Visceral adiposity index and risks of cardiovascular events and mortality in prevalent hemodialysis patients

Cardiovascular Diabetology

Original Investigation

Yi-Fang Chuang¹  Shih-Ping Hsu²  Mei-Fen Pai²  Yen-Ling Chiu²  Ju-Yeh Yang²  Hung-Yuan Chen²  Yu-Sen Peng² 

[1] Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan;Department of Internal Medicine, Far Eastern Memorial Hospital, Division of Nephrology, #21 Nan-Ya South Rd, Section 2, Banciao District, New Taipei City, Taiwan;Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan;

关键词: Visceral adiposity index;    Cardiovascular complication;    Abdominal obesity;    Survival;   

DOI  :  10.1186/s12933-014-0136-5

 received in 2014-08-21, accepted in 2014-09-29,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundThe visceral adiposity index (VAI) is a newly-derived measure of visceral adiposity with well-validated predictive power for cardiovascular (CV) outcomes in the general population. However, this predictability has not been investigated in hemodialysis patients, and whether VAI is superior to waist circumference (WC) and waist-to-height ratio (WHtR) in predicting CV outcomes and survival in hemodialysis patients remains unknown.MethodsWe performed a prospective study including 464 prevalent hemodialysis patients. The composite outcome was the occurrence of death and CV events during follow-up. Using multivariate Cox regression analysis, VAI, WC and WHtR were tested for the predictive power of outcomes. To evaluate the predictive performance of the VAI, WC and WHtR, time-dependent receiver operating characteristic curve (ROC) analysis was performed.ResultsVAI, WC and WHtR positively correlated with each other. Patients with a higher VAI (tertile 3 vs. tertile 1, adjusted hazard ratio (HR), 1.65; 95% confidence interval (CI), 1.12-2.42; tertile 2 vs. tertile 1, adjusted HR, 1.52; 95% CI, 1.1-2.18) had more composite outcomes. VAI had a similar predictive power of all-cause mortality to WC and WHtR, but superior predictive power of composite and CV outcomes to WC when analyzed by a stepwise forward likelihood ratio test. In time-dependent ROC analysis, VAI, WC and WHtR showed similar predictive performance for outcomes.ConclusionVAI is an optimal method to measure visceral adiposity to assess long-term CV outcomes and all-cause mortality in prevalent hemodialysis patients. VAI may provide a superior predictive power of CV outcomes to WC and WHtR.Trial registrationClinicalTrials.gov NCT01457625

【 授权许可】

Unknown   
© Chen et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.