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Background: Obesity and metabolic syndrome (MetS) are growing problems in type 1 diabetic patients; these can influence clinical complications and also treatment regimens. Visceral adipose tissue inflammation plays an important role in cardiovascular complications. Visceral adiposity index (VAI), lipid accumulation product index (LAP), and triglyceride (TG)/high-density lipoprotein (HDL) ratio have been strongly correlated with insulin resistance and visceral adipose tissue amount in previous studies. Therefore, this study aimed to investigate and compare the usefulness of these indices to detect MetS in patients with type 1 diabetes mellitus (T1DM). Materials and Methods: Patients with T1DM and gender- and age-matched controls were included in this cross-sectional study. MetS was defined using both International Diabetes Federation (IDF), World Health Organization (WHO), and National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. T1DM patients were divided into two groups according to the IDF criteria. VAI, LAP, and TG/HDL ratio were calculated for all patients. Groups were compared accordingly. Results: One hundred twenty-six patients with T1DM were included in the study. Increased VAI was observed in association with MetS. Patients with MetS (32.2%) had the highest VAI than healthy controls (8.21 ± 8.86; 3.49 ± 2.73, respectively, P < 0.01). For determining MetS in type 1 diabetes, the cutoff value of VAI was 2.65 [area under the curve (AUC) = 0.837, sensitivity 80.0%, specificity 72.8%], LAP was 27.57 (AUC = 0.842, sensitivity 80.0%, specificity74.0%), TG/HDL ratio was 2.18 (AUC = 0.826, sensitivity 75.0%, specificity 74.0%), each P < 0.001. Conclusions: MetS becomes increasingly common in T1DM. VAI, LAP, and TG/HDL ratio were useful for predicting MetS in patients with T1DM. [ABSTRACT FROM AUTHOR]

Background: Limited information is available on arterial stiffness risk among hypertensive patients with metabolically abnormal but normal weight. Visceral adiposity index (VAI) is a novel indicator for visceral fat mass and metabolism, however, whether can be used to assessed arterial stiffness in a normal-weight population remains unclear. The goal of this study was to examine the independent association of VAI with arterial stiffness in normal-weight hypertensive patients. Methods: 3258 participants recruited from the China H-type Hypertension Registry Study. VAI value was calculated using sex-specific equations. High arterial stiffness was defined as baPWV ≥ 18 m/s. Multivariable regression analysis was used to identify the association of VAI with baPWV and high arterial stiffness. Results: Of participants, 50.5% (1644) were males, the mean age was 65.5 (SD, 9.1) years. Mean VAI and baPWV were 2.0 (SD, 2.3) and 18.2 (SD, 3.9) m/s, respectively. For each unit increase of lg VAI in multivariable regression analysis, there was a 1.05 m/s increase in baPWV (95% CI 0.67, 1.43) and a 2.13-fold increase in the risk of high arterial stiffness (95% CI 1.59, 2.86). In all models, the VAI was consistently and significantly associated with baPWV after adjustment for different confounders. High VAI levels were stably associated with baPWV in all subgroups. Conclusions: We found positive association of VAI with baPWV and high arterial stiffness in normal-weight adults with hypertension. The establishment of this association could help the arterial stiffness risk stratification in normal-weight hypertensive populations, who are frequently overlooked in preventing cardiovascular disease. [ABSTRACT FROM AUTHOR]

Background /aim: Acromegaly is a rare chronic endocrine disorder, the active form of which is associated with an increased risk of cardiovascular and metabolic disease. Therefore, early diagnosis and treatment of cardiovascular diseases in acromegaly patients are important in terms of morbidity and mortality. The aim of this study was to determine whether the visceral adiposity index (VAI), lipid accumulation product (LAP), and plasma atherogenic index (PAI) are early cardiovascular risk markers in patients with active acromegaly. Materials and methods: The study included 45 patients newly diagnosed with acromegaly and 45 age–sex matched healthy control subjects. The VAI, LAP, and PAI values were calculated, and carotid artery intima media thickness (CIMT) was measured in both the patients and control groups. Results: The PAI, VAI, LAP, and CIMT values were significantly higher in patients with acromegaly compared with the control subjects (p < 0.004, p < 0.027, p <0.012, and p <0.001, respectively). In the patient group, a significant positive correlation was found between the growth hormone (GH) and insulin-like growth factor I (IGF-I) levels, and between the VAI, LAP and PAI values. A significant positive correlation was determined between CIMT and LAP values in the patient group. Conclusion: CIMT is a noninvasive method used to show early atherosclerosis. However, it is operator dependent. Therefore, VAI, LAP and PAI can be used as noninvasive, simple measurement methods to evaluate early atherosclerosis in patients with acromegaly [ABSTRACT FROM AUTHOR]

Background: This study assessed the performance of visceral adiposity index and body shape index in predicting diabetes mellitus (DM) risk and compared their predictive ability to that of body mass index and waist circumference. Methods: Among 8249 consecutive subjects who attended the Nationwide Health Check Up System for Senior Citizens (≥ 65 years) between 2008 and 2018, we examined the associations of several adiposity indices with DM risk and explored gender differences. Results: Among all adiposity indicators, Chinese visceral adiposity index (CVAI) demonstrated the highest discriminatory ability for diabetes mellitus with area under receiver operating characteristic curves (AUC) of 0.65, 0.68, and 0.66 for men, women, and all participants, respectively, and optimal cut-offs set as 126.09 in men and 117.77 in women. Compared with body shape index (ABSI), both CVAI and VAI were strongly associated with baseline DM (adjusted OR: 4.85, 95% CI: 4.05–5.82 and 4.22, 95% CI: 3.53–5.05 for 4th vs 1st quartile groups by CVAI and VAI, P < 0.001), which was more pronounced in older adult women (Pinteraction < 0.05). Over a median of 5.25 years (IQR: 3.07–6.44 years) follow-up, Cox regression models showed higher predictive ability of CVAI and VAI compared to ABSI. Further, both CVAI and VAI independently predicted new-onset DM (adjusted HR: 1.29, 95% CI: 1.22–1.37 and 1.16, 95% CI: 1.11–1.21 by CVAI and VAI) and composite endpoint of new DM and death among those without baseline DM. Conclusions: Our population-based data demonstrated that Chinese visceral adiposity index may serve as a superior clinical indicator of diabetes when compared with conventional anthropometric indices among older adult Chinese, especially in women. [ABSTRACT FROM AUTHOR]

Background: Visceral adiposity index (VAI), a surrogate marker of adiposity and insulin resistance, has been demonstrated to be significantly related to cardiovascular disease. It remains indistinct whether VAI predicts adverse prognosis after percutaneous coronary intervention (PCI) for patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) and type 2 diabetes mellitus (T2DM).Methods: A total of 798 participants who met the enrollment criteria were finally brought into this study. VAI was determined by waist circumference, body mass index, fasting triglyceride, and high-density lipoprotein cholesterol as previously reported. Adverse prognosis included all-cause death, non-fatal myocardial infarction, non-fatal ischemic stroke, and ischemia-driven revascularization, the composite of which was defined as the primary endpoint.Results: Higher VAI maintained as a significant and independent risk predictor for the primary endpoint, regardless of the adjustment for the various multivariate models [hazard ratio (95% CI) for fully adjusted model: 2.72 (2.02–3.68), p < 0.001]. The predictive value of VAI was further confirmed in sensitivity analysis where VAI was taken as a continuous variate. There was a dose-response relationship of VAI with the risk of the primary endpoint (p for overall association < 0.001). Moreover, the ability of VAI on the prediction of the primary endpoint was consistent between subgroups stratified by potential confounding factors (all p for interaction > 0.05). VAI exhibited a significant incremental effect on risk stratification for the primary endpoint beyond existing risk scores, expressed as increased Harrell's C-index, significant continuous net reclassification improvement, and significant integrated discrimination improvement.Conclusion: VAI is a significant indicator for predicting worse prognosis and plays an important role in risk stratification among patients with NSTE-ACS and T2DM undergoing elective PCI. The present findings require further large-scale, prospective studies to confirm.

BackgroundMetabolic syndrome (MetS) is a pathophysiological change based on the abnormal metabolism of many substances. The study aims to investigate the performance of visceral adiposity index (VAI) and lipid accumulation product (LAP) of MetS in young adults.Methods448 young adults aged between 19 and 24 years old in Qinhuangdao had been included in this cross-sectional study. Receiver operating characteristic (ROC) curve analyses were used to assess the accuracy of these two obesity indicators for MetS.ResultsThe prevalence of MetS was 2.0%. In male subjects, LAP had the highest area under the ROC curve (AUC) value (AUC = 0.963), followed by VAI (AUC = 0.937). In female subjects, LAP also had the highest AUC value (AUC = 0.931), followed by VAI (AUC = 0.861). No significant difference was found between the two obesity indicators (P > 0.05).ConclusionThe two obesity indicators were valuable for the screening of MetS in young adults, and LAP was the simpler of the two.

