Evaluation of Visceral Adiposity Indexes Associated with Atherogenic Plasma Index in Individuals with Type 2 Diabetes

Year 2022, , 54 - 59, 30.04.2022

Sevil Karahan Yılmaz , Fatih Özçiçek , Cuma Mertoğlu , Yusuf Kemal Arslan

https://doi.org/10.18678/dtfd.1055306

Abstract

Aim: This study was aimed to investigate visceral adiposity indicators and the atherogenic index of plasma (AIP) in type 2 diabetes mellitus (T2DM) patients.
Material and Methods: A total of 353 adults aged between 18 and 74 years were included in this study. Bodyweight, height, waist, and hip circumference were measured; fasting blood glucose, HbA1c, and lipid profile (total cholesterol, triglyceride, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol) values were analyzed. Visceral adiposity index (VAI), lipid accumulation product (LAP), body adiposity index (BAI), body shape index (ABSI), body roundness index (BRI), conicity index (CI), and AIP levels were calculated.
Results: The study included 116 (32.9%) males and 237 (67.1%) females, with a mean age of 57.8±11.5 years. AIP z-scores were found to be directly related to T2DM (OR, 5.03; 95% CI: 1.95-13.01), while VAI z-scores were less associated with T2DM (OR, 1.10; 95% CI: 1.03-1.18). According to the ROC curve analysis, although the area under the curve (AUC) is weak to distinguish diabetic patients with VAI, LAP, and AIP, it is statistically significant (p<0.001, AUC: 0.619, cut-off= 5.1, 95% CI: 0.561-0.677; p=0.007, AUC: 0.583, cut-off= 63.2, 95% CI: 0.523-0.642; and p=0.001, AUC: 0.606, cut-off= 0.4, 95% CI: 0.547-0.665, respectively).
Conclusion: VAI, LAP, and AIP are strong predictors of diabetes, AIP is a better predictor of predicting diabetes than VAI and LAP.

Keywords

Atherogenic plasma index, visceral adiposity index, lipid accumulation product, type 2 diabetes

Tip 2 Diyabetli Bireylerde Aterojenik Plazma İndeksi ile İlişkili Visseral Adipozite İndekslerinin Değerlendirilmesi

Abstract

Amaç: Bu çalışmanın amacı tip 2 diyabet (T2DM) hastalarında visseral yağlanma göstergelerini ve aterojenik plazma indeksini (atherogenic index of plasma, AIP) araştırmaktır.
Gereç ve Yöntemler: Bu çalışmaya 18 ve 74 yaşları arası toplam 353 yetişkin birey dahil edildi. Vücut ağırlığı, boy uzunluğu, bel ve kalça çevresi ölçüldü; açlık kan şekeri, HbA1c ve lipid profil (total kolesterol, trigliserit, düşük dansiteli lipoprotein kolesterol ve yüksek dansiteli lipoprotein kolesterol) değerleri analiz edildi. Visseral adipozite indeksi (visceral adiposity index, VAI), lipit birikim ürünü (lipid accumulation product, LAP), vücut adipozite indeksi (body adiposity index, BAI), vücut şekli indeksi (body shape index, ABSI), vücut yuvarlaklık indeksi (body roundness index, BRI), koniklik indeksi (conicity index, CI) ve AIP seviyeleri hesaplandı.
Bulgular: Çalışmaya, yaş ortalaması 57,8±11,5 yıl olan 116 (%32,9) erkek ve 237 (%67,1) kadın dahil edildi. AIP z-skorlarının doğrudan T2DM ile ilişkili olduğu (OR, 5,03; %95 GA: 1,95-13,01), VAI z-skorlarının T2DM ile daha az ilişkili olduğu (OR, 1,10; %95 GA: 1,03-1,18) belirlendi. ROC eğrisi analizine göre, eğri altında kalan alan (area under the curve, AUC) VAI, LAP ve AIP ile diyabetik hastaları ayırt etmekte zayıf olsa da istatistiksel olarak anlamlıdır (sırasıyla p<0,001; AUC: 0,619; kesme değeri= 5,1; %95 GA: 0,561-0,677; p=0,007; AUC: 0,583; kesme değeri= 63,2; %95 GA: 0,523-0,642 ve p=0,001; AUC: 0,606; kesme değeri= 0,4; % 95 GA: 0,547-0,665).
Sonuç: VAI, LAP ve AIP diyabetin güçlü prediktörleridir, AIP diyabeti öngörmede VAI ve LAP’den daha iyi bir prediktördür.

