Association Between Chinese Visceral Adipose Index and Albuminuria in Chinese Adults: A Cross-Sectional Study

Figures & data

Figure 1 A flow chart.

Table 1 Participant Characteristics

Variables	Overall(n=2026)	Normal Albuminuria(n=1526)	Albuminuria(n=500)	p value
Age(yr)	58.137 ± 10.878	57.024 ± 10.956	61.534 ± 9.901	<0.001
BMI (kg/m^2)	23.792 ± 3.490	23.520 ± 3.372	24.623 ± 3.709	<0.001
WC (cm)	83.603 ± 9.901	82.563 ± 9.571	86.776 ± 10.222	<0.001
SBP (mmHg)	132.565 ± 20.227	129.033 ± 18.916	143.344 ± 20.303	<0.001
DBP (mmHg)	81.347 ± 10.906	80.112 ± 10.362	85.118 ± 11.648	<0.001
FPG (mmol/l)	5.312 ± 1.687	5.128 ± 1.398	5.875 ± 2.272	<0.001
PPG (mmol/l)	8.084 ± 3.922	7.645 ± 3.510	9.426 ± 4.730	<0.001
HbA1c (%)	5.959 ± 1.081	5.855 ± 0.947	6.276 ± 1.366	<0.001
TC (mmol/l)	5.219 ± 1.011	5.180 ± 0.999	5.337 ± 1.038	0.003
TG (mmol/l)	1.480 (1.040, 2.160)	1.420 (1.020, 2.038)	1.690(1.160, 2.550)	<0.001
LDL-C (mmol/l)	2.913 ± 0.822	2.907 ± 0.825	2.932 ± 0.814	0.555
HDL-C (mmol/l)	1.521 ± 0.359	1.523 ± 0.357	1.514 ± 0.363	0.626
UA (umol/l)	322.566 ± 83.964	317.073 ± 79.963	339.330 ± 93.244	<0.001
BUN (mmol/l)	5.439 ± 1.566	5.366 ± 1.457	5.662 ± 1.841	<0.001
SA (g/l)	47.231 ± 3.185	47.149 ± 3.023	47.480 ± 3.629	0.044
ALT (U/l)	21.000(15.000, 29.000)	20.000(15.000, 29.000)	22.000(16.000, 32.250)	0.002
AST (U/l)	25.000(21.000, 30.000)	25.000(21.000, 30.000)	26.000(21.750, 33.000)	0.003
eGFR (mL/min/1.73m^2)	121.866(102.631, 142.516)	123.484(105.083, 143.715)	117.467(93.520, 140.350)	<0.001
UACR (mg/g)	13.351(7.339, 29.598)	9.814(6.278, 15.473)	64.943(41.571, 153.581)	<0.001
CVAI	94.928 ± 39.954	89.544 ± 38.497	111.361 ± 39.871	<0.001
TyG	8.766 ± 0.667	8.690 ± 0.615	8.998 ± 0.759	<0.001
Gender				0.765
Male	700 (34.551%)	530 (34.731%)	170 (34.000%)
Female	1326 (65.449%)	996 (65.269%)	330 (66.000%)
Preexisting hypertension				<0.001
No	1394 (68.806%)	1158 (75.885%)	236 (47.200%)
Yes	632 (31.194%)	368 (24.115%)	264 (52.800%)
Preexisting DM				<0.001
No	1693 (83.564%)	1334 (87.418%)	359 (71.800%)
Yes	333 (16.436%)	192 (12.582%)	141 (28.200%)
Ethnicity				<0.001
Han	1423 (70.237%)	1044 (68.414%)	379 (75.800%)
Tujia	580 (28.628%)	468 (30.668%)	112 (22.400%)
Other	23 (1.135%)	14 (0.917%)	9 (1.800%)