Background: The visceral adiposity index (VAI) is a newly developing indicator about visceral fat function and insulin resistance. This research aims to assess the association between organ damage and VAI in the community-dwelling elderly Chinese population. Methods: In total, 3363 elderly participants were recruited between June 2014 and August 2019. VAI was used to measure visceral adipose accumulation, and organ damage was measured with standardized methods, including arterial stiffness, lower extremity atherosclerosis, carotid hypertrophy, left ventricular hypertrophy, micro-albuminuria, and chronic kidney disease. Results: According to multivariable linear regression analysis, VAI was related to carotid-femoral pulse wave velocity (cf-PWV; β = 0.047, P = 0.024), urine albumin to creatinine ratio (UACR; β = 3.893, P = 0.008), estimated glomerular filtration rate (eGFR; β = − 0.526, P = 0.003) and loge(ankle-to-brachial index) (ABI; β = -0.003, P = 0.024). Using multivariable stepwise logistic regression model, higher VAI was found to be significantly related to cf-PWV > 10 m/s (OR 1.44, [95% CI 1.17–1.78]; Pfor trend < 0.001), and chronic kidney disease (CKD; OR 1.54, [95% CI 1.09–2.20]; Pfor trend = 0.015). Conclusions: Since higher VAI is related to increased risk of arterial stiffness and CKD, it may serve as a useful index for the assessment of arteriosclerosis and CKD in elderly population. Trial registration: NSS, NCT02368938. [ABSTRACT FROM AUTHOR]

Background: To investigate the relationship between visceral adiposity index (VAI) and other metabolic syndrome (MetS)-related parameters, and thyroid nodules. Methods: This single-center, prospective, case–control study included 67 patients with thyroid nodules and 48 healthy volunteers with similar age, sex, and body mass index (BMI). Biochemical parameters were obtained from medical charts. Anthropometric measurements and total body composition analysis were performed to calculate VAI and other MetS parameters. The parenchymal structure was evaluated according to VESINC (Volume, Echogenicity, Sonographic texture, Infiltration of pseudonodular Nodules, Cysts) system on thyroid ultrasound and nodule characteristics were also detected. MetS was defined according to International Diabetes Federation criteria. Results: We examined a total of 67 patients with thyroid nodule and 48 healthy volunteers. Sixty-one (91%) were female in the patient group; and 43 (90%) were female in the control group. The mean age was 48.5 ± 11.6 years in the patient group; 47.2 ± 9.5 years in the control. The median VAI was significantly higher in the patient group than the control group [4.1 interquartile range (IQR: 2.6–5.9) vs. 3 (IQR: 2–4.3), P = 0.024]. There was a positive correlation between VAI and BMI, waist/hip ratio (WHpR), waist/height ratio (WHtR), and homeostasis of model assessment of insulin resistance (HOMA-IR). On the other hand, there was no significant correlation between VAI and thyroid function tests and autoantibodies and thyroid volume. Conclusions: In conclusion, we demonstrated that MetS was more common in patients with thyroid nodules. Although VAI and HOMA-IR levels were significantly different between the two groups, we found no significant difference in terms of waist circumference, WHpR, and WHtR. This might suggest that VAI compared with these parameters, better predicts the risk of MetS in patients with thyroid nodules. [ABSTRACT FROM AUTHOR]

Background: Metabolic syndrome (MetS) is a pathophysiological change based on the abnormal metabolism of many substances. The study aims to investigate the performance of visceral adiposity index (VAI) and lipid accumulation product (LAP) of MetS in young adults. Methods: 448 young adults aged between 19 and 24 years old in Qinhuangdao had been included in this cross-sectional study. Receiver operating characteristic (ROC) curve analyses were used to assess the accuracy of these two obesity indicators for MetS. Results: The prevalence of MetS was 2.0%. In male subjects, LAP had the highest area under the ROC curve (AUC) value (AUC = 0.963), followed by VAI (AUC = 0.937). In female subjects, LAP also had the highest AUC value (AUC = 0.931), followed by VAI (AUC = 0.861). No significant difference was found between the two obesity indicators (P > 0.05). Conclusion: The two obesity indicators were valuable for the screening of MetS in young adults, and LAP was the simpler of the two. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease (CVD) is one of the debilitating consequences of polycystic ovary syndrome (PCOS). Early diagnosis of metabolic syndrome (MetS) with a simple but accurate method can reduce the risk of progression to CVD in PCOS. Aims: This study aimed to determine the accuracy of various anthropometric indices and lipid accumulation product (LAP), in assessing the risk of MetS in PCOS. Settings and Design: This is a cross-sectional study including 150 PCOS women and 100 control subjects. Materials and Methods: Anthropometric parameters were measured and calculated. Lipid profile, fasting plasma glucose (FPG), and insulin were estimated. MetS was detected according to the International Diabetes Federation criteria. Statistical Analysis: Logistic regression and receiver operating characteristic curve analysis were applied to determine the potential association of anthropometric indices such as body mass index, waist circumference (WC), waist-to-hip ratio, waist-to-height ratio, conicity index (CI), visceral adiposity index (VAI), abdominal volume index (AVI), body adiposity index (BAI), and a body shape index (ABSI) and LAP with MetS. Results: In our study of PCOS women of the south Indian population, the prevalence of MetS was 59.3%, which was higher than other populations and the cutoff values of VAI and LAP were 6.05 and 53, respectively. VAI showed the strongest association with MetS, followed by diastolic blood pressure BP, FPG, and LAP. Conclusions: We recommend VAI and LAP as new indices for MetS diagnosis. As these indices exhibit population specificity, it is imperative that independent cutoffs are determined for every demographic population. [ABSTRACT FROM AUTHOR]

Background: This study was conducted to assess gender difference in the association of chronic kidney disease (CKD) with visceral adiposity index (VAI) and lipid accumulation product index (LAP) in Korean adults. Materials and methods: The study was performed using data from the 2015 Korean National Health and Nutrition Examination Survey and included 4947 adults aged 20 years or older. Results: There were several key findings in the present study. First, overall, after adjusting for related variables (including age), CKD (estimated glomerular filtration rate < 60 ml/min/1.73 m2) was positively associated with the quartiles of VAI and LAP. Second, when analyzed separately for gender, the results in men and women were different. After adjusting for the related variables (except age), CKD was positively associated with the quartiles of VAI and LAP in both men and women. After further adjustment for age, CKD was still positively associated with the quartiles of VAI and LAP in men. However, in women, the relationships between CKD and the quartiles of VAI and LAP were no longer significant. Conclusions: The VAI and LAP index were positively associated with CKD in Korean men but not in women. [ABSTRACT FROM AUTHOR]

Background and Aims: Obesity is characterized as overall or regional adiposity accumulation. However, the metabolic status underlying fat accumulation was not well understood. We sought to identify metabolite profiles based on their correlations with body mass index (BMI), body fat percentage (BFP), waist circumference (WC), and visceral adiposity index (VAI) in young Chinese adults (19-37 years old), and their associations with dietary consumption were also explored.Methods and Results: A total of 86 plasma samples were analyzed using untargeted lipidomics and metabolomics approaches. Metabolite profiles of adiposity indices were identified using random forest modelling. Ridge regression was used to generate metabolite scores. Overall, 30, 46, 30, and 20 metabolites correlated with BMI, BFP, WC, and VAI, respectively, which resulted in metabolite scores for each index. Top three enriched categories of the identified metabolites were glycerophospholipids, glycerolipids, and sphingolipids, with some specific metabolites (such as phosphatidylserine (37:2), phatidylethanolamine (42:4), and ceramide (40:0)) exclusively associated with overall adiposity, and some other metabolites exclusively associated with abdominal adiposity indices, e.g., triradylglycerol (45:0, 52:4, and 35:0) and diacylglycerol (38:4, 36:3, and 36:5). Moreover, metabolite scores were negatively associated with the intake of food rich in protein or fiber, while they were positively associated with food rich in carbohydrate, with similar results for adiposity indices.Conclusion: We observed unique metabolite profiles of regional or overall fat deposition in young adults. Glycerophospholipids, glycerolipids, or sphingolipids may be involved in the regulation of adiposity accumulation, affected by dietary exposures. [ABSTRACT FROM AUTHOR]

Background: Risk of chronic kidney disease (CKD) is higher in normal-weight metabolically unhealthy people, especially when combined with hypertension. In this context, whether the visceral adiposity index (VAI), which reflects body fat distribution and metabolism, can be used to identify the risk of CKD among normal-weight hypertensive patients is unclear.Objectives: This study aimed to evaluate the association between VAI and renal function in normal-weight hypertensive patients.Methods: In this cross-sectional study, 8591 hypertensive patients with normal BMI from the China H-type Hypertension Registry Study were analyzed. The VAI was calculated with serum triglycerides, serum HDL cholesterol, waist circumference, and BMI. VAI was ln-transformed for analysis on account of the skewed distribution. Estimated glomerular filtration rate (eGFR) was calculated using the CKD-Epidemiology Collaboration equation. CKD was defined as an eGFR <60 mL · min-1 · 1.73 m-2. Multivariable linear and multivariable logistic regression analyses were performed to evaluate the association of VAI with eGFR and CKD.Results: The prevalence rate of CKD was 10.1%. Multivariable linear regression analyses showed that an elevated lnVAI reduced eGFR by 2.63 mL · min-1 · 1.73 m-2 (95% CI: -3.54, -1.72 mL · min-1 · 1.73 m-2). Multivariable logistic regression analysis showed that an elevated lnVAI was independently associated with the prevalence of CKD (OR: 1.59; 95% CI: 1.31, 1.93). As possible confounding factors were removed the association became greater. The higher the VAI was, the greater the decrease in eGFR and the higher the risk of CKD. No significant interactions were found in any of the subgroups (age, sex, physical activity, current smoking, current drinking, fasting glucose, LDL cholesterol, blood pressure, and antihypertensive drugs).Conclusions: VAI, as a simple surrogate measure of visceral fat accumulation, is independently and inversely associated with renal function in normal-weight Chinese hypertensive adults.This trial was registered at chictr.org.cn as ChiCTR1800017274. [ABSTRACT FROM AUTHOR]

