Obesity (Silver Spring, Md.) · 2025
Visceral Adiposity Thresholds for Cardiovascular Risk Stratification: A Simplified Biomarker-Driven Model.
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Guo Tangmeng, He Ping, Lu Weilin, Huang Lili, Liu Chengyun, Cheng Bei, Zhang Yuanyuan, Zhang Qi, Chen Yanxu, Liu Minghao, Zhou Peien, Liu Junxi, Gu Xinchun, Sun Zhengyang, Zhang Qiang, Xiao Sihao
Аннотация
OBJECTIVE: VAT volume is a critical determinant of cardiometabolic risk, yet population-specific thresholds and accessible predictive tools remain undefined.
METHODS: Using US National Health and Nutrition Examination Survey (NHANES) data, we analyzed dual-energy x-ray absorptiometry (DXA)-derived VAT volume. Threshold effects and sex/ethnicity interactions were evaluated via multivariable regression, while LASSO regularization and ROC analyses identified a simplified predictive model.
RESULTS: A VAT volume threshold of 327.0 cm3 stratified CVD risk, distinguishing compensatory from pathological adiposity. The high-VAT group exhibited elevated CVD prevalence (2.41% vs. 1.12%, p = 0.016), metabolic dysregulation, and socioeconomic disparities. Males showed higher risk thresholds than females (387.5 vs. 312.0 cm3, p-interaction = 0.029). Non-Hispanic White participants and multiracial groups exhibited abrupt risk escalation above 399.5 and 270.0 cm3 (aOR = 1.08-1.12, p < 0.001), absent in non-Hispanic Black individuals and Hispanic individuals. A tri-biomarker model (waist circumference + triglycerides + apolipoprotein B) achieved near-equivalent accuracy to DXA-based VAT quantification (AUC = 0.821 vs. 0.819, p = 0.66), with high sensitivity (80.95% vs. 69.05%) and cost-effectiveness.
CONCLUSIONS: This study establishes the first sex-specific and ethnicity-specific VAT thresholds for CVD risk stratification and provides a clinically actionable tool for visceral adiposity screening.
METHODS: Using US National Health and Nutrition Examination Survey (NHANES) data, we analyzed dual-energy x-ray absorptiometry (DXA)-derived VAT volume. Threshold effects and sex/ethnicity interactions were evaluated via multivariable regression, while LASSO regularization and ROC analyses identified a simplified predictive model.
RESULTS: A VAT volume threshold of 327.0 cm3 stratified CVD risk, distinguishing compensatory from pathological adiposity. The high-VAT group exhibited elevated CVD prevalence (2.41% vs. 1.12%, p = 0.016), metabolic dysregulation, and socioeconomic disparities. Males showed higher risk thresholds than females (387.5 vs. 312.0 cm3, p-interaction = 0.029). Non-Hispanic White participants and multiracial groups exhibited abrupt risk escalation above 399.5 and 270.0 cm3 (aOR = 1.08-1.12, p < 0.001), absent in non-Hispanic Black individuals and Hispanic individuals. A tri-biomarker model (waist circumference + triglycerides + apolipoprotein B) achieved near-equivalent accuracy to DXA-based VAT quantification (AUC = 0.821 vs. 0.819, p = 0.66), with high sensitivity (80.95% vs. 69.05%) and cost-effectiveness.
CONCLUSIONS: This study establishes the first sex-specific and ethnicity-specific VAT thresholds for CVD risk stratification and provides a clinically actionable tool for visceral adiposity screening.