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Predictive value of visceral adiposity index for type 2 diabetes mellitus

A 15-year prospective cohort study

Prädiktiver Wert des Viszerale-Adipositas-Index bei Diabetes mellitus Typ 2

Eine prospektive 15-Jahres-Kohortenstudie

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Abstract

Background

The emerging term “visceral adiposity index (VAI)” was reported to be closely correlated with glycemic disturbances and diabetes risk. However, whether VAI could predict future type 2 diabetes mellitus (DM) is unknown. Here, we aimed to assess the predictive value of VAI for DM in a Chinese population via a prospective cohort study.

Patients and methods

This prospective cohort study was conducted based on a 15-year follow-up in a general Chinese population from an urban community. In all, 711 subjects underwent a health examination in 1992, and in 2007 the same examination was repeated. Twenty-four subjects were excluded from the analysis because DM was diagnosed at baseline. Waist circumference (WC), body mass index (BMI), VAI, and cardiovascular risk factors were collected at baseline. Hazard ratios (HRs) for DM incidence were estimated applying Cox proportional hazards models. Paired homogeneity tests were used to explore whether there was a statistical difference between the HRs of VAI and the other two indicators.

Results

In all, 74 individuals developed DM during a follow-up of 15 years. The risk of future DM increased with increasing levels of VAI. After adjusting for confounders, for each SD increment in natural logarithm-transformed VAI, BMI, and WC the HRs were 1.538 (95 % CI: 1.225–1.930), 1.639 (95 % CI: 1.289–2.084) and 1.858 (95 % CI: 1.458–2.369), respectively. However, paired homogeneity tests showed no statistical difference among the HRs.

Conclusion

VAI could independently predict DM in the Chinese study population, although the predictive power was not higher than that of simple anthropometric measures (BMI and WC). Our study does not support the clinical application of VAI; however, more studies based on different ethnic groups still need to be performed.

Zusammenfassung

Hintergrund

Der neue Begriff „Viszerale-Adipositas-Index“ (Visceral Adiposity Index, VAI) soll eng mit Störungen des Blutzuckerwerts und Diabetesrisiko korreliert sein. Jedoch ist bisher nicht bekannt, ob der VAI einen Prädiktor für einen zukünftigen Diabetes mellitus (DM) Typ 2 darstellt. Es wurde nun versucht, den prädiktiven Wert des VAI für DM bei Chinesen in einer prospektiven Kohortenstudie zu ermitteln.

Patienten und Methoden

Die vorliegende prospektive Kohortenstudie wurde auf der Grundlage einer 15-jährigen Verlaufsbeobachtung bei einer Stichprobe der allgemeinen chinesischen Bevölkerung aus städtischem Raum durchgeführt. Im Jahr 1992 wurden 711 Teilnehmer medizinisch untersucht, und 2007 erfolgte die gleiche Untersuchung bei ihnen noch einmal. Aus der Auswertung ausgeschlossen wurden 24 Personen, weil zu Studienbeginn ein DM diagnostiziert wurde. Bauchumfang (BU), Body-Mass-Index (BMI), VAI und kardiovaskuläre Risikofaktoren wurden zu Beginn dokumentiert. Die Hazard Ratio (HR) für die Inzidenz eines DM wurde unter Verwendung des Cox-Proportional-Hazards-Modells ermittelt. Der gepaarte Homogenitätstest wurde eingesetzt, um zu untersuchen, ob ein statistischer Unterschied zwischen der HR des VAI und den HR der anderen beiden Indikatoren besteht.

Ergebnisse

Während der 15-jährigen Verlaufsbeobachtung trat bei 74 Teilnehmern ein DM auf. Das Risiko, in Zukunft an DM zu erkranken, stieg mit zunehmenden VAI-Werten. Nach Adjustierung für Störfaktoren betrug die HR für jeden Anstieg der Standardabweichung (SD) der in natürliche Logarithmuswerte umgewandelten Werte für VAI, BMI und BU 1538 (95%-KI: 1,225–1,930), 1,639 (95%-KI: 1,289–2,084) bzw. 1,858 (95%-KI: 1,458–2,369). Jedoch ergaben gepaarte Homogentitätstests keine statistischen Unterschiede zwischen den HR.

Schlussfolgerung

Der VAI erwies sich als unabhängiger Prädiktor für DM in der chinesischen Stichprobe, wobei die prädiktive Power nicht besser als die einfacher anthropometrischer Werte (BMI und BU) ist. Die vorliegende Studie spricht nicht für den klinischen Einsatz des VAI, es sind jedoch noch weitere Studien auf der Grundlage unterschiedlicher Ethnizitäten erforderlich.

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Compliance with ethical guidelines

Conflict of interest. Y. Wang, S. He, J. He, S. Wang, K. Liu, and X. Chen state that there are no conflicts of interest. All studies on humans described in the present manuscript were carried out with the approval of the responsible ethics committee and in accordance with national law and the Helsinki Declaration of 1975 (in its current, revised form). Informed consent was obtained from all patients included in studies.

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, West China Hospital, Sichuan University, 610041, Chengdu, China

    Y. Wang, S. He, J. He, S. Wang, K. Liu & X. Chen

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  1. Y. Wang
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  2. S. He
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  3. J. He
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  4. S. Wang
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  5. K. Liu
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Corresponding author

Correspondence to X. Chen.

Additional information

Yong Wang and Sen He contributed equally to this work.

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Wang, Y., He, S., He, J. et al. Predictive value of visceral adiposity index for type 2 diabetes mellitus. Herz 40 (Suppl 3), 277–281 (2015). https://doi.org/10.1007/s00059-014-4175-1

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  • DOI: https://doi.org/10.1007/s00059-014-4175-1

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