Introduction: This study investigates the effects of dapagliflozin on the visceral adiposity index (VAI), lipid accumulation product (LAP), product of triglycerides and glucose (TyG) and triglycerides to HDL-cholesterol ratio (TG/HDL-C) in patients with type 2 diabetes mellitus (T2D). Methods: In this real-life study, dapaglifozin was added to metformin alone (group 1, no. 42) or insulin plus metformin (group 2, no. 58) in 100 T2D patients. Results: In group 1, after 6 months of dapaglifozin addition, a significant decrease in BMI (p < 0.001), waist circumference (WC) (p < 0.001), systolic blood pressure (SBP) (p = 0.009), diastolic blood pressure (DBP) (p = 0.012), mean fasting blood glucose (FBG), post-breakfast glucose (PBG), post-lunch glucose (PLG) and post-dinner glucose (PDG) (all p < 0.001), HbA1c (p < 0.001), VAI (p = 0.020), LAP (p = 0.028), Tyg (p < 0.001), TG/HDL-C (p = 0.020) and glutamate pyruvate transaminase (GPT) (p < 0.001) was observed compared to baseline. After 12 months a significant decrease in BMI (p < 0.001), WC (p = 0.006), SBP (p = 0.023), DBP (p = 0.005), mean FPG, PBG, PLG and PDG (all p < 0.001), HbA1c (p < 0.001), total cholesterol (p = 0.038), triglycerides (p = 0.026), VAI (p = 0.013), GPT (p < 0.001), LAP index (p = 0.024), Tyg index (p < 0.001) and TG/HDL-c ratio (p = 0.016) was observed compared to baseline. In group 2, after 6 months of dapaglifozin addition, a significant decrease in BMI (p < 0.001), WC (p < 0.001), SBP (p = 0.015), DBP (p = 0.007), mean FPG, PBG, PLG and PDG (all p < 0.001), HbA1c (p < 0.001), VAI (p = 0.040), LAP (p = 0.047), Tyg (p < 0.001), TG/HDL-C (p = 0.048) and GPT (p < 0.001) was observed compared to baseline. By contrast, after 12 months a significant decrease in BMI (p < 0.001), WC (p < 0.001), SBP (p = 0.001), DBP (p = 0.002), mean FPG, PBG, PLG and PDG (all p < 0.001), HbA1c (p < 0.001), GPT (p < 0.001) and Tyg index (p = 0.003) was observed compared to baseline. Conclusions: Dapagliflozin treatment significantly reduced surrogate indexes of insulin resistance and adiposity in patients with T2D. [ABSTRACT FROM AUTHOR]

The visceral adiposity index (VAI) has been shown to be a reliable estimate of visceral adiposity, but little is known about its association with specific dietary patterns such as the Dietary Approaches to Stop Hypertension (DASH) diet, particularly in older adults. Many studies have shown the DASH diet to be beneficial for cardiometabolic health. The purpose of this study was to investigate the relationship between DASH diet scores and the VAI in older adults using a nationally representative dataset. Using the National Health and Nutrition Examination Surveys (NHANES) from 2011 to 2014, data from 508 community-dwelling older adults were examined, and dietary intake was evaluated using the Dixon's DASH diet index. Using multiple linear regression analysis, the relationship between VAI and DASH diet score was assessed while controlling for demographic variables. Participants' average DASH diet score was 2.41 (SE = 0.07), and the average VAI was 1.55 (SE = 0.08). The results suggest a significant inverse relationship between the DASH diet and VAI (β = −0.19, t = −2.73, p = 0.009). Results of this study suggest that protective properties of the DASH diet pattern may be due in part to its inverse relationship with visceral adiposity. This information supports practitioners' use of the VAI with older adults in addition to providing nutrition counseling with the DASH diet to reduce patients' cardiometabolic risk. • Higher DASH diet scores may be protective against visceral adiposity in older adults. • Visceral adiposity in older adults may differ by sociodemographic characteristics. • The Visceral Adiposity Index can easily be calculated using clinical data. [ABSTRACT FROM AUTHOR]

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Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide. The aim of this study is to investigate body composition and phenotype of Egyptian women with non-alcoholic fatty liver disease (NAFLD) and compare with those without and determine the optimal cut-off values of central obesity indices for predicting NAFLD. The study included 100 women with NAFLD and 100 age and sex matched healthy controls without NAFLD. All women were subjected to ultrasonography examination. Anthropometric measurements included weight, height, waist circumference (WC), hip circumference (HC) and skinfolds thickness were assessed for all participants. Body fat % was evaluated by Tanita body composition analyzer. Body mass index (BMI), WC / height ratio (WHtR), WC / HC ratio (WHR) and visceral adiposity index (VAI) were calculated. Receiver-operating characteristic (ROC) curve was used to determine the optimal cut-off values. Data showed significant higher levels of WHtR, WHR, BMI, sum of skinfolds, body fat %, serum fasting blood lipids and glucose in NAFLD women compared to group of patients without NAFLD. The area under curve (AUC) was 0.920 for VIA, 0.883 for WHtR and 0.647 for WHR. The optimal cutoff value of VAI was 3.66, of WHtR was 0.66 and WHR was 0.84. All values showed high sensitivity and specificity values. NAFLD women were obese, had excess subcutaneous fat and body fat ratio. Central obesity indices are closely associated with the presence of NAFLD in Egyptian women and might be responsible for its development. Visceral adiposity index had superior diagnostic performance. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study was to obtain the cutoff points of visceral adiposity index (VAI), a new marker of indirect evaluation of visceral fat, to assess its association with metabolic syndrome (MetS) in a population of children and adolescents. Methods: This cross sectional study was conducted on children and adolescents aged 7-18 years attended in the fifth phase of a national school-based surveillance survey. The odds ratio (OR) of cardiometabolic risk factors across tertile categories of VAI was determined using the logistic regression models and the valid cut-off values of VAI for predicting MetS was obtained using the receiver operation characteristic (ROC) curve analysis. Results: A total of 3843 students (52.3% boys, 12.3 [12.2-12.4] years) were included in the analysis. The mean of VAI was significantly higher in participants who had MetS (2.60 [2.42-2.78] vs 1.22 [1.19-1.25]; P

Abstract Background The role of body fat distribution in uric acid metabolism is still ambiguity. We aimed to investigate the independent contribution of visceral adipose measured by visceral adiposity index and lipid accumulation product and liver fat assessed by fatty liver index to the risk of hyperuricemia. Methods We conducted a cross-sectional study involving 1284 participants aged ≥ 40 years old recruited from communities in Zhonglou district, Changzhou. Each participant completed a standard questionnaire, and provided blood samples for biochemical measurements. Visceral adiposity index, fatty liver index and lipid accumulation product were calculated by simple anthropometric and functional parameters. Hyperuricemia was defined as serum uric acid ≥ 420 μmol/l for males and ≥ 360 μmol/l for females. Results The prevalence of hyperuricemia was 15.9% and gradually increased across tertiles of adiposity-based indices. The visceral adipose-based measurements (visceral adiposity index, fatty liver index, lipid accumulation product) had better power to discriminate hyperuricemia than body mass index (BMI), waist circumference and neck circumference, and visceral adiposity index exhibited the highest power, with the area under the receiver operating characteristics curve (AUROC) of 0.662 (0.636–0.688). Multivariate logistic regression found 1.49-fold, 2.21-fold and 2.12-fold increased risk of hyperuricemia with 1-unit increment of visceral adiposity index, fatty liver index, and lipid accumulation product, respectively. Compared to tertile 1, the odds ratios of hyperuricemia for the second tertile and the third tertile of visceral adiposity index were 1.57 (1.00–2.50) and 3.11 (1.96–4.94), those of fatty liver index were 1.64 (1.05–2.68) and 3.58 (1.94–6.01), and those of lipid accumulation product were 1.93 (1.19–3.15) and 3.53 (2.05–6.09), respectively. However, no significant associations of BMI, waist circumference and neck circumference with hyperuricemia were observed. Conclusions Visceral adipose accumulation increased the risk of hyperuricemia, independently of BMI, waist circumference and neck circumference, among middle-aged and elderly Chinese adults.

