Visceral fat index/percentage body fat ratio is independently associated with proximal aortic dilatation in a middle-aged and aged Chinese population in Liujiang of Guangxi

Abstract

Background and aims: Increased volume of visceral adipose tissue is associated with worsening of cardiovascular disease risk factors that contribute to aortic dilatation. We investigated the effects of visceral fat index (VFI) and VFI/percentage body fat (PBF) ratio on proximal aortic size and proximal aortic dilatation (PAD), to assess whether excess visceral fat deposition is an independent risk factor for PAD.

Methods: 738 participants aged 35 years or more were included in this cross-sectional survey. The sizes of aortic valve annulus (AVA), sinuses of Valsalva (SV), sinotubular junction (STJ), and ascending aorta (AscAo) were measured by transthoracic ultrasound. Multivariate linear regression, binary logistic regression, Bayesian linear regression, and receiver operating characteristic curves were performed to clarify the effects of VFI and VFI/PBF ratio on PAD.

Results: There were 78 participants (10.6%) with PAD. VFI and VFI/PBF ratio in the population with PAD was significantly increased, compared to the population without PAD (p < 0.001). However, PBF was not significantly different between the two populations. VFI/PBF ratio was positively associated with sizes of AVA, SV, STJ, and AscAo (p < 0.05), and was independently related to PAD (p < 0.05). A 1-SD increment in VFI/PBF ratio was associated with 13.35-fold increased risk of PAD (odds ratio: 13.35, p < 0.05).

Conclusions: VFI/PBF ratio is independently associated with PAD. An increased proportion of visceral fat may contribute to PAD. VFI/PBF ratio calculation may be used for the preliminary identification of individuals at high risk of PAD in the Chinese population.

Keywords: Cross-sectional study; Percentage body fat; Proximal aortic dilatation; Proximal aortic size; Visceral fat index.