Abstract
Background and objectives: The visceral adiposity index (VAI), estimating visceral adiposity dysfunction through a simple formula, could serve as a useful tool for identifying individuals at higher cardiometabolic risk. Its relationship with insulin resistance (IR), assessed using the homeostasis model assessment of IR (HOMA-IR), and metabolic syndrome (MetS) components remains unclear. The study aimed to investigate the association of VAI with both HOMA-IR and MetS. Materials and Methods: After undergoing anthropometric and biochemical studies, 783 individuals were divided into three groups according to a number of present MetS components. The VAI cut-offs signaling MetS and HOMA-IR were determined by maximizing the sum of the sensitivity and specificity. Correlation analysis was performed to explore the associations between VAI and other tested parameters. A logistic stepwise regression analysis was applied to identify statistically significant determinants of HOMA-IR. Given the variability of reference values, two thresholds of HOMA-IR were applied, namely 2.0 and 3.8. Results: VAI increased significantly between the groups with a rising number of MetS components. The VAI cut-off for MetS was 2.37, with a sensitivity of 0.86 and a specificity of 0.78. The same cut-off point identified subjects with HOMA-IR = 3.8, with a sensitivity of 0.79 and a specificity of 0.66. The VAI cut-off for HOMA-IR = 2.0 was 1.89, with a sensitivity of 0.74 and a specificity of 0.68. The strongest correlations of VAI were noted with HOMA-IR (r = 0.51) and insulin (r = 0.49), respectively, while the strongest correlation of HOMA-IR was with waist circumference (r = 0.54). Not one of the routine parameters was a significant predictor in the regression analysis. Conclusions: The obtained results show an existing association of VAI with HOMA-IR. The high sensitivity and specificity of the cut-offs may allow the application of VAI in common clinical practice.
Highlights
Cardiometabolic diseases are the global leading causes of death and represent a significant economic burden on health systems
According to body mass index (BMI) and waist circumference (WC), Group A consisted of normal weight subjects, while Group C consisted of subjects in the obesity range
The obtained results of the correlation analysis confirm an association of visceral adiposity index (VAI) and HOMA-insulin resistance (IR), the logistic regression did not prove VAI a stronger predictor of homeostasis model assessment of IR (HOMA-IR) among others
Summary
Cardiometabolic diseases are the global leading causes of death and represent a significant economic burden on health systems. Metabolic syndrome (MetS) has been defined as a single nosological entity, among others, to clearly identify individuals with high cardiometabolic risk eligible for targeted preventive interventions [1,2]. MetS is a cluster of clinical, metabolic, and biochemical abnormalities, such as central adiposity, hypertension, hyperglycemia, and dyslipidemias. Visceral obesity, as measured by waist circumference (WC), is stressed over other components of MetS [3]. The visceral adiposity index (VAI), estimating visceral adiposity dysfunction through a simple formula, could serve as a useful tool for identifying individuals at higher cardiometabolic risk. Its relationship with insulin resistance (IR), assessed using the homeostasis model assessment of IR (HOMA-IR), and metabolic syndrome (MetS) components remains unclear. The study aimed to investigate the association of VAI with both HOMA-IR and MetS
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