title: The application of visceral adiposity index in identifying type 2 diabetes risks based on a prospective cohort in China.
abstract: BACKGROUND
  Visceral adiposity index (VAI), a novel sex-specific index for visceral fat measurement, has been proposed recently. We evaluate the efficacy of VAI in identifying diabetes risk in Chinese people, and compare the predictive ability between VAI and other body fatness indices, i.e., waist circumference (WC), body mass index (BMI) and waist- to- height ratio (WHtR).
  
  
  METHODS
  Participants (n=3,461) were recruited from an ongoing cohort study in Jiangsu Province, China. Hazard ratio (HR) and corresponding 95% confidence interval (CI) between diabetes risk and different body fatness indices were evaluated by Cox proportional hazard regression model. Receiver operating characteristic (ROC) curve and area under curve (AUC) were applied to compare the ability of identifying diabetes risk between VAI, WC, WHtR and BMI.
  
  
  RESULTS
  A total number of 160 new diabetic cases occurred during the follow-up, with an incidence of 4.6%. Significant positive associations were observed for VAI with blood pressure, fasting plasma glucose, triglyceride, WC, BMI and WHtR. Moreover, increased VAI was observed to be associated with higher diabetes risk with a positive dose-response trend (p for trend<0.001). As compared to individuals with the lowest VAI, those who had the highest VAI were at 2.55-fold risk of diabetes (95% CI: 1.58-4.11). The largest AUC was observed for VAI, following by WC, WHtR and BMI.
  
  
  CONCLUSIONS
  VAI is positively associated with the risk of diabetes. Compared to other indices for body fatness measurements, VAI is a better and convenience surrogate marker for visceral adipose measurement and could be used in identifying the risk of diabetes in large-scale epidemiologic studies.
authors.forename: Chen
authors.initials: C
authors.lastname: Chen
authors.forename: Yan
authors.initials: Y
authors.lastname: Xu
authors.forename: Zhi-rong
authors.initials: ZR
authors.lastname: Guo
authors.forename: Jie
authors.initials: J
authors.lastname: Yang
authors.affiliation: School of Public Health, Southeast University, Nanjing, Jiangsu 210009, China. jswuming@vip.sina.com.
authors.forename: Ming
authors.initials: M
authors.lastname: Wu
authors.forename: Xiao-shu
authors.initials: XS
authors.lastname: Hu
mesh_terms: D050154:Adiposity; D002681:China; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000209:etiology / Q000473:pathology*; D005260:Female; D006801:Humans; D015994:Incidence; D050152:Intra-Abdominal Fat / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000150:complications / Q000453:epidemiology / Q000473:pathology*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012372:ROC Curve; D012307:Risk Factors; D055105:Waist Circumference