Evaluation of Visceral adiposity index as a predictor of metabolic syndrome and insulin resistance among Korean adults

Background/Objectives: The visceral adiposity index (VAI) is an indicator that reflects the distribution of visceral fat and has been associated with increased risk of cardiometabolic disorders. This study aimed to evaluate VAI in predicting metabolic syndrome and insulin resistance among the Korean population. Methods/Statistical analysis: This study was a retrospective cross-sectional study and was performed in 23,356 Korean adults aged >20 years. The criteria for diagnosis of metabolic syndrome were defined according to the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP III). Insulin resistance was diagnosed via a homeostasis model assessment of insulin sensitivity (HOMA-IR) and was determined as a HOMA-IR value ≥3.0. Furthermore, anthropometric parameters including waist circumference (WC), and waist-to-height ratio (WHtR), body mass index (BMI) were also evaluated. Findings: In both genders, the area under the curve (AUC) for predicting metabolic syndrome was higher for VAI than for other anthropometric and biochemical parameters. The AUC values for VAI were 0.888, 0.859, and 0.932 for all subjects, men, and women, respectively. The optimal cutoff of VAI for predicting metabolic syndrome, which was estimated from the ROC curve, was 1.84 for all subjects. The highest and lowest AUCs for predicting insulin resistance were observed for WHtR and VAI, respectively. The AUC values for VAI were 0.705, 0.659, and 0.778 for all subjects, men, and women, respectively. After controlling for relevant variables, VAI showed a significant correlation with metabolic syndrome and insulin resistance, regardless of anthropometric indices or biochemical metabolic syndrome risk factors. Improvements/Applications: VAI was a stronger predictor of metabolic syndrome in the Korean population, especially in comparison to WC, BMI, and WHtR. However, the ability of VAI to predict insulin resistance was lower than that of WHtR.