Table 2 Univariate and Multivariate Analysis of Factors Associated with UACR

Variables	Univariate Analysis		Multivariate Analysis
	β(95% CI)	p value	β(95% CI)	p value
Age*	0.030 (0.026, 0.035)	<0.001	–	–
BMI*	0.051 (0.036, 0.066)	<0.001	–	–
WC*	0.025 (0.020, 0.030)	<0.001	–	–
SBP	0.024 (0.022, 0.027)	<0.001	0.017 (0.013, 0.020)	<0.001
DBP	0.025 (0.020, 0.029)	<0.001	−0.002 (−0.008, 0.004)	0.485
FPG	0.186 (0.156, 0.216)	<0.001	0.079 (0.031, 0.128)	0.001
PPG	0.078 (0.064, 0.091)	<0.001	0.002 (−0.016, 0.021)	0.805
HbA1c	0.261 (0.213, 0.309)	<0.001	0.004 (−0.071, 0.079)	0.913
TC	0.109 (0.057, 0.161)	<0.001	0.212 (0.122, 0.301)	<0.001
TG*	0.099 (0.069, 0.130)	<0.001	–	–
LDL-C	0.018 (−0.046, 0.083)	0.575	−0.239 (−0.345, −0.132)	<0.001
HDL-C*	0.022 (−0.126, 0.169)	0.773	-	-
UA	0.002 (0.001, 0.002)	<0.001	0.000 (−0.000, 0.001)	0.262
BUN	0.103 (0.070, 0.137)	<0.001	0.052 (0.021, 0.083)	0.001
SA	0.022 (0.005, 0.038)	0.010	−0.003 (−0.019, 0.013)	0.711
ALT	0.004 (0.001, 0.006)	0.001	0.000 (−0.003, 0.004)	0.876
AST	0.005 (0.001, 0.008)	0.008	0.001 (−0.005, 0.006)	0.764
eGFR	−0.002 (−0.003, −0.001)	<0.001	−0.000 (−0.001, 0.001)	0.613
CVAI	0.009 (0.007, 0.010)	<0.001	0.004 (0.002, 0.005)	<0.001
TyG	0.421 (0.344, 0.499)	<0.001	−0.028 (−0.132, 0.076)	0.598
Female*	0.166 (0.055, 0.278)	0.003	-	-
Preexisting hypertension	0.840 (0.731, 0.948)	<0.001	0.309 (0.195, 0.423)	<0.001
Preexisting DM	0.809 (0.670, 0.947)	<0.001	0.338 (0.177, 0.499)	<0.001
Tujia ethnicity	−0.400 (−0.517, −0.284)	<0.001	−0.136 (−0.247, −0.025)	0.017

Table 3 Multivariate Logistic Analysis for the Association Between CVAI and Albuminuria

Variable	Crude Model	p value	Model 1	p value	Model 2	p value
	OR(95% CI)		OR(95% CI)		OR(95% CI)
CVAI	1.015 (1.012, 1.018)	<0.001	1.013 (1.010, 1.016)	<0.001	1.007 (1.003, 1.010)	<0.001
CVAI/10	1.157 (1.125, 1.190)	<0.001	1.135 (1.102, 1.169)	<0.001	1.068 (1.030, 1.106)	<0.001
Pre SD increase	1.792 (1.604, 2.002)	<0.001	1.657 (1.474, 1.863)	<0.001	1.298 (1.127, 1.496)	<0.001
CVAI group
Q1	Ref.		Ref.		Ref.
Q2	1.657 (1.253, 2.190)	<0.001	1.401 (1.052, 1.866)	0.021	0.981 (0.714, 1.349)	0.908
Q3	3.353 (2.576, 4.365)	<0.001	2.628 (1.995, 3.460)	<0.001	1.434 (1.031, 1.994)	0.032
p for trend		<0.001		<0.001		0.014

Notes: Model 1 was adjusted for age, sex and ethnicity. Model 2 was adjusted for variables in model 1 plus SBP, DBP, FPG, PPG, HbA1c, TC, LDL-C, UA, BUN, eGFR, preexisting hypertension and preexisting DM.

