Key result
Elevated CVAI linked to ~96% higher osteoporosis risk in females with T2D.
Why the study?
The sex- and duration-specific association between the Chinese Visceral Adiposity Index and osteoporosis in patients with type 2 diabetes remains unclear.
Is the Chinese Visceral Adiposity Index associated with osteoporosis in middle-aged and elderly Chinese patients with Type 2 diabetes?
Cross-Sectional (n=4,214)
Is the Chinese Visceral Adiposity Index associated with osteoporosis in middle-aged and elderly Chinese patients with Type 2 diabetes?
Elevated Chinese Visceral Adiposity Index is positively associated with osteoporosis in female patients with Type 2 diabetes, highlighting them as key targets for prevention, whereas the association is inverse in prevalent male patients.
Introduction and Objective: The Chinese Visceral Adiposity Index (CVAI) is a population-specific visceral fat marker, but its sex- and duration-specific association with osteoporosis in patients with Type 2 diabetes (T2D) remains unclear. This study aimed to investigate the sex-heterogeneous association between CVAI and osteoporosis in middle-aged and elderly patients with T2D. Methods: Patients with T2D aged >=50 years were recruited between January 2014 and December 2023, and were categorized as either incident (diagnosis within 3 months) or prevalent T2D. Bone status was assessed by DXA and classified into normal, osteopenia and osteoporosis. Logistic regression and RCS analyses were performed, with adjustment for potential confounders. Effect modification by sex and diabetes duration was also evaluated. Results: Among 4,214 eligible participants, the detection rates of osteopenia and osteoporosis were 46.2% and 40.8% in all,55.1% and 26.7% in male, 38.0% and 53.7% in female, respectively. No significant difference was observed between incident and prevalent cases. In males, a significant inverse association between CVAI and osteoporosis was observed among prevalent patients. In contrast, a significant positive linear association was observed in females regardless of diabetes duration. Compared with the lowest CVAI quartile (Q1), the risk of osteoporosis in incident female patients increased by 39.6%, 95.5%, and 93.3% for Q2-Q4, respectively; Corresponding increase among prevalent patients were 14.6%, 52.8%, and 94.4%. A significant interaction was identified between female sex and high CVAI, with 33% of the association attributable to their interaction. Conclusion: CVAI is associated with osteoporosis in a sex-heterogeneous manner among patients with T2D. Females with elevated CVAI are key targets for osteoporosis prevention. Disclosure Z. Wang: None. X. Li: None. J. Zhang: None.
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Wang et al. (2026) conducted a cross-sectional in Type 2 diabetes and osteoporosis (n=4,214). Chinese Visceral Adiposity Index (CVAI) vs. Lowest CVAI quartile (Q1) was evaluated on Osteoporosis. Elevated Chinese Visceral Adiposity Index was positively associated with osteoporosis in females with Type 2 diabetes, increasing risk by up to 95.5% compared to the lowest quartile.
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