Association of cumulative exposure to Chinese visceral adiposity index and gastrointestinal cancer: a prospective cohort study.
Level 3 - non-randomized controlled study
Prospective cohort study
PubMed 40678066 · doi:10.3389/fonc.2025.1534682
What was done
Researchers evaluated 44,213 participants from the Kailuan Cohort in China who completed three consecutive health examinations between 2006 and 2010. Participants were categorized into quartiles based on cumulative Chinese visceral adiposity index (cumCVAI). The relationship between cumCVAI and gastrointestinal (GI) cancer incidence was analyzed using Kaplan-Meier curves, restricted cubic splines to assess dose-response nonlinearity, and multivariable Cox proportional hazards regression models alongside subgroup analyses.
What was found
GI cancer incidence rates per 1,000 person-years increased across cumCVAI quartiles: 1.00 in Q1, 1.45 in Q2, 1.62 in Q3, and 2.11 in Q4. Restricted cubic spline curves confirmed a significant dose-response relationship (P for overall trend < 0.001; P for nonlinear trend < 0.001). After multivariable adjustment, compared with Q1, the risk of GI cancer was significantly elevated in Q2 (HR 1.26; 95% CI 1.01, 1.58), Q3 (HR 1.31; 95% CI 1.05, 1.64), and Q4 (HR 1.48; 95% CI 1.19, 1.85). The association was particularly evident in older individuals, females, participants with BMI ≥ 24 kg/m², non-smokers, and non-drinkers.
Why it matters
This study demonstrates that sustained, cumulative visceral adiposity measured by CVAI is an independent risk factor for gastrointestinal cancers, highlighting the potential preventive value of long-term visceral fat control.
Limits
The study was conducted within a single cohort (Kailuan) in China, which may limit generalizability to other populations. The abstract pools all gastrointestinal cancers together rather than reporting site-specific outcomes (e.g., colorectal, gastric, esophageal), omits total cancer case numbers and median follow-up duration, and residual confounding cannot be ruled out.
Cited by
- context People with high visceral fat have a 44% higher chance of developing cancer.