Abstract Background Rational measures in estimating adiposity distribution in diabetic patients has yet to be validated. This study aims to provide insight about the possible links between routinely available body adiposity parameters and the development of both diabetes and insulin resistance. Methods We performed a population-based cross-sectional study in 9496 subjects aged 40 years or older. All of the body adiposity measures including body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), waist-height ratio (WHtR), visceral adiposity index (VAI), body adiposity index (BAI) and lipid accumulation product index (LAP) were separately evaluated according to standard measurement methods. Diabetes was diagnosed according to the American Diabetes Association 2010 criteria. Results All tested body adiposity measurements were significantly associated with fasting plasma glucose (FPG), oral glucose tolerance test (OGTT) 2 h glucose, HbA1c and fasting insulin. Compared with other adiposity phenotypes, LAP have shown the relatively strongest while BAI have shown the relatively weakest association with increased odds of both diabetes and insulin resistance across all logistic regression models. Additionally, LAP provided the best discrimination accuracy for diabetes [area under the curve (AUC): 0.658 95% confidence intervals (CI) 0.645–0.671] and insulin resistance (AUC: 0.781 95% CI 0.771–0.792) when compared with other body adiposity parameters. Conclusions The LAP index seems to be a better indicator than other adiposity measures tested in the study to evaluate the association of visceral fat mass with diabetes and insulin resistance, which should be given more consideration in the clinical practice.

Aim: To study visceral adiposity index (VAI) and its association with cardiometabolic risk in different phenotypes of polycystic ovary syndrome (PCOS). Materials and Methods: It is a case–control cross-sectional study where 100 reproductive age (18–35 years) women with PCOS were classified in different phenotypes as per Rotterdam criteria and compared with age and Body mass index (BMI) matched 50 eumenorrheic and nonhirsute women. Various anthropometric, clinical, biochemical, and hormonal parameters were measured in both women with PCOS and controls. VAI was calculated using waist circumference (WC), BMI, serum triglyceride, and High density lipoprotein (HDL) cholesterol levels in all the subjects and compared between cases and controls. Subsequently, women with PCOS were assessed for cardiometabolic risk according to androgen excess society statement 2010 as “at risk” and “at high risk.” Finally, risk was correlated with VAI for all the phenotypes of PCOS. Results: Mean VAI was significantly higher (P < 0.001) in cases than controls (2.07 vs. 1.27). Mean VAI in phenotype A (O+P+HA), B (O+HA), C (P+HA), and D (O+P) was 2.46, 2.48, 1.47, and 1.70, respectively. A total of 56% of women with PCOS were at risk and 12% at high risk for cardiometabolic disease. Metabolic syndrome was prevalent in 11% of cases and 1% had type 2 diabetes mellitus. Phenotypically, 88% of women with PCOS with phenotype A (O+P+HA), 67% of B (O+HA), 67% of C (P+HA), and 55% of D (O+P) were at increased risk. VAI was found to be positively correlated with WC (r, 0.550), waist to hip ratio (r, 0.295), Homeostasis model assessment of insulin resistance (HOMA IR) (r, 0.455), and cardiometabolic risk (r, 0.399). Also, it was the best factor associated with cardiometabolic risk (area under curve, 0.793). Conclusion: This study concluded that visceral adiposity index can be used as simple and effective tool for assessing the cardiometabolic risk in women with PCOS as higher VAI values were observed in those cases who were at high risk for developing cardiometabolic disorder in future.

Background Obesity is the cornerstone of metabolic syndrome (MetS); it is not possible to use BMI to differentiate between lean mass and fat mass. We aimed to investigate, for the first time, the possible association of new obesity indices; visceral adiposity index (VAI) and body adiposity index (BAI), with parameters of MetS in Egyptian obese patients. Patients and methods This was a case–control study that included unrelated 150 obese patients and 50 healthy controls. Obese patients were then subdivided into two subgroups, nondiabetic patients (n=85) and 65 patients with type 2 diabetes mellitus. We measured the anthropometric measures; BMI, waist/hip ratio, waist/height ratio, BAI, and VAI. Results Among obese patients, we found significant positive correlations between parameters of MetS and obesity indices. Among obesity indiced, the highly significant positive correlations were found between VAI and parameters of MetS. After adjusting for the traditional risk factors, logistic regression analysis test found that the VAI value was the best predictor of type 2 diabetes mellitus in comparison with BMI and BAI. Receiver operating characteristic curve was used to assess the power of obesity indices; the sensitivity and the specificity of BMI were 94.7 and 99.9%, for VAI, they were 74.4 and 99.9%, and, for BAI, they were 83.3 and 58%, respectively. Conclusion BMI is still the most powerful diagnostic tool for obesity. Although, in certain conditions, where there are limitations of using BMI, we can use other obesity indices, VAI and BAI could be used to discriminate cardiovascular risk among obese patients.

Abstract Background The present study evaluated the predictive ability of five known “best” obesity and lipid-related parameters, including body mass index (BMI), waist-to-height ratio (WHtR), triglyceride-to-high-density-lipoprotein-cholesterol (TG/HDL-C), lipid accumulation product (LAP) and visceral adiposity index (VAI), in identifying metabolic syndrome (MetS) in Chinese elderly population. Methods A total of 6722 elderly Chinese subjects (≥60 years) were recruited into our community-based cross-sectional study from April 2015 to July 2017. The anthropometrics, blood pressure, fasting plasma glucose, blood lipid profiles, family history and health-related behaviours were assessed. Results The prevalence of MetS was 40.4% (32.5% in males and 47.2% in females). With the increase in the number of MetS components (from 0 to 5), all the five parameters showed an increase trend in both genders (all P for trend

Background: Increased visceral adiposity, insulin resistance, and β-cell dysfunction predispose to type 2 diabetes (T2D). The Visceral Adiposity Index (VAI) is an indicator of visceral fat function obtained from the association between BMI, Triglycerides, HDL-C, and waist circumference, and is a reliable tool to assess the cardiometabolic risk, however, its association with insulin resistance and decreased β-cell function in primary prevention for T2D has not been fully yielded. Methods: This is a retrospective cross-sectional study that included 354 asymptomatic subjects, without any known chronic disease, with at least two risk factors for T2D that underwent an oral glucose tolerance test. Patients with newly diagnosed T2D were excluded from the analysis. Results: Participants were 51 ± 8 years old, 72.2% were women, had a mean body mass index of 29.9 ± 6.5 kg/m2 and a median VAI of 3.00. The homeostasis model assessment of insulin resistance (HOMA-IR) (r = 0.324), Matsuda index (r = -0.325), first-phase insulin secretion (S1PhOGTT) (r = 0.138), second-phase insulin secretion (S2PhOGTT) (r = 0.137), HOMA-B (r = 0.224), and disposition index (r = -0.165) were significantly correlated with the VAI. After multiple linear regression analysis, the VAI was independently associated with HOMA-IR (β = 0.305), Matsuda Index (β = -0.303), S1PhOGTT (β = 0.143), S2PhOGTT (β = 0.140), HOMA-B (β = 0.204), and the disposition index (β = -0.146). Likewise, a VAI of 2.23 had a sensitivity/specificity of 81.9% and 41.5%, respectively, for identifying a HOMA-IR ≥ 2.5; and a VAI of 3.00 had a sensitivity/specificity of 61.3% and 41.8%, respectively, for identifying a disposition index ≤1.24. Conclusions: The VAI was independently associated with insulin resistance, impaired insulin secretion and β-cell dysfunction in subjects at risk for developing T2D.

BackgroundObesity, mainly visceral obesity, and metabolic syndrome (MetS) are major risk factors for the development of type 2 diabetes, cardiovascular diseases, and cancer. Data analyzing the association of obesity and MetS with gastroenteropancreatic neuroendocrine neoplasms (GEP-NEN) are lacking. Fatty liver index (FLI) is a non-invasive tool for identifying individuals with non-alcoholic fatty liver disease (NAFLD). Visceral adiposity index (VAI) has been suggested as a gender-specific indicator of adipose dysfunction. Both indexes have been proposed as early predictors of MetS. This study aimed to investigate the association of FLI VAI as early predictors of MetS with gastroenteropancreatic neuroendocrine tumors (GEP-NETs).MethodsA cross-sectional, case–control, observational study was carried out at the ENETS Centers of Excellence Multidisciplinary Group for Neuroendocrine Tumors, University “Federico II”. VAI and FLI were calculated.ResultsWe enrolled 109 patients with histologically confirmed G1/G2 GEP-NET (53 M; 57.06 ± 15.96 years), as well as 109 healthy subjects, age, sex- and body mass index-matched. Forty-four GEP-NET patients were G2, of which 21 were with progressive disease, and 27 patients had metastases. GEP-NET patients had a higher value of VAI (p < 0.001) and FLI (p = 0.049) and higher MetS presence (p < 0.001) compared with controls. VAI and FLI values and MetS presence were higher in G2 than in G1 patients (p < 0.001), in patients with progressive disease, and in metastatic vs non-metastatic patients (p < 0.001). In addition, higher values of VAI and FLI and higher MetS presence were significantly correlated with the worst clinical severity of NENs. The cut-off values for the FLI and MetS to predict high grading of GEP-NETs and the presence of metastasis were also provided.ConclusionsThis is the first study investigating an association between VAI and FLI as early predictors of MetS and GEP-NET. Our findings report that the worsening of clinicopathological characteristics in GEP-NET is associated with higher presence of MetS, NAFLD, evaluated by FLI, and visceral adiposity dysfunction, evaluated by VAI. Addressing the clinical evaluation of MetS presence, NAFLD, and visceral adiposity dysfunction might be of crucial relevance to establish targeted preventive and treatment interventions of NEN-related metabolic comorbidities.

