Association of Visceral Fat Mass Index with Diabetes and Vascular Complications: NHANES 2011-2018 Cross-Sectional...

Background: Visceral fat mass index (vFMI), a key visceral obesity marker, is linked to insulin resistance and cardiovascular impairment. This study examined the relationship between vFMI, people living with diabetes, and its vascular complications. Methods: Data from NHANES (2011-2018) were used, including participants aged 18 years and older. Multivariable logistic regression models examined associations between vFMI and diabetes, diabetic nephropathy (DN), and cardiovascular disease (CVD). Result: A total of 4,847 participants were included, comprising 2,469 (50.9%) males and 2,378 (49.1%) females, with a mean age of 40 years. The prevalence of diabetes, DN, and CVD was 11.6% (567), 2.8% (136), and 4.3% (208), respectively. Participants in the highest vFMI quartile had a markedly higher risk of diabetes [odds ratio (OR): 5.85, 95% confidence interval (CI): 3.25 to 10.55], DN (OR: 2.84, 95% CI: 0.89 to 9.08), and CVD (OR: 2.55, 95% CI: 1.10 to 5.93) versus the lowest quartile. Nonlinear regression identified critical thresholds for log-transformed vFMI, beyond which risks sharply increased: 0.252 for diabetes and 0.241 for DN. Subgroup analysis showed stronger associations in younger participants (≤40 years), those with lower triglyceride levels, and those with higher β-cell function. Conclusion: Higher vFMI correlates with greater prevalence of diabetes and related complications, indicating that visceral fat plays a critical role in their development.