Visceral adiposity index outperforms common anthropometric indices in predicting 10‐year diabetes risk: Results from the ATTICA study

Background Visceral adiposity index (VAI) is a novel marker of visceral adipose tissue accumulation and dysfunction. The study aim was to explore the association of VAI with the 10‐year type 2 diabetes mellitus (T2DM) incidence in apparently healthy individuals and compare its T2DM predictive ability against common anthropometric indices. Methods In 2001 to 2002, the ATTICA study (Greece) recruited a random sample of 1514 and 1528 CVD‐free men (18‐87 years old) and women (18‐89 years old), respectively. Sociodemographic, lifestyle, clinical, and biochemical characteristics of participants were measured at baseline, and the 10‐year follow‐up was performed during 2011 to 2012. After excluding participants with diabetes at baseline and participants without complete follow‐up information regarding diabetes status and/or baseline VAI values, the working sample consisted of 1049 participants. In this sample, the predictive value of baseline VAI value was studied in relation to 10‐year diabetes incidence. Results One hundred thirty‐three incident cases of diabetes were documented (10‐year incidence: 12.7%). In the fully adjusted model, VAI significantly increased diabetes risk by 22% (OR per 1‐unit increase =1.22; 95%CI, 1.09‐1.37). Markers of oxidative stress and inflammation were found to, at least partly, mediate this relationship. Also, a moderating effect of menstruation status was revealed among women. VAI showed the highest predictive ability and contributed the most, along with waist‐to‐height ratio, to the correct classification of participants who developed diabetes. Conclusions The present findings suggest that VAI may be a useful index for predicting long‐term diabetes development and may exhibit better predictive ability to commonly used anthropometric indices.