Global heart
Association Between the Chinese Visceral Adiposity Index-Frailty Index (CVAI-FI) and the Incidence of New-Onset Stroke in Individuals with Cardiovascular-Kidney-Metabolic Syndrome Stage 0-3: Evidence From a National Population-Based Study
By Zhao E, Xie H, Dong B and 1 others.
Abstract
Objective
Cardiovascular-Kidney-Metabolic (CKM) syndrome represents a multisystem disorder linking metabolic dysfunction with cardiovascular complications. While the Chinese Visceral Adiposity Index (CVAI) and Frailty Index (FI) independently predict adverse outcomes, their combined utility for stroke prediction across CKM syndrome stages 0-3 remains unexplored.
Methods
We analyzed 6,772 participants aged ≥45 years from the China Health and Retirement Longitudinal Study (2011-2020). Participants were classified into CKM stages 0-3, excluding stage 4 or baseline stroke. CVAI was calculated using age, BMI, waist circumference, triglycerides, and HDL-C. FI incorporated 32 health deficits following standardized methodology. The CVAI-FI index was derived as the product of CVAI and FI. Cumulative exposure was assessed in 4,170 participants with measurements from Waves 1 (2011) and 3 (2015). Multivariable logistic regression evaluated associations with incident stroke, adjusting for sociodemographic, behavioral, and clinical confounders. Model performance was assessed using ROC curves, with incremental value determined through NRI and IDI. Restricted cubic splines characterized dose-response relationships.