Background: As one of the critical indicators of obesity, the interaction between visceral fat content and lung disease is the focus of current research. However, the exact relationship between Visceral adipose index (VAI) and lung function is not fully understood. The purpose of this study was to evaluate the relationship between VAI and lung function, METHODS: Our study included all participants from the baseline survey population in Xinjiang in the Natural Population Cohort Study in Northwest China. A field survey was conducted in rural areas of Moyu County, Xinjiang, China, between 35 and 74 years old from June to December 2018. We collected standard questionnaires and completed physical examinations, visceral fat tests, and lung function measurements.Results: The study included 2367 participants with a mean VAI of 10.35 ± 4.35, with males having a significantly higher VAI than females: 13.17 ± 3.91 vs. 7.58 ± 2.65. The piecewise linear spline models indicated a significant threshold effect between lung function and VAI in the general population and the males population, showing an inverted U-shaped curve. But there was no significant association between VAI and lung function in females. FEV1% predicted and FVC% predicted increased with the increase of VAI (β 0.76; 95% CI 0.30, 1.21) and (β 0.50; 95% CI 0.06, 0.94) in males with VAI ≤ 14, while FEV1% predicted and FVC% predicted decreased with the increase of VAI (β - 1.17; 95% CI - 1.90, - 0.45) and (β - 1.36; 95% CI - 2.08, - 0.64) in males with VAI ≥ 15.Conclusions: The relationship between lung function and VAI in male participants showed an inverted U-shaped curve, with the turning point of VAI between 14 and 15. The association between visceral fat and lung function was more robust in males than in females. [ABSTRACT FROM AUTHOR]

Introduction and aim Cardiovascular diseases remain the most common cause of morbidity and mortality in patients with diabetes. Epicardial adipose tissue (EAT), visceral fat depot of the heart, was found to be associated with coronary artery disease in cardiac and non-cardiac patients. Increased visceral adiposity is associated with proinflammatory activity, impaired insulin sensitivity, increased risk of atherosclerosis and high mortality. In the present study we aimed to investigate the relationship between EAT and visceral adiposity index (VAI) in patients with diabetes. Methods This was a cross-sectional study involving 128 patients with type 2 diabetes mellitus (73 females, 55 males; mean age, 54.09+±+9.17 years) and 32 control subjects (23 females, 9 males; mean age, 50.09+±+7.81 years). EAT was measured by using a trans-thoracic echocardiograph. Parameters such as waist circumference (WC), body mass index (BMI), triglyceride and high density lipoprotein (HDL) cholesterol were used to calculate VAI. Result EAT and VAI measurements were significantly higher in patients with diabetes when compared to control subjects. In the bivariate correlation analysis, VAI was positively correlated with uric acid level (r=0.214, p=0.015), white blood cell count (r= 0.262, p=0.003), platelet count (r=0.223, p=0.011) and total cholesterol levels (r= 0.363, p<0.001). Also, VAI was found to be the independent predictor of EAT. Conclusion Simple calculation of VAI was found to be associated with increased EAT in patients with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Background and Objective: Researchers have identified neck circumference (NC) as a valuable tool to detect obesity and metabolic syndrome (MS). We conducted this study to define cutoffs of NC to identify obesity, abdominal obesity, and MS in adult women diagnosed with polycystic ovary syndrome (PCOS). Methods: Adult women newly diagnosed with PCOS using the revised Rotterdam criteria having NC measure data in a cross-sectional study titled "Biochemical and Hormonal Profile of Patients with Polycystic Ovary Syndrome" were analyzed. Results: Finally, 200 women were analyzed; their mean age was 23.3 (±4.9) years, body mass index (BMI) 26.47 (±5.09) kg/m2, NC 34.6 (±3.04) cm, waist circumference (WC) 88.18 (±11.98) cm, and visceral adiposity index (VAI) was 3.31 (±1.37). NC had positive correlations with age, BMI, WC, systolic and diastolic blood pressure, serum triglyceride, VAI, and testosterone levels. NC cutoff 32.75 cm showed 87.3% sensitivity and 74.4% specificity in detecting abdominal obesity (AUC 0.889, P < 0.001) and 88.0% sensitivity and 68.0% specificity for diagnosis of overweight/obesity (AUC 0.877, P < 0.001). NC 34.25 cm showed 63.0% sensitivity and 64.0% specificity for diagnosis of MS (AUC 0.681, P < 0.001). Conclusion: Neck circumference may be a simple and convenient tool in assessing obesity, central obesity, and MS in women with PCOS. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Psoriasis is a chronic, inflammatory disease that appears with variable trigger factors. We know that obesity and other metabolic syndrome criteria are high in psoriasis patients. The aim of this study is to evaluate the relationship between visceral fat markers, risk of cardiometabolic disease, and psoriasis area severity index (PASI) in individuals with and without psoriasis. METHODS: A total of 203 subjects, 102 psoriasis patients and 101 healthy individuals, were included in the study. Lipid accumulation product (LAP) index, visceral adiposity index (VAI), plasma atherogenicity index (PAI), body mass index (BMI), PASI, triglyceride (TG), and high-density lipoprotein cholesterol (HDL-c) values were measured. RESULTS: LAP index, VAI, PAI, BMI, and TG levels were significantly high (p<0.001) and HDL-c levels were significantly low (p=0.009) in patients with psoriasis compared to healthy individuals. CONCLUSION: LAP index, VAI, and PAI calculations can be recommended as a potential biomarker for early diagnosis of cardiometabolic diseases common in patients with psoriasis. [ABSTRACT FROM AUTHOR]

Background: Obesity, mainly visceral obesity, and metabolic syndrome (MetS) are major risk factors for the development of type 2 diabetes, cardiovascular diseases, and cancer. Data analyzing the association of obesity and MetS with gastroenteropancreatic neuroendocrine neoplasms (GEP-NEN) are lacking. Fatty liver index (FLI) is a non-invasive tool for identifying individuals with non-alcoholic fatty liver disease (NAFLD). Visceral adiposity index (VAI) has been suggested as a gender-specific indicator of adipose dysfunction. Both indexes have been proposed as early predictors of MetS. This study aimed to investigate the association of FLI VAI as early predictors of MetS with gastroenteropancreatic neuroendocrine tumors (GEP-NETs). Methods: A cross-sectional, case–control, observational study was carried out at the ENETS Centers of Excellence Multidisciplinary Group for Neuroendocrine Tumors, University "Federico II". VAI and FLI were calculated. Results: We enrolled 109 patients with histologically confirmed G1/G2 GEP-NET (53 M; 57.06 ± 15.96 years), as well as 109 healthy subjects, age, sex- and body mass index-matched. Forty-four GEP-NET patients were G2, of which 21 were with progressive disease, and 27 patients had metastases. GEP-NET patients had a higher value of VAI (p < 0.001) and FLI (p = 0.049) and higher MetS presence (p < 0.001) compared with controls. VAI and FLI values and MetS presence were higher in G2 than in G1 patients (p < 0.001), in patients with progressive disease, and in metastatic vs non-metastatic patients (p < 0.001). In addition, higher values of VAI and FLI and higher MetS presence were significantly correlated with the worst clinical severity of NENs. The cut-off values for the FLI and MetS to predict high grading of GEP-NETs and the presence of metastasis were also provided. Conclusions: This is the first study investigating an association between VAI and FLI as early predictors of MetS and GEP-NET. Our findings report that the worsening of clinicopathological characteristics in GEP-NET is associated with higher presence of MetS, NAFLD, evaluated by FLI, and visceral adiposity dysfunction, evaluated by VAI. Addressing the clinical evaluation of MetS presence, NAFLD, and visceral adiposity dysfunction might be of crucial relevance to establish targeted preventive and treatment interventions of NEN-related metabolic comorbidities. [ABSTRACT FROM AUTHOR]

Background/Objectives: The visceral adiposity index (VAI) is an indicator that reflects the distribution of visceral fat and has been associated with increased risk of cardiometabolic disorders. This study aimed to evaluate VAI in predicting metabolic syndrome and insulin resistance among the Korean population. Methods/Statistical analysis: This study was a retrospective cross-sectional study and was performed in 23,356 Korean adults aged >20 years. The criteria for diagnosis of metabolic syndrome were defined according to the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP III). Insulin resistance was diagnosed via a homeostasis model assessment of insulin sensitivity (HOMA-IR) and was determined as a HOMAIR value =3.0. Furthermore, anthropometric parameters including waist circumference (WC), and waist-to-height ratio (WHtR), body mass index (BMI) were also evaluated. Findings: In both genders, the area under the curve (AUC) for predicting metabolic syndrome was higher for VAI than for other anthropometric and biochemical parameters. The AUC values for VAI were 0.888, 0.859, and 0.932 for all subjects, men, and women, respectively. The optimal cutoff of VAI for predicting metabolic syndrome, which was estimated from the ROC curve, was 1.84 for all subjects. The highest and lowest AUCs for predicting insulin resistance were observed for WHtR and VAI, respectively. The AUC values for VAI were 0.705, 0.659, and 0.778 for all subjects, men, and women, respectively. After controlling for relevant variables, VAI showed a significant correlation with metabolic syndrome and insulin resistance, regardless of anthropometric indices or biochemical metabolic syndrome risk factors. Improvements/Applications: VAI was a stronger predictor of metabolic syndrome in the Korean population, especially in comparison to WC, BMI, and WHtR. However, the ability of VAI to predict insulin resistance was lower than that of WHtR. [ABSTRACT FROM AUTHOR]

