Abstract
Background We aimed to evaluate the association between the Chinese visceral adiposity index (CVAI) and its dynamic change and risk of carotid plaque based on a large Chinese cohort. Methods and Results This cohort included 23 522 participants aged 20 to 80 years without elevated carotid intima-media thickness and carotid plaque at baseline and who received at least 2 health checkups. CVAI was calculated at baseline and at every checkup. The dynamic change in CVAI was calculated by subtracting CVAI at baseline from that at the last follow-up. Cox proportional hazard regression model was used to estimate hazard ratios (HRs) and 95% CIs. The restricted cubic spline was applied to model the dose-response association between CVAI and carotid plaque risk. During the 82 621 person-years of follow-up, 5987 cases of carotid plaque developed (7.25/100 person-years). We observed a significant positive correlation between CVAI and carotid plaque risk (HR, 1.53; 95% CI, 1.48-1.59 [P<0.001]) in a nonlinear dose-response pattern (P(nonlinearity)<0.001). The sensitivity analyses further confirmed the robustness of the results. The association was significant in all subgroup analyses stratified by sex, hypertension, and fatty liver disease except for the diabetes subgroup. The association between CVAI and carotid plaque risk was much higher in men than in women. No significant association was identified between change in CVAI and carotid plaque risk. Conclusions CVAI was positively associated with carotid plaque risk in a nonlinear dose-response pattern in this study. Individuals should keep their CVAI within a normal level to prevent the development of carotid plaque.