Yu Sung Ryul, Shin Kyung-A
Department of Clinical Laboratory Science, Semyung University, Jaecheon, Republic of Korea.
Department of Clinical Laboratory Science, Shinsung University, Dangjin, Republic of Korea.
Diabetes Metab Syndr Obes. 2023 Feb 17;16:495-504. doi: 10.2147/DMSO.S397043. eCollection 2023.
The visceral adiposity index (VAI) and lipid accumulation product (LAP) are useful for assessing visceral obesity. However, these indices were developed for Caucasians, and it is necessary to confirm whether the VAI and LAP are appropriate indicators for identifying obesity phenotypes in Asians. This study investigated whether the VAI and LAP are effective indicators for diagnosing four obesity phenotypes in South Korean adults.
This cross-sectional study enrolled 23,310 adult participants (age ≥20 years) who had undergone a health checkup at a general hospital in Gyeonggi-do, South Korea from January 2017 to December 2020. VAI and LAP were calculated based on the presented mathematical model according to sex. According to the metabolic health status and presence or absence of obesity, the obesity phenotypes were classified into 4 groups: metabolically healthy non-obese (N=14,240, 61.1%), metabolically unhealthy non-obese (N=477, 2.0%), metabolically healthy obese (MHO; N=6796, 29.2%), and metabolically unhealthy obesity (MUO; N=1797, 7.7%).
The receiver operating characteristics curve analysis showed VAI best predicted MUO among the four obesity phenotypes, whereas the LAP showed excellent discriminating ability for the MUO group (area under the curve 0.877, 0.849, and 0.921 and 0.923, 0.907, and 0.954 for all participants, men, and women, respectively). The optimal VAI cutoff values for identifying the MUO group were 1.83 in men and 1.58 in women, and the optimal cutoff values for the LAP were 41.45 in men and 23.83 in women, with a higher value for men. After adjusting for potential confounding factors, the VAI and LAP were associated with an increased risk in the MHO and MUO groups among the obesity phenotypes in both sexes.
In South Korean adults, the VAI and LAP are closely related to the MUO phenotype in both sexes and are effective indices for predicting the MUO phenotype.
内脏脂肪指数（VAI）和脂质蓄积产物（LAP）有助于评估内脏肥胖。然而，这些指标是针对白种人开发的，有必要确认VAI和LAP是否是识别亚洲人肥胖表型的合适指标。本研究调查了VAI和LAP是否是诊断韩国成年人四种肥胖表型的有效指标。
这项横断面研究纳入了2017年1月至2020年12月在韩国京畿道一家综合医院接受健康检查的23310名成年参与者（年龄≥20岁）。根据性别，基于所提供的数学模型计算VAI和LAP。根据代谢健康状况和肥胖与否，将肥胖表型分为4组：代谢健康非肥胖（N = 14240，61.1%）、代谢不健康非肥胖（N = 477，2.0%）、代谢健康肥胖（MHO；N = 6796，29.2%）和代谢不健康肥胖（MUO；N = 1797，7.7%）。
受试者工作特征曲线分析显示，在四种肥胖表型中，VAI对MUO的预测能力最佳，而LAP对MUO组具有出色的区分能力（所有参与者、男性和女性的曲线下面积分别为0.877、0.849和0.921以及0.923、0.907和0.954）。识别MUO组的最佳VAI临界值男性为1.83，女性为1.58，LAP的最佳临界值男性为41.45，女性为23.83，男性的值更高。在调整潜在混杂因素后，VAI和LAP与两性肥胖表型中的MHO和MUO组风险增加相关。
在韩国成年人中，VAI和LAP与两性的MUO表型密切相关，是预测MUO表型的有效指标。