Existing obesity- and lipid-related indices are inconsistent with metabolic syndrome (MetS) in chronic kidney disease (CKD) patients. We compared seven indicators, including waist circumference (WC), body mass index (BMI), visceral fat area (VFA), subcutaneous fat area (SFA), visceral adiposity index (VAI), Chinese VAI and lipid accumulation product (LAP), to evaluate their ability to predict MetS in CKD patients with and without Type 2 diabetes mellitus (T2DM) under various criteria. Multivariate logistic regression analysis was used to investigate the independent associations between the indices and metabolic syndrome among 547 non-dialysis CKD patients, aged ≥18 years. The predictive power of these indices was assessed using receiver operating characteristic (ROC) curve analysis. After adjusting for potential confounders, the correlation between VAI and MetS was strongest based on the optimal cut-off value of 1.51 (sensitivity 86.84%, specificity 91.18%) and 2.35 (sensitivity 83.54%, specificity 86.08%), with OR values of 40.585 (8.683–189.695) and 5.076 (1.247–20.657) for males and females with CKD and T2DM. In CKD patients without T2DM, based on the optimal cut-off values of 1.806 (sensitivity 98.11%, specificity 72.73%) and 3.11 (sensitivity 84.62%, specificity 83.82%), the OR values were 7.514 (3.757–15.027) and 3.008 (1.789–5.056) for males and females, respectively. The area under ROC curve (AUC) and Youden index of VAI were the highest among the seven indexes, indicating its superiority in predicting MetS in both male and female CKD patients, especially those with T2DM.

Visceral adiposity index (VAI) is a sex-specific surrogate marker of adipose tissue distribution and function. Little is known about the longitudinal relationship between VAI and proteinuria. This study aimed to examine the prospective relationship of baseline VAI with new-onset of proteinuria in hypertensive patients without major cardiovascular diseases. A total of 10 699 hypertensive patients without proteinuria (negative urine dipstick reading) at baseline from the renal sub-study of the China Stroke Primary Prevention Trial (CSPPT) were included. Participants were randomly assigned to a double-blind daily treatment with 10 mg enalapril and 0.8 mg folic acid or 10 mg enalapril alone. Participants were followed every 3 months after randomization. The primary outcome was new-onset proteinuria, defined as a urine dipstick reading of ≥1+ at the exit visit. The secondary outcome was progression of proteinuria, defined as a urine dipstick reading of trace or ≥1+ at the exit visit. During a median follow-up duration of 4.4 years, a total of 396 (3.7%) participants developed new-onset proteinuria, while 1236 (11.6%) participants met progression of proteinuria. When VAI was categorized into quartiles, compared with participants in quartile 1–3 (<2.99), a significantly higher risk of new-onset proteinuria (OR, 1.43; 95%CI: 1.07–1.91) and progression of proteinuria (OR, 1.23; 95%CI: 1.03–1.46) was found in those in quartile 4 (≥2.99). Moreover, the positive association was consistent in participants with or without general obesity, abdominal obesity, and dyslipidemia (all P -interactions > 0.05). There was a positive association between VAI levels and the risk of new-onset proteinuria in hypertensive patients. [ABSTRACT FROM AUTHOR]

Aim: Our study aimed to examine the relationship of the visceral adiposity index (VAI) with clinical and histological parameters in biopsy-proven nonalcoholic fatty liver disease (NAFLD) cases and evaluate its place in clinical practice. Materials and Methods: The study included 57 biopsy-proven NAFLD cases and 57 healthy controls. The VAI values of the cases were calculated with the formula based on body mass index, waist circumference, triglycerides, and high-density lipoprotein cholesterol levels. The relationships between VAI values and clinical and histological parameters were examined. Results: While the VAI was significantly higher in the NAFLD cases in comparison to the control group (3.5 ± 3.09 vs. 1.60 ± 0.98, respectively, P < 0.001), this difference was more noticeable in the nonalcoholic steatohepatitis (NASH) group (3.60 ± 3.35) (P < 0.001). In distinguishing the NAFLD group and the healthy group in VAI, it was determined that VAI had a sensitivity of 72%, specificity of 68%, and an area under the receiver operating characteristic curve value of 76.9%. No significant relationship was found between the histological parameters and VAI scores. Conclusions: Our study showed that VAI was increased in the NAFLD cases. This increase was observed to be more noticeable in especially the NASH cases. It is possible for this index to be a practical modality that could be used in clinical practice in prediction of especially NASH cases, which constitute the progressive form of the disease, but in this sense, there is a need for further studies. [ABSTRACT FROM AUTHOR]

Background: Visceral Adiposity Index (VAI) is considered to be a reliable indicator for evaluation of visceral adipose dysfunction and cardiovascular disease risk. However, no previous studies have reported the VAI variation after bariatric surgery and the predictive effect of preoperative VAI on diabetes remission. The aim of this study is to evaluate whether preoperative VAI is useful to predict diabetes remission in low BMI Chinese patients after bariatric surgery. Methods: Eighty-seven type 2 diabetes mellitus patients with BMI < 35 kg/m2 underwent bariatric surgery from May 2010 to March 2018 in our hospital. VAI, glycolipid metabolic parameters, and anthropometric variables were measured before and 4 years after surgery. Complete remission was defined as follows: HbA1c < 6%, FPG < 5.6 mmol/L, achieved without anti-diabetic medication. Analysis included using binary logistic regression to identify predictors and ROC curves to determine clinically useful cutoff values. Results: Seventy-four patients (85.1%) underwent Roux-en-Y gastric bypass (RYGB), while the remaining 13 patients (14.9%) underwent sleeve gastrectomy (SG). Patients' weight, glycemic control, and lipid profiles were improved significantly after surgery (p < 0.05). Complete remission of T2DM was found in 35 patients (40.2%) 1 year after surgery. VAI decreased from baseline 4.41 to 1.74 in 3 months after surgery (p < 0.05) and showed a downward trend over the period from 6 months to 4 years. Patients with complete remission had a significantly shorter duration of diabetes, lower HbA1c level, and higher VAI, in comparison to those without remission. Binary logistics regression and ROC curves analysis confirm that VAI, HbA1c, and duration of diabetes can predict diabetes remission after bariatric surgery, and the VAI of 4.46 is a useful threshold for predicting surgical efficacy. Conclusion: VAI is a significant predictor of diabetes remission for lower BMI patients with T2DM following bariatric surgery in China. The VAI of 4.46 is a useful threshold for predicting surgical efficacy. Multi-center and larger prospective studies are needed to confirm our findings. [ABSTRACT FROM AUTHOR]

Background: The effects of visceral adiposity on decreased lung function have drawn much attention. Recently, the visceral adiposity index (VAI) has been proposed as a visceral fat distribution and dysfunction marker. However, the relationship between the VAI and lung function has not been investigated. The objective of the study was to analyze the association between the VAI and lung function and evaluate the potential of VAI as a predictor of lung function.Methods: We collected data from a population-based study of 1786 subjects aged 40 years or older. All subjects completed a questionnaire and underwent anthropometric measurements and laboratory tests. Linear and logistic regression models were developed to assess the association between the VAI and lung function.Results: The VAI was inversely related to FVC%predicted in men and negatively associated with both FVC%predicted and FEV1%predicted in women. In the linear regression analysis, the decrease in FVC%predicted associated with each 10% increase in the VAI was 1.127% in men and 1.943% in women; the decrease in FEV1%predicted associated with each 10%increase in the VAI was 0.663% in men and 1.738% in women. Further regression analysis revealed that the VAI was positively correlated with FVC and FEV1 impairment in women.Conclusions: We were the first to show a clear correlation between the VAI and lung function impairment in the Chinese population. The VAI could be a simple and reliable approach in daily practice, and individuals, especially women with a high VAI, should receive additional screening and preventive interventions for respiratory disease. [ABSTRACT FROM AUTHOR]

Background and purpose: The burden of cervical arterial atherosclerosis, which is an important risk factor of stroke, is huge in China. The visceral adiposity index (VAI) is a convenient index that is related to a series of metabolic abnormalities and a variety of diseases, including cerebrovascular diseases. This study aimed to explore the relationship between VAI and cervical arterial atherosclerosis. Methods: This cross‐sectional study used the multistage stratified random cluster sampling method to acquire a representative sample of residents aged ≥40 in the general population of northeast China. All participants completed a detailed questionnaire and provided blood samples. Cervical vascular ultrasound was performed by experienced ultrasound doctors. VAI was calculated by a well‐established formula and analyzed by quartiles (Q1–Q4). Results: A total of 3688 people aged ≥40 years who underwent cervical arterial ultrasound were finally included, amongst whom 3.2% had increased intima‐media thickness (IMT), 48.6% had carotid plaque and 4.0% had cervical artery stenosis (CAS). After adjusting for several parameters, little statistical significance was found between VAI and increased IMT; compared with the VAI‐Q1 group, the VAI‐Q2, VAI‐Q3 and VAI‐Q4 groups were more likely to have CAS [odds ratio (OR) 2.01, 95% confidence interval (CI) 1.17–3.43; OR 1.82, 95% CI 1.05–3.15; OR 1.79, 95% CI 1.03–3.12] and the VAI‐Q3 and VAI‐Q4 groups were at greater risk of carotid plaque (OR 1.30, 95% CI 1.05–1.62; OR 1.34, 95% CI 1.07–1.67). Conclusions: The VAI was related to carotid plaque and CAS in the general population that is older than 40 years. [ABSTRACT FROM AUTHOR]

