Abstract
Background and objectives: Visceral adiposity is linked to excess morbidity and mortality and positively correlates with the risk of insulin resistance, type-2 diabetes mellitus, cardiovascular disease and premature death. The study was conducted to find out the relationship between visceral adiposity index (VAI) and homeostatic model assessment insulin resistance (HOMA-IR) in diabetes mellitus (DM).
 Materials and methods: This cross sectional study was carried out on adult population with and without DM. Waist circumference (WC) and body mass index (BMI) were measured. BMI of 25-29.9 kg/m2 and ≥30 kg/m2 was defined as overweight and obese respectively. HOMA-IR method was used to calculate insulin resistance (IR). Standard formula using BMI, WC, triglyceride (TG) and high density lipoprotein cholesterol (HDL-c) was used to calculate VAI. Blood was analyzed for fasting blood glucose (FBS), TG, HDL-c and insulin level.
 Results: A total of 439 individuals were included in the study of which 269 had DM and 170 were healthy volunteers and the mean age was 41.47±6.82 and 36.16±7.44 years respectively. Compared to healthy controls, a greater number of diabetics had high VAI (86.5% vs. 98.9%) and high IR (43.5% vs. 85.1%). We found the highest sensitivity and specificity at a cut-off of 2.23 of VAI while at 3.65 had the highest specificity. Insulin resistance was observed significantly higher in those with diabetes compared to control, both in case of normal and high VAI at all cut-offs of VAI. Among anthropometric parameters (WC, BMI and VAI), VAI had positive (r=0.21, p<0.001) correlation with HOMA-IR than WC (r=0.10, p=0.043). Visceral fat was linearly related with insulin resistance (ß=0.18, p<0.001). Area under the curve (AUC) (0.66) showed that VAI can discriminate HOMA-IR.
 Conclusion: There was a high rate of raised VAI in cases with DM. VAI had positive association with HOMA-IR in diabetes mellitus. Although weak, there was an acceptable discrimination between them.
 Ibrahim Med. Coll. J. 2020; 14(1): 5-12
Highlights
Visceral adiposity has become a major concern in public health due to its significant role in obesity associated diseases
There was a high rate of raised visceral adiposity index (VAI) in cases with diabetes mellitus (DM)
We found a high rate of raised VAI (98.9%) in people with diabetes mellitus and an association with insulin resistance in whole population but not in between control and DM groups
Summary
Visceral adiposity has become a major concern in public health due to its significant role in obesity associated diseases. Previous studies have reported that individuals with high visceral adiposity are at increased risk of IMC J Med Sci 2020; 14(1): 002 insulin resistance and metabolic disorders, and are more likely to develop diabetes [2,3,4]. Major metabolic abnormality behind type-2 diabetes mellitus is insulin resistance and the compensatory hyperinsulinemia [5]. Release of inflammatory cytokines by macrophages in visceral adipose tissue impairs insulin sensitivity [7]. Visceral adiposity is linked to excess morbidity and mortality and positively correlates with the risk of insulin resistance, type-2 diabetes mellitus, cardiovascular disease and premature death. The study was conducted to find out the relationship between visceral adiposity index (VAI) and homeostatic model assessment insulin resistance (HOMA-IR) in diabetes mellitus (DM)
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