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The following is a summary of “Association between visceral adiposity index and all-cause and cardiovascular mortality in the non-elderly adults,” published in the February 2025 issue of Endocrinology by Zhang et al. 

The visceral adiposity index (VAI) reflects changes in visceral adipose function and is linked to cardiometabolic risk.  

Researchers conducted a retrospective study to examine the association between VAI and all-cause as well as cardiovascular mortality in the U.S. population aged 20-65 years.  

They analyzed data from 9,094 U.S. adults aged 20-65 years from the 2009-2018 National Health and Nutrition Examination Survey (NHANES). The exposure variable was the VAI, and the outcome variables were all-cause and cardiovascular mortality. A Cox regression model was used to examine the relationship between VAI and mortality. Nonlinear associations were explored using restricted cubic splines (RCS), and a 2-piecewise Cox proportional hazards model was applied around the inflection point. Subgroup analyses and interaction tests further assessed the link between VAI and mortality in different populations. Time-dependent Receiver Operating Characteristic (ROC) curve analyses were conducted to evaluate VAI’s predictive ability for survival.  

The results showed that during a median follow-up of 74 months, 251 deaths from all causes and 50 from cardiovascular disease were recorded, RCS analysis revealed no nonlinear association between VAI and all-cause mortality (P for overall = 0.0006, P for nonlinear = 0.9927), but a nonlinear association with cardiovascular mortality was found. For cardiovascular mortality, a significant positive correlation was observed when VAI was below 2.49, with a 122% increased risk for each unit rise in VAI [HR]=2.22, 95% [CI]: 1.36-3.61). For VAI ≥ 2.49, no significant effect on cardiovascular mortality risk was noted. Subgroup analyses showed consistent results, with no significant interactions (all P for interaction > 0.05). Additionally, the areas under the curve (AUC) for predicting all-cause mortality at 2, 5, and 10 years were 0.82, 0.80, and 0.79, respectively, and for cardiovascular mortality, 0.86, 0.86, and 0.82.  

Investigators concluded that the VAI had a positive association with all-cause mortality and a nonlinear association with cardiovascular mortality in non-elderly adults, with a threshold of 2.49 for cardiovascular mortality. 

Source: frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2025.1523731/abstract