The visceral adiposity index and risk of type 2 diabetes mellitus in China: A national cohort analysis.

AIMS Visceral Adiposity Index (VAI) is a sex-specific index of visceral adiposity based on body mass index, waist circumference, triglycerides and high-density lipoprotein cholesterol. This study aims to demonstrate the association of VAI and its longitudinal transition patterns with type 2 diabetes mellitus (T2DM) in middle-aged and older Chinese. MATERIALS AND METHODS Data from the China Health and Retirement Longitudinal Study (2011, 2013, 2015, and 2018) were analysed. Participants were classified into high- and low-VAI groups at baseline, and subsequently into four transition patterns during follow-up (2011-2015): maintained-high, maintained-low, high-to-low, and low-to-high VAI. Multivariable Cox frailty models with random effects were used to assess the associations of VAI and its transitions with T2DM. RESULTS A total of 7245 participants were analysed, among which 818 developed T2DM by 2018. A positive association between baseline high-VAI levels and T2DM was observed (HR = 1.49, 95% CI: 1.27-1.75). Compared with people with maintained low-VAI pattern during follow-up, those with transition patterns of maintained-high VAI, high-to-low VAI, and low-to-high VAI were at higher risk of T2DM (HR = 1.97, 1.52, and 1.56, respectively, all p < 0.05). The risk of T2DM decreased significantly in the high-to-low VAI group as compared to the maintained-high VAI group (HR = 0.77, 95% CI: 0.60-0.99). CONCLUSIONS This study demonstrated the significant associations of baseline VAI and its transitions with the risk of new-onset T2DM. Early prevention efforts are needed to control the development of T2DM in Chinese with high-VAI levels.