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Association Between Visceral Adiposity Index and Metabolic Syndrome and Its Components: Evidence From the PERSIAN
Negin Letafatkar1, Ehsan Amini-Salehi1, Seyyed Mohammad Hashemi2
1Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.
Background:
The Visceral Adiposity Index (VAI) is proposed as a surrogate marker of visceral adipose dysfunction. We evaluated its association with metabolic syndrome (MetS) and its components in a large Iranian population.
Methods:
This cross-sectional study included 10,520 participants from the PERSIAN Guilan Cohort Study. VAI was calculated using sex-specific equations. MetS was defined according to Adult Treatment Panel III criteria. Multivariable logistic regression assessed associations between VAI and MetS, while ROC analysis evaluated the discriminatory ability of VAI for identifying MetS.
Results:
MetS was present in 40.7% of participants (24.5% of men, 54.7% of women). VAI was significantly higher in individuals with MetS than in those without [3.31 (IQR 2.40-4.69) vs. 1.64 (1.14-2.32); p < 0.01]. In the fully adjusted model, each one-unit increase in VAI was associated with higher odds of MetS in the overall population (OR = 2.41; 95% CI: 2.31-2.51), with a stronger association in women than in men (OR = 3.20 vs. 1.92; p for interaction < 0.001). VAI showed good discriminatory ability for identifying MetS in the total population (AUC = 0.84; 95% CI: 0.83-0.84), men (AUC = 0.83; 95% CI: 0.81-0.84), and women (AUC = 0.84; 95% CI: 0.83-0.85). Optimal VAI cut-off values were 2.42 in the overall population, 2.08 in men and 2.69 among women. VAI was most strongly associated with triglycerides and HDL-C, while significant associations were also observed with elevated fasting plasma glucose (FPG) and blood pressure (BP).
Conclusion:
VAI was strongly associated with the presence of MetS in this large Iranian population and demonstrated good discriminatory ability. Although part of this association may reflect shared components between VAI and the MetS definition, its significant associations with elevated FPG and BP suggest a broader relationship with cardiometabolic risk. Prospective studies and external validation are warranted before clinical application.