The relationship between Visceral Adiposity Index and estimated Pulse Wave Velocity: Insights from NHANES Database

Background Obesity and arterial stiffness are known risk factors for cardiovascular disease, but the relationship between visceral adiposity index (VAI) and estimated pulse wave velocity (ePWV) is still unclear. Methods The cross-sectional study used data from the 2007–2016 survey cycle of the National Health and Nutrition Examination Survey (NHANES ) database. After data cleaning, the researchers conducted a comprehensive weighted statistical analysis of the final data set. This included data on demographics, medical history, tests, examinations and chronic comorbidities. The researchers used restricted cubic spline curves to examine potential linear associations between VAI and ePWV. In addition, weighted linear univariate and multivariate regression analyses were performed to further explore the potential relationship between VAI and ePWV. Finally, multiple subgroup analyses and interaction tests, as well as sensitivity analyses, were performed to test the stability of the relationship. Results Finally, 10458 adult participants aged 20 years or older were included in this study, with a mean (SD) age of 49.2 ± 17.4 years after weighted analysis. Restricted cubic spline analysis showed a potentially "inverted-L" non-linear relationship between VAI and ePWV ( P for non-linearity: <0.001).The inflection point analysis suggests its inflection point is (1.48: 1.38–1.57). Linear multivariate regression analysis suggested a significant positive correlation between VAI (0.2SD) and ePWV values (β = 0.1, 95% CI 0.04–0.17, p < 0.001). The positive correlation between VAI (0.2SD) and ePWV levels remained stable in model analyses adjusted for all covariates. And in the highest quartile Q4 group, it showed a significant positive correlation compared to Q1 (β = 0.53, 95% CI 0.41–0.64, p < 0.001). These findings remained stable and consistent in subsequent subgroup and sensitivity analyses. Conclusions According to this study, elevated VAI levels are related to estimated pulse wave velocity, and there is an interaction between VAI and ePWV in populations that are aging, hypertensive, and diabetic.