Applicability of visceral adiposity index in predicting metabolic syndrome in adults with obstructive sleep apnea: a cross-sectional study

Abstract

BackgroundObstructive sleep apnea (OSA) is severely affected by visceral adiposity (VA) that correlates to another disorder—metabolic syndrome (MetS). However, little is known concerning the relation of visceral adiposity index (VAI)—a novel and simple indicator of VA, with OSA and MetS. The objective of the study was to analyze the association of VAI with both disorders and applicability to identify OSA patients at risk of MetS.MethodsConsecutive individuals undergoing polysomnography and biochemical tests were enrolled, and differences in all subjects grouped by apnea-hypopnea index (AHI) were analyzed. Spearman correlation was performed for assessing the relationship between VAI, OSA-related indices and metabolic score—total number of the positive diagnostic criteria of MetS. Receiver operating characteristic (ROC) curve was conducted to obtain a cut-off value of VAI for predicting incident MetS by sex. Then, the risk of MetS in OSA patients according to the cut-offs was attained by logistic regression.ResultsA total of 411 individuals were enrolled. Of whom, 361 subjects were diagnosed OSA (mild in 67 patients, moderate in 89 and severe in 205, respectively). A significant increasing trend based on AHI was observed in the variables of blood pressure, triglycerides, fasting glucose, incident MetS, metabolic score and VAI (all p < 0.05). Irrespective of gender, VAI was all significantly correlated with PSG characteristics as AHI, mean nocturnal oxygen saturation, the lowest oxygen saturation, metabolic score(all p < 0.05). A VAI of 2.282, 2.105, 2.511 (for all subjects, males and females, separately) were calculated to determine the occurrence of MetS. According to the cut-offs, OSA patients tended to suffer from greater risk in MetS (odds ratio [OR] = 10.237, p = 0.000; OR = 13.556, p = 0.000; OR = 21.458, p = 0.000).ConclusionsThe present study suggested that VAI was significantly associated with MetS and OSA. As a simple and alternative approach obtained in everyday practice, it may offer a powerful tool to identify patients with OSA at risk of MetS.

Clinical surrogate markers for predicting metabolic syndrome in middle‐aged and elderly Chinese

“…As a good clinical marker of abdominal fat function, VAI was correlated to cardiometabolic diseases. This important relationship between VAI and MetS has been observed in 361 Chinese individuals with obstructive sleep apnea (men: AUC 0.838; women: AUC 0.826). One study from Brazil with 221 older adults suggested that VAI was associated with MetS components.…”

Association between anthropometric indicators of adiposity and hypertension in a Brazilian population: Baependi Heart Study

“…Regarding the VAI, several studies have demonstrated its usefulness in measuring of visceral fat [23,30], prediction of metabolic syndrome [31] and arterial stiffness [32], and as risk marker to cardiometabolic diseases [25,30,33–35,36]. Elisha et al [37], analyzing 99 overweight women in the postmenopausal period, observed that the VAI was a weak predictor to change of visceral fat percentage after a weight loss program for six months.…”

Are visceral adiposity index and lipid accumulation product reliable indices for metabolic disturbances in patients with type 2 diabetes mellitus?

“…The majority of previous studies reported VAI and LAP to be reliable indices in prediction of many metabolic disturbances …”

“…Even though a large number of studies in adult population indicate VAI and LAP as reliable markers of cardiometabolic risk advantageous over BMI and WC, there are another ones that report the opposite …”

“…Furthermore, higher VAI and LAP were associated with metabolic syndrome (MetS), with the presence of DM2, and with chronic kidney disease (CKD), showing even better discriminative power in relation to cardiometabolic risk than anthropometric parameters alone …”