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Accepted for/Published in: JMIR Public Health and Surveillance

Date Submitted: Jun 6, 2025
Open Peer Review Period: Jun 5, 2025 - Jul 31, 2025
Date Accepted: Apr 20, 2026
(closed for review but you can still tweet)

The final, peer-reviewed published version of this preprint can be found here:

Association Between Low Chinese Visceral Adiposity Index Values and Chronic Lung Disease in Older Adults: Cohort Study

Zhu X, Tian H, Liu Z, Huang Z, Yuan M, Tu Z, Cui K, Liu J, Gong X

Association Between Low Chinese Visceral Adiposity Index Values and Chronic Lung Disease in Older Adults: Cohort Study

JMIR Public Health Surveill 2026;12:e78627

DOI: 10.2196/78627

PMID: 42160772

PMCID: 13189530

Low Chinese visceral adiposity index is associated with chronic lung disease in older adults, but not middle-aged adults: Cohort study

  • Xiaorong Zhu; 
  • Hui Tian; 
  • Zhi Liu; 
  • Zhoubin Huang; 
  • Miaomiao Yuan; 
  • Zhangshun Tu; 
  • Kaiwang Cui; 
  • Jianping Liu; 
  • Xiangwen Gong

ABSTRACT

Background:

Background:

Visceral fat content, a key indicator of obesity, has been increasingly linked to chronic lung diseases (CLD). However, the precise relationship between the Chinese Visceral Adiposity Index (CVAI) and CLD remains unclear.

Objective:

Objective:

This study aimed to investigate the association between CVAI and CLD risk.

Methods:

Methods:

Data from 6695 participants aged ≥45 years in the China Health and Retirement Longitudinal Study (CHARLS) were analyzed. Restricted cubic spline models were applied to evaluate dose-response relationships between CVAI and CLD across three population subgroups. Cox models were used to assess the hazard ratio (HR) and 95% confidence interval (Cl) of CVAI quintiles on CLD incidence in the significantly associated population.

Results:

Results:

Restricted cubic spline analysis revealed a significant L-shaped relationship between CVAI and CLD incidence in the older population (≥60 years) (overall P = 0.011, nonlinear P = 0.037), rather then in the middle-aged and older population (≥ 45 years old) (P for overall = 0.180) or middle-aged population (45-59 years old) (P for overall = 0.537). The inflection point of CVAI for CLD risk was identified at 123.76 in the elderly. After multivariable adjustment, compared with participants in the fourth quintile (Q4), those in the first quintile (Q1) exhibited a significantly increased risk of CLD (HR = 1.38, 95% CI: 1.04–1.83). The subgroup analyses, which were stratified by sociodemographic factors and lifestyle, showed consistent results across most subgroups (P for interaction > 0.05).

Conclusions:

Conclusion: Low CVAI is negatively correlated with the risk of chronic lung diseases in the elderly population rather than middle-aged individuals.


 Citation

Please cite as:

Zhu X, Tian H, Liu Z, Huang Z, Yuan M, Tu Z, Cui K, Liu J, Gong X

Association Between Low Chinese Visceral Adiposity Index Values and Chronic Lung Disease in Older Adults: Cohort Study

JMIR Public Health Surveill 2026;12:e78627

DOI: 10.2196/78627

PMID: 42160772

PMCID: 13189530

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