There is a positive association between VAI and CMM risk that is independent of established risk factors and consistent with a linear dose-response pattern, and the VAI provides significant improvement in CMM risk prediction beyond established risk factors.
Key Findings
Results
Cardiometabolic multimorbidity developed in 197 participants over a 12- to 15-year follow-up period.
Study population consisted of 3348 adults with mean age 63 years, 45.1% male
Participants were free from hypertension, coronary heart disease, diabetes, and stroke at baseline (wave 4, 2008-2009)
CMM was assessed at wave 10 (2021-2023)
CMM was defined as the presence of 2 or more of the following: hypertension, cardiovascular disease, diabetes, or stroke
Results
Each 1 SD increment in VAI was associated with significantly higher odds of cardiometabolic multimorbidity after adjustment for established risk factors.
Odds ratio of 1.33 (95% CI, 1.19 to 1.50) per 1 SD increment in VAI
Adjustment covariates included age, sex, smoking, alcohol intake, systolic blood pressure, total cholesterol level, and handgrip strength
The association persisted after further adjustment for physical activity
Associations were qualitatively similar across VAI tertiles
Results
The relationship between VAI and CMM risk followed a predominantly linear dose-response pattern.
Restricted cubic spline analysis was used to assess the shape of the association
P value for nonlinearity was .062, indicating no significant departure from linearity
The pattern was described as 'predominantly linear'
Results
VAI significantly improved cardiometabolic multimorbidity risk discrimination beyond established risk factors.
C-index change was 0.0205 (P=.021) when VAI was added to the model with established risk factors
P value for difference in -2 log likelihood was <.001
Both discrimination and model fit were significantly improved by the addition of VAI
Methods
VAI was calculated using a combination of anthropometric and metabolic parameters.
VAI incorporates both anthropometric measures and metabolic parameters
Multivariable logistic regression models were used to estimate odds ratios and 95% CIs
Analyses were conducted using data from the English Longitudinal Study of Ageing
Kunutsor S, Jae S, Laukkanen J. (2026). Visceral Adiposity Index Is Associated With Cardiometabolic Multimorbidity and Improves Risk Prediction: The English Longitudinal Study of Ageing.. Mayo Clinic proceedings. https://doi.org/10.1016/j.mayocp.2025.09.021