Visceral adiposity index is strongly associated with hyperuricemia independently of metabolic health and obesity phenotypes

Abstract

Visceral adiposity index (VAI) is a novel sex-specific index for visceral adipose function; however the association between VAI and hyperuricemia in China is unknown. We aimed to investigate this association, also whether it was independent of metabolic health and obesity phenotypes. 7632 adult subjects from the China Health and Nutrition Survey 2009 were retained. Subjects were categorized into four obesity phenotypes based on a cross-classification of BMI and metabolic health status by two representative criteria. VAI was the best predictors for hyperuricemia irrespective of obesity phenotypes, with area under curve (AUC) ranging 0.665-0.719. The odd ratio (OR) for hyperuricemia in the highest quartile of the VAI were 6.93 (95% CI 5.79-8.29) after adjusting for age and gender. Following further adjustments for metabolic obesity phenotypes and lifestyle confounders, the ORs were 4.88 (3.92-6.09) and 5.65 (4.68-6.82) according to these two criteria, respectively. A similar significant pattern was still found even after adjustment for blood pressure and other cardiovascular risks. Within each metabolic obesity phenotype, the significant association between VAI and hyperuricemia was consistently evident. In conclusion, the association of the VAI with hyperuricemia was significant, especially this association was independent of metabolic health and obesity phenotypes in the Chinese population.

Figure 1

Prevalence of hyperuricemia according to metabolic health and obesity status (metabolic obesity phenotypes). The metabolic health status was defined by ATP-III and HOMA criteria, respectively; the obesity status was defined by body mass index. Abbreviations: ATP-III, the Adult Treatment Panel-III; HOMA, homeostasis model assessment of insulin resistance; MHNO, metabolically healthy non-obese; MUNO, metabolically unhealthy non-obese; MHO, metabolically healthy obese; and MUO, metabolically unhealthy obese.

Figure 2

Adjusted odds ratios (OR) and 95% confidence intervals (CI) for hyperuricemia risk associated with visceral obesity index within each metabolic obesity phenotype defined by ATP-III criteria. Vertical bars are 95% CIs. The adjusted OR was obtained from Model 3: adjusted for age, sex, urban/rural resident, smoking status, alcohol status, white blood cell, total cholesterol, blood pressure, glucose and hs-CRP. Abbreviations: ATP-III, the Adult Treatment Panel-III; MHNO, metabolically healthy non-obese; MUNO, metabolically unhealthy non-obese; MHO, metabolically healthy obese; and MUO, metabolically unhealthy obese.

Figure 3

Adjusted odds ratios (OR) and 95% confidence intervals (CI) for hyperuricemia risk associated with visceral obesity index within each metabolic obesity phenotype defined by HOMA criteria. Vertical bars are 95% CIs. The adjusted OR was obtained from Model 3: adjusted for age, sex, urban/rural resident, smoking status, alcohol status, white blood cell, total cholesterol, blood pressure, glucose and hs-CRP. Abbreviations: HOMA, homeostasis model assessment of insulin resistance; MHNO, metabolically healthy non-obese; MUNO, metabolically unhealthy non-obese; MHO, metabolically healthy obese; and MUO, metabolically unhealthy obese.