目的 评估年龄调整内脏脂肪指数（AVAI）与骨关节炎患病率之间的关联。方法 采用加权多元Logistic回归模型和平滑曲线拟合分析AVAI和骨关节炎患病率之间的关系，通过亚组分析和交互作用检验探讨这一关系在不同亚组人群之间的效应差异。此外，通过受试者工作特征曲线（ROC）分析评估AVAI对骨关节炎的预测效能。结果 本研究基于美国国家健康与营养调查（NHANES）2011—2018年数据，共纳入5 929例参与者。较高的AVAI指数与骨关节炎患病率呈正相关（OR=1.22，95%CI：1.07~1.40）。随着AVAI指数的增加，骨关节炎患病风险呈现先上升后缓慢下降的趋势，AVAI的拐点为-4.48。在性别、年龄、教育程度和婚姻状况亚组中观察到交互作用。结论 AVAI与骨关节炎患病率之间存在非线性关系，当AVAI低于-4.48时，骨关节炎的患病风险增加。AVAI可作为一种有效、便捷的筛查工具，用于早期识别骨关节炎高风险人群。

    Objective This study aimed to evaluate the association between the age-adjusted visceral adiposity index（AVAI）and the prevalence of osteoarthritis（OA）．Methods Survey-weighted multivariable logistic regression models and smooth curve fitting were used to examine the relationship between AVAI and OA prevalence．Subgroup analyses and interaction tests were conducted to explore potential effect modifications across different population subgroups．Additionally，the predictive capability of AVAI for osteoarthritis was assessed using receiver operating characteristic（ROC）curve analysis． Results A total of 5 929 participants from the National Health and Nutrition Examination Survey（NHANES）2011–2018 were included．Higher AVAI levels were significantly associated with an increased prevalence of OA（OR=1.22；95%CI：1.07–1.40）．As AVAI increased，the risk of OA initially rose and then gradually declined，with an inflection point observed at ?4.48．Significant interactions were found across subgroups stratified by sex，age，education level，and marital status．Conclusions There exists a nonlinear relationship between AVAI and OA prevalence，with a significant increase in osteoarthritis risk observed when AVAI falls below -4.48．AVAI serves as an effective and convenient screening tool for identifying individuals at high risk of OA at an early stage．