Objective: Visceral adiposity index (VAI) and lipid accumulation product index (LAPI) are the new methods to determine the visceral adiposity and to predict the cardiometabolic risks in patients with. In this study, it was aimed to determine whether VAI or LAPI could be a predictor for metabolic syndrome (MS) in obesity, and to evaluate their relationship with other biochemical and anthropometric parameters. Methods: All patients who were admitted to the obesity outpatient clinic for the first time in January-February 2020 were included in the study. Age, gender, height, weight, body mass index, waist circumference (WC), hip circumference, waist/hip (W/H) ratio, biochemical parameters, and degree of hepatosteatosis were recorded. The presence of MS was determined according to the National Cholesterol Education Program Adult Treatment Panel-III criteria. VAI and LAPI were calculated according to fixed formulations. Results were evaluated by SPSS. Results: A total of 49 subjects, (48 females), with obesity were included in the study. Thirty-two patients (65.3%) had MS. In the MS (+) group, fasting blood glucose (FBG), insulin resistance (HOMA-IR) and triglyceride (TG) levels, VAI, LAPI, diabetes mellitus and hypertension ratios were higher than the group with MS (-). A positive correlation was observed between VAI and LAPI. There was a positive correlation between the VAI and the TG value, and a negative correlation between the VAI and high density lipoprotein value. A positive correlation was observed between LBU and TG, FBG, HOMA-IR, WC, W/H ratios. Conclusion: It is important to determine the comorbidities in obesity on a timely manner and to make the necessary interventions. With a simple formulation, VAI and LAPI can predict important health risks accompanying obesity. [ABSTRACT FROM AUTHOR]

Background: Obesity and hypertension are major risk factors for cardiovascular diseases that affect millions of people worldwide. Both conditions are associated with chronic low-grade inflammation, which is mediated by adipokines such as adiponectin. Adiponectin is the most abundant adipokine that has a beneficial impact on metabolic and vascular biology, while high serum concentrations are associated with some syndromes. This "adiponectin paradox" still needs to be clarified in obesity-associated hypertension. The aim of this study was to investigate how adiponectin affects blood pressure, inflammation, and metabolic function in obesity hypertension using a Chinese adult case-control study., Methods: A case-control study that had finished recruiting 153 subjects divided as four characteristic groups. Adiponectin serum levels were tested by ELISA in these subjects among these four characteristic Chinese adult physical examination groups. Waist circumference (WC), body mass index (BMI), systolic blood pressure (SB), diastolic blood pressure (DB), and other clinical laboratory data were collected. Analyzation of correlations between the research index and differences between groups was done by SPSS., Results: Serum adiponectin levels in the| normal healthy group (NH group) were significantly higher than those in the newly diagnosed untreated just-obesity group (JO group), and negatively correlated with the visceral adiposity index. With multiple linear egression analysis, it was found that, for serum adiponectin, gender, serum albumin (ALB), alanine aminotransferase (ALT) and high-density lipoprotein cholesterol (HDLC) were the significant independent correlates, and for SB, age and HDLC were the significant independent correlates, and for DB, alkaline phosphatase (ALP) was the significant independent correlate. The other variables did not reach significance in the model., Conclusions: Our study reveals that adiponectin's role in obesity-hypertension is multifaceted and is influenced by the systemic metabolic homeostasis signaling axis. In obesity-related hypertension, compensatory effects, adiponectin resistance, and reduced adiponectin clearance from impaired kidneys and liver all contribute to the "adiponectin paradox"., (© 2024. The Author(s).)

Background: This study aimed to compare anthropometric indices to predict type 2 diabetes mellitus (T2DM) among first-degree relatives of diabetic patients in the Iranian community., Methods: In this study, information on 3483 first-degree relatives (FDRs) of diabetic patients was extracted from the database of the Endocrinology and Metabolism Research Center of Isfahan University of Medical Sciences. Overall, 2082 FDRs were included in the analyses. A logistic regression model was used to evaluate the association between anthropometric indices and the odds of having diabetes. Furthermore, a receiver operating characteristic (ROC) curve was applied to estimate the optimal cutoff point based on the sensitivity and specificity of each index. In addition, the indices were compared based on the area under the curve (AUC)., Results: The overall prevalence of diabetes was 15.3%. The optimal cutoff points for anthropometric measures among men were 25.09 for body mass index (BMI) (AUC = 0.573), 0.52 for waist-to-height ratio (WHtR) (AUC = 0.648), 0.91 for waist-to-hip ratio (WHR) (AUC = 0.654), 0.08 for a body shape index (ABSI) (AUC = 0.599), 3.92 for body roundness index (BRI) (AUC = 0.648), 27.27 for body adiposity index (BAI) (AUC = 0.590), and 8 for visceral adiposity index (VAI) (AUC = 0.596). The optimal cutoff points for anthropometric indices were 28.75 for BMI (AUC = 0.610), 0.55 for the WHtR (AUC = 0.685), 0.80 for the WHR (AUC = 0.687), 0.07 for the ABSI (AUC = 0.669), 4.34 for the BRI (AUC = 0.685), 39.95 for the BAI (AUC = 0.583), and 6.15 for the VAI (AUC = 0.658). The WHR, WHTR, and BRI were revealed to have fair AUC values and were relatively greater than the other indices for both men and women. Furthermore, in women, the ABSI and VAI also had fair AUCs. However, BMI and the BAI had the lowest AUC values among the indices in both sexes., Conclusion: The WHtR, BRI, VAI, and WHR outperformed other anthropometric indices in predicting T2DM in first-degree relatives (FDRs) of diabetic patients. However, further investigations in different populations may need to be implemented to justify their widespread adoption in clinical practice., (© 2024. The Author(s).)

Background: Obesity refers to a significant contributor to the development of obstructive sleep apnea (OSA). Early prediction of OSA usually leads to better treatment outcomes, and this study aims to employ novel metabolic markers, visceral adiposity index (VAI), and lipid accumulation product (LAP) to evaluate the relationship to OSA., Methods: The data used in the current cross-sectional investigation are from the National Health and Nutrition Examination Survey (NHANES), which was carried out between 2015 and 2018. To examine the correlation between LAP and VAI levels and OSA, multivariate logistic regression analysis was adopted. In addition, various analytical methods were applied, including subgroup analysis, smooth curve fitting, and threshold effect analysis., Results: Among totally 3932 participants, 1934 were included in the OSA group. The median (Q1-Q3) values of LAP and VAI for the participants were 40.25 (21.51-68.26) and 1.27 (0.75-2.21), respectively. Logistic regression studies indicated a positive correlation between LAP, VAI, and OSA risk after adjusting for potential confounding variables. Subgroup analysis revealed a stronger correlation between LAP, VAI levels, and OSA among individuals aged < 60 years. Through smooth curve fitting, specific saturation effects of LAP, VAI, and BMD were identified, with inflection points at 65.684 and 0.428, respectively., Conclusion: This study demonstrates that elevated levels of LAP and VAI increase the risk of OSA, suggesting their potential as predictive markers for OSA and advocating for dietary and exercise interventions to mitigate OSA risk in individuals with high LAP and VAI levels., (© 2024. The Author(s).)

Systemic sclerosis (SSc) is an autoimmune disease characterized by systemic inflammation, endothelial dysfunction, generalized fibrosis and high cardiovascular mortality. The evaluation of cardiovascular risk through the visceral adiposity index (VAI) has been helpful due to its direct relationship to the body and visceral fat percentage. We evaluated the influence of body composition and anthropometrics on cardiovascular risk as measured by VAI in healthy controls (HC) and SSc. An analytical cross-sectional study of 66 participants (33 SSc and 33 HC), mean age 52.7 ± 10, 95% women, was conducted from August 2020 to January 2021. Inclusion criteria in cases were consecutive patients with SSc (ACR/EULAR 2013), 63.6% were diffuse cutaneous (dcSS) subtype, and 36.4 were limited cutaneous (lcSS) subtype. HC was matched by age and gender. Serum lipid profiles and InBody anthropometrics were analyzed and compared. We performed descriptive statistics, bivariate analysis with Student's t, or Mann-Whitney U, correlation and chi-square according to the variable type and distribution. Total cholesterol was significantly higher in SSc than HC (345 vs 194, p = < 0.001). The BMI was higher in HC (26.2 vs 28.9, p < 0.001). Kilograms of muscle (19.8 vs 28.9, p < 0.001) and total fat (23.4 vs 28.9, p < 0.001) were lower in SSc patients compared to HC. VAI was similar when BMI < 25, but significantly higher when BMI > 25 in SSc than in HC (3 vs 1.9, p = 0.030). The increase in BMI at overweight or obese in SSc is associated with a significant increase in cardiovascular risk., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Aims: Considering the positive association between visceral adiposity index (VAI) and type 2 diabetes mellitus (T2DM), no comprehensive assessment on the summarized and dose-response relationship between VAI and T2DM has yet been reported. Therefore, we performed a meta-analysis, including dose-response analysis, to quantitively elucidate this association., Data Synthesis: MEDLINE via PubMed and Embase databases were searched for relevant articles up to December 14, 2021. Random-effects generalized least squares regression models were used to assess the quantitative association between VAI and T2DM risk across studies. Restricted cubic splines were used to model the dose-response association. A total of 9 prospective cohort studies and 5 cross sectional studies were included in our review. Based on the meta-analysis, the pooled RR of T2DM was 2.05 (95% CI 1.74-2.41) for the highest versus reference VAI category. We found that the risk of T2DM was increased by 44% (RR, 1.44; 95% CI, 1.23-1.68) with each 1-unit increment of VAI. While, we found no evidence of a nonlinear dose-response association of VAI and T2DM (P non-linearity  = 0.428). With the linear cubic spline model, when compared to population with VAI at 0.6, for those with VAI at 2.0, the risk of T2DM was increased by 81% (RR, 1.81; 95% CI 1.55-2.12)., Conclusions: Our meta-analysis provides quantitative data suggesting that VAI is associated with an increased risk of T2DM. Public health strategies focusing on weight loss among obesity, especially the people characterized by the thin-on-the-outside--fat-on-the-inside phenotype could possibly reduce a substantial risk of T2DM., Systematic Review Registration: PROSPERO CRD42022372666., Competing Interests: Disclosure of potential conflicts of interest The authors declare that they have no conflict of interest., (Copyright © 2023 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)

