Key result
High CVAI is linked to ~84% higher CVD risk, outperforming other insulin resistance indices.
Why the study?
The comparative ability of seven insulin resistance indices to predict cardiovascular disease among individuals without a history of CVD was unclear.
Does the Chinese visceral adiposity index (CVAI) outperform other insulin resistance indices in predicting cardiovascular disease risk in individuals without a history of CVD?
Cohort (n=5,194)
Does the Chinese visceral adiposity index (CVAI) outperform other insulin resistance indices in predicting cardiovascular disease risk in individuals without a history of CVD?
The Chinese visceral adiposity index (CVAI) is a superior predictor of cardiovascular disease risk compared to other insulin resistance indices, particularly in women under 65 years of age.
Aims This study investigated and compared the abilities of seven insulin resistance (IR) indices, including the triglyceride-glucose index (TyG), TyG-waist circumference (TyG-WC), TyG-waist-to-hip ratio (TyG-WHtR), lipid accumulation product (LAP), visceral adiposity index (VAI), Chinese visceral adiposity index (CVAI), and metabolic score for insulin resistance (METS-IR) to predict cardiovascular disease (CVD) among participants without a history of CVD. Methods The population was recruited from the prospective Asymptomatic Polyvascular Abnormalities Community (APAC) Study in Hebei. This prospective study included 5,194 individuals without history of CVD who were stratified into CVD group and non-CVD group. The seven IR indices (TyG, TyG-WC, TyG-WHtR, LAP, VAI, CVAI, and METS-IR) were calculated. The primary endpoint was CVD. Results Over a 12-year follow-up period, 373(7.2%) CVD were documented. The seven IR indices were strongly positively associated with CVD risk. Compare to other IR indices, CVAI was the strongest predictor for CVD (HR:1.84 95% CI: 1.45–2.35; p < 0.001) and showed the highest diagnostic value for CVD (AUC: 0.654 95% CI: 0.640–0.666; p < 0.001). Adding CVAI to the based model exhibited the maximum increased on incremental risk stratification for CVD (NRI: 0.355; IDI: 0.010; all p < 0.001). Moreover, there was a non-linear association between CVAI and CVD, with a threshold point of 96.21. The association between CVAI and CVD risk was more prominent among individuals aged<65 years, female, and non-hypertension (all P interaction<0.001). Conclusion Compared to the other six tested IR indices, CVAI might be the most valuable index to predict and stratify CVD risk, with enhanced prediction in women under 65 years of age. This suggests that strategies aimed at improving risk stratification should incorporate CVAI into risk algorithms.
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Tu et al. (2026) conducted a cohort in Participants without a history of cardiovascular disease (n=5,194). Chinese visceral adiposity index (CVAI) vs. Other insulin resistance indices (TyG, TyG-WC, TyG-WHtR, LAP, VAI, METS-IR) and lower CVAI was evaluated on Cardiovascular disease (composite of stroke and myocardial infarction) (HR 1.84, 95% CI 1.45-2.35, p=<0.001). The Chinese visceral adiposity index (CVAI) was the strongest predictor of cardiovascular disease risk among seven insulin resistance indices, with a high CVAI significantly increasing risk (HR 1.84).
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