Lipid ratios and obesity indices are effective predictors of metabolic syndrome in women with polycystic ovary syndrome

Background: Insulin resistance (IR) is common in women with polycystic ovary syndrome (PCOS). Metabolic syndrome (MS) involves IR, arterial hypertension, dyslipidemia, and visceral fat accumulation. Therefore, fatness indices and blood lipid ratios can be considered as screening markers for MS. Our study aimed to evaluate the predictive potential of selected indirect metabolic risk parameters to identify MS in PCOS. Methods: This cross-sectional study involved 596 women aged 18–40 years, including 404 PCOS patients diagnosed according to the Rotterdam criteria and 192 eumenorrheic controls (CON). Anthropometric and blood pressure measurements were taken, and blood samples were collected to assess glucose metabolism, lipid parameters, and selected hormone levels. Body mass index (BMI), waist-to-height ratio (WHtR), homeostasis model assessment for insulin resistance index (HOMA-IR), visceral adiposity index (VAI), lipid accumulation product (LAP), non-high-density lipoprotein cholesterol (non-HDL-C), and triglycerides-to-HDL cholesterol ratio (TG/HDL-C) were calculated. MS was assessed using the International Diabetes Federation (IDF) and the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) criteria. Results: MS prevalence was significantly higher in PCOS versus CON. Patients with both MS and PCOS had more unfavorable anthropometric, hormonal, and metabolic profiles versus those with neither MS nor PCOS and versus CON with MS. LAP, TG/HDL-C, VAI, and WHtR were the best markers and strongest indicators of MS in PCOS, and their cut-off values could be useful for early MS detection. MS risk in PCOS increased with elevated levels of these markers and was the highest when TG/HDL-C was used. Conclusions: LAP, TG/HDL-C, VAI, and WHtR are representative markers for MS assessment in PCOS. Their predictive power makes them excellent screening tools for internists and enables acquiring accurate diagnoses using fewer MS markers.

Association of Chinese Visceral Adiposity Index and Its Dynamic Change With Risk of Carotid Plaque in a Large Cohort in China

Background We aimed to evaluate the association between the Chinese visceral adiposity index (CVAI) and its dynamic change and risk of carotid plaque based on a large Chinese cohort. Methods and Results This cohort included 23 522 participants aged 20 to 80 years without elevated carotid intima‐media thickness and carotid plaque at baseline and who received at least 2 health checkups. CVAI was calculated at baseline and at every checkup. The dynamic change in CVAI was calculated by subtracting CVAI at baseline from that at the last follow‐up. Cox proportional hazard regression model was used to estimate hazard ratios (HRs) and 95% CIs. The restricted cubic spline was applied to model the dose‐response association between CVAI and carotid plaque risk. During the 82 621 person‐years of follow‐up, 5987 cases of carotid plaque developed (7.25/100 person‐years). We observed a significant positive correlation between CVAI and carotid plaque risk (HR, 1.53; 95% CI, 1.48–1.59 [ P <0.001]) in a nonlinear dose‐response pattern ( P nonlinearity <0.001). The sensitivity analyses further confirmed the robustness of the results. The association was significant in all subgroup analyses stratified by sex, hypertension, and fatty liver disease except for the diabetes subgroup. The association between CVAI and carotid plaque risk was much higher in men than in women. No significant association was identified between change in CVAI and carotid plaque risk. Conclusions CVAI was positively associated with carotid plaque risk in a nonlinear dose‐response pattern in this study. Individuals should keep their CVAI within a normal level to prevent the development of carotid plaque.

Evaluation of the Association between Obesity Markers and Type 2 Diabetes: A Cohort Study Based on a Physical Examination Population

Purpose. To evaluate the predictive effect of different obesity markers on the risk of developing type 2 diabetes in a population of healthy individuals who underwent physical examination and to provide a reference for the early detection of individuals at risk of diabetes. Methods. This retrospective cohort study included 15206 healthy subjects who underwent a physical examination (8307 men and 6899 women). Information on the study population was obtained from the Dryad Digital Repository. Cox proportional risk models were used to calculate the hazard ratio (HR) and 95% confidence interval (CI) of different obesity markers, including the lipid accumulation index (LAP), body mass index (BMI), waist-to-height ratio (WHtR), visceral adiposity index (VAI), and body roundness index (BRI) on the development of type 2 diabetes. The effectiveness of each obesity marker in predicting the risk of developing type 2 diabetes was analyzed using the receiver operating characteristic curve (ROC curve) and the area under the curve (AUC). Results. After a mean follow-up of 5.4 years, there were 372 new cases of type 2 diabetes. After correcting for confounding factors such as age, sex, smoking, alcohol consumption, exercise, and blood pressure, Cox proportional risk model analysis showed that elevations in BMI, LAP, WHtR, VAI, and BRI increased the risk of developing type 2 diabetes. The ROC curve results showed that LAP was the best predictor of the risk of developing diabetes, with an AUC (95% CI) of 0.759 (0.752–0.766), an optimal cutoff value of 16.04, a sensitivity of 0.72, and a specificity of 0.69. Conclusion. An increase in the BMI, LAP, WHtR, VAI, and BRI can increase the risk of developing type 2 diabetes, with LAP being the best predictor of this risk.

