DOI: 10.1111/dom.15424 ISSN: 1462-8902

Associations between Chinese visceral adiposity index and risks of all‐cause and cause‐specific mortality: A population‐based cohort study

Xiaoyan Wu, Chunqi Wang, Deliang Lv, Bowang Chen, Yi Wu, Xiaobing Wu, Yang Yang, Jianlan Cui, Wei Xu, Hao Yang, Lijuan Song, Wenyan He, Yan Zhang, Hongyun Guan, Fengzhu Xie, Wei Xie, Qinggang Shang, Zhiguang Zhao, Xi Li
  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Internal Medicine



To determine the associations between the Chinese visceral adiposity index (CVAI) and the risks of all‐cause and cause‐specific mortality.

Materials and Methods

A total of 3 916 214 Chinese adults were enrolled in a nationwide population cohort covering all 31 provinces of mainland China. The CVAI was calculated based on age, body mass index, waist circumference, and triglyceride and high‐density lipoprotein cholesterol concentrations. We used a Cox proportional hazards regression model to determine the hazard ratios and 95% confidence intervals (CIs) for risk of mortality associated with different CVAI levels.


The median follow‐up duration was 3.8 years. A total of 86 158 deaths (34 867 cardiovascular disease [CVD] deaths, 29 884 cancer deaths, and 21 407 deaths due to other causes) were identified. In general, after adjusting for potential confounding factors, a U‐shaped relationship between CVAI and all‐cause mortality was observed by restricted cubic spline (RCS). Compared with participants in CVAI quartile 1, those in CVAI quartile 4 had a 23.0% (95% CI 20.0%–25.0%) lower risk of cancer death, but a 23.0% (95% CI 19.0–27.0) higher risk of CVD death. In subgroup analysis, a J‐shaped and inverted U‐shaped relationship for all‐cause mortality and cancer mortality was observed in the group aged < 60 years.


The CVAI, an accessible indicator reflecting visceral obesity among Chinese adults, has predictive value for all‐cause, CVD, and cancer mortality risks. Moreover, the CVAI carries significance in the field of health economics and secondary prevention. In the future, it could be used for early screening purposes.

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