Visceral Adiposity Index as a Predictor of Chronic Kidney Disease in a Relatively Healthy Population in Taiwan

Abstract

Objectives: Abdominal obesity is an independent risk factor for cardiovascular disease and chronic kidney disease (CKD). Visceral adiposity index (VAI), a simple formula representing visceral adipose dysfunction, has already been proven to have a strong correlation with various cardiometabolic disorders. Limited studies are available regarding the relationship between VAI and renal function decline. Therefore, the purpose of this study was to evaluate the relationship between VAI and renal function and to estimate the risk of chronic kidney disease in a relatively healthy adult population in Taiwan.

Design: The design of the study is retrospective cross-sectional analysis.

Subjects: This study involved 23,570 subjects aged ≥18 years who underwent annual heath checkups between January and December 2013. A multivariate logistic regression model was used to assess the relationship between VAI and CKD. Receiver-operating characteristic curve and Youden index were developed to determine the discrimination power of VAI for metabolic syndrome and CKD.

Intervention: None, observational study.

Main outcome measure: The main outcome measure of this study was CKD.

Results: In our study, the adjusted odds ratio (OR) of abnormal VAI for CKD was 1.5 (95% confidence interval [CI], 1.08-2.08; P = .016) in all subjects. A higher VAI was superior in association with CKD in men than women (OR, 1.62; 95% CI, 1.13-2.32; P = .009 vs. OR, 1.28; 95% CI, 0.66-2.47; P = .469, respectively). The area under the curve for VAI was 0.694 (95% CI, 0.660-0.729; P < .001), and using a Youden index with a cut-off VAI value of 2.96 for CKD discrimination obtained a sensitivity of 67.7% and specificity of 65.1%.

Conclusions: A higher VAI score was associated with increased risks of CKD. VAI would be an applicable tool for early detection of CKD in relatively healthy adults in Taiwan, especially men.