Data used for analysis in the study.

BackgroundObesity and cardiovascular disease (CVD) are both associated with sedentary behavior. However, the role that sedentary behavior plays in the relationship between obesity and CVD in patients with diabetes remains unclear. This study aimed to examine how the weight-adjusted waist index (WWI) relates to CVD risk in patients with diabetes and to explore sedentary behavior’s potential mediating role in this relationship.MethodsThe present study analyzed data from 4,937 participants across seven NHANES cycles (2007–2020). Using logistic regression models and restricted cubic spline analyses, we evaluated the associations between WWI, sedentary behavior, and CVD in patients with diabetes. Subgroup and sensitivity analyses were conducted to confirm the stability of the results. Mediation analysis explored the mediating role of sedentary behavior in the associations between WWI and CVD.ResultsThe present study found that diabetic patients with CVD had higher WWI levels (11.8 ± 0.69)compared to diabetic patients without CVD (11.60 ± 0.73). WWI was positively associated with CVD in patients with diabetes(OR = 1.27, 95% CI: 1.06–1.53; P ConclusionWe found that WWI is associated with an increased risk of CVD in patients with diabetes, and sedentary behavior partially mediates this relationship. Reducing sedentary behavior may be a key strategy to reduce obesity and CVD risk in patients with diabetes.