Keywords

Aterojenik plazma indeksi, visseral adipozite indeksi, lipid birikim ürünü, tip 2 diyabet

References

• Zheng Y, Ley SH, Hu FB. Global etiology and epidemiology of type 2 diabetes mellitus and its complications. Nat Rev Endocrinol. 2018;14(2):88-98.
• T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü. Türkiye beslenme ve sağlık araştırması (TBSA). Sağlık Bakanlığı Yayın No: 1132. Ankara:Tiraj; 2019.
• Darroudi S, Fereydouni N, Tayefi M, Ahmadnezhad M, Zamani P, Tayefi B, et al. Oxidative stress and inflammation, two features associated with a high percentage body fat, and that may lead to diabetes mellitus and metabolic syndrome. BioFactors. 2019;45(1):35-42.
• Han TS, Al-Gindan YY, Govan L, Hankey JR, Lean MEJ. Associations of BMI, waist circumference, body fat, and skeletal muscle with type 2 diabetes in adults. Acta Diabetol. 2019;56(8):947-54.
• West-Eberhard MJ. Nutrition, the visceral immune system, and the evolutionary origins of pathogenic obesity. Proc Natl Acad Sci USA. 2019;116(3):723-31.
• Sam S. Differential effect of subcutaneous abdominal and visceral adipose tissue on cardiometabolic risk. Horm Mol Biol Clin Investig. 2018;33(1).
• Lee SW, Son JY, Kim JM, Hwang SS, Han JS, Heo NJ. Body fat distribution is more predictive of all-cause mortality than overall adiposity. Diabetes Obes Metab. 2018;20(1):141-7.
• Marcadenti A, Fuchs FD, Moreira LB, Gus M, Fuchs SC. Adiposity phenotypes are associated with type-2 diabetes: LAP index, body adiposity index, and neck circumference. Atherosclerosis. 2017;266:145-50.
• Javed A, Jumean M, Murad MH, Okorodudu D, Kumar S, Somers VK, et al. Diagnostic performance of body mass index to identify obesity as defined by body adiposity in children and adolescents: a systematic review and meta-analysis. Pediatr Obes. 2015;10(3):234-44.
• Fang H, Berg E, Cheng X, Shen W. How to best assess abdominal obesity. Curr Opin Clin Nutr Metab Care. 2018;21(5):360-5.
• Omura-Ohata Y, Son C, Makino H, Koezoka R, Tochiya M, Tamanaha T, et al. Efficacy of visceral fat estimation by dual bioelectrical impedance analysis in detecting cardiovascular risk factors in patients with type 2 diabetes. Cardiovasc Diabetol. 2019;18(1):137.
• Bertoli S, Leone A, Krakauer NY, Bedogni G, Vanzulli A, Redaelli VI, et al. Association of body shape index (ABSI) with cardio-metabolic risk factors: a cross-sectional study of 6081 Caucasian adults. PLoS One. 2017;12(9):e0185013.
• Sözmen K, Ünal B, Sakarya S, Dinç G, Yardım N, Keskinkılıç B, et al. Association of anthropometric measurement methods with cardiovascular disease risk in Turkey. Dicle Med J. 2016;43(1):99-106.
• Zhu XW, Deng FY, Lei SF. Meta-analysis of the atherogenic index of plasma and other lipid parameters in relation to risk of type 2 diabetes mellitus. Prim Care Diabetes. 2015;9(1):60-7.
• Küçükerdönmez Ö, Karaçil Ermumcu MŞ, Seçkiner S, Köksal E. Evaluation of abdominal obesity/adiposity and atherogenic predictors in individuals with type 2 diabetes. Bes Diy Derg. 2018;46(1):7-15.
• Alkhalaqi A, Al-Naimi F, Qassmi R, Shi Z, Ganji V, Salih R, et al. Visceral adiposity index is a better predictor of type 2 diabetes than body mass index in Qatari population. Medicine (Baltimore). 2020;99:35(e21327).
• Liu J, Fan D, Wang X, Yin F. Association of two novel adiposity indicators with visceral fat area in type 2 diabetic patients: Novel adiposity indexes for type 2 diabetes. Medicine (Baltimore). 2020;99(19):e20046.
• Tian T, Pei H, Chen Z, Hailili G, Wang S, Sun Y, et al. Comparison of lipid accumulation product and body mass index as indicators of diabetes diagnosis among 215,651 Chinese adults. Peer J. 2020;8:e8483.
• Pekcan G. Beslenme durumunun saptanması. In: Baysal A, Aksoy M, Besler HT, editors. Diyet el kitabı. 7th ed. Ankara: Hatiboğlu; 2013.
• Golabi S, Ajloo S, Maghsoudi F, Adelipour M, Naghashpour M. Associations between traditional and non-traditional anthropometric indices and cardiometabolic risk factors among inpatients with type 2 diabetes mellitus: a cross-sectional study. Int J Med Res. 2021;49(10):3000605211049960.
