Dose-response relationship between visceral fat index and untreated hypertension in Chinese rural population: the RuralDiab study

The study aimed to explore the association of visceral fat index (VFI) with untreated hypertension in different genders and evaluate the practicability of VFI as a marker for discriminating untreated hypertension in Chinese rural population. A total of 12,536 eligible participants aged 35 years and older were derived from the RuralDiab study in China. VFI was assessed with bioelectrical impendence methods and divided into sex-specific quartiles. Logistic regression and restricted cubic spline regression were performed. Receiver operating characteristic curve was applied to analyze the discriminating performance of VFI. Meanwhile, a meta-analysis was conducted to validate the result of this study.

Compared with the lowest VFI quartile, the adjusted odds ratios (ORs) and 95% confidence interval (95% CI) in the highest VFI quartile were 3.68 (2.91–4.66) in male and 2.63 (2.12–3.25) in female (P_trend < .01). Nonlinear increasing trends about the risk of untreated hypertension were observed with the continuously increasing VFI in both genders (P_linearity < .01). The sensitivity and specificity in the optimal cutoff values for VFI were 58.37% and 62.26% in male, and 49.09% and 66.67% in female. The area under the curves (95% CI) were 0.64 (0.63–0.66) in male and 0.61 (0.60–0.62) in female. Meta-analysis results displayed the pooled odds ratios (95% CI) of 2.65 (1.79–3.93) in male and 2.27 (1.74–2.95) in female. VFI was significantly positively correlated with the risk of untreated hypertension, and dose-response relationships were observed in both genders in Chinese rural population. However, VFI as a marker had limited potential for discriminating untreated hypertension.