Influence of endotoxemy on development of non-alcoholic fatty liver disease

Objective — to investigate endotoxin levels and to assess the relationship between endotoxemia and metabolic parameters and the degree of steatosis and fibrosis in patients with non‑alcoholic fatty liver disease (NAFLD) against the background of metabolic syndrome (MS). Materials and methods. The study included 68 patients with NAFLD with metabolic disorders and 20 people of the control group. Women prevailed in both investigational groups, the mean age was 49.34 ± 10.8 years. All patients underwent evaluation of their anthropometric parameters, investigation of body composition with determination of the percentage of visceral adipose tissue (VAT). To reveal VAT dysfunction, visceral adiposity index (VAI) was calculated with M. C. Amato method. Steatometry was performed by determining the wave attenuation coefficient and carrying out shear wave elastography. Endotoxin levels in blood serum were determined using a set of reagents «LAL Chromogenic Endpoint Assay» manufactured by «Hycult Biotech» (Netherlands). Results. Bacterial endotoxin levels in peripheral blood in the examined patients were almost three times higher in comparison with the control group (p < 0.05). Patients with overweight and obesity had significantly higher endotoxin levels compared with the control group (p < 0.05). The significant increase in endotoxin levels has been defined in obese NAFLD patients compared to the NAFLD patients with normal weight (p < 0.05). The direct correlation was found between endotoxin parameters and parameters of abdominal and visceral obesity. In the group of patients with high VAT activity, the maximal values of this indicator were observed, which significantly differed from the corresponding indicator in patients with low and medium VAI (p < 0.05). There was a direct correlation between moderate endotoxin and insulin resistance, a direct weak relationship between endotoxin and lipid profile parameters. In patients with grade 2 and 3 steatosis, significant differences in the level of endotoxemia were observed compared with the control group (p < 0.05) and patients with grade 1 steatosis (p < 0.05). At high grades of liver fibrosis (F3F4) there was a tendency to reduce endotoxemia compared with the low‑grade fibrosis (p < 0.05). Conclusions. The revealed relationships between endotoxemia level and metabolic factors of NAFLD development indicate the pathogenetic role of bacterial endotoxemia in triggering a cascade of metabolic reactions with the subsequent accumulation of lipids in the liver tissue and the progression of steatosis and fibrosis.

Interaction Between Caveolin-1 Polymorphism with Dietary Fat Quality Indices and the Relationship with Visceral Adiposity Index (VAI) and Body Adiposity Index (BAI) Among Overweight and Obese Women: A Cross-Sectional Study

Background & Aims: Caveolin-1(CAV-1) in adipocyte tissue, and other parts of body, possess numerous biological functions. In the present study, we sought to investigate the interaction between CAV-1 polymorphism with dietary fat quality indices and the relationship with visceral adiposity index (VAI) and body adiposity index (BAI) among overweight and obese women. Methods This study was conducted on 386 women, aged 18-48 years old. Biochemical measurements were measured by standard protocols. We used a food frequency questionnaire (FFQ) to calculate the dietary intake and the indices of dietary fat quality intake. Anthropometric values and body composition were measured by standard methods. Finally, the CAV-1 genotype was measured using PCR-RFLP method. Results We found a marginally significant difference in waist-to-hip ratio (WHR) (P=0.06) and BAI (P=0.06) of participants, after adjusting with potential cofounders. For dietary intakes, after adjusting with the energy intake, mean differences in biotin (P=0.04) and total fiber (P=0.06) were significant and marginally significant, respectively. The interaction between two risk allele genotype group (AA) with omega-6 to omega-3 ratio (W6/W3) on BAI, after adjustment with potential cofounders (age, physical activity, energy intake, education), was marginally positive (β = 14.08, 95%CI= -18.65,46.81, P= 0.07). In comparison to the reference group (GG), there was a positive interaction between the two risk allele (AA) with W6/W3 ratio on VAI (β = 2.81, 95%CI= 1.20,8.84, P= 0.06) in the adjusted model. Conclusions We found that there may be an interaction between CAV-1 genotypes with dietary quality fat indices on VAI and BAI among overweight and obese women.

The Visceral Adiposity Index in Non-Alcoholic Fatty Liver Disease and Liver Fibrosis—Systematic Review and Meta-Analysis

(1) Background: In order to avoid a liver biopsy in non-alcoholic fatty liver disease (NAFLD), several noninvasive biomarkers have been studied lately. Therefore, we aimed to evaluate the visceral adiposity index (VAI) in NAFLD and liver fibrosis, in addition to its accuracy in predicting NAFLD and NASH. (2) Methods: We searched PubMed, Embase, Scopus, and Cochrane Library, identifying observational studies assessing the VAI in NAFLD and liver fibrosis. QUADAS-2 was used to evaluate the quality of included studies. The principal summary outcomes were mean difference (MD) and area under the curve (AUC). (3) Results: A total of 24 studies were included in our review. VAI levels were significantly increased in NAFLD (biopsy-proven and ultrasound-diagnosed), simple steatosis vs. controls, and severe steatosis vs. simple steatosis. However, no significant MD was found according to sex, liver fibrosis severity, simple vs. moderate and moderate vs. severe steatosis, pediatric NAFLD, and NASH patients. The VAI predicted NAFLD (AUC 0.767) and NASH (AUC 0.732). (4) Conclusions: The VAI has a predictive value in diagnosing NAFLD and NASH, with significantly increased values in adult NAFLD patients, simple steatosis compared to controls, and severe steatosis compared to simple steatosis.

