Association between age-adjusted visceral adiposity index and obstructive sleep apnea: a study based on NHANES 2015-2018.

Background: Obstructive sleep apnea (OSA) is a common sleep disorder that significantly impairs sleep quality and daytime functionality, with a well-established association with obesity. To enhance the precision of OSA risk assessment, this study introduces the age-adjusted visceral adiposity index (AVAI) and investigates its association with OSA. Methods: The study utilized data from the 2015-2018 National Health and Nutrition Examination Survey (NHANES). The association of AVAI with OSA was examined through a multivariate logistic regression model. Propensity score matching (PSM) was leveraged for mitigating baseline characteristic imbalances and validating the robustness of the findings. Interaction and subgroup analyses were conducted to explore potential effect modifiers. In addition, receiver operating characteristic (ROC) curve analysis was performed to evaluate the discriminative ability of AVAI for OSA. Results: Among 3,611 participants, 1,753 were diagnosed with OSA. AVAI was significantly associated with OSA [odds ratio (OR) =1.15, 95% confidence interval (CI): 1.09, 1.21]. Participants in the highest AVAI quartile (Q4) had a notably elevated likelihood of OSA in contrast to those in the lowest quartile (Q1) (OR =2.67, 95% CI: 1.96, 3.64). This relation remained significant in the PSM-adjusted sample (OR =1.14, 95% CI: 1.09, 1.20). Subgroup analyses demonstrated that the link of AVAI to OSA was particularly significant in females, non-hypertensive individuals, non-diabetic individuals, and those without cardiovascular disease. Conclusions: This cross-sectional study establishes AVAI's independent association with OSA. Clinically, AVAI may help identify current high-risk profiles to guide targeted management, though predictive applications require future validation.