Visceral Adiposity Index and Public Health Strategies for Metabolic Syndrome Prevention in Postmenopausal Women

Abstract Background Postmenopausal women are at increased risk for metabolic syndrome (MetS), largely due to visceral adiposity accumulation. The Visceral Adiposity Index (VAI), an indirect marker of visceral fat dysfunction, may serve as a valuable predictor of MetS. Objective This study aims to investigate the association between VAI and MetS in postmenopausal women. Methods Using data from the 1999–2020 National Health and Nutrition Examination Survey (NHANES), we analyzed 5,159 postmenopausal women. MetS was defined according to the NCEP-ATP III criteria. Weighted multivariable logistic regression, subgroup analyses, and restricted cubic spline models were employed to assess the relationship between VAI and MetS. Results A significant positive association was observed between VAI and MetS (OR: 3.72, 95% CI: 3.26–4.25, P < 0.01), persisting after multivariable adjustments. In subgroup analyses, the association was stronger in non-hypertensive individuals (OR: 4.21, 95% CI: 3.48–5.09) compared to those with hypertension (OR: 2.97, 95% CI: 2.45–3.60, P-interaction < 0.01). Restricted cubic spline models suggested a nonlinear relationship, indicating that a significant positive linear relationship between MetS and VAI. Conclusion VAI is strongly associated with MetS risk in postmenopausal women and may serve as a practical tool for early screening and risk stratification. These findings highlight the need for targeted metabolic interventions in this high-risk population.