464-P: Visceral Adiposity Index Identifies Both Type 2 Diabetes Mellitus and Prediabetes Better than Established Indices of Visceral Obesity in a Pad Cohort

Abstract

T2DM is a major risk factor for cardiovascular morbidity and mortality in PAD. Clinical assessment of patients at risk for the development of T2DM remains challenging. Visceral obesity is a known risk factor of T2DM, but there is no consensus for a clinically applicable measurement. This study aimed to investigate the potential association of a novel visceral obesity parameter, visceral adiposity index (VAI), with dysglycemia (prediabetes and T2DM) in comparison to established indices in a PAD cohort. 366 patients with diagnosed PAD (defined by an ABI<0.9 and Fonaine stage) were enrolled into this cross-sectionally designed study. All patients without known T2DM underwent screening with an OGTT. T2DM and prediabetes (PRE - IFG and IGT) were defined according to the ADA criteria. VAI was calculated according to the Amato formula. The cohort consisted of 43 patients with normal glucose tolerance (NGT), 159 patients with PRE and 164 patients with manifest T2DM. VAI was significantly higher in T2DM and PRE against NGT (median 2.33, IQR 1.35-3.44; 1.95, 1.26-2.86; 1.41, 1.18-2.41; p=0.006). In a multivariable binary logistic regression model adjusted for age, gender, LDL-C, serum creatinine, systolic blood pressure, smoking status and CRP the odds ratio for the highest VAI tertile for dysglycemia was 3.34 (95% confidence interval 1.38-8.06), 1.9 (1.07-3.38) for T2DM and 2.65 (1.05-6.68) for PRE alone. The same model for dysglycemia was significant, but weaker, for BMI above 25 kg/m2(2.27, 1.11-4.66) and waist circumference (WC) >80cm in female and >94cm in male patients (2.38, 1.01-5.62), but not significant for waist-hip ratio (WHR) >0.85 in female and >0.9 in male patients (2.24, 0.91-5.52). BMI, WC and WHR models neither predicted T2DM nor PRE (data not shown). Higher VAI values are associated with different states of dysglycemia alone and combined in a PAD cohort. In these patients VAI is superior to more common parameters of obesity. Disclosure B. Zierfuss: None. C. Hoebaus: None. C.T. Herz: None. R. Koppensteiner: None. G. Schernthaner: None.