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.

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).

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.

Comparison of novel visceral obesity indexes with traditional obesity measurements in predicting of metabolically unhealthy nonobese phenotype in hemodialysis patients

Background Normal-weight maintenance hemodialysis (MHD) patients with abdominal obesity exhibited a more proatherogenic profile than overweight and obesity patients with abdominal obesity, highlighting the importance of early identification of metabolically unhealthy nonobese (MUNO) in this population. Visceral fat accumulation plays a crucial role in the development of MUNO. Lipid accumulation product (LAP), visceral adiposity index (VAI) have been proved as reliable visceral obesity markers. The Chinese visceral adiposity index (CVAI) and a body shape index (ABSI) are newly discovered indexes of visceral obesity and have been reported to be associated with multiple metabolic disorders. There are limited studies investigating the associations between different visceral obesity indices and risk of MUNO, especially in hemodialysis patients. Moreover, no general agreement has been reached to date regarding which of these obesity indices performs best in identifying MUNO. We aimed to investigate the prevalence of MUNO in MHD patients and compare the associations between different adiposity indices (CVAI, ABSI,VAI, LAP, body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHtR)) with MUNO risk in this population. Methods We conducted a multi-center cross-sectional study in Guizhou Province, Southwest China. 1302 nonobese adult MHD patients were included in our study. MUNO was defined as being nonobese and having the presence of > = 2 components of metabolic syndrome (MetS). Nonobese was defined as BMI less than 25 kg/m2. VAI, LAP, CVAI, ABSI, BMI, WC and WHtR were calculated. Logistic regression analyses and receiver operator curve (ROC) analyses were performed. Results 65.6% participants were metabolically unhealthy. The ROC curve analysis demonstrated that of the seven obesity indices tested, the VAI (AUC 0.84 for women and 0.79 for men) followed by LAP (AUC 0.78 for women and 0.72 for men) had the highest diagnostic accuracy for MUNO phenotype while ABSI exhibited the lowest AUC value for identifying MUNO phenotype Conclusions Metabolically unhealthy is highly prevalent in nonobese MHD patients. VAI and LAP outperformed CVAI in discriminating MUNO in MHD patients. Though ABSI could be a weak predictor of MUNO, it is not better than WHtR, WC and BMI.