The Association Of Novel Anthropometric Indicators With Cardiovascular Disease And Its Important Risk Factors

Background:Cardiovascular disease（CVD）is the leading cause of death worldwide.In China,the incidence and prevalence of cardiovascular disease continue to rise,with290 million people suffering.It has become a major public health problem,and its control is urgent.Currently,the main risk factors known to cause CVD include hypertension,diabetes,and overweight/obesity.It is important to choose a convenient diagnostic approach for risk factors through primary prevention to reduce the number of cardiovascular diseases.Anthropometric indicators have been widely used because they are convenient,noninvasive,and cost less.Epidemiological investigations have found that the risk of cardiovascular disease and its risk factors can be predicted and avoided using anthropometric indicators.However,traditional anthropometric indicators have certain limitations,and the studies on new anthropometric indicators are relatively few and mainly cross-sectional.Therefore,this study explores the relationship between novel anthropometric indicators,including body shape index（ABSI）,body roundness index（BRI）,body fat index（BAI）,abdominal volume index（AVI）,hip index（HI）,body obesity estimator（CUN-BAE）,and cardiovascular disease as well as its risk factors（hypertension,diabetes）.The study was divided into two parts as follows:Part I:The association of novel anthropometric indicators with cardiovascular risk factors（hypertension,diabetes）Objective:To investigate the association of novel anthropometric indicators with the prevalence of major cardiovascular risk factors（hypertension,diabetes）and to assess their ability to screen and diagnose disease.Methods:The study was selected from the Northeast region of China.Spearman correlation was used to analyze the correlation between each anthropometric index and disease,and logistic regression models were used to analyze the risks of hypertension and diabetes.Different anthropometric indicators’discriminatory ability and optimal cut-off values were assessed using the receiver operating curve（ROC）and the area under curve（AUC）.Results:A total of 11838 participants were included in the cross-sectional study,in which the crude prevalence of hypertension and diabetes was 50.6%and 4.5%,respectively.Except for HI,all anthropometric indicators were positively correlated with hypertension and diabetes（P<0.001）.Logistic regression analysis showed that the association of BRI,AVI,and CUN-BAE with hypertension and diabetes increased with higher quartile levels（P<0.001）.The relationship of HI with diabetes and hypertension in women decreased with the increase of the quartile level（P<0.05）.Adjusting for confounding factors and comparing the highest quartile of each index,men had the largest AVI for hypertension,OR_AVI=3.89,and the CUN-BAE had the largest association in women OR_CUN-BAE=3.78.Except for BAI,the fourth quartile of all indicators was associated with diabetes prevalence,with WHR having the greatest association with women,OR_WHR=2.89.Regardless of gender,the CUN-BAE had the best efficacy in identifying hypertension,with an optimal cut-off of 24.25 and 35.92.WHR has the best efficacy in identifying diabetes.However,BAI is not suitable for screening for diabetes,while ABSI and HI are weakly associated with diabetes and hypertension that are not good diagnostic and screening indicators.Conclusion:BRI,AVI,and CUN-BAE are associated with the prevalence of hypertension and diabetes and can be used as new indicators for Disease diagnosis.CUN-BAE has the largest association with hypertension in men before model adjustment and in women,making it the best indicator to screen for hypertension.WHR is the best indicator to identify diabetes.BAI is not suitable for screening for diabetes,and the ABSI and HI are not good early screening indicators.Part II:The correlation between novel anthropometric indicators and cardiovascular diseasesObjective:To explore the results of prospective studies of novel anthropometric indicators and new-onset cardiovascular disease in the context of important cardiovascular disease risk factors.Additionally,it aims to compare the predictive validity of new anthropometric and traditional indicators for the risk of cardiovascular disease to provide a basis for prevention and control.Methods:The first part of the study participants were used as the baseline population,and the information on new CVD patients was collected after a mean follow-up of 4.66years.Spearman correlation was used to analyze the correlation of each anthropometric index with the CVD.The COX risk regression models and ROC curves were used to explore the anthropometric indicators’predictive ability and optimal cut-off values.RESULTS:There were 466 new cases of CVD in this study,and the prevalence of CVD in men and women was 5.8%and 4.2%,respectively.All indicators except HI were positively correlated with CVD.After correcting for confounders such as age and sex,increased levels of BMI,WC,WHR,WHt R,BRI,BAI,and CUN-BAE could increase the incidence of CVD.CUN-BAE had the best ability to predict CVD incidence in the whole population and famale.Its predictive validity decreased in men after stratification by gender and was lower than WHt R and BMI.BRI had a similar predictive ability to BMI and WHt R.ROC curve analysis showed that CUN-BAE was the best indicator of CVD,with a cut-off of 25.04 and 34.14 for men and women,respectively（P<0.001）.However,ABSI and HI were not associated with the incidence of CVD（P>0.05）.Conclusion:Elevated BRI,BAI,and CUN-BAE are independently associated with the incidence of CVD and can be used as predictors of CVD.Compared with traditional indicators,CUN-BAE had a better predictive ability in the whole population and the female group but decreased in the male group.The predictive ability of BRI was not inferior to traditional indicators,while CUN-BAE had high predictive value and could be considered an early screening indicator for predicting CVD.