Longitudinal increases in Chinese Visceral Adiposity Index (CVAI) were associated with increased CVD risk in middle-aged and older Chinese adults, with a 20% increased risk per standard deviation increase in cumulative CVAI, suggesting CVAI changes may provide additional information for comprehensive CVD risk assessment.
Key Findings
Results
During the follow-up period, 375 participants developed incident CVD.
3,805 CVD-free participants aged ≥45 years were included from the China Health and Retirement Longitudinal Study (CHARLS).
Participants were followed from 2015 until 2020 with a median follow-up of 4.9 years.
375 participants (9.86%) developed CVD during follow-up.
Participants were categorized into CVAI change groups using K-means clustering.
Results
Higher CVAI change groups were associated with progressively greater CVD risk compared to the low-increasing CVAI group.
Hazard ratio for moderate-increasing CVAI group: HR 1.25 (95% CI, 0.89 to 1.74).
Hazard ratio for moderate high-increasing CVAI group: HR 1.56 (95% CI, 1.09 to 2.24).
Hazard ratio for high-increasing CVAI group: HR 1.87 (95% CI, 1.21 to 2.89).
P for trend = 0.002 across CVAI change groups.
Multivariable-adjusted Cox proportional hazards regression models were used for analysis.
Results
Each standard deviation increase in cumulative CVAI was associated with a 20% increased CVD risk.
HR 1.20 (95% CI, 1.06 to 1.37) per standard deviation increase in cumulative CVAI.
The relationship between cumulative CVAI and CVD risk was linear (P for nonlinearity = 0.998).
Restricted cubic spline regression models were used to assess the shape of the association.
Results
Cumulative CVAI showed modest but slightly superior predictive performance for CVD compared to other adiposity measures.
The area under the curve (AUC) for cumulative CVAI was 0.598.
Cumulative CVAI performed slightly better than body mass index, waist circumference, and Visceral Adiposity Index.
The authors noted the predictive accuracy was modest, and further validation is needed.
Background
Visceral adiposity as measured by CVAI had not previously been thoroughly investigated in relation to longitudinal CVD risk in Chinese populations.
Previous studies established visceral adiposity as a risk factor for CVD, but longitudinal changes in CVAI and CVD risk were not well characterized.
The study focused on middle-aged and older Chinese adults aged ≥45 years.
CHARLS was used as the data source for this longitudinal analysis.
Huang L, Kang K. (2026). Association between changes in Chinese visceral adiposity index and cardiovascular disease among middle-aged and older Chinese adults.. Scientific reports. https://doi.org/10.1038/s41598-025-31561-6