Visceral Adiposity Index (VAI) Is Predictive of an Altered Adipokine Profile in Patients with Type 2 Diabetes

摘要

Aims: Although there is still no clear definition of ‘‘adipose tissue dysfunction’’ or ATD, the identification of a clinical markerudof altered fat distribution and function may provide the needed tools for early identification of a condition ofudcardiometabolic risk. Our aim was to evaluate the correlations among various anthropometric indices [BMI, WaistudCircumference (WC), Hip Circumference (HC), Waist/Hip ratio (WHR), Body Adiposity Index (BAI) and Visceral adiposity Indexud(VAI)] and several adipocytokines [Visfatin, Resistin, Leptin, Soluble leptin receptors (sOB-R), Adiponectin, Ghrelin, Adipsin,udPAI-1, vascular endothelial growth factor (VEGF), Hepatocyte growth factor (HGF) TNF-a, hs-CRP, IL-6, IL-18] in patients withudtype 2 diabetes (DM2).udMaterials and Methods: Ninety-one DM2 patients (age: 65.2566.38 years; 42 men and 49 women) in stable treatment forudthe last six months with metformin in monotherapy (1.5–2 g/day) were cross-sectionally studied. Clinical, anthropometric,udand metabolic parameters were evaluated. Serum adipocytokine levels were assayed with Luminex based kits.udResults: At the Pearson’s correlation, among all the indices investigated, VAI showed a significant correlation with almost alludadipocytokines analyzed [Visfatin, Resistin and hsCRP (all p,0.001); Adiponectin, sOb-R, IL-6, IL-18, HGF (all p,0.010);udGhrelin and VEGF (both p,0.05)]. Through a two-step cluster analysis, 55 patients were identified with the most alteredudadipocytokine profile (patients with ATD). At a ROC analysis, VAI showed the highest C-statistic [0.767 (95% CI 0.66–0.84)] ofudall the indices.udConclusions: Our study suggests that the VAI, among the most common indexes of adiposity assessment, shows the bestudcorrelation with the best known adipocytokines and cardiometabolic risk serum markers. Although to date we are still farudfrom clearly identifying an ATD, the VAI would be an easy tool for clearly mirroring a condition of cardiometabolic risk, in theudabsence of an overt metabolic syndrome.