Differential Associations of Visceral Adiposity with Pulmonary Function Impairment by Sex: Identification of a Male-Specific Risk Threshold.

作者：Yu Zhao, Xiu-qin Ma, Qing-chun Liu, Wei Zhang, G. Fan, Rong Wang · 发表于：Clinical Nutrition ESPEN · 年份：2026 · DOI：10.1016/j.clnesp.2026.102968 · 被引用次数：1 · 研究领域：Medicine

BACKGROUND Visceral adiposity, a core aspect of nutritional status, is increasingly recognized as a modifiable risk factor for extra-metabolic diseases. However, evidence regarding its sex-specific impact on pulmonary function, a key determinant of healthy aging, remains scarce. This study aimed to investigate the differential associations between the Visceral Adiposity Index (VAI) and impaired pulmonary function in middle-aged and older males and females. METHODS This study included 6,749 participants (3,374 males, 3,375 females) from the 2015 China Health and Retirement Longitudinal Study (CHARLS). Pulmonary function was assessed by peak expiratory flow (PEF), with impairment defined as PEF <80% of the predicted value. The nonlinear association between visceral adiposity index (VAI) and pulmonary function impairment was examined using restricted cubic splines within multivariate logistic regression models, with knots placed at the 5th, 25th, 75th, and 95th centiles. To assess the robustness of the identified VAI threshold, we performed knot placement sensitivity analyses and generated bootstrap 95% confidence intervals (500 replicates). A formal VAI×sex interaction term was included in a combined model to test for sex differences. RESULTS The association between visceral adiposity index (VAI) and pulmonary function impairment was explored. A potential threshold effect at VAI ≈ 103 was observed in males, beyond which the risk of impairment appeared to increase. In female...