile 2	0.12 (-0.21, 0.44)	1.11 (0.83, 1.48)
Tertile 3	0.49 (0.16, 0.81)	1.71 (1.14, 2.57)
p for trend	0.0194	0.0371
Fully adjusted model (Model 3)
Continuous	0.04 (0.01, 0.08)	1.04 (1.01, 1.07)
Categories
Tertile 1	Reference	Reference
Tertile 2	0.15 (-0.17, 0.47)	1.13 (0.79, 1.60)
Tertile 3	0.41 (0.08, 0.73)	1.68 (1.04, 2.71)
p for trend	0.0138	0.0254

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[1] * Corresponding author. E-mail address: liaoruoxi@wchscu.cn (R. Liao).