The visceral adiposity index is a predictor of incident nonalcoholic fatty liver disease: A population-based longitudinal study - 18/05/20

Doi : 10.1016/j.clinre.2019.04.002

Takuro Okamura ^a, Yoshitaka Hashimoto ^a, Masahide Hamaguchi ^a,⁎ , Akihiro Obora ^b, Takao Kojima ^b, Michiaki Fukui ^a
^a Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465, Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
^b Department of Gastroenterology, Asahi University Hospital, Gifu, Japan

^⁎Corresponding author.

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Highlights

•	Visceral adiposity index (VAI), calculated with body mass index, high-density lipoprotein cholesterol, triglyceride and waist circumference, has been suggested as a marker of visceral fat accumulation and dysfunction.
•	We investigate the impact of VAI on incident non-alcoholic fatty liver disease (NAFLD) in this historical cohort study of 8399 (3773 men and 4626 women) participants.
•	During the median 4.5-year follow-up for men and 4.9-year follow-up for women, 1078 participants (737 men and 341 women) developed NAFLD. In Cox proportional hazard models, the hazard ratios of incident NAFLD in the highest quartile (VAI: men, > 1.13; women, > 0.83) were 3.69 (95% confidence interval 2.84–4.86, P < 0.001) in men and 4.93 (1.30–2.33, P < 0.001) in women, compared to the lowest quartile (VAI: men, < 0.44; women, < 0.36).
•	VAI can be a predictor of incident NAFLD.

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Summary

Background and aims

: Visceral adiposity index (VAI), calculated with body mass index, high-density lipoprotein cholesterol, triglyceride and waist circumference, has been proposed as a marker of visceral fat accumulation and dysfunction.

Methods

The impact of VAI on incident nonalcoholic fatty liver disease (NAFLD) in a historical cohort study of 8399 (3773 men and 4626 women) participants. NAFLD was defined as having fatty liver diagnosed by abdominal ultrasonography. We divided the participants into two groups according to sex and into quartiles according to VAI (Q1–4). We calculated VAI using the formulas. Men: VAI = [waist circumference (WC)/39.68 + (1.88 × body mass index [BMI])] × [triglycerides (TG)/1.03] × [1.31/high-density lipoprotein cholesterol (HDL)]; women: VAI = [WC/36.58 + (1.89 × BMI)] × (TG/0.81) × (1.52/HDL). We performed Cox proportional hazard models, adjusting for age, alanine aminotransferase, fasting plasma glucose, systolic blood pressure, alcohol consumption, smoking status and exercise.

Results

During the median 4.5-year follow-up for men and 4.9-year follow-up for women, 1078 participants (737 men and 341 women) developed NAFLD. The 4000 days cumulative incidence rate of NAFLD for men and women were 7.5% and 2.2% in Q1, 14.5% and 4.0% in Q2, 22.3% and 6.7% in Q3 and 33.8% and 16.7% in Q4. The hazard ratios of incident NAFLD in Q4 (VAI: men, > 1.13; women, > 0.83) were 3.69 (95% confidence interval 2.84–4.86, P < 0.001) in men and 4.93 (3.28–7.73, P < 0.001) in women, compared to Q1 (VAI: men, < 0.44; women, < 0.36).