Abstract
We investigated the association of the newly established lipid accumulation product (LAP) and visceral adiposity index (VAI) with intracranial atherosclerotic stenosis (ICAS) in middle-aged and elderly Chinese. From June 2012 to January 2013, consecutive patients ≥40 years of age who underwent cerebral vascular imaging for various medical reasons were enrolled in this study. Multivariate logistic regression models were used to evaluate the correlation of VAI and LAP with the risk of ICAS. In total, 845 patients were included in the study. The prevalence of ICAS gradually increased in females and in all patients with advancing tertiles of VAI or LAP. After adjusting for potential risks, both the VAI and LAP were related to ICAS in females [VAI: odds ratio (OR) = 3.25, 95% confidence interval (95%CI) = 1.17–9.03, P = 0.024; LAP: OR = 4.11, 95%CI = 1.39–12.12, P = 0.011; tertiles 3 vs. 1]. The sensitivity, specificity, and positive predictive value (PPV) were 74.7%, 45.5%, and 84.4% for VAI (cut-off: 1.71) and 79.3%, 40.5%, and 84.1% for LAP (cut-off: 23.99). The same relationships in males were not significant. Both VAI and LAP were closely associated with an increased risk of ICAS in middle-aged and elderly Chinese females.
Highlights
Stroke is the second leading cause of mortality and morbidity in China and its prevalence is expected to increase further as the Chinese population ages
Significant differences were found among visceral adiposity index (VAI) tertiles in age, hypertension, diabetes mellitus (DM), body mass index (BMI), waist circumference (WC), fasting plasma glucose (FPG), TG, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), and Framingham risk score (FRS) (P < 0.05)
Significant differences were observed among VAI tertiles in DM, coronary heart disease (CHD), BMI, WC, FPG, FRS, HDL-C, LDL-C, and TG (P < 0.05)
Summary
Stroke is the second leading cause of mortality and morbidity in China and its prevalence is expected to increase further as the Chinese population ages. The VAI is calculated from anthropometric parameters [WC and body mass index (BMI)] and metabolic indicators [high density lipoprotein cholesterol (HDL-C) and TG]6. Both the VAI and LAP are two reliable markers of central lipid accumulation, and their positive predictive values for cardiometabolic diseases has been demonstrated[6,7,8,9,10,11,12,13]. The LAP can be used to predict all-cause mortality in non-diabetic patients with cardiovascular risk factors[10] and its accurate predictive value in insulin resistance (IR)[11], DM12, and metabolic syndrome (MetS)[13] has been reported. In this study we evaluated whether the VAI and LAP can be used as indicators of the risk of ICAS in Chinese patients
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