中国内脏脂肪指数与脂肪肝发生风险的回顾性队列研究

BackgroundObesity is an important risk factor for the development of fatty liver. The current diagnostic indexes of obesity cannot effectively reflect the role of adipose tissue distribution in the development of fatty liver. ObjectiveTo assess the correlation of the baseline visceral adiposity indexVAIand the Chinese visceral adiposity indexCVAIwith the risk of fatty liver. MethodsThis was a retrospective cohort study involving 17 086 adults receiving physical examination at the Health Management Center of Nanjing Drum Tower Hospitalthe Affiliated Hospital of Nanjing University Medical School from February 2018 to November 2021. Physical examination records were reviewed by the electronic information system of the Health Management Centerand baseline characteristicsphysical examination findingslaboratory testing and equipment inspection data were collected. Fatty liver was determined by follow-up abdominal ultrasound and computed tomographyCT. Follow-up was ended in December 2022and follow-up events were recorded as the interval from non-occurrence of fatty liver at baseline to the first onset of fatty liver or at the end of the follow-up. Subjects were divided into fatty liver group and non-fatty liver group. Baseline VAI and CVAI were compared between groups. They were further divided into four groups based on the quartiles of baseline VAI and CVAIand the incidence of fatty liver was compared. The correlation of VAI and CVAI with fatty liver was identified by Cox regression. The potential of VAI and CVAI in predicting fatty liver was assessed by the receiver operating characteristicROCcurves. Differences in the area under the curveAUCbetween VAI and CVAI were compared by the Delong's test. ResultsThe mean ageBMI and follow-up period of the subjects were44.313.2years old23.22.6 kg/m2 and2.71.1yearsrespectively. By the end of follow-upfatty liver was detected in 2 52314.8%subjects. The incidence of fatty liver was significantly higher in men than women 19.4%1 837/9 461vs. 9.0%686/7 625 P<0.001. The VAI and CVAI of the fatty liver group were significantly higher than those of the non-fatty liver groupP<0.05. Trend testing showed that the incidence of fatty liver significantly increased with the increasing baseline VAI2 trend=1 034.9 and CVAI2 trend=1 334.8both P<0.001. Multivariate Cox regression showed that the risk of fatty liver in the VAI-Q4 group and CVAI-Q4 group was 2.579 times95%CI=2.088-3.186and 3.375 times95%CI=2.488-4.576that of the VAI-Q1 grouprespectively. The ROC curve showed that the AUC of CVAI in predicting fatty liver was greater than that of VAI0.737 vs. 0.708P<0.001. Stratified analysis showed that CVAI was significantly correlated with the occurrence of fatty liver in gender age and BMI subgroupsP<0.001. ConclusionBaseline CVAI is significantly correlated with fatty liver developmentand superior to VAI in predicting fatty liver.