• Li X, Li HY, Yu ZW, Zhang YT, Tong XW, Gao XY. Association among lipid accumulation product, Chinese visceral obesity index and diabetic retinopathy in patients with type 2 diabetes: a cross-sectional study. Diabetes Metab Syndr Obes. 2021;14:4971-9.
• Shu L, Zhao Y, Shen Y, Jia L, Zhang J. Interaction analysis of lipid accumulation product and family history of diabetes on impaired fasting glucose and diabetes risk in population with normotension in Eastern China: a community-based cross-sectional survey. Research Square. 2022. doi: 10.21203/rs.3.rs-226460/v2
• Fu L, Zhou Y, Sun J, Zhu Z, Xing Z, Zhou S, et al. Atherogenic index of plasma is associated with major adverse cardiovascular events in patients with type 2 diabetes mellitus. Cardiovasc Diabetol. 2021;20(1):201.
• Oh JY, Sung YA, Lee HJ. The visceral adiposity index as a predictor of insulin resistance in young women with polycystic ovary syndrome. Obesity (Silver Spring). 2013;21(8):1690-4.
• Silva NF, Pinho CPS, Diniz AS, Arruda IKG, Leão APD, Rodrigues IG. The applicability of the visceral adiposity index (VAI) for predicting visceral fat. Rev Bras Cineantropom Desempenho Hum. 2022;24:e83146.
• Ahn N, Baumeister SE, Amann U, Rathmann W, Peters A, Huth C, et al. Visceral adiposity index (VAI), lipid accumulation product (LAP), and product of triglycerides and glucose (TyG) to discriminate prediabetes and diabetes. Sci Rep. 2019;9(1):9693.
• Elizalde-Barrera CI, Rubio-Guerra AF, Lozano-Nuevo JJ, Olvera-Gomez JL. Triglycerides and waist to height ratio are more accurate than visceral adiposity and body adiposity index to predict impaired fasting glucose. Diabetes Res Clin Pract. 2019;153:49-54.
• Khan HS. The lipid accumulation product is better than BMI for identifying diabetes. Diabetes Care. 2006;29(1):151-3.
• Gârgavu SR, Clenciu D, Roșu MM, Țenea Cojan TȘ, Costache A, Vladu IM, et al. Visceral adiposity index (VAI) - a potential marker of cardiometabolic risk. Arch Balk Med Union. 2018;53(2):246-51.
• Pekgor S, Duran C, Eryılmaz MA, Berberoglu B. The comparision of visceral adiposity index and atherogenic index of plasma in overweight and obese patients. Acta Medica Mediterr. 2020;36(2):813-19.
• Abolnezhadian F, Hosseini SA, Alipour M, Zakerkish M, Cheraghian B, Ghandil P, et al. Association metabolic obesity phenotypes with cardiometabolic index, atherogenic index of plasma and novel anthropometric indices: A link of FTO-rs9939609 polymorphism. Vasc Health Risk Manag. 2020;16:249-56.
• Sayın S, Kutlu R, Koçak A. The relationship between atherogenic index of plasma and major risk factors of cardiovascular disease in obese and non-obese individuals. Eur J Res. 2019;5(4):678-85.
• Shen SW, Lu Y, Li F, Yang CJ, Feng YB, Li HW, et al. Atherogenic index of plasma is an effective index for estimating abdominal obesity. Lipids Health Dis. 2018;17(1):11.
• Phapale YS, Badade ZG, Kaul SK, Rai S. Assessment of atherogenic indices in type 2 diabetes mellitus. J Clin Diagn Res. 2019;13(12):BC10-3.
• Rawat S, Kumar S, Arora M, Iqbal S, Batra J, Sharma S, et al. Assessment of atherogenic index of plasma, non-HDL cholesterol and other cardiac indices as risk factors for CVD in type II diabetes. Int J Health Clin Res. 2020;3(5):137-41.
• Randrianarisoa E, Lehn-Stefan A, Hieronimus A, Rietig R, Fritsche A, Machann J, et al. Visceral adiposity index as an independent marker of subclinical atherosclerosis in individuals prone to diabetes mellitus. J Atheroscler Thromb. 2019;26(9):821-34.
• Atalay H, Böyük B, Değirmencioğlu Ş, Güzel S, Çelebi A, Ekizoğlu i. Effect of the atherogenic index of plasma on microvascular complications associated with type 2 diabetes mellitus. Istanbul Med J. 2015;16(3):111-5.
• Gebreyesus HA, Abreha GF, Besherae SD, Abera MA, Weldegerima AH, Gidey AH, et al. High atherogenic risk concomitant with elevated HbA1c among persons with type 2 diabetes mellitus in North Ethiopia. PLoS One. 2022;17(2):e0262610.