medwireNews: A large cohort study has found a significant association between the visceral adiposity index (VAI) and an elevated risk for cancer overall as well as six specific types of cancer.
The researchers explain in Cancer that “[t]he VAI integrates anthropometric measurement (waist circumference and BMI) and metabolic parameters (including triglyceride levels and high-density lipoprotein cholesterol), offering a comprehensive assessment of visceral adiposity and metabolic health.”
They highlight, however, that their results “provide evidence that the VAI does not improve cancer risk prediction beyond the BMI.”
The team continues: “Considering that the BMI is cheaper, widely used, and easy to implement, this marker should continue to be used to identify individuals at higher risk of developing cancer among those who are seemingly healthy to support prevention and early detection.”
Giving the rationale for the study, the investigators say that the VAI “is a marker of visceral fat accumulation and metabolic dysfunction, but there is limited evidence of its association with cancer.”
Therefore, they analyzed data from 385,477 participants (53.3% women; mean age, 56.3 years) of the UK Biobank prospective cohort who were cancer-free at baseline and had available anthropometric and metabolic measurements required to calculate the VAI as well as information on covariates.
Allowing for a 2-year landmark period after recruitment “to reduce the potential for reverse causality and survival bias,” the median follow-up was 8.2 years and during this period 47,882 participants developed cancer.
After adjusting for a raft of factors including age, ethnicity, income, deprivation, lifestyle factors, and comorbidities, individuals in the highest VAI tertile had a significantly higher risk for any cancer than those in the lowest tertile, at a hazard ratio (HR) of 1.05.
This was also the case for uterine, gallbladder, kidney, liver, colorectal, and breast cancer, with respective HRs of 2.09, 1.83, 1.39, 1.25, 1.14, and 1.11. The increased risk for colorectal cancer was especially pronounced for proximal colon cancer, with an HR of 1.25.
But when BMI was included in the model, only the increased risks for gallbladder and proximal colon cancers remained significant, while the risk for esophageal cancer became significant in this analysis.
Furthermore, using the Harrell C‐index to compare the predictive ability between the VAI and BMI, “demonstrated little difference in the prediction of all‐cause and site‐specific cancers when using the VAI instead of the BMI, except for breast cancer and all‐cause cancer, for which prediction was better using the BMI than the VAI,” write the researchers.
Carlos Celis‐Morales and colleagues from the University of Glasgow in the UK conclude: “The prognostic and etiologic roles of visceral fat accumulation and dysfunction in cancer warrant further research.”
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