Discriminatory Ability of Visceral Adiposity Index (VAI) in Diagnosis of Metabolic Syndrome: A Population Based Study

Abstract

Background Visceral adiposity index (VAI) has been suggested as an index of visceral adiposity. This study was conducted to determine the discriminatory ability of VAI in diagnosis of metabolic syndrome (MetS).

Methods and materials We used the data of 5 312 subjects aged 18–74 years of a cohort study conducted among 6 140 individuals aged 10–90 years in Amol, northern Iran. The city population was divided into 16 strata based on gender and age groups in 10-year intervals. The subjects were randomly selected from each stratum. MetS was defined based on National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATPIII), American Heart Association/National Heart, Lung and Blood Institute (AHA/NHLBI) update of Adult Treatment Panel III (ATPIII), International Diabetes Federation (IDF) and joint interim statement (JIS) definitions. The discriminatory ability of VAI and other obesity measures were evaluated using receiver operating characteristic (ROC) curves.

Results While waist circumference (WC) showed the highest discriminatory ability for MetS in IDF definition in men (AUC=0.899 [CI=0.888–0.910]), VAI had the greatest discriminatory ability according to other definitions in men and women. The related AUCs of VAI were 0.866 (95%CI: 0.850–0.881), 0.829 (95%CI: 0.813–0.846), 0.859 (95%CI: 0.844–0.873) and 0.876 (95%CI: 0.863–0.889) based on NCEP/ATPIII, AHA/NHLBI update of ATPIII, IDF and JIS definition in men, and also 0.888 (95%CI: 0.875–0.902), 0.894 (95%CI: 0.881–0.907), 0.883 (95%CI: 0.869–0.897) and 0.879 (95%CI: 0.864–0.894) in women, respectively.

Conclusion VAI showed an excellent discriminatory ability in diagnosis of MetS. Considering its relatively simple calculation, this index could be suggested as a reliable tool in medical practice.

Key words

visceral adiposity index - metabolic syndrome - discriminatory ability - adiposity

• References

• 1 Chen J, Gu D, Huang J et al. Metabolic syndrome and salt sensitivity of blood pressure in non-diabetic people in China: a dietary intervention study. The Lancet 2009; 373: 829-835
• 2 Ervin RB. Prevalence of metabolic syndrome among adults 20 years of age and over, by sex, age, race and ethnicity, and body mass index: United States. National health statistics reports 2009; 13: 1-8
• 3 Kotronen A, Westerbacka J, Bergholm R et al. Liver fat in the metabolic syndrome. The Journal of Clinical Endocrinology & Metabolism 2007; 92: 3490-3497
• 4 Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. Jama 2002; 287: 356-359
• 5 Bozorgmanesh M, Hadaegh F, Azizi F. Predictive performances of lipid accumulation product vs. adiposity measures for cardiovascular diseases and all-cause mortality, 8.6-year follow-up: Tehran lipid and glucose study. Lipids in health and disease 2010; 9: 1
• 6 Bozorgmanesh M, Hadaegh F, Azizi F. Diabetes prediction, lipid accumulation product, and adiposity measures; 6-year follow-up: Tehran lipid and glucose study. Lipids in health and disease 2010; 9: 1
• 7 Alberti KGMM, Zimmet PF. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus. Provisional report of a WHO consultation. Diabetic medicine 1998; 15: 539-553
• 8 Expert Panel on Detection E . Executive summary of the Third Report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). Jama 2001; 285: 2486
• 9 Grundy SM, Cleeman JI, Daniels SR et al. Diagnosis and management of the metabolic syndrome an American Heart Association/National Heart, Lung, and Blood Institute scientific statement. Circulation 2005; 112: 2735-2752
• 10 Alberti KGMM, Zimmet P, Shaw J. Metabolic syndrome – a new world-wide definition. A consensus statement from the international diabetes federation. Diabetic medicine 2006; 23: 469-480
• 11 Alberti K, Eckel RH, Grundy SM et al. Harmonizing the metabolic syndrome a joint interim statement of the international diabetes federation task force on epidemiology and prevention; national heart, lung, and blood institute; American heart association; world heart federation; international atherosclerosis society; and international association for the study of obesity. Circulation 2009; 120: 1640-1645
• 12 Panel NOEIE . Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. 1998
• 13 Amato MC, Giordano C, Galia M et al. Visceral Adiposity Index A reliable indicator of visceral fat function associated with cardiometabolic risk. Diabetes care 2010; 33: 920-922
• 14 Schuster J, Vogel P, Eckhardt C et al. Applicability of the visceral adiposity index (VAI) in predicting components of metabolic syndrome in young adults. Nutr Hosp 2014; 30: 806-812
• 15 Knowles K, Paiva L, Sanchez S et al. Waist circumference, body mass index, and other measures of adiposity in predicting cardiovascular disease risk factors among Peruvian adults. International journal of hypertension 2011; DOI: DOI 10.4061/2011/931402.
• 16 Hosmer Jr DW, Lemeshow S, Sturdivant RX. Applied logistic regression. John Wiley & Sons; 2013