Abstract
BackgroundThe Visceral Adiposity Index (VAI) is a sex-specific mathematical index, based on Waist Circumference (WC), Body Mass Index (BMI), triglycerides (TG) and HDL cholesterol (HDL) levels, indirectly expressing visceral adipose function and insulin sensitivity. Our aim was to find the optimal cut-off points of VAI identifying a visceral adipose dysfunction (VAD) associated with cardiometabolic risk in a Caucasian Sicilian population.MethodsMedical check-up data of 1,764 Primary Care patients (PC patients) were retrospectively and cross-sectionally examined using a receiver-operating characteristic (ROC) curve to determine appropriate stratified-for-age cut-off of VAI, for the identification of PC patients with Metabolic Syndrome (MetS) according to the NCEP-ATP III criteria. The PC patients with higher VAI scores were subdivided into three groups according to VAI tertiles (i.e. PC patients with mild VAD, moderate VAD or severe VAD). Finally, VAD classes were compared to classical cardio- and cerebrovascular risk factors as independent predictors of coronary heart disease and/or myocardial infarction, transient ischemic attack and/or ischemic stroke.ResultsModerate and severe VADs proved to be independently associated with cardiovascular events [(OR: 5.35; 95% CI: 1.92-14.87; p = 0.001) and (OR: 7.46; 95% CI: 2.64-21.05; p < 0.001) respectively]. Mild, moderate and severe VADs were found to be independently associated with cerebrovascular events [(OR: 2.73; 95% CI: 1.12-6.65; p = 0.027), (OR: 4.20; 95% CI: 1.86-9.45; p = 0.001) and (OR: 5.10; 95% CI: 2.14-12.17; p < 0.001) respectively].ConclusionsOur study suggests that among Caucasian Sicilian subjects there are clear cut-off points of VAI able to identify a VAD strongly associated with cardiometabolic risk.
Highlights
The Visceral Adiposity Index (VAI) is a sex-specific mathematical index, based on Waist Circumference (WC), Body Mass Index (BMI), triglycerides (TG) and HDL cholesterol (HDL) levels, indirectly expressing visceral adipose function and insulin sensitivity
The term ‘cardiometabolic risk’ was coined by the American Diabetes Association [1] and the American Heart Association [2] to describe the overall risk of developing type 2 diabetes and cardiovascular diseases
For 1,764 of the 13,195 PC patients, complete information was available on the following aspects: age, sex, smoking habits, WC, BMI, age of first heart and/or cerebrovascular event, diagnosis of diabetes mellitus according to the American Diabetes Association [14], presence of high blood pressure according to ESH/ ESC criteria [15], dyslipidemia as defined by NCEP Adult Treatment Panel (ATP) III [16], coronary heart disease (CHD) and/or myocardial infarction (MI) and transient ischemic attack (TIA) and/or ischemic stroke (IS)
Summary
The Visceral Adiposity Index (VAI) is a sex-specific mathematical index, based on Waist Circumference (WC), Body Mass Index (BMI), triglycerides (TG) and HDL cholesterol (HDL) levels, indirectly expressing visceral adipose function and insulin sensitivity. Our research group developed the Visceral Adiposity Index (VAI), a mathematical model that uses both anthropometric (body mass index [BMI] and WC) and functional (triglycerides [TG] and high-density lipoprotein [HDL] cholesterol) simple parameters [10] This index, which could be considered a simple surrogate marker of VAD, showed a strong association with both the rate of peripheral glucose utilization (M value) during the Euglycemic-hyperinsulinemic Clamp and with visceral adipose tissue (VAT) measured with MRI. It showed a strong independent association with both cardiovascular and cerebrovascular events [10] and showed better predictive power for incident diabetes events than its individual components (WC, BMI, TG and HDL) [11]
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