Diagnostic Accuracy of Visceral Adiposity Index in Patients With Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis

Background: Many studies have shown that visceral adiposity index (VAI) is valuable in the diagnosis of nonalcoholic fatty liver disease (NAFLD), but the accuracy of VAI in the diagnosis of NAFLD is not consistent. we aimed to assess the VAI as a predictor of NAFLD. Methods: The Cochrane Library, PubMed, Embase, and other databases were searched to collect all the documents that meet the inclusion criteria, The retrieval period is from the establishment of the database to September 2021. The methodological quality of the included studies was evaluated using the quadas-2 tool. The heterogeneity among the studies was analyzed by the Cochran-Q test and I2 test, and the appropriate model was selected according to the heterogeneity. The diagnostic efficacy of VAI was evaluated by meta-analysis and a Fagan diagram was drawn to evaluate the diagnostic ability of VAI.Results: A total of 9 studies were included. The overall quality of the included studies was good. Meta-analysis showed that the combined sensitivity (Sen combined) of VAI in the diagnosis of NAFLD was 0.70 [95% CI (0.69-0.71)], the combined specificity (Spe combined) was 0.67 [95% CI (0.67-0.68)], PLR combined was 2.08 [95% CI (1.87-2.31)], NLP combined was 0.39 [95% CI (0.34-0.44)], and DOR combined was 5.81 [95% CI (4.73-7.14)]. The corresponding AUC was 0.79 [95% CI (0.75-0.82)]. Meta-regression analysis showed that the gold index was a potential source of heterogeneity (P < 0.05). The Fagan diagram shows that the precision of NAFLD diagnosis is 70% when the pre-test probability is set to 50% and then supplemented by VAI.Conclusion: VAI has a certain value in the diagnosis of NAFLD and may be helpful in the early detection of NAFLD, but it still needed a large number of prospective studies to support this.