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Purpose <p>To examine the association between the skeletal muscle mass-to-visceral fat area ratio (SVR) and prevalent cardiovascular disease (CVD) in a nationally representative U.S. population.</p> Methods <p>We analyzed data from the U.S. National Health and Nutrition Examination Survey (NHANES), 2011–2018. Associations of SVR with composite CVD and its subtypes (heart failure [HF], coronary heart disease [CHD], angina pectoris [AP], myocardial infarction [MI], or stroke) were estimated using multivariable logistic models; linear trend across SVR tertiles was tested, and nonlinearity was assessed using restricted cubic spline (RCS) models. Subgroup analyses assessed heterogeneity.</p> Results <p>The sample comprised 9,997 participants. In multivariable-adjusted logistic models, higher SVR was associated with lower odds of CVD (Model 4: OR = 0.44; 95% CI 0.29–0.67; P &lt; 0.001), with a dose–response (P for trend = 0.001). In subtype analyses, the highest SVR category was associated with lower odds of HF (OR = 0.42, 95% CI 0.18–0.96; P = 0.047), CHD (OR = 0.28, 95% CI 0.11–0.71; P = 0.011), and MI (OR = 0.33, 95% CI 0.11–0.94; P = 0.045), with significant trends for all three outcomes (P for trend &lt; 0.05). RCS models showed nonlinear associations of SVR with composite CVD, CHD, and MI, but not with HF, stroke or AP. Subgroup analyses detected interactions for poverty-income ratio (PIR) and BMI strata (both P for interaction = 0.005).</p> Conclusion <p>Higher SVR may be a potential CVD risk marker, whereas associations with AP and stroke were weak or non-significant. Prospective validation is warranted.</p> <p><i>Level of evidence</i>: Level V—cross-sectional observational study.</p>

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Association of the skeletal muscle mass-to-visceral fat area ratio with cardiovascular disease: a cross-sectional study based on NHANES

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月2日

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  • Ruixue Li,
  • Tianqi Liu,
  • Wei Xin,
  • Zi Liang,
  • Chenguang Zhao,
  • Zinan Zhao,
  • Tian Zhang,
  • Fei Zhao,
  • Wenfeng Xu,
  • Pengfei Jin

摘要

Purpose

To examine the association between the skeletal muscle mass-to-visceral fat area ratio (SVR) and prevalent cardiovascular disease (CVD) in a nationally representative U.S. population.

Methods

We analyzed data from the U.S. National Health and Nutrition Examination Survey (NHANES), 2011–2018. Associations of SVR with composite CVD and its subtypes (heart failure [HF], coronary heart disease [CHD], angina pectoris [AP], myocardial infarction [MI], or stroke) were estimated using multivariable logistic models; linear trend across SVR tertiles was tested, and nonlinearity was assessed using restricted cubic spline (RCS) models. Subgroup analyses assessed heterogeneity.

Results

The sample comprised 9,997 participants. In multivariable-adjusted logistic models, higher SVR was associated with lower odds of CVD (Model 4: OR = 0.44; 95% CI 0.29–0.67; P < 0.001), with a dose–response (P for trend = 0.001). In subtype analyses, the highest SVR category was associated with lower odds of HF (OR = 0.42, 95% CI 0.18–0.96; P = 0.047), CHD (OR = 0.28, 95% CI 0.11–0.71; P = 0.011), and MI (OR = 0.33, 95% CI 0.11–0.94; P = 0.045), with significant trends for all three outcomes (P for trend < 0.05). RCS models showed nonlinear associations of SVR with composite CVD, CHD, and MI, but not with HF, stroke or AP. Subgroup analyses detected interactions for poverty-income ratio (PIR) and BMI strata (both P for interaction = 0.005).

Conclusion

Higher SVR may be a potential CVD risk marker, whereas associations with AP and stroke were weak or non-significant. Prospective validation is warranted.

Level of evidence: Level V—cross-sectional observational study.