Chinese Visceral Adiposity Index Trajectory and Stroke in Prediabetes and Diabetes: A Prospective Cohort Study

AIMS: Stroke is a common diabetic complication, by which the Chinese visceral adiposity index (CVAI) is confirmed as a better predictor of visceral fat. However, the relationship between CVAI change and the stroke risk among patients with diabetes and prediabetes remains unclear. Therefore, we aimed to examine the association of CVAI trajectory with the risk of stroke. MATERIALS AND METHODS: This prospective cohort study included 11,339 patients with prediabetes and diabetes from the Kailuan study. These participants had complete repeated metabolic and body measurements that formed the continuous CVAI records. The stroke cases were identified by medical records. Latent mixture modelling was conducted to fit four groups of CVAI trajectories. Cox proportional hazard regression models were used to examine the associations between CVAI trajectories and the risk of stroke and its subtypes. RESULTS: Four distinct CVAI trajectories were identified: the low-stable, moderate low-stable, moderate high-stable, and high-increasing groups. Compared with low-stable CVAI, moderate high-stable (HR: 1.50, 95%CI: 1.10-2.04) and high-increasing CVAI (HR: 2.15, 95%CI: 1.49-3.10) were positively associated with the risk of stroke. Similarly, moderate high-stable (HR: 1.70, 95%CI: 1.21-2.39) and high-increasing CVAI trajectory groups (HR: 2.53, 95%CI: 1.71-3.73) had an increased risk of ischaemic stroke compared with the low-stable CVAI group. However, a significant association was not found between CVAI trajectory and risk of haemorrhage stroke. CONCLUSION: A long-term elevated CVAI is associated with a higher risk of stroke, especially ischaemic stroke. This finding suggests the health benefits of low CVAI levels and the importance of regular surveillance among patients with prediabetes and diabetes.