Association between appendicular skeletal muscle mass‐to‐visceral fat area ratio and cardiovascular disease: A cross‐sectional study

OBJECTIVES: The primary objective of this study was to examine the association between the skeletal muscle mass-to-visceral fat area ratio (SVR) and cardiovascular disease (CVD) prevalence. METHODS: This study employed data from the 2011-2018 National Health and Nutrition Examination Survey (NHANES) to derive the SVR using dual-energy X-ray absorptiometry (DXA) measurements. CVD status was ascertained using self-reported physician-diagnosed medical history. Subsequent multivariable logistic regression analyses were performed to examine the relationship between SVR and CVD prevalence. Restricted cubic spline regression was utilized to examine underlying non-linear associations between the SVR and CVD risk. Stratified subgroup analyses were ultimately performed to assess the robustness of the findings. Sensitivity analyses were conducted with additional adjustment for total body fat percentage, and sex-stratified restricted cubic spline analyses were also conducted to explore potential differences in nonlinear associations between men and women. RESULTS: This study included 9383 participants, among whom 348 were diagnosed with CVD. Multivariable logistic regression models demonstrated a statistically significant inverse relationship between SVR and CVD prevalence (OR = 0.093; 95% CI: 0.016-0.542; p = 0.011). The association persisted after adjustment for total body fat percentage. RCS analysis revealed a non-linear association between the SVR and CVD risk. Moreover, subgroup analyses confirmed that the protective effect of SVR remained consistent across various baseline characteristics. CONCLUSION: The findings indicate that lower SVR correlates with an elevated risk of CVD, and this association has been robustly demonstrated across multiple studies.