Association between visceral adiposity index and heart failure: A cross-sectional study

Clin Cardiol. 2023 Mar;46(3):310-319. doi: 10.1002/clc.23976. Epub 2023 Jan 18.

Abstract

Background: Obesity is an important risk factor for heart failure (HF).

Hypothesis: Visceral adiposity index (VAI) is a simple metric for assessing obesity; however, the association between VAI and risk for HF has not been studied.

Methods: A cross-sectional study involving 28 764 participants ≥18 years of age from the National Health and Nutrition Examination Survey (NHANES), 2009-2018, in the United States was performed. VAI was calculated using body mass index (BMI), waist circumference (WC), triglycerides (TG), and high-density lipoprotein cholesterol. VAI was analyzed as a continuous and categorical variable to examine its association with HF. Subgroup analysis was also performed.

Results: The highest VAI (fourth quartile [Q4]) was found among males, BMI, systolic and diastolic blood pressure, WC, hypertension, diabetes, liver disease, coronary heart disease, smoking, total cholesterol, and TG. More participants in Q4 took β-receptor blockers, angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers/angiotensin receptor-neprilysin inhibitor, calcium channel blockers, and antidiabetic and antihyperlipidemic medications. Participants with HF exhibited greater VAI. A per-unit increase in VAI resulted in a 4% increased risk for HF (odds ratio [OR] 1.04 [95% confidence interval (CI) 1.02-1.05]). After multivariable adjustment, compared with the lowest quartile, the OR for Q3 was 1.55 (95% CI 1.24-1.94). Subgroup analysis revealed no significant interactions between VAI and specific subgroups.

Conclusion: VAI was independently associated with the risk for HF. As a noninvasive index of visceral adiposity, VAI could be used for a "one shot" assessment of HF risk and may serve as a novel marker.

Keywords: VAI; heart failure; visceral adiposity index; visceral fat.

MeSH terms

  • Adiposity*
  • Body Mass Index
  • Cholesterol, HDL
  • Cross-Sectional Studies
  • Heart Failure* / complications
  • Heart Failure* / diagnosis
  • Heart Failure* / epidemiology
  • Humans
  • Male
  • Nutrition Surveys
  • Obesity / complications
  • Obesity / diagnosis
  • Obesity / epidemiology
  • Obesity, Abdominal / complications
  • Obesity, Abdominal / diagnosis
  • Obesity, Abdominal / epidemiology
  • Risk Factors
  • Triglycerides

Substances

  • Triglycerides
  • Cholesterol, HDL