Abstract

Visceral adiposity mediates insulin resistance, but their association among adults with prediabetes is scarce in the literature. This study is aimed to determine the association of visceral adiposity index (VAI) with insulin resistance in adults with prediabetes. This cross-sectional study was done among 117 adults with newly detected prediabetes [m/f; 23/94; mean ± SD: Age 36.30 ± 9.99 years, BMI 28.89 ± 4.35 kg/m2] based on American Diabetes Association 2018 criteria and 141 matched healthy controls [m/f: 28/113; mean ± SD: 35.30 ± 6.88 years, BMI 25.03 ± 4.58]. Waist circumference, body mass index, fasting triglyceride, HDL cholesterol, fasting blood glucose and insulin were measured in each group to calculate VAI and homeostatic model assessment of insulin resistance (HOMA-IR). People with prediabetes had significantly higher median value of VAI {3.08 (2.26) vs. 1.86 (2.31); p 1) (98.3% vs. 85.8%; p < 0.001) than the control population. HOMA-IR level was significantly higher in prediabetes with high VAI (cut-off of 2.64) than control with normal VAI [2.78 (2.22, 4.15) vs. 2.20 (1.53, 3.36); p = 0.002]. VAI was positively correlated with HOMA-IR in females with prediabetes (r = 0.299, p = 0.003). VAI had predictive association with prediabetes [OR (95% CI: 9.504 (2.173, 41.576); p = 0.03] and high insulin resistance (HOMA-IR ≥ 2.6) in females with prediabetes [OR (95% CI) = 3.50 (1.476, 8.297); p = 0.004] only. It could satisfactorily discriminate prediabetes in both sexes (male: AUC = 0.767, p = 0.001; female: AUC = 0.641, p < 0.001) and high insulin resistance in females with prediabetes (AUC = 0.641; p = 0.019) only. So, VAI was associated with prediabetes and insulin resistance only in females with prediabetes.

Highlights

  • Bangladesh is dealing with a huge burden of diabetes and prediabetes [1]

  • Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) level was significantly higher in prediabetes with high Visceral adiposity index (VAI) than control with normal VAI [2.78 (2.22, 4.15) vs. 2.20 (1.53, 3.36); p = 0.002]

  • The mean or median value of body mass index (BMI), waist circumference (WC), FBG, TG and VAI were significantly higher in the participants with prediabetes

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Summary

Introduction

Prediabetes is the preceding stage of development of DM. It is associated with insulin resistance, metabolic syndrome and cardiovascular diseases [2]. Visceral adiposity index (VAI) is a simple clinico-biochemical and gender-specific tool that represents adipose tissue dysfunction and ultimate insulin resistance. It is better than body mass index (BMI) and waist circumference (WC) alone to predict cardiovascular events. VAI can be used as an early indicator of cardiometabolic risk especially in patients before developing overt metabolic syndrome [5]. The association of VAI with insulin resistance in prediabetes has not been studied among Bangladeshi adults. We decided to look at the association of VAI and insulin resistance in adults with prediabetes, and see whether VAI could predict insulin resistance and prediabetes

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