Predictive ability of Chinese Visceral Adipose Index for gastric intestinal metaplasia in Korean adults

BACKGROUND: Gastric intestinal metaplasia (GIM) is a precancerous lesion of gastric cancer. Despite increasing interest for association between obesity and gastric cancer, there is still ongoing controversy for effect of obesity on gastric cancer. Therefore, it is important to discover obesity index with reliable predictability for GIM. METHOD: Study participants were 85,986 Koreans who were free of GIM at endoscopy. They were categorized by quartile levels of body mass index (BMI), waist circumference (WC), and Chinese visceral adipose index (CVAI). Cox proportional hazard assumption was used to evaluate hazard ratio (HR) and 95% confidence interval (CI) for incident GIM (adjusted HR [95% CI]) according to quartile levels of BMI, WC, and CVAI for about 8 years' follow-up. Using the Time ROC package, ROC and AUC were calculated for each quartile group of BMI, WC, and CVAI at 2, 4, 6, and 8 years. RESULTS: In men, BMI ≥ quartile 3, WC ≥ quartile 2, and CVAI ≥ quartile 2 were more significantly associated with incident GIM, compared with quartile 1 groups (reference). In women, while BMI and WC did not show the significant association with GIM, CVAI was solely associated with the increased risk of GIM. Time-dependent ROC and AUC analyses indicated that CAVI was superior to BMI and WC in predicting GIM among both men and women. The predictive ability of CVAI was more prominent in women than men. CONCLUSION: CVAI was an effective predictor for GIM, surpassing the predictive ability of BMI, and WC.