The Feasibility Of Two Anthropocentric(VAI And LAPI) To Identify Left Atrial Enlargement Among The Rural Population In Northeast:a Cross-sectional Study

Objective:We aimed to examine whether the visceral adiposity index(VAI)and lipid accumulation product index(LAPI),which are suggested to assess visceral fat,can identify left atrial enlargement(LAE)in the rural population of China.Another objective was to compare the relative strength of the identifying capacity of anthropometric obesity indices on LAE among body mass index(BMI),waist circumference(WC),waist-to-height ratio(WHt R),VAI and LAPI.Methods: This cross-sectional study was conducted in the rural areas of northeast China from January 2012 to August 2013 using a multistage,stratified random cluster-sampling scheme.All participants completed a questionnaire,and underwent complete physical examination and echocardiogram.We defined LAE as a LA diameter exceeding 4.0 cm in men and 3.8 cm in women.We conducted a multivariable logistic regression analysis and Pearson's correlation to identify independent factors of LAE.ROC curve analysis was carried out to compare which was the best indicator to evaluate LAE among VAI,LAPI,BMI,WC and WHtR.Results: There were 4958 males and 5908 females involved in this study,and 1096participants(10.07%)suffered from LAE.All the 5 anthropometric measures were positively correlated with LAE.The prevalence of LAE increased across quartiles for VAI,BMI,LAPI,WC,and WHR.Multivariable logistic regression analysis of the presence of LAE for the highest quartile vs.the lowest quartile of each anthropometric measure showed that WC had the largest values of ORs in men(OR: 9.447,95% CI: 6.102–14.628)and BMI had the largest values of ORs in women(OR: 9.238,95% CI: 6.539–13.050)and VAI had the smallest ORs(OR: 2.024,95% CI: 1.399–2.928 in men;OR:2.263,95% CI: 1.670–3.065 in women).LAPI had the smallest values of ORs in men(OR : 2.222,95%CI: 1.461-3.378).LAPI had the smallest values of ORs in women(OR:2.089;95%CI: 1.481-2.946).WC showed the highest AUC for LAE(AUC: 0.734,95% CI: 0.711–0.757 for men and AUC: 0.738,95% CI: 0.719–0.757 for women),while VAI had the lowest AUC for LAE(AUC: 0.588,95% CI: 0.561–0.615 for men and AUC: 0.611,95% CI: 0.589–0.633 for women).Conclusion:In our study,VAI and LAPI were demonstrated positively correlated with LAE.Furthermore,WC,rather than VAI,LAPI,is the best index of evaluating left atrial size.