Association of visceral adiposity index (VAI) and handgrip strength with incident cardiovascular disease in middle-aged and older adults: a prospective cohort study.

BACKGROUND

Evidence regarding the combined association of the visceral adiposity index (VAI), an indicator of visceral fat distribution and dysfunction, and handgrip strength with cardiovascular disease (CVD) remains limited. This study aimed to examine the association of VAI and/or handgrip strength with CVD among middle-aged and older adults.

METHODS

A total of 6967 participants free of CVD at baseline were included from the China Health and Retirement Longitudinal Study. The primary outcome was incident CVD. Cox proportional hazards models were applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).

RESULTS

The mean age of the study was 58.6 (9.2) years and 3677 (52.8%) were female. Over a median follow-up of 8.9 years, 1539 (22.1%) participants developed CVD. Compared with participants in the lowest VAI quartile (<2.04), those in quartiles 2-4 (≥2.04) had significantly higher risks of CVD (HR, 1.36; 95%CI: 1.16-1.61), heart disease (HR, 1.28; 95%CI: 1.09-1.50), and stroke (HR, 1.82; 95%CI: 1.39-2.39). When handgrip strength was assessed as sex-specific quartiles, compared with participants in the quartile 1-2, those in quartiles 3-4 had lower risks of CVD (HR, 0.83; 95%CI: 0.74-0.92), heart disease (HR, 0.82; 95%CI: 0.72-0.93), and stroke (HR, 0.81; 95%CI: 0.66, 1.00). Jointly, the highest risk of CVD was observed in participants with higher VAI (≥2.04) and lower handgrip strength (the quartile 1-2) (HR, 1.51; 95%CI:1.24-1.85).

CONCLUSION

High VAI and low handgrip strength were independently associated with increased CVD risk. Participants with combined phenotype of high VAI and low handgrip strength had the highest CVD risk.