Table 1_Association between visceral adiposity index and endometriosis: a population-based study.docx

Objectives Obesity and endometriosis are intricately linked. The body mass index (BMI) is commonly used as an indicator of obesity, but it has limitations. The visceral adiposity index (VAI) is a novel, low-cost composite index that reflects visceral adiposity accumulation and metabolic health status. The objective of our research was to investigate the association between VAI and endometriosis. Methods This is a cross-sectional study. The investigation utilized information from the NHANES (1999–2006), focusing on participants aged ≥20 years. We evaluated the association between VAI and endometriosis through five complementary approaches: multivariable-adjusted weighted logistic regression, trend tests, sensitivity analyses, subgroup analyses, and restricted cubic spline (RCS) curve. Results After screening, our analysis included 2,056 eligible subjects, among whom 163 cases of endometriosis were identified. The final adjusted logistic regression model demonstrated a significant positive association between VAI and endometriosis (OR = 1.08, 95% CI: 1.04–1.12, p < 0.001). Results of restricted cubic spline fitting revealed a linear positive correlation between VAI and endometriosis (p for overall < 0.001; p for non-linear = 0.539). The results of subgroup analyses showed that some specific demographic, lifestyle, and reproductive characteristics were not statistically significant in influencing the correlation between VAI and endometriosis (p > 0.05 for all interactions). Conclusion Our study observed a statistically significant association between VAI and endometriosis. More prospective cohort investigations with large samples are required to further validate these findings because the etiology of endometriosis remains unclear.