Abstract: Background　The Chinese visceral adiposity index（CVAI） is a new obesity index that has been proven to be associated with prehypertension and hypertension. Still，there is a lack of research on the relationship between the CVAI and nocturnal hypertension（NH）. Objective　To investigate the correlation between CVAI and nocturnal hypertension （NH） in young and middle-aged adults. Methods　A total of 981 young and middle-aged patients with essential hypertension admitted to the Department of Hypertension of the Fifth Affiliated Hospital of Xinjiang Medical University were consecutively enrolled from February 2023 to September 2023，and the general data，biochemical indexes，and 24-hour ambulatory blood pressure monitoring results of the patients were collected and the CVAI was calculated，and the patients were divided into 95 cases of the non-nocturnal hypertension（NNH） group and 886 cases of the NH group according to the whether they were combined with NH or not. Differences in age，gender，and other indicators were compared between the groups. Correlation analysis was performed using the Pearson or Spearman method. Multivariate Logistic regression was used to analyze the correlation between CVAI and NH in young and middle-aged people. Results　Compared with the NNH group， the NH group had higher CVAI，24-hour average systolic and diastolic blood pressure，daytime average systolic and diastolic blood pressure，nocturnal average systolic and diastolic blood pressure，and maximum systolic and diastolic blood pressure， and the differences were statistically significant（all P<0.05）. Pearson correlation analysis showed that CVAI was positively correlated with 24-hour average systolic and diastolic blood pressure，daytime average systolic and diastolic blood pressure， nocturnal average systolic and diastolic blood pressure，and maximum systolic and diastolic blood pressure（r=0.202，0.183，0.200，0.171，0.168，0.174，0.132，0.157，all P<0.05）. Multivariate Logistic regression showed that high CVAI was an independent risk factor for NH in young and middle-aged adults after adjustment for relevant confounders（OR=1.009，95%CI=1.002-1.016，P=0.014）. According to the CVAI quartiles，the patients were categorized into Q1（<103.5243，n=245），Q2（103.5243-129.7140，n=246），Q3（129.7140-156.2704，n=245）and Q4（>156.2704，n=245）. The risk of developing nocturnal hypertension in the Q2，Q3 and Q4 groups was 1.779（OR=1.779，95%CI=1.002-3.157），2.023（OR=2.023，95%CI=1.061-3.858），and 3.053（OR=3.053，95%CI=1.383-6.737） times greater than that of the Q1 group. Subgroup analysis showed that the association between CVAI and NH was more significant in the overweight/obese （BMI ≥ 24 kg/m2 ） population（P=0.021）. Conclusion　CVAI was associated with the risk of developing NH in young and middle-aged adults，and the association was more significant in the overweight/obese（BMI ≥ 24 kg/m2 ） population，which was a risk factor for NH in this population.

Key words: Nocturnal hypertension, Chinese visceral adiposity index, Visceral obesity indicator, Young and middle-aged, Correlation study

摘要： 背景　中国人内脏脂肪指数（CVAI）是一种新型肥胖指标，已被证实其与高血压前期及高血压密切相关，但目前缺乏CVAI与中青年夜间高血压（NH）相关性的研究。目的　探讨CVAI与中青年NH的相关性。方法　纳入2023年2月—2023年9月新疆医科大学第五附属医院高血压科的中青年原发性高血压患者981例为研究对象，收集患者的一般资料、生化指标、24 h动态血压监测结果并计算CVAI。根据是否合并NH分为非NH（NNH）组95例和NH组886例。比较组间一般资料、生化指标、24 h动态血压、CVAI等指标的差异。采用Pearson相关性分析探索CVAI与NH的相关性。采用多因素Logistic回归分析评估中青年NH的影响因素。结果　NH组的CVAI、全天平均收缩压及舒张压、日间平均收缩压及舒张压、夜间平均收缩压及舒张压、最高收缩压及舒张压高于NNH组，差异有统计学意义（P均<0.05）。Pearson相关性分析显示，CVAI与全天平均收缩压及舒张压、日间平均收缩压及舒张压、夜间平均收缩压及舒张压、最高收缩压及收缩压均呈正相关（r=0.202、0.183、0.200、0.171、0.168、0.174、0.132、0.157，P均<0.05）。多因素Logistic回归分析显示，校正性别、年龄等混杂因素后，高CVAI是中青年NH的独立危险因素（OR=1.009，95%CI=1.002~1.016，P=0.014）；根据CVAI四分位数分为Q1组（<103.5243，n=245）、Q2组（103.5243~129.7140，n=246）、Q3组（129.7140~156.2704，n=245）和Q4组（>156.2704，n=245）组，Q2、Q3和Q4组夜间高血压患病风险分别是Q1组的1.779倍（OR=1.779，95%CI=1.002~3.157）、2.023倍（OR=2.023，95%CI=1.061~3.858）和3.053倍（OR=3.053，95%CI=1.383~6.737）。亚组分析结果显示，在超重/肥胖（BMI≥24 kg/m2）人群中，CVAI与NH的关联更为显著（P=0.021）。结论　CVAI与中青年NH发生风险相关，且在超重/肥胖（BMI≥24 kg/m2）人群中关联性更为显著，是该人群发生NH的危险因素。

关键词: 夜间高血压, 中国人内脏脂肪指数, 内脏肥胖指标, 中青年, 相关性研究