Table 4 Multinomial Logistic Regression Model of Factors Influencing the Degree of Albuminuria (Normal Albuminuria, Microalbuminuria and Macroalbuminuria)

Factors	Microalbuminuria		Macroalbuminuria
	OR(95% CI)	p value	OR(95% CI)	p value
CVAI	1.0080 (1.0046, 1.0113)	<0.001	1.0110 (1.0030, 1.0191)	0.007
SBP	1.0203 (1.0123, 1.0284)	<0.001	1.0348 (1.0169, 1.0530)	<0.001
DBP	1.0098 (0.9962, 1.0236)	0.160	1.0123 (0.9819, 1.0437)	0.432
FPG	1.0987 (0.9872, 1.2228)	0.085	1.0721 (0.8713, 1.3191)	0.511
PPG	1.0138 (0.9719, 1.0574)	0.525	1.0066 (0.9241, 1.0965)	0.879
HbA1c	0.9645 (0.8087, 1.1503)	0.688	1.1517 (0.8272, 1.6036)	0.403
TC	1.3900 (1.1370, 1.6992)	0.001	1.7866 (1.1794, 2.7063)	0.006
LDL-C	0.6770 (0.5247, 0.8736)	0.003	0.4582 (0.2589, 0.8112)	0.007
eGFR	1.0001 (0.9977, 1.0025)	0.925	0.9858 (0.9774, 0.9943)	0.001
Ethnicity
Tujia	0.9871 (0.7452, 1.3074)	0.934	0.7396 (0.3371, 1.6225)	0.452
Han(RC)	Ref.		Ref.
Preexisting DM
Yes	1.4082 (0.9801, 2.0234)	0.064	3.7627 (1.8348, 7.7161)	<0.001
No(RC)	Ref.		Ref.
Preexisting hypertension
Yes	1.8285 (1.4144, 2.3638)	<0.001	1.3819 (0.7431, 2.5699)	0.307
No(RC)	Ref.		Ref.

Notes: RC: Reference Category;Normal albuminuria group was used as the control group of other groups.

Table 5 Threshold Effect of the Association Between CVAI and Albuminuria in Han and Tujia Ethnicity

	Total	p value	Han Ethnicity	p value	Tujia Ethnicity	p value
	OR(95% CI)		OR(95% CI)		OR(95% CI)
Model I
A straight line effect	1.007 (1.003, 1.010)	<0.001	1.004 (1.000, 1.008)	0.049	1.013 (1.006, 1.020)	<0.001
Model II
Inflection point	97.201		98.527		159.785
< Inflection point segment effect 1	0.996 (0.990, 1.003)	0.288	0.996 (0.989, 1.004)	0.308	1.006 (0.998, 1.014)	0.159
> Inflection point segment effect 2	1.014 (1.008, 1.020)	<0.001	1.011 (1.004, 1.017)	0.002	1.098 (1.041, 1.158)	0.001
Difference between effect 2 and effect 1	1.018 (1.008, 1.028)	<0.001	1.015 (1.003, 1.026)	0.014	1.091 (1.031, 1.155)	0.002
Log-likelihood ratio test		<0.001		0.015		0.001

Notes: Model I and Model II were adjusted for age, sex, SBP, DBP, FPG, PPG, HbA1c, TC, LDL-C, UA, BUN, ALT, AST, eGFR, preexisting hypertension and preexisting DM.

Figure 2 The relationship between CVAI and albuminuria. The midline represents a smooth curve fit between variables. The curves on either side represent the 95% confidence interval for the fit. The model was adjusted for SBP, DBP, FPG, PPG, HbA1c, TC, LDL-C, UA, BUN, ALT, AST, eGFR, preexisting hypertension and preexisting DM.

Figure 3 The relationship between CVAI and albuminuria in Han and Tujia ethnicity. The model was adjusted for SBP, DBP, FPG, PPG, HbA1c, TC, LDL-C, UA, BUN, ALT, AST, eGFR, preexisting hypertension and preexisting DM.

Data Sharing Statement

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.