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. 2025 Jul 21:12:1602288.
doi: 10.3389/fnut.2025.1602288. eCollection 2025.

Association between visceral adiposity index and endometriosis: a population-based study

Jiajia Zhang #  1 , Qian Zhang #  1 , Tianyu Chu  1 , Xian Chen  1 , Hui Zhou  1 , Dewu Xu  2 , Chunlin Dong  1 , Yibo Wu  1
Affiliations

Association between visceral adiposity index and endometriosis: a population-based study

Jiajia Zhang et al. Front Nutr. .

Abstract

Objectives: Obesity and endometriosis are intricately linked. The body mass index (BMI) is commonly used as an indicator of obesity, but it has limitations. The visceral adiposity index (VAI) is a novel, low-cost composite index that reflects visceral adiposity accumulation and metabolic health status. The objective of our research was to investigate the association between VAI and endometriosis.

Methods: This is a cross-sectional study. The investigation utilized information from the NHANES (1999-2006), focusing on participants aged ≥20 years. We evaluated the association between VAI and endometriosis through five complementary approaches: multivariable-adjusted weighted logistic regression, trend tests, sensitivity analyses, subgroup analyses, and restricted cubic spline (RCS) curve.

Results: After screening, our analysis included 2,056 eligible subjects, among whom 163 cases of endometriosis were identified. The final adjusted logistic regression model demonstrated a significant positive association between VAI and endometriosis (OR = 1.08, 95% CI: 1.04-1.12, p < 0.001). Results of restricted cubic spline fitting revealed a linear positive correlation between VAI and endometriosis (p for overall < 0.001; p for non-linear = 0.539). The results of subgroup analyses showed that some specific demographic, lifestyle, and reproductive characteristics were not statistically significant in influencing the correlation between VAI and endometriosis (p > 0.05 for all interactions).

Conclusion: Our study observed a statistically significant association between VAI and endometriosis. More prospective cohort investigations with large samples are required to further validate these findings because the etiology of endometriosis remains unclear.

Keywords: NHANES; cross-sectional survey; endometriosis; obesity; visceral adiposity index.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of the inclusion and exclusion of study participants.
Figure 2
Figure 2
RCS curve of the association between the VAI index and endometriosis among all study participants.
See this image and copyright information in PMC

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