Department of Public Health, Faculty of Medicine and Dentistry, Palacký University Olomouc, 77515 Olomouc, Czech Republic.
3rd Department of Internal Medicine-Nephrology, Rheumatology and Endocrinology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacký University Olomouc, 77900 Olomouc, Czech Republic.
Medicina (Kaunas). 2019 Aug 29;55(9):545. doi: 10.3390/medicina55090545.
The visceral adiposity index (VAI), estimating visceral adiposity dysfunction through a simple formula, could serve as a useful tool for identifying individuals at higher cardiometabolic risk. Its relationship with insulin resistance (IR), assessed using the homeostasis model assessment of IR (HOMA-IR), and metabolic syndrome (MetS) components remains unclear. The study aimed to investigate the association of VAI with both HOMA-IR and MetS. After undergoing anthropometric and biochemical studies, 783 individuals were divided into three groups according to a number of present MetS components. The VAI cut-offs signaling MetS and HOMA-IR were determined by maximizing the sum of the sensitivity and specificity. Correlation analysis was performed to explore the associations between VAI and other tested parameters. A logistic stepwise regression analysis was applied to identify statistically significant determinants of HOMA-IR. Given the variability of reference values, two thresholds of HOMA-IR were applied, namely 2.0 and 3.8. VAI increased significantly between the groups with a rising number of MetS components. The VAI cut-off for MetS was 2.37, with a sensitivity of 0.86 and a specificity of 0.78. The same cut-off point identified subjects with HOMA-IR = 3.8, with a sensitivity of 0.79 and a specificity of 0.66. The VAI cut-off for HOMA-IR = 2.0 was 1.89, with a sensitivity of 0.74 and a specificity of 0.68. The strongest correlations of VAI were noted with HOMA-IR (r = 0.51) and insulin (r = 0.49), respectively, while the strongest correlation of HOMA-IR was with waist circumference (r = 0.54). Not one of the routine parameters was a significant predictor in the regression analysis. The obtained results show an existing association of VAI with HOMA-IR. The high sensitivity and specificity of the cut-offs may allow the application of VAI in common clinical practice.
内脏脂肪指数（VAI）通过一个简单的公式来估计内脏脂肪功能障碍，可以作为识别更高心血管代谢风险个体的有用工具。其与胰岛素抵抗（IR）的关系，通过使用稳态模型评估的胰岛素抵抗（HOMA-IR）来评估，以及代谢综合征（MetS）成分仍不清楚。本研究旨在探讨 VAI 与 HOMA-IR 和 MetS 的关系。在进行人体测量和生化研究后，783 人根据存在的 MetS 成分数量分为三组。通过最大化敏感性和特异性的总和来确定指示 MetS 和 HOMA-IR 的 VAI 截止值。进行相关分析以探讨 VAI 与其他测试参数之间的关系。应用逻辑逐步回归分析来确定 HOMA-IR 的统计学显著决定因素。鉴于参考值的可变性，应用了两个 HOMA-IR 阈值，即 2.0 和 3.8。VAI 在具有更多 MetS 成分的组之间显着增加。MetS 的 VAI 截止值为 2.37，灵敏度为 0.86，特异性为 0.78。相同的截止值识别出 HOMA-IR = 3.8 的受试者，灵敏度为 0.79，特异性为 0.66。HOMA-IR = 2.0 的 VAI 截止值为 1.89，灵敏度为 0.74，特异性为 0.68。VAI 最强的相关性分别为 HOMA-IR（r = 0.51）和胰岛素（r = 0.49），而 HOMA-IR 的最强相关性为腰围（r = 0.54）。回归分析中没有一个常规参数是显著的预测因子。所得结果表明 VAI 与 HOMA-IR 之间存在关联。截止值的高灵敏度和特异性可能允许在常规临床实践中应用 VAI。
