Liang Xiaomin, Xing Zemao, Li Ying, Gui Shuiqing, Hu Haofei
Department of Critical Care Medicine, Shenzhen Second People's Hospital, Shenzhen, Guangdong, China.
Department of Nephrology, Shenzhen Second People's Hospital, Shenzhen, Guangdong, China.
Front Endocrinol (Lausanne). 2024 Dec 4;15:1441878. doi: 10.3389/fendo.2024.1441878. eCollection 2024.
Previous studies have identified a positive link between the visceral adiposity index (VAI) and diabetes in specific populations. Our investigation focused on examining this association in normoglycemic adults in Japan.
A cohort study of NAGALA (NAfld in the Gifu Area Longitudinal Analysis) was undertaken from 2004 to 2015 in Japan. The link between VAI and diabetes was evaluated using multivariate Cox proportional hazards regression and restricted cubic spline (RCS) regression models. Receiver operating characteristic (ROC) curve analysis was performed to assess the predictive value of the VAI for incident diabetes.
Our study included 15,452 participants, with 8,418 men (54.48%) and 7,034 women (45.52%). The average age was 43.71 ± 8.90, and 373 participants (2.41%) developed diabetes. VAI was positively related to diabetes (HR=1.13, 95% CI 1.08-1.18). The inflection point of the non-linear relationship was observed at a VAI value of 4.67. For the VAI values up to 4.67, one unit increase in the VAI related to a 24% increase in new-onset diabetes (HR=1.24, 95% CI 1.12-1.37, p<0.0001). Subgroup analysis detected a more robust relationship in women (HR=1.40, 95% CI 1.14-1.70, p=0.0010). ROC analysis indicated that VAI, with an AUC of 0.7479 (95% CI: 0.7237-0.7720), had good predictive power.
Our cohort study validated the positive and non-linear relationship between the VAI and diabetes in normoglycemic adults in Japan. The relevance was more marked in women than in men. For those with a VAI below 4.67, a further reduction in the VAI could potentially lead to a significant decrease in diabetes risk.
既往研究已确定在内脏脂肪指数（VAI）与特定人群的糖尿病之间存在正相关。我们的调查重点是在日本血糖正常的成年人中研究这种关联。
2004年至2015年在日本开展了一项NAGALA（岐阜地区非酒精性脂肪性肝病纵向分析）队列研究。使用多变量Cox比例风险回归和受限立方样条（RCS）回归模型评估VAI与糖尿病之间的关联。进行受试者工作特征（ROC）曲线分析以评估VAI对新发糖尿病的预测价值。
我们的研究纳入了15452名参与者，其中男性8418名（54.48%），女性7034名（45.52%）。平均年龄为43.71±8.90岁，373名参与者（2.41%）患糖尿病。VAI与糖尿病呈正相关（HR=1.13，95%CI 1.08-1.18）。非线性关系的拐点出现在VAI值为4.67时。对于VAI值高达4.67的情况，VAI每增加一个单位，新发糖尿病的风险增加24%（HR=1.24，95%CI 1.12-1.37，p<0.0001）。亚组分析发现女性中的关联更强（HR=1.40，95%CI 1.14-1.70，p=0.0010）。ROC分析表明，VAI的曲线下面积（AUC）为0.7479（95%CI：0.7237-0.7720），具有良好的预测能力。
我们的队列研究证实了在日本血糖正常的成年人中VAI与糖尿病之间存在正相关且为非线性关系。这种相关性在女性中比在男性中更明显。对于VAI低于4.67的人群，进一步降低VAI可能会显著降低糖尿病风险。
