The Status Of Clustering Of Cardiometabolic Risk Factors And Its Relationship With Adiposity Indices Among Xinjiang Residents

ObjectiveThis study aims to investigate the status and prevalence of clustering of cardiometabolic risk factors(CCRF),to explore the association of different adiposity indices with CCRF and to compare the efficiency of different adiposity indices on identifying CCRF among Xinjiang residents.MethodsData used in this study came from Chinese National Special Fund for Health-Scientific Research in the Public Interest "study on prevalence of chronic cardiopulmonary disease in Tibet and Xinjiang area".Using stratified multi-stage random sampling,approximately 7 000 participants from 7 sample sites in Xinjiang autonomous region were examined in this community-based cross-sectional survey with international standardized examination in 2015-2016.The participants were surveyed for cardiovascular risk factors including lifestyle factors like smoking and drinking,blood pressure,fasting blood glucose and lipids,body height,weight,waist circumference(WC),body fat percentage(BFP)and visceral fat index(VFI).People aged 35 and over in Xinjiang were subjects in this study.Of 4 001 participants were eligible for analysis.CCRF was defined by the existence of 2 or more of the following cardiovascular risk factors:hypertension,diabetes,hypertriglyceridemia and low high density lipoprotein cholesterol(HDL-C)level.All of the adiposity indices were divided into four groups by their quartile Multivariate logistic regression analysis was used to explore the association of adiposity indices with each cardiovascular risk factors and CCRF.Receiver operating characteristics(ROC)analyses were employed to compare the efficiency of different adiposity indices on early identifying CCRF.ResultsA total of 4 001(1 914 males and 2 087 females)eligible participants were included in analysis,with average age 54.26=13.24 years.The overall prevalence of hypertension was 32.79%(age-standard prevalence 30.03%),31.97%(age-standard prevalence 29.72%)in men and 33.54%(age-standard prevalence 30.51%)in women.289 cases of diabetes were detected and the overall prevalence was 7.22%(age-standard prevalence 6.58%),7.52%(age-standard prevalence 6.98%)for men and 6.95%(age-standard prevalence 6.26%)for women;330 cases of hypertriglyceridemia were diagnosed with the overall prevalence of 8.25%(age-standard prevalence 8.36%)and the prevalence in men[10.61%(age-standard prevalence 11.09%)]was significantly higher than in women[6.09%(age-standard prevalence 5.85%)]);475 cases of low HDL-C level were detected with overall prevalence of 11.87%(age-standard prevalence 12.27%)and prevalence for men[16.67%(age-standard prevalence 17.40%)]was significantly higher than for women[7.47%(age-standard prevalence 7.58%)]as well.A total of 440 participants were detected with CCRF with overall prevalence of 11.00%(age-standard prevalence 10.27%),and prevalence in men[13.22%(age-standard prevalence 12.89%)]was significantly higher than in women[8.96%(age-standard prevalence 7.96%)].The most prevalent modes of CCRF was hypertension + diabetes(hypertension + HDL-C level in men,hypertension + diabetes in women).In both men and women,each incensement of standard deviation(SD)for BFP was associated with greater risk of CCRF,so did VFI,BMI,WC and WHtR.Odds ratio(95%confidential interval)[OR(95%CI)]was 1.74(1.49,2.05)for BFP,1.92(1.67,2.22)for VFI,1.87(1.63,2.16)for BMI,2.01(1.73,2.35)for WC and 1.85(1.61,2.13)for WHtR in men and 1.80(1.47,2.21)for BFP,1.80(1.55,2.11)for VFI,1.83(1.57,2.14)for BMI,1.81(1.54,2.15)for WC and 1.77(1.50,2.10)for WHtR in women.In both men and women,CCRF risk tended to increase with the incensement of BFP,as well as VFI,BMI,WC and WHtR(P for trend<0.01).The area under the ROC curves(AUCs)for WC in detecting CCRF was:0.700(0.679,0.720),0.692(0.671,0.713)for VFI,0.690(0.669,0.711)for WHtR,0.680(0.659,0.701)for BMI,0.666(0.644,0.687)for BFP in men and VFI:0.716(0.696,0.735)for VFI,0.713(0.693,0.732)for BFP,0.703(0.683,0.723)for WHtR,0.692(0.672,0.712)for WC and 0.673(0.653,0.693)for BMI in women.In men,AUCs for WC and VFI were significantly larger than that for BFP(P<0.01)and no significant differences were seen among other indices;in women,AUCs for PBF?VFI and WHtR were significantly larger than that for BMI(P<0.01)and no significant differences were seen among other indices.Additionally,both WC(0.32)and VFI(0.32)yielded the greatest Youden index in identifying CCRF in men,and the sensitivity were 71.54%and 73.12%,respectively.WHtR(0.33)yielded the greatest Youden index in women,so did VFI(0.33)and BFP(0.33)and their sensitivities were 72.73%,66.41%and 57.75%,respectively.ConclusionThe prevalence of CCRF in Xinjiang residents was high.The most prevalent pattern of CCRF was hypertension + diabetes.Elevated levels of adiposity indices were independently associated with high prevalence of cardiometabolic risk factors and CCRF.WC and VFI could be better candidates for identifying CCRF in men,WHtR and VFI in women.Comprehensive prevention and intervention on cardiometabolic risk factors and clustering are needed,especially for hypertension and diabetes.VFI can help to early identify CCRF effectively in both gender.