Correlation between Chinese Visceral Adiposity Index and Nocturnal Hypertension in Young and Middle-aged People

doi:10.12114/j.issn.1007-9572.2025.0168

Abstract

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 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 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 two 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 group (<103.524 3, n=245), Q2 group (103.524 3-129.714 0, n=246), Q3 group (129.714 0-156.270 4, n=245) and Q4 group (>156.270 4, n=245). The risk of developing nocturnal hypertension in the Q2 group, Q3 group and Q4 group 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—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病患者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回归模型分析中青年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（<103.524 3，n=245）、Q2组（103.524 3~129.7140，n=246）、Q3组（129.714 0~156.270 4，n=245）和Q4组（>156.270 4，n=245），Q2组、Q3组和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

CLC Number:

R 544.1

ZHANG Qiuyu,HU Xiaoyong,TANG Rui, et al. Correlation between Chinese Visceral Adiposity Index and Nocturnal Hypertension in Young and Middle-aged People[J]. Chinese General Practice, 2026, 29(07): 872-878. DOI: 10.12114/j.issn.1007-9572.2025.0168.
张秋雨,胡晓咏,唐瑞等. 中国人内脏脂肪指数与中青年夜间高血压的相关性研究[J]. 中国全科医学, 2026, 29(07): 872-878. DOI: 10.12114/j.issn.1007-9572.2025.0168.

Figures/Tables 4

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组别	例数	性别[例（%）]		年龄（±s，岁）	吸烟史[例（%）]		饮酒史[例（%）]		BMI（±s，kg/m²）	WC （±s，cm）
组别	例数	男	女	年龄（±s，岁）	否	是	否	是	BMI（±s，kg/m²）	WC （±s，cm）
NNH组	95	43（45.3）	52（54.7）	53.6±8.7	73（76.8）	22（23.2）	72（75.8）	23（24.2）	25.5±3.0	90.87±9.83
NH组	886	584（65.9）	302（34.1）	50.2±9.4	514（58.0）	372（42.0）	488（55.1）	398（44.9）	27.1±4.0	96.03±10.52
检验统计量值		15.865^a		3.336	12.657^a		15.022^a		-4.845	-4.573
P值		<0.001		<0.001	<0.001		<0.001		<0.001	<0.001
组别	TG[M（P₂₅，P₇₅），mmol/L]	HDL-C[M（P₂₅，P₇₅），mmol/L]	TC[M（P₂₅，P₇₅），mmol/L]	LDL-C[M（P₂₅，P₇₅），mmol/L]	CVAI （±s）	BUN[M（P₂₅，P₇₅），mmol/L]
NNH组	1.54（1.13，2.27）	1.34（1.18，1.55）	4.44（3.91，5.35）	2.67（2.20，3.20）	116.09±35.28	5.01（4.23，5.80）
NH组	1.75（1.29，2.45）	1.31（1.16，1.52）	4.65（3.97，5.40）	2.82（2.33，3.35）	132.75±42.09	5.14（4.38，6.10）
检验统计量值	-2.385^b	-1.540^b	-1.089^b	-1.573^b	-3.720	-1.287^b
P值	0.017	0.124	0.276	0.116	<0.001	0.198
组别	Scr[M（P₂₅，P₇₅），umol/L]	红细胞[M（P₂₅，P₇₅），×10¹²/L]	血红蛋白[M（P₂₅，P₇₅），g/L]	冠心病史[例（%）]		糖尿病病史[例（%）]
组别	Scr[M（P₂₅，P₇₅），umol/L]	红细胞[M（P₂₅，P₇₅），×10¹²/L]	血红蛋白[M（P₂₅，P₇₅），g/L]	否	是	否	是
NNH组	65.41（56.91，74.97）	4.68（4.42，5.04）	141（129，150）	84（88.4）	11（11.6）	82（86.3）	13（13.7）
NH组	70.80（60.33，80.24）	4.89（4.57，5.24）	148（137，158）	775（87.5）	111（12.5）	740（83.5）	146（16.5）
检验统计量值	-2.789^b	-3.741^b	-4.599^b	0.071^a		0.493^a
P值	0.005	<0.001	<0.001	0.790		0.482
组别	全天平均收缩压（±s，mmHg）	全天平均舒张压（±s，mmHg）	夜间平均收缩压（±s，mmHg）	夜间平均舒张压（±s，mmHg）	日间平均收缩压（±s，mmHg）	日间平均舒张压（±s，mmHg）	最高收缩压（±s，mmHg）	最高舒张压（±s，mmHg）
NNH组	118±7	73±5	108±6	65±4	121±8	75±6	155±18	103±20
NH组	137±13	88±10	132±14	84±10	138±13	89±10	172±20	115±17
检验统计量值	-22.801	-22.608	-32.472	-36.777	-19.334	-18.854	-7.953	-5.621
P值	<0.001	<0.001	<0.001	<0.001	<0.001	<0.001	<0.001	<0.001

