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The application of visceral adiposity index in identifying type 2 diabetes risks based on a prospective cohort in China

Chen Chen12, Yan Xu3, Zhi-rong Guo4, Jie Yang2, Ming Wu126* and Xiao-shu Hu156*

Author Affiliations

1 School of Public Health, Southeast University, Nanjing, Jiangsu 210009, China

2 Department of Chronic Diseases Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China

3 Department of Immune Planning, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China

4 School of Public Health, Soochow University, Suzhou, Jiangsu 215123, China

5 Jiangsu Food and Drug Administration, Nanjing, Jiangsu 210009, China

6 Jiangsu Provincial Center for Disease Control and Prevention, No. 172, Jiangsu Road, Nanjing 210009, China

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Lipids in Health and Disease 2014, 13:108  doi:10.1186/1476-511X-13-108

Published: 8 July 2014



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).


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.


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.


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.

Diabetes; Visceral adiposity index; Body mass index; Waist circumference; Waist-to-height ratio