Association of the visceral adiposity index with osteoarthritis among the U.S. adult females from NHANES 2011-2020: a cross-sectional study

Background The visceral adiposity index(VAI) is a marker of abdominal fat distribution and adipose tissue function. However, the association between VAI and osteoarthritis(OA) is unclear among the U.S. adult females. Methods Cross-sectional data for adults aged 20 years and older from 2011–2020 National Health and Nutrition Examination Survey(NHANES) were included. Weighted multivariate logistic regression analyses were used for assessing the correlation between VAI and OA. Subgroup analyses were performed to validate the finding. Moreover, mediation analysis was conducted to access the magnitude of the mediating effect of the BMI on the relationship between VAI and OA. Finally,the nonlinear relationship between VAI and OA was assessed by restricted cubic spline(RCS). Result There was a significant positive association between VAI and the OA, even after adjusting for multiple potential confounders(p for trend = 0.05). Subgroup analyses showed that the positive association between VAI and OA persisted in all populations with different characteristics, confirming its validity in all populations. Besides, the result of the mediation analysis indicated that the mediating effect of VAI on osteoarthritis through BMI is significant(p for trend < 0.01). Finally, RCS result showed a significant nonlinear relationship between VAI and OA(p-non-linear < 0.05). Conclusions Our findings indicated that there is a possible nonlinear positive correlation between VAI and OA. In addition, the nonlinear relationship between VAI and osteoarthritis warrants further study.