{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T02:42:45Z","timestamp":1772160165812,"version":"3.50.1"},"reference-count":36,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T00:00:00Z","timestamp":1755820800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T00:00:00Z","timestamp":1755820800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2025,11]]},"abstract":"Abstract<\/jats:title>\n \n Aims<\/jats:title>\n \n This study aimed to investigate the association between Chinese visceral adiposity index (\n CVAI<\/jats:styled-content>\n ) and heart failure (\n HF<\/jats:styled-content>\n ) risk in diabetic individuals and to evaluate the predictive capability of\n CVAI<\/jats:styled-content>\n compared to other obesity metrics.\n <\/jats:p>\n <\/jats:sec>\n \n Materials and Methods<\/jats:title>\n \n A prospective cohort study (Kailuan Study) spanning 2006 to 2022 involved 12\u2009243 diabetic patients. Participants were stratified into\n CVAI<\/jats:styled-content>\n quartiles (\n Q1<\/jats:styled-content>\n : <96.13,\n n<\/jats:italic>\n \u2009=\u20093060;\n Q2<\/jats:styled-content>\n : 96.13 to <121.25,\n n<\/jats:italic>\n \u2009=\u20093061;\n Q3<\/jats:styled-content>\n : 121.25 to <146.85,\n n<\/jats:italic>\n \u2009=\u20093061;\n Q4<\/jats:styled-content>\n : \u2265146.85,\n n<\/jats:italic>\n \u2009=\u20093061). The relationship between\n CVAI<\/jats:styled-content>\n and\n HF<\/jats:styled-content>\n occurrence was assessed using the Kaplan\u2013Meier analysis and Cox regression models, supplemented by sensitivity analyses. Restricted cubic splines were used to evaluate potential nonlinear associations. Subgroup analyses examined the influence of sociodemographic factors and health behaviours. Receiver operating characteristic (\n ROC<\/jats:styled-content>\n ) analysis compared\n CVAI<\/jats:styled-content>\n with other obesity indices. Statistical significance was set at\n p<\/jats:italic>\n \u2009<\u20090.05.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Over a median follow\u2010up of 15\u2009years, 861 new\n HF<\/jats:styled-content>\n cases were recorded.\n HF<\/jats:styled-content>\n incidence rose with increasing\n CVAI<\/jats:styled-content>\n quartiles (\n Q1<\/jats:styled-content>\n \u2013\n Q4<\/jats:styled-content>\n : 3.05\u20137.20\/1000 person\u2010years;\n p<\/jats:italic>\n \u2009<\u20090.05). Adjusted\n HRs<\/jats:styled-content>\n (95%\n CI<\/jats:styled-content>\n ) for\n HF<\/jats:styled-content>\n in\n Q2<\/jats:styled-content>\n \u2013\n Q4<\/jats:styled-content>\n compared to\n Q1<\/jats:styled-content>\n were 1.32 (1.06\u20131.65), 1.41 (1.13\u20131.75) and 1.91 (1.55\u20132.35) (\n P<\/jats:italic>\n trend<\/jats:sub>\n \u2009<\u20090.01). Age significantly modified the\n CVAI<\/jats:styled-content>\n \u2010\n HF<\/jats:styled-content>\n relationship (\u226560\u2009years:\n HR<\/jats:styled-content>\n \u2009=\u20092.06, 1.60\u20132.64;\n P<\/jats:italic>\n interaction<\/jats:sub>\n \u2009<0.01).\n CVAI<\/jats:styled-content>\n exhibited a linear correlation with\n HF<\/jats:styled-content>\n (\n P<\/jats:italic>\n nonlinear<\/jats:sub>\n \u2009=\u20090.75) and demonstrated superior\n ROC<\/jats:styled-content>\n \u2010predictive accuracy compared to other indices (\n p<\/jats:italic>\n \u2009<\u20090.01).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n CVAI<\/jats:styled-content>\n is independently associated with\n HF<\/jats:styled-content>\n risk, especially in elderly patients, supporting its utility for visceral fat\u2010related risk stratification.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/dom.70053","type":"journal-article","created":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T10:08:51Z","timestamp":1755857331000},"page":"6516-6526","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Association between Chinese visceral adiposity index and heart failure in diabetic patients"],"prefix":"10.1111","volume":"27","author":[{"given":"Shiwei","family":"Kang","sequence":"first","affiliation":[{"name":"School of Public Health North China University of Science and Technology Tangshan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuohua","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Kailuan General Hospital Tangshan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zuxu","family":"Lin","sequence":"additional","affiliation":[{"name":"School of Public Health North China University of 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