中国全科医学2026，Vol.29Issue(18)：2482-2488,7.DOI:10.12114/j.issn.1007-9572.2025.0394
中国内脏脂肪指数与2型糖尿病合并左心室舒张功能障碍的关联性研究
Association between the Chinese Visceral Adiposity Index and Left Ventricular Diastolic Dysfunction in Type 2 Diabetes Mellitus
摘要
Abstract
Background The incidence of type 2 diabetes mellitus(T2DM)has risen steadily in recent years.Cardiovascular disease is a common complication of T2DM,with left ventricular diastolic dysfunction(LVDD)often occurring at an early stage.Central(visceral)obesity is closely linked to cardiovascular risk;however,the performance of visceral-fat-focused indices in identifying LVDD among patients with T2DM remains under-studied.Objective To evaluate the association between the Chinese visceral adiposity index(CVAI)and LVDD in patients with T2DM and to assess CVAI's diagnostic utility.Methods This retrospective study enrolled 1 028 T2DM patients who attended the Second Affiliated Hospital of Kunming Medical University(Metabolic Management Center)from January 2019 to August 2024(647 males,381 females).Patients were classified as a T2DM group(n=257)or an LVDD group(n=771)based on the presence of LVDD.We assessed correlations between CVAI and other visceral-type obesity measures and echocardiographic structural and functional parameters.Multivariable Logistic regression evaluated the independent association of CVAI with LVDD.Diagnostic performance was assessed by receiver operating characteristic(ROC)curves.Subgroup analyses were conducted by sex,age,and BMI.Results Compared with the T2DM group,the LVDD group had higher BMI,neck circumference,waist circumference(WC),hip circumference,visceral fat area(VFA),and CVAI(P<0.05 for all).When stratified by CVAI quartiles,LVDD prevalence increased across quartiles:Q1 64.2%,Q2 71.2%,Q3 79.4%,Q4 85.2%(χ2trend=34.715,P<0.05).Correlation analyses demonstrated that WC,BMI,VFA,and CVAI were positively correlated with left atrial diameter(LAD),interventricular septal thickness(IVST),left ventricular posterior wall thickness(LVPWT),and left ventricular end-diastolic diameter(LVDd),and negatively correlated with left ventricular ejection fraction(LVEF)(P<0.05).After adjustment for confounders,patients in the CVAI Q4 group had a 2.361-fold increased risk of LVDD compared with Q1(95%CI=1.349-4.133,P=0.003).ROC analysis yielded an area under the curve(AUC)of 0.621 for CVAI in diagnosing LVDD,outperforming VFA(0.557),BMI(0.589),and WC(0.599).A combined predictive model achieved an AUC of 0.727(95%CI=0.692-0.763,P<0.001),with sensitivity 0.726 and specificity 0.638.Subgroup analyses indicated that CVAI Q4 was a significant risk factor for LVDD in both male and female subgroups(OR=1.948 and 8.617,respectively;P<0.05).In participants aged<60 years,CVAI Q3 and Q4 were associated with increased LVDD risk(OR=2.387 and 4.371,respectively;P<0.05).In the normal-BMI subgroup,CVAI Q3 was associated with higher LVDD risk(OR=3.997,P<0.05).Conclusion CVAI is an independent risk factor for LVDD among patients with T2DM and demonstrates superior discriminative ability compared with conventional obesity indices.Its predictive value is particularly notable in women and in individuals under 60 years of age.关键词
糖尿病,2型/左心室舒张功能障碍/中国内脏脂肪指数/内脏脂肪型肥胖/Logistic模型Key words
Diabetes mellitus,type 2/Left ventricular diastolic dysfunction/Chinese visceral adiposity index/Visceral fat obesity/Logistic models分类
医药卫生引用本文复制引用
李亚婵,杨阳,徐千婷,柯亭羽..中国内脏脂肪指数与2型糖尿病合并左心室舒张功能障碍的关联性研究[J].中国全科医学,2026,29(18):2482-2488,7.基金项目
云南省卫生健康委员会高层次人才培养计划(L-2019014) （L-2019014）
云南省万人计划名医专项(YNWR-MY-2020-022) （YNWR-MY-2020-022）
云南省科技厅-昆明医科大学联合专项基础研究计划(202201AY070001-127) （202201AY070001-127）
昆明医科大学第二附属医院博士科研项目(2024BS12) （2024BS12）
