EXPLORING VISCERAL ADIPOSITY INDEX AS A PREDICTOR OF VISCERAL ADIPOSITY DYSFUNCTION AND EVALUATING ITS PERFORMANCE IN PREDICTING HEPATIC INSULIN RESISTANCE IN INDIAN TYPE 2 DIABETICS

摘要

Objective: Visceral adiposity index (VAI) is a simple clinical algorithm developed as a surrogate marker for characterizing visceral adiposity dysfunction (VAD). This study aimed to explore an optimal VAI cut off value for predicting VAD as reflected quantitatively by magnetic resonance imaging (MRI) and to evaluate its merit in predicting the severity of the cardiometabolic risk (CMR) in type 2 diabetic patients of India. Methods: Data was collected from 81 diabetics and 48 healthy participants, who underwent metabolic assessments. VAI derived using BMI, waist circumference (WC), triglycerides (TG) and HDLc, was studied against visceral fat area measuring ≥130 cm 2 by MRI as it is associated with higher CMR through raised VAD. Optimal VAI cutoff was determined using the area under the receiver operator characteristic curve (AUROC). Diabetic participants were divided into VAD absent, and VAD present groups based on derived VAI cut off to study associated difference in their metabolic profile. Results: Diabetic group had significantly deranged metabolic profile compared to the healthy control group. M ost of the diabetic group participants had a visceral fat area between 101 and 200 cm 2 . From the ROC curve analysis (AUROC = 0.761), VAI cut-off of 2.0 predicted VAD with sensitivity and specificity of 73.21% and 71.23% respectively. Diabetic participants with VAI values more than 2, had significantly (p<0.05) higher WC, visceral fat, fasting insulin, HOMA-IR (Homeostatic model assessment for insulin resistance), TG (p<0.01), non-HDLc and apolipoprotein B/A1 ratio values. Age adjusted partial correlation analysis showed a significant (p<0.01) positive correlation between VAI and HOMA-IR. Conclusion: VAI was useful in predicting VAD and identifying the severity of CMR within type 2 diabetics. VAI can replace imaging procedures with the advantages of reduced economic burden and can be used as screening tool for surveillance of CMR in Indian population.