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. 2025 Sep 3:18:5063-5071.
doi: 10.2147/IJGM.S536352. eCollection 2025.

Association Between the Chinese Visceral Adiposity Index and Obstructive Sleep Apnoea in Hypertensive Patients with Normal-Weight: A Cross-Sectional Study

Delian Zhang #  1   2   3   4   5 , Kangxin Cai #  1   2   3   4   5 , Qing Zhu  1   2   3   4   5 , Aliye Abulaiti  1   2   3   4   5 , Jing Hong  1   2   3   4   5 , Yingchun Wang  1   2   3   4   5 , Nanfang Li  1   2   3   4   5
Affiliations

Association Between the Chinese Visceral Adiposity Index and Obstructive Sleep Apnoea in Hypertensive Patients with Normal-Weight: A Cross-Sectional Study

Delian Zhang et al. Int J Gen Med. .

Abstract

Objective: Previous studies have mainly focused on the relationship between the Chinese Visceral Adiposity Index (CVAI) and obstructive sleep apnea (OSA) in general or overweight/obese populations. However, normal-weight hypertensive patients represent a clinically relevant yet understudied group, in whom OSA risk may be underestimated due to the absence of overt obesity. This study aimed to investigate the association between CVAI and OSA in normal-weight patients with hypertension, given the important role of visceral adiposity in the pathogenesis of OSA.

Materials and methods: In this cross-sectional study, hypertensive patients admitted between January 1, 2021, and December 31, 2023, were enrolled. Multivariate logistic and linear regression analyses were conducted. Additionally, restricted cubic spline (RCS) analyses were used to examine potential dose-response relationships.

Results: A total of 6659 hypertensive patients were included. After adjusting for potential confounders, elevated CVAI levels were significantly associated with an increased risk and severity of OSA. RCS analyses demonstrated a clear linear dose-response relationship between CVAI and both the presence of OSA and apnea-hypopnea index (AHI) levels. These results were robust across both subgroup and sensitivity analyses.

Conclusion: Our study results indicate that CVAI is associated with the occurrence and severity of OSA in hypertensive patients with normal body weight. Further research is needed to confirm these findings.

Keywords: Chinese visceral adiposity index; apnoea-hypopnea index; cross-sectional study; obstructive sleep apnoea.

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Conflict of interest statement

The authors have no conflicts of interest to declare for this work.

Figures

Figure 1
Figure 1
Flowchart of the study participant selection process.
Figure 2
Figure 2
Prevalence of obstructive sleep apnoea (OSA) stratified by Chinese visceral adiposity index (CVAI) quartiles.
Figure 3
Figure 3
Dose-response relationship between CVAI and OSA, AHI. (A) Association with OSA. (B) Association with AHI.
Figure 4
Figure 4
Subgroup analyses for per SD increment in Chinese visceral adiposity index (CVAI) on obstructive sleep apnoea (OSA). (A) Impact on OSA. (B) Impact on AHI.
See this image and copyright information in PMC

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