Objectives: The obesity rate among middle-aged and young adults in China is increasing annually, and the incidence of cardiovascular diseases is becoming more prevalent in younger populations. However, it has not yet been reported whether obesity is associated with early vascular aging (EVA). This study aims to explore the correlation between obesity and EVA in middle-aged and young adult health check-up populations, providing a reference for the prevention of cardiovascular diseases., Methods: A total of 15 464 middle-aged and young adults aged 18-59 who completed brachial-ankle pulse wave velocity (baPWV) test in the Third Xiangya Hospital of Central South University from January to December 2020 were included. Among them, 1 965 individuals with normal blood pressure and no cardiovascular risk factors were selected as the healthy population. The baPWV thresholds for determining EVA in each age group for males and females were calculated based on the baPWV values of the healthy population. The number and percentage of individuals meeting the EVA criteria in the middle-aged and young adult health check-up populations were statistically analyzed by age and gender. The differences in obesity indicators [visceral adiposity index (VAI), body mass index (BMI), waist circumference (WC)] between the EVA and non-EVA groups for males and females were compared. Using EVA as the dependent variable, VAI, BMI, and WC were included as independent variables in a Logistic model to analyze the correlation between each obesity indicator and EVA before and after adjusting for other influencing factors. Furthermore, the correlation between each obesity indicator and EVA in each age group was analyzed., Results: In the health check-up populations, the detection rate of EVA in different age groups was 1.65%-10.92% for males, and 1.16%-10.50% for females, the detection rate of EVA increased with age in both males and females. Except for the 40-<50 age group, the EVA detection rate was higher in males than in females in all other age groups. Regardless of gender, obesity indicators VAI, BMI, and WC were significantly higher in the EVA group than in the non-EVA group (all P <0.01). Before and after adjusting for other influencing factors, VAI and WC were both correlated with EVA (both P <0.05). BMI was a risk factor for EVA before adjusting for other influencing factors ( P <0.01), but after adjustment, the correlation between BMI and EVA was not statistically significant ( P =0.05). After adjusting for other influencing factors, the correlation between VAI and EVA was statistically significant in the 18-<40 and 50-<60 age groups (both P <0.05), while the correlation between BMI and WC with EVA was not statistically significant (both P >0.05). In the 40-<50 age group, the correlation between VAI and BMI with EVA was not statistically significant (both P >0.05), but the correlation between WC and EVA was statistically significant ( P <0.01)., Conclusions: VAI is closely related to the occurrence of EVA in middle-aged and young adults aged 18-<40 and 50-<60 years, while WC is closely related to the occurrence of EVA in those aged 40-<50 years.

Background: Cardiometabolic multimorbidity (CMM) has emerged as a prominent public health concern. Hypertensive patients are prone to develop comorbidities. Moreover, the accumulation of visceral adipose tissue is the main cause for the development of cardiometabolic diseases. The cardiometabolic index (CMI), lipid accumulation product (LAP), visceral adiposity index (VAI), and Chinese visceral adiposity index (CVAI) not only assess adipose tissue mass but also reflect adipose tissue dysfunction. So far, no study has been reported to evaluate the association of CMI, LAP, VAI, and CVAI with CMM risk in hypertensive patients. Therefore, this study aimed to assess the association between these adiposity indicators and the risk of CMM among Chinese hypertensive patients., Methods: In this cross-sectional study, a total of 229,287 hypertensive patients aged 35 years and older were included from the National Basic Public Health Service Project. All participants underwent a face-to-face questionnaire survey, physical examination, and the collection of fasting venous blood samples. Multivariable logistic regression models were performed to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Receiver operating characteristic curve was utilized to evaluate the identification ability for CMM., Results: After adjusting for confounders, each 1-standard deviation increase in CMI, LAP, VAI, and CVAI was associated with a 14%, 8%, 12%, and 54% increased risk of CMM, respectively. When comparing the highest quartile of these indicators with the lowest quartile, individuals in the highest quartile of CMM, LAP, VAI, and CVAI had a 1.39-fold (95% CI 1.30, 1.48), 1.28-fold (95% CI 1.19, 1.37), 1.37-fold (95% CI 1.29, 1.46), and 2.56-fold (95% CI 2.34, 2.79) increased risk of CMM after adjusting for potential confounders. Notably, a nonlinear association was observed for CMI, LAP, and VAI with the risk of CMM (all P nonlinearity < 0.001). CVAI exhibited the highest area under the receiver operating characteristic curve (AUC) among all the included adiposity indices in this analysis., Conclusion: This study indicated the significant positive association of CMI, LAP, VAI, and CVAI with the risk of CMM in hypertensive patients. Among these indicators, CVAI demonstrated the most robust performance in predicting CMM risk and may serve as a valuable tool for identifying CMM risk in Chinese hypertensive patients., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Dong, Lin, Zhou, Yang, Liu, Chen, Liu and Zhang.)

The importance of cardiovascular/cardiometabolic risk is a special one, because it may influence atherogenesis and its clinical consequences: ischemic heart disease, cerebrovascular disease, peripheral artery disease, but also diabetes mellitus (DM). To evaluate the cardiometabolic risk associated with visceral obesity, a useful indicator for the clinical practice was searched. The visceral adiposity index (VAI) could become an easy-to-use tool to evaluate the cardiometabolic risk in everyday practice. VAI indicates the function of visceral adipose tissue and its growth is independently correlated with cardiovascular and cerebrovascular risk. The medical world tried to identify an easy way to assess cardiovascular risk, so the visceral adiposity index was introduced, whose formula includes a number of cardiovascular risk factors.

Abstract Background Visceral adiposity index (VAI) was closely associated with metabolic syndrome, however almost no research focused on VAI and hyperuricemia, therefore, this study was conducted to determine the relationship of VAI and hyperuricemia free of metabolic syndrome and estimate the power of VAI as predictor for hyperuricemia. Methods A cross-sectional research coming from a health check-up program was conducted. All participants were divided into four groups according to VAI quartiles. A multivariate logistic analysis was used to analyze the relationship between the quartiles and hyperuricemia. A receiver operating characteristic (ROC) curve analysis was used to evaluate the accuracy of predictions for hyperuricemia. Results VAI was independent risk factor of hyperuricemia. The ORs of which in the upper quartile were 3.077 (95%CI 1.78-5.293), P = 0.000, in model 1, after adjusting for age, systolic blood pressure, diastolic blood pressure, heart rate, fast plasma glucose, serum creatinine, triglyceride, total cholesterol, high density lipoprotein cholesterol, and low density lipoprotein cholesterol; and 3.041 (95CI 1.767-5.233), P = 0.000, in model 2, after adjusting for the above plus physical activity, diet, smoking habits, alcohol consumption, hypertension and diabetes history. The area under the ROC curve (AUC) value of VAI was 0.618 (95%CI 0.572-0.665), P = 0.000; it was higher than WC, which was 0.556 (95%CI 0.508-0.604), P = 0.024, for hyperuricemia. Conclusions VAI was associated with hyperuricemia among individuals free of metabolic syndrome, and also a powerful indicator.

A randomized, clinical trial was performed to examine whether Apple cider vinegar (ACV) can result in dietary modifications that provides beneficial effects on the management of body weight and serum metabolic profiles in overweight or obese individuals. The participants (n = 39) were randomly allocated into the ACV (subjected to a restricted calorie diet (RCD) with 250 kcal/day energy deficit and 30 mL/d of ACV)) or the control group (RCD only) for 12 weeks. The ACV significantly reduced body weight, BMI, Hip circumference, visceral adiposity index (VAI) and appetite score (P ≤ 0.00). Furthermore, Plasma triglyceride (TG) and total cholesterol (TC) levels significantly decreased and high density lipoprotein cholesterol (HDL-C) concentration significantly increased in the ACV group in comparison to the control group (P ≤ 0.05). Thus, ACV along with RCD can be considered as an effective strategy for reducing anthropometric parameters, TG and TC level, VAI, appetite and increasing HDL-C concentration in overweight or obese individuals.