Introduction and Objective: This study explored anthropometric indicators to improve body mass index (BMI)’s predictive value for cardiovascular (CV) events in individuals without carotid plaques, improving early risk stratification in subclinical populations.Methods: The study included 1043 participants (aged 50-80) from a 2013-2014 community cohort, followed for CV events (2021-2022). Carotid plaque was excluded using ultrasound. Visceral fat area (VFA) was assessed via MRI. The neck circumference [NC], neck-to-height ratio [NHtR], waist-to-height ratio [WHtR], waist-to-hip ratio [WHR], neck-to-limb length ratio [NLR], and waist-to-limb length ratios [WLR] were calculated.Results: Obesity indices (BMI, waist circumference, NC, NHtR, WHtR, WHR, NLR, and WLR) were significantly correlated with VFA (all P < 0.001). During 7.6 years of follow-up, 97 CV events (9.3%) were recorded. NHtR and NLR emerged as significant CV risk predictors, with hazard ratios of 1.33 and 1.31, respectively. NLR notably improved predictive accuracy (C-statistic= 0.671 [95% CI: 0.616-0.726], P = 0.002).Conclusion: Anthropometric indices incorporating NC (NHtR and NLR) improved BMI’s predictive value for CV risk and were strongly associated with visceral fat. NHtR and NLR could refine CV risk assessment in individuals without carotid plaques.
X. Li: None. T. Hu: None. Y. Xu: None. X. Ma: None. Y. Bao: None.
National Natural Science Foundation of China (82400999); China Postdoctoral Science Foundation (2024M762052); Shanghai Research Center for Endocrine and Metabolic Diseases (2022ZZ01002); Clinical Research Project of Health Industry of Shanghai Municipal Health Commission (20224Y0155); Shanghai Rising Star of Medical Talent Youth Development Program (YYXX202302)
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