title: Visceral adiposity index (VAI) is predictive of an altered adipokine profile in patients with type 2 diabetes.
abstract: OBJECTIVE
  Although there is still no clear definition of "adipose tissue dysfunction" or ATD, the identification of a clinical marker of altered fat distribution and function may provide the needed tools for early identification of a condition of cardiometabolic risk. Our aim was to evaluate the correlations among various anthropometric indices [BMI, Waist Circumference (WC), Hip Circumference (HC), Waist/Hip ratio (WHR), Body Adiposity Index (BAI) and Visceral adiposity Index (VAI)] and several adipocytokines [Visfatin, Resistin, Leptin, Soluble leptin receptors (sOB-R), Adiponectin, Ghrelin, Adipsin, PAI-1, vascular endothelial growth factor (VEGF), Hepatocyte growth factor (HGF) TNF-α, hs-CRP, IL-6, IL-18] in patients with type 2 diabetes (DM2).
  
  
  METHODS
  Ninety-one DM2 patients (age: 65.25 ± 6.38 years; 42 men and 49 women) in stable treatment for the last six months with metformin in monotherapy (1.5-2 g/day) were cross-sectionally studied. Clinical, anthropometric, and metabolic parameters were evaluated. Serum adipocytokine levels were assayed with Luminex based kits.
  
  
  RESULTS
  At the Pearson's correlation, among all the indices investigated, VAI showed a significant correlation with almost all adipocytokines analyzed [Visfatin, Resistin and hsCRP (all p<0.001); Adiponectin, sOb-R, IL-6, IL-18, HGF (all p<0.010); Ghrelin and VEGF (both p<0.05)]. Through a two-step cluster analysis, 55 patients were identified with the most altered adipocytokine profile (patients with ATD). At a ROC analysis, VAI showed the highest C-statistic [0.767 (95% CI 0.66-0.84)] of all the indices.
  
  
  CONCLUSIONS
  Our study suggests that the VAI, among the most common indexes of adiposity assessment, shows the best correlation with the best known adipocytokines and cardiometabolic risk serum markers. Although to date we are still far from clearly identifying an ATD, the VAI would be an easy tool for clearly mirroring a condition of cardiometabolic risk, in the absence of an overt metabolic syndrome.
authors.affiliation: Dipartimento Biomedico di Medicina Interna e Specialistica (Di.Bi.M.I.S.), Section of Endocrinology, Diabetology and Metabolism, University of Palermo, Palermo, Italy.
authors.forename: Marco C
authors.initials: MC
authors.lastname: Amato
authors.affiliation: Dipartimento Biomedico di Medicina Interna e Specialistica (Di.Bi.M.I.S.), Section of Endocrinology, Diabetology and Metabolism, University of Palermo, Palermo, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Pizzolanti
authors.affiliation: Dipartimento Biomedico di Medicina Interna e Specialistica (Di.Bi.M.I.S.), Section of Endocrinology, Diabetology and Metabolism, University of Palermo, Palermo, Italy.
authors.forename: Vittoria
authors.initials: V
authors.lastname: Torregrossa
authors.affiliation: Dipartimento di Biopatologia e Biotecnologie Mediche e Forensi (Di.Bi.Me.F), Section of Clinical Pathology, University of Palermo, Palermo, Italy.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Misiano
authors.affiliation: Dipartimento di Biopatologia e Biotecnologie Mediche e Forensi (Di.Bi.Me.F), Section of Clinical Pathology, University of Palermo, Palermo, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Milano
authors.affiliation: Dipartimento Biomedico di Medicina Interna e Specialistica (Di.Bi.M.I.S.), Section of Endocrinology, Diabetology and Metabolism, University of Palermo, Palermo, Italy.
authors.forename: Carla
authors.initials: C
authors.lastname: Giordano
mesh_terms: D054392:Adipokines / Q000097:blood* / Q000378:metabolism; D050154:Adiposity; D000368:Aged; D000886:Anthropometry; D016000:Cluster Analysis; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000473:pathology; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000473:pathology*; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D012372:ROC Curve
chemical_list: D054392:Adipokines; D008055:Lipids