Construction and validation of a risk assessment model for atherosclerotic cardiovascular disease based on body composition and physical fitness indicators

Abstract:

Objective To investigate the moderate or high risk of atherosclerotic cardiovascular disease（ASCVD） in the health check-up population based on body composition and physical fitness indicators，to develop a risk assessment tool for ASCVD，and to provide reasonable suggestions for the prevention and intervention of ASCVD.Methods Physical examination data were collected from 1 620 individuals，aged 35-59 years，who underwent physical examination in The Second Affiliated Hospital of Chongqing Medical University from July 2020 to January 2022，among whom 1200 were included in the modeling set and 420 were included in the validation set. The risk of ASCVD in the respondents was calculated according to the color diagram of the 10-year risk assessment process of ASCVD. A risk assessment model for ASCVD was constructed based on body composition and physical fitness indicators，and then internal validation was performed for the model. Finally the model was assessed in terms of discriminatory ability，consistency，and clinical practicability.Results In this study，the risk assessment model for ASCVD was established as Logit（P）=-0.298+2.151×sex+0.046×mean liver fat - 0.016×mean bone mineral density + 0.005×abdominal muscle area +0.330×visceral adipose tissue/subcutaneous adipose tissue ratio -0.027×grip strength values of body mass index -0.025×balance force. This model had a specificity of 74.9%，a sensitivity of 81.2%，and an area under the ROC curve of 0.845（95%CI：0.820-0.865）.Conclusion Although the risk assessment model for ASCVD established in this study has good discriminatory ability and clinical practicability，it lacks a good calibration degree in different datasets，and therefore，it is necessary to expand the sample size in the future to further improve the model.