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.

The Visceral Adiposity Index in Non-Alcoholic Fatty Liver Disease and Liver Fibrosis — Systematic Review and Meta-Analysis

Review question / Objective: The objective of the study was to compare the mean difference and AUROC of Visceral Adiposity Index (VAI) in NAFLD/NASH/liver fibrosis patients and controls in observational studies. Condition being studied: Nonalcoholic fatty liver disease (NAFLD) is a multi-system disease, being mainly a liver pathology involving excessive hepatic fat accumulation unrelated to alcohol consumption or other secondary causes of hepatic steatosis. It is an emerging cause of concern and increasing clinical burden, imposing a public health challenge. NAFLD is the most common chronic liver disease and is predicted to be the most common indication for a liver transplant in Western countries by 2030, owing to a prevalence of 25% worldwide. The visceral adiposity index (VAI) is a scoring system based on body mass index, triglycerides, high-density lipoproteins (HDLs), and waist circumferences (WCs).

Relationship between Serum Kallistatin and Afamin and Anthropometric Factors Associated with Obesity and of Being Overweight in Patients after Myocardial Infarction and without Myocardial Infarction

Extensive clinical and epidemiological evidence has linked obesity to a broad spectrum of cardiovascular disease (CVD), including coronary disease, heart failure, hypertension, cerebrovascular disease, atrial fibrillation, ventricular arrhythmias, and sudden death. In addition, increasing knowledge of regulatory peptides has allowed an assessment of their role in various non-communicable diseases, including CVD. The study assessed the concentration of kallistatin and afamin in the blood serum of patients after a myocardial infarction and without a cardiovascular event, and determined the relationship between the concentration of kallistatin and afamin and the anthropometric indicators of being overweight and of obesity in these groups. Serum kallistatin and afamin were quantified by ELISA tests in a cross-sectional study of 160 patients who were divided into two groups: study group (SG) (n = 80) and another with no cardiovascular event (CG) (n = 80). Serum kallistatin concentration was significantly higher in the SG (p < 0.001), while the level of afamin was significantly lower in this group (p < 0.001). In addition, a positive correlation was observed in the SG between the afamin concentration and the waist to hip ratio (WHR), lipid accumulation product (LAP) and the triglyceride glucose index (TyG index). In the CG, the concentration of kallistatin positively correlated with the LAP and TyG index, while the concentration of afamin positively correlated with all the examined parameters: body mass index (BMI), waist circumference (WC), hip circumference (HC), waist to hip ratio (WHtR), visceral adiposity index (VAI), LAP and TyG index. Serum kallistatin and afamin concentrations are associated with the anthropometric parameters related to being overweight and to obesity, especially to those describing the visceral distribution of adipose tissue and metabolic disorders related to excessive fatness.

Visceral adiposity index performed better than traditional adiposity indicators in predicting unhealthy metabolic phenotype among Chinese children and adolescents

The relationship between visceral adiposity index (VAI) and unhealthy metabolic phenotype remained unclear in children and adolescents. This study aimed to investigate their association and compared the ability of VAI and traditional adiposity indicators (body mass index, waist circumference and waist-to-height ratio) to predict metabolically unhealthy phenotype among normal-weight, overweight and obese children and adolescents. In this cross-sectional study, 1722 children and adolescents aged 12–18 years were selected by cluster random sampling, underwent a questionnaire survey, physical examination and biochemical tests. Participants were divided into four phenotypes according to the combination of the weight status determined by body mass index (BMI) and metabolic syndrome components. Receiver operating characteristic (ROC) analysis and multivariate logistic regression were used to compare the predictive capacity between VAI and traditional adiposity indicators and their relationship with metabolically unhealthy phenotype. We found that VAI had better performance in predicting metabolically unhealthy phenotype than traditional adiposity indicators, the area under the receiver-operating characteristic curve (AUC) were 0.808 and 0.763 for boys and girls with normal-weight, 0.829 and 0.816 for boys and girls with overweight and obese (all P < 0.001). VAI was most strongly related to metabolically unhealthy phenotype whether or not to adjust the age, the adjusted OR and 95%CI was 6.15 (4.13–9.14) in boys with normal weight, and 5.90 (3.06–11.36), 4.95 (2.35–10.41) in boys and girls with overweight and obese, respectively (all P < 0.001). Our findings suggested VAI could be used as a comprehensive predictor to identify unhealthy metabolic phenotype in children and adolescents.