title: Predictive value of visceral adiposity index for type 2 diabetes mellitus: A 15-year prospective cohort study.
abstract: BACKGROUND
  The emerging term "visceral adiposity index (VAI)" was reported to be closely correlated with glycemic disturbances and diabetes risk. However, whether VAI could predict future type 2 diabetes mellitus (DM) is unknown. Here, we aimed to assess the predictive value of VAI for DM in a Chinese population via a prospective cohort study.
  
  
  METHODS
  This prospective cohort study was conducted based on a 15-year follow-up in a general Chinese population from an urban community. In all, 711 subjects underwent a health examination in 1992, and in 2007 the same examination was repeated. Twenty-four subjects were excluded from the analysis because DM was diagnosed at baseline. Waist circumference (WC), body mass index (BMI), VAI, and cardiovascular risk factors were collected at baseline. Hazard ratios (HRs) for DM incidence were estimated applying Cox proportional hazards models. Paired homogeneity tests were used to explore whether there was a statistical difference between the HRs of VAI and the other two indicators.
  
  
  RESULTS
  In all, 74 individuals developed DM during a follow-up of 15 years. The risk of future DM increased with increasing levels of VAI. After adjusting for confounders, for each SD increment in natural logarithm-transformed VAI, BMI, and WC the HRs were 1.538 (95 % CI: 1.225-1.930), 1.639 (95 % CI: 1.289-2.084) and 1.858 (95 % CI: 1.458-2.369), respectively. However, paired homogeneity tests showed no statistical difference among the HRs.
  
  
  CONCLUSIONS
  VAI could independently predict DM in the Chinese study population, although the predictive power was not higher than that of simple anthropometric measures (BMI and WC). Our study does not support the clinical application of VAI; however, more studies based on different ethnic groups still need to be performed.
authors.affiliation: Department of Cardiovascular Medicine, West China Hospital, Sichuan University, 610041, Chengdu, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Wang
authors.forename: S
authors.initials: S
authors.lastname: He
authors.forename: J
authors.initials: J
authors.lastname: He
authors.forename: S
authors.initials: S
authors.lastname: Wang
authors.forename: K
authors.initials: K
authors.lastname: Liu
authors.forename: X
authors.initials: X
authors.lastname: Chen
mesh_terms: D050154:Adiposity; D000328:Adult; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index