组别	例数	性别[例（%）]		年龄（±s，岁）	吸烟史[例（%）]		饮酒史[例（%）]		BMI（±s，kg/m²）	WC （±s，cm）
组别	例数	男	女	年龄（±s，岁）	否	是	否	是	BMI（±s，kg/m²）	WC （±s，cm）
NNH组	95	43（45.3）	52（54.7）	53.6±8.7	73（76.8）	22（23.2）	72（75.8）	23（24.2）	25.5±3.0	90.87±9.83
NH组	886	584（65.9）	302（34.1）	50.2±9.4	514（58.0）	372（42.0）	488（55.1）	398（44.9）	27.1±4.0	96.03±10.52
检验统计量值		15.865^a		3.336	12.657^a		15.022^a		-4.845	-4.573
P值		<0.001		<0.001	<0.001		<0.001		<0.001	<0.001
组别	TG[M（P₂₅，P₇₅），mmol/L]	HDL-C[M（P₂₅，P₇₅），mmol/L]	TC[M（P₂₅，P₇₅），mmol/L]	LDL-C[M（P₂₅，P₇₅），mmol/L]	CVAI （±s）	BUN[M（P₂₅，P₇₅），mmol/L]
NNH组	1.54（1.13，2.27）	1.34（1.18，1.55）	4.44（3.91，5.35）	2.67（2.20，3.20）	116.09±35.28	5.01（4.23，5.80）
NH组	1.75（1.29，2.45）	1.31（1.16，1.52）	4.65（3.97，5.40）	2.82（2.33，3.35）	132.75±42.09	5.14（4.38，6.10）
检验统计量值	-2.385^b	-1.540^b	-1.089^b	-1.573^b	-3.720	-1.287^b
P值	0.017	0.124	0.276	0.116	<0.001	0.198
组别	Scr[M（P₂₅，P₇₅），umol/L]	红细胞[M（P₂₅，P₇₅），×10¹²/L]	血红蛋白[M（P₂₅，P₇₅），g/L]	冠心病史[例（%）]		糖尿病病史[例（%）]
组别	Scr[M（P₂₅，P₇₅），umol/L]	红细胞[M（P₂₅，P₇₅），×10¹²/L]	血红蛋白[M（P₂₅，P₇₅），g/L]	否	是	否	是
NNH组	65.41（56.91，74.97）	4.68（4.42，5.04）	141（129，150）	84（88.4）	11（11.6）	82（86.3）	13（13.7）
NH组	70.80（60.33，80.24）	4.89（4.57，5.24）	148（137，158）	775（87.5）	111（12.5）	740（83.5）	146（16.5）
检验统计量值	-2.789^b	-3.741^b	-4.599^b	0.071^a		0.493^a
P值	0.005	<0.001	<0.001	0.790		0.482
组别	全天平均收缩压（±s，mmHg）	全天平均舒张压（±s，mmHg）	夜间平均收缩压（±s，mmHg）	夜间平均舒张压（±s，mmHg）	日间平均收缩压（±s，mmHg）	日间平均舒张压（±s，mmHg）	最高收缩压（±s，mmHg）	最高舒张压（±s，mmHg）
NNH组	118±7	73±5	108±6	65±4	121±8	75±6	155±18	103±20
NH组	137±13	88±10	132±14	84±10	138±13	89±10	172±20	115±17
检验统计量值	-22.801	-22.608	-32.472	-36.777	-19.334	-18.854	-7.953	-5.621
P值	<0.001	<0.001	<0.001	<0.001	<0.001	<0.001	<0.001	<0.001

检验统计量值	性别	年龄	吸烟史	饮酒史	BMI	WC	TG	HDL-C	TC	LDL-C	BUN	Scr
r（r_s）值	-0.490^a	-0.067	0.307^a	0.313^a	0.760	0.922	0.331^a	-0.396^a	-0.046^a	0.051^a	0.116^a	0.309^a
P值	<0.001	0.036	<0.001	<0.001	<0.001	<0.001	<0.001	<0.001	0.151	0.110	<0.001	<0.001
检验统计量值	红细胞	血红蛋白	冠心病史	糖尿病病史	全天平均收缩压	全天平均舒张压	日间平均收缩压	日间平均舒张压	夜间平均收缩压	夜间平均舒张压	最高收缩压	最高舒张压
r（r_s）值	0.285^a	0.387^a	0.053^a	0.094^a	0.202	0.183	0.200	0.171	0.168	0.174	0.132	0.157
P值	<0.001	<0.001	0.096	0.003	<0.001	<0.001	<0.001	<0.001	<0.001	<0.001	<0.001	<0.001

检验统计量值	性别	年龄	吸烟史	饮酒史	BMI	WC	TG	HDL-C	TC	LDL-C	BUN	Scr
r（r_s）值	-0.490^a	-0.067	0.307^a	0.313^a	0.760	0.922	0.331^a	-0.396^a	-0.046^a	0.051^a	0.116^a	0.309^a
P值	<0.001	0.036	<0.001	<0.001	<0.001	<0.001	<0.001	<0.001	0.151	0.110	<0.001	<0.001
检验统计量值	红细胞	血红蛋白	冠心病史	糖尿病病史	全天平均收缩压	全天平均舒张压	日间平均收缩压	日间平均舒张压	夜间平均收缩压	夜间平均舒张压	最高收缩压	最高舒张压
r（r_s）值	0.285^a	0.387^a	0.053^a	0.094^a	0.202	0.183	0.200	0.171	0.168	0.174	0.132	0.157
P值	<0.001	<0.001	0.096	0.003	<0.001	<0.001	<0.001	<0.001	<0.001	<0.001	<0.001	<0.001

变量	B	SE	Wald χ²值	P值	OR（95%CI）
CVAI （以实测值纳入）	0.009	0.004	6.024	0.014	1.009（1.002~1.016）
CVAI（以Q1组为参照）
Q2组	0.576	0.293	3.874	0.049	1.779（1.002~3.157）
Q3组	0.705	0.329	4.576	0.032	2.023（1.061~3.858）
Q4组	1.116	0.404	7.634	0.006	3.053（1.383~6.737）