Neck circumference, waist-to-height ratio, Chinese visceral adiposity index and incident heart failure.
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BACKGROUND: The indicators of abdominal obesity have shown to be associated with a high risk of cardiovascular diseases (CVDs), even adjusted for body mass index (BMI). We aimed to investigate the association between neck circumference, waist-to-height ratio (WHtR), Chinese visceral adiposity index (CVAI) and incident heart failure (HF) in Chinese adults. METHODS: The current study included 86,546 participants from two independent cohorts: the Kailuan I study established in 2006 and the Kailuan study II established in 2008. Participants aged 18-80 years who were free of CVDs or cancer were recruited at baseline. The values of neck circumference, WHtR and CVAI were available in 2014. The trajectory analysis was conducted using repeated measures of WHtR and CVAI in the 2008, 2010, 2012 and 2014 surveys. The incident HF cases were identified via reviewing medical records by cardiologists. RESULTS: During a mean follow-up of 5.62 years, 724 incident HF cases were documented. The highest quartiles of neck circumference, WHtR and CVAI respectively, were significantly associated with a high risk of HF compared to the lowest quartiles of adiposity measures (neck circumference: HR:1.30, 95%CI: 1.03-1.65; WHtR: HR:1.49, 95%CI: 1.16-1.92; and CVAI: HR:1.98, 95%CI: 1.48-2.65). The combination of adiposity measures with BMI or metabolic abnormalities jointly predicted incident HF. Presence of hypertension and diabetes appeared to be the major mediators, accounting for ∼ 8.11-24.7% of the associations between three indicators of abdominal obesity and HF risk. CONCLUSION: The new indices of abdominal adiposity could help to identify those who were at a high risk of HF, especially in the presence of high BMI or metabolic abnormalities.