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Relationships between the visceral adiposity index (VAI) and type 2 diabetes mellitus (T2DM) have been underexplored. The purpose of this study is to explore association between VAI and T2DM in adults in the US. Based on the National Health and Nutrition Examination Survey 2007-2018, 11,214 participants aged 20 years or older were included in a cross-sectional study. Multifactorial logistic regression analysis and smoothed curve fitting analysis were performed to investigate links between VAI and the prevalence of T2DM, as well as the stability and incidence between subgroups. In a fully adjusted continuous model, the aggregate population risk of T2DM increased 0.43-fold with each 1-unit increase in VAI [odds ratio (OR) = 1.43; 95% confidence interval (CI) 1.35-1.50]. In the fully adjusted categorical model with VAI scores stratified by quartiles, results showed a higher T2DM advantage among participants in the second, third, and fourth quartiles (Q2: OR 1.35, 95% CI 1.06-1.71; Q3: OR 2.46, 95% CI 1.95-3.11; Q4: OR 4.42, 95% CI 3.55-05.50). Compared with Q1, the prevalence of T2DM in the total population increased 3.42-fold in Q4. The above results indicated that VAI was positively associated with the prevalence of T2DM, which was consistent and nonlinear with the smoothed curve-fitting analysis (P for non-linear = 0). Subgroup analyses after adjusting for covariates showed that keeping with the overall population results, it also was found that there was an interaction between sex and hypertension in the subgroups. VAI was positively associated with the prevalence of T2DM and was more prevalent in women, non-hypertensive than in men, hypertensive populations., (© 2024. The Author(s).)

Objective: To investigate the association between the visceral adiposity index and the prevalence of diabetes and prediabetes in the US adult population., Method: We conducted a cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018 for ten consecutive years, including 18745 eligible participants. The weighted multivariate logistic model and fitting curve were used to explore the correlation and dose-response relationship between visceral adiposity index (VAI) and diabetes (DM) and prediabetes in the general population and the prevalence of different subgroups., Results: In the fully adjusted continuous model, the risk of diabetes and prediabetes in the general population increased 0.15 times [1.15 (1.10,1.20), p<0.0001] with every increase of 1 unit of VAI. In the fully adjusted classification model, with the lowest quartile array Q1 of VAI as the reference group, Q2 of the second Quantile group, Q3 of the third Quantile group, and Q4 of the Quartile group increased 0.26 times [1.26 (1.10,1.44), p<0.001], 0.65 times [1.65 (1.43,1.89), p<0.0001], 1.60 times [2.60 (2.28,2.97), p<0.0001] respectively with the risk of diabetes and prediabetes. The above results showed that VAI was positively associated with the prevalence of diabetes and prediabetes, and the fitted curves showed a non-linear trend. (P for non-linear = 0<0.05). The results of the subgroup population were consistent with the total population and a significant interaction was found in gender (P for interaction<0.0001)., Conclusion: In conclusion, we found a non-linear positive association between VAI and the risk of diabetes and prediabetes in the US adult population and found that women have a higher risk of diabetes and prediabetes than men; therefore, we should focus on the female population, and we call for the use of VAI to manage the development of diabetes and prediabetes in the clinical setting., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Zheng et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Delayed emergency department (ED) LOS has been associated with increased mortality and increased hospital length of stay (LOS) for various patient populations. Trauma patients often require significant effort in evaluation, workup, and disposition; however, patient and hospital characteristics associated with increased LOS in the ED for trauma patients remain unclear., Methods: The Trauma Quality Improvement Project database (2014-2016) was queried for all adult blunt trauma patients. Patients discharged from the ED to the operating room were excluded. Univariate and multivariable linear regression analysis was conducted to identify independent predictors of ED LOS, controlling for patient characteristics (age, gender, race, insurance status), hospital characteristics (teaching status, ACS trauma verification level, geographic region), abbreviated injury scale and comorbid status., Results: 412,000 patients met inclusion criteria for analysis. When controlling for covariates, an increase in age by 1 y resulted in 0.63 increased minutes in the ED (P < 0.001). In multivariable linear regression controlling for injury severity and comorbid conditions, non-white race groups, university status, and northeast region were associated with increased ED LOS. Black and Hispanic patients spent on average 41 and 42 more minutes, respectively, in the ED room when compared with white patients (P < 0.001). Patients seen at University hospitals spent 52 more minutes in the ED when compared with community hospitals, whereas patients at nonteaching hospitals spent 31 fewer minutes (P < 0.001). Patients seen in the Midwest spent the least amount of time in the ED, with patients in the South, West, and Northeast spending 45, 36, and 89 more minutes, respectively (P < 0.001). Non-Medicaid patients at level 1 trauma centers and those requiring intensive care admission had significantly decreased ED LOS. Medicaid patients took the longest to move through the ED with Medicare, BlueCross, and Private insurance outpacing them by 17, 23, and 23 min, respectively (P < 0.001). ACS level 1 trauma centers moved patients through the ED fastest, whereas ACS level II trauma centers and level III trauma centers moved patients through 50 and 130 min slower when compared with ACS level 1 trauma centers (P < 0.001)., Conclusions: ED LOS varied significantly by patient and hospital characteristics. Medicaid patients and those patients at university hospitals were associated with significantly higher ED LOS, whereas ACS trauma verification level status had strong correlation with ED LOS. These results may allow targeted quality improvement programs to enhance ED LOS., (Copyright © 2019 Elsevier Inc. All rights reserved.)