Abstract: Background　The Chinese visceral adiposity index (CVAI) is a new simple index to assess visceral fat in the human body, which is closely related to cardiovascular diseases and metabolic diseases. At present, there is limited research on the correlation between CVAI and diabetes. Objective　The purpose of this study was to explore the association between CVAI nd diabetes, to provide a scientific basis for the screening and prediction of diabetes, and to provide new enlightenment and suggestions for the clinical practice of diabetes prevention and treatment and diabetes management. Methods　From January to December 2023, a stratified multi-stage cluster sampling method was adopted to conduct questionnaire surveys, physical examinations, and laboratory tests among urban and rural residents aged 40 years and above in Liaoning Province. Indicators including height, body weight, waist circumference (WC), blood pressure, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), glycosylated hemoglobin (HbA1c), and fasting plasma glucose (FPG) of the participants were determined to calculate the Cardiovascular Age Index (CVAI). Binary Logistic multivariate regression analysis and restricted cubic spline plots were employed to evaluate the association between the CVAI index and diabetes mellitus (DM). Receiver operating characteristic (ROC)curves were utilized to assess the predictive value of CVAI, body mass index (BMI), and WC for the risk of DM in the total population, as well as in male and female subgroups separately. The area under the ROC curve (AUC), sensitivity, specificity, and optimal cut-off values were calculated accordingly. Results　A total of 32 813 participants were included in this study, among whom 8 421 were diabetic patients, with a prevalence rate of 25.7%. The mean CVAI was (119.37±37.01). When CVAI was grouped by quartiles, the prevalence rates of diabetes in the Q1, Q2, Q3, and Q4 groups were 13.9% (1 138/8, 204), 22.7% (1 862/8, 203), 29.4% (2 415/8, 203), and 36.6% (3 006/8, 203), respectively. Result s of the binary Logistic multivariate regression analysis showed that after adjusting for confounding factors, compared with the Q1 group, the Q2 group (OR=1.74, 95%CI=1.60-1.89), Q3 group (OR=2.38, 95%CI=2.20-2.58), and Q4 group (OR=3.18, 95%CI=2.94-3.44) of CVAI were all associated with a higher risk of diabetes (P<0.05). Result s of the restricted cubic restricted cubic spline analysis showed a significant non-linear relationship between CVAI and diabetes risk (P<0.01). The risk of diabetes increased significantly with the elevation of CVAI levels (P<0.05). Result s of the ROC curve analysis indicated that the AUCs of CVAI, BMI, and WC for predicting the risk of diabetes were 0.635 (95%CI=0.628-0.642, P<0.001), 0.611 (95%CI=0.604-0.608, P<0.001), and 0.579 (95%CI=0.572-0.586, P<0.001), respectively. Conclusion　CVAI is positively correlated with diabetes, and it is recommended to promote CVAI to identify potential high-risk groups of diabetes at an early stage and carry out health management and intervention for the occurrence and development of diabetes in a timely manner.

Key words: Diabetes, Chinese visceral adiposity index, Cross-sectional study, Liaoning province

摘要： 背景　中国内脏脂肪指数（CVAI）是一种新的简易评估人体内脏脂肪的指标，与心血管疾病和代谢性疾病密切相关。目前，CVAI与糖尿病的相关性研究较为有限。目的　本研究旨在探讨CVAI与糖尿病的关联性，为糖尿病的筛查和预测提供科学依据，为糖尿病预防和治疗与糖尿病管理提供新的启示和建议。方法　2023年1月—12月运用分层多阶段整群抽样的方式，对辽宁省年龄在40岁及以上的城乡居民展开问卷调查、进行体格检查以及开展实验室检查，对被调查对象身高、体质量、腰围（WC）和血压，总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、糖化血红蛋白（HbA1c）和空腹血糖（FPG）等指标进行测定以计算CVAI。采用二元Logistic多因素回归分析和限制性立方样条图评估CVAI指数与糖尿病之间的相关性。采用受试者工作特征（ROC）曲线评估CVAI、BMI、腰围（WC）对总人群、男性、女性糖尿病患病风险的预测价值，并计算ROC曲线下面积（AUC）、灵敏度、特异度、最佳截断值。结果　本研究总计纳入32 813例研究对象，有8 421例糖尿病患者，患病率为25.7%。平均CVAI为（119.37±37.01），CVAI按照四分位数分组中Q1组、Q2组、Q3组、Q4组糖尿病患病率分别为13.9%（1 138/8 204）、22.7%（1 862/8 203）、29.4%（2 415/8 203）和36.6%（3 006/8 203）。二元Logistic多因素回归分析结果显示，在对混杂因素进行调整后，与Q1组相比，CVAI的Q2组（OR=1.74，95%CI=1.60~1.89）、Q3组（OR=2.38，95%CI=2.20~2.58）、Q4组（OR=3.18，95%CI=2.94~3.44）均与糖尿病患病的高风险存在关联（P<0.05）。限制性立方样条图分析结果显示，CVAI与糖尿病风险呈现显著的非线性关系（P<0.01）。随着CVAI水平的增加，糖尿病患病风险明显升高（P<0.05）。ROC曲线结果显示，CVAI、BMI、WC对糖尿病患病风险预测的AUC分别为0.635（95%CI=0.628~0.642，P<0.001）、0.611（95%CI=0.604~0.608，P<0.001）和0.579（95%CI=0.572~0.586，P<0.001）。结论　CVAI与糖尿病患病之间呈现出显著的正相关关系，能够在早期确定糖尿病潜在的高危人群，以便及时针对糖尿病的发生和发展实施健康管理及干预措施。

关键词: 糖尿病, 内脏脂肪指数, 横断面研究, 辽宁省