IOS Research Spotlight: Visceral Adiposity Index (VAI) Shows Non-Linear Link to Prediabetes and Diabetes Risk, Revealing Critical Threshold

FOR IMMEDIATE RELEASE

International Obesity Society (IOS) – A new study by IOS members, published in Frontiers in Endocrinology, provides crucial insights into the complex relationship between visceral fat and dysglycemia. The research, analyzing data from over 24,000 U.S. adults, reveals a significant and non-linear association between the Visceral Adiposity Index (VAI) and the combined risk of prediabetes and diabetes, identifying a specific threshold where risk escalates more sharply.

Addressing a Global Metabolic Challenge

Diabetes and its precursor, prediabetes, represent a massive and growing global health burden, with projections indicating over 1.3 billion people could be living with diabetes by 2050. Prediabetes is a critical window for intervention, as it significantly increases the risk of progressing to full-blown diabetes and associated complications like cardiovascular and kidney disease. Visceral fat accumulation is a key driver of metabolic dysfunction, but precise, accessible measurement tools are needed for large-scale risk assessment.

Study Design and Key Findings

The research team, led by Lan Huang and corresponding author Yue Wen from West China Hospital, Sichuan University, China, utilized data from the National Health and Nutrition Examination Survey (NHANES, 1999-2018). They investigated the link between VAI—a simple metric calculated from waist circumference, BMI, triglycerides, and HDL cholesterol—and dysglycemic states.

The analysis yielded several pivotal findings:

1. Strong Positive Association: A clear, dose-response relationship was observed. Compared to individuals in the lowest VAI quartile, those in the highest quartile had a2.8 times higher odds of having prediabetes or diabetes, even after adjusting for numerous confounders including age, gender, lifestyle, and comorbidities.

   
   

2. Non-Linear Relationship and Critical Threshold: The study uncovered a non-linear, threshold effect. The association between VAI and dysglycemia risk was not a straight line. An inflection point was identified at aVAI of 2.10. Below this point, each unit increase in VAI was associated with a sharper rise in risk (Odds Ratio: 2.47). Above 2.10, the risk continued to increase but at a relatively slower rate (OR: 1.57).

   
   

3. Consistency Across Subgroups: This positive association held true across various population subgroups stratified by gender, age, smoking status, alcohol consumption, and hypertension, indicating the robustness of VAI as a risk indicator.

Clinical and Public Health Implications

"This research underscores the value of VAI as a practical, non-invasive tool for early risk stratification," commented the authors. "The identification of a specific threshold at VAI=2.10 is particularly significant. It provides a potential target for clinical monitoring and public health initiatives, suggesting that maintaining a VAI below this level could be a key strategy for diabetes prevention."

The findings highlight that:

• VAI is a strong, independent marker for the risk of both prediabetes and diabetes.

  
  

• Early intervention targeting visceral fat reduction is crucial, especially for individuals approaching or exceeding the VAI threshold of 2.10.

  
  

• This simple index, derived from routine clinical measurements, can be easily integrated into primary care and health screenings to identify high-risk individuals before glucose metabolism severely deteriorates.

Conclusion and Future Directions

This study, led by IOS members, advances our understanding of the visceral fat-dysglycemia link by quantifying its non-linear nature. It strengthens the evidence for using VAI in preventive cardiometabolic medicine. The authors call for further prospective studies to validate this threshold in diverse populations and to explore whether interventions that lower VAI effectively reduce the incidence of diabetes.

Read the Full Study:

The open-access article, "The non-linear relationship between the visceral adiposity index and the risk of prediabetes and diabetes," is available in Frontiers in Endocrinology: https://doi.org/10.3389/fendo.2025.1407873

About the International Obesity Society (IOS):

The IOS is a global organization dedicated to creating a collaborative research ecosystem, promoting excellence in integrated patient care, and defining the future of obesity treatment through innovation and education. We connect experts worldwide to translate scientific discovery into improved outcomes for people living with obesity and its related metabolic conditions.