Supplementary Material for: The Association of Cumulative Chinese Visceral Adiposity Index and New-Onset Hypertension in Middle-Aged and Elderly Chinese Populations: A cohort study

Introduction: Previous studies have reported a significant relationship between the baseline Chinese visceral adipose index (CVAI) and the risk of new-onset hypertension (NOH). However, the long-term effect of the CVAI and the risk of NOH remains uncertain. This study aimed to investigate the association between the cumulative CVAI and the risk of NOH. Methods: Data were obtained from the China Health and Retirement Longitudinal Study from 2011 to 2020. In total, of 2836 Chinese participants ≥45 years were included. Multivariable logistic regression analysis as well as restricted cubic spline regression analysis were performed to assess the association of the cumulative CVAI, visceral adiposity index (VAI), and lipid accumulation product (LAP) with the risk of NOH. Furthermore, receiver operating characteristic (ROC) curve analysis was used to determine the area under the ROC curves between the risk of NOH and the adiposity indices to compare the predictive powers of the cumulative CVAI, VAI, and LAP for NOH. Results: During the 5-year follow-up period, 433 cases of NOH were recorded. The cumulative CVAI, VAI, and LAP were positively associated with the risk of NOH. After adjusting for potential confounders, as compared to the lowest quartile of the cumulative CVAI, VAI, and LAP, the participants in the highest quartile had a significantly higher risk for NOH (odds ratio = 1.74, 1.46, and 1.95; 95% confidence interval = 1.25–2.42, 1.05–2.03, and 1.39–2.75, respectively). ROC analysis revealed that the cumulative CVAI had the highest relationship with the risk of NOH. Conclusion: The cumulative CVAI was positively associated with an increased risk of NOH in middle-aged and elderly Chinese populations. In addition, the performance of the cumulative CVAI to predict NOH was superior to other visceral obesity indices. Monitoring long-term changes to the CVAI may assist with early identification of individuals at high risk of NOH.

引言：既往研究表明，基线中国内脏脂肪指数（Chinese visceral adipose index, CVAI）与新发高血压（new-onset hypertension, NOH）风险存在显著关联。然而，CVAI对NOH风险的长期影响仍不明确。本研究旨在探讨累积性CVAI与NOH风险之间的关联。方法：研究数据来源于2011至2020年的中国健康与养老追踪调查（China Health and Retirement Longitudinal Study）。最终纳入2836名年龄≥45岁的中国受试者。采用多变量logistic回归分析及限制性立方样条回归分析，评估累积性CVAI、内脏脂肪指数（visceral adiposity index, VAI）及脂肪堆积产物（lipid accumulation product, LAP）与NOH风险的关联。此外，通过受试者工作特征（receiver operating characteristic, ROC）曲线分析计算ROC曲线下面积，以比较累积性CVAI、VAI及LAP对NOH的预测效能。结果：在5年随访期间，共记录到433例NOH病例。累积性CVAI、VAI及LAP均与NOH风险呈正相关。校正潜在混杂因素后，与累积性CVAI、VAI及LAP最低四分位数组受试者相比，最高四分位数组受试者的NOH风险显著升高（比值比分别为1.74、1.46和1.95；95%置信区间分别为1.25~2.42、1.05~2.03及1.39~2.75）。ROC分析显示，累积性CVAI与NOH风险的相关性最强。结论：在中国中老年人群中，累积性CVAI与NOH风险升高呈正相关。此外，累积性CVAI预测NOH的效能优于其他内脏肥胖相关指数。监测CVAI的长期变化有助于早期识别NOH高风险个体。