Visceral adiposity index outperforms common anthropometric indices in predicting 10-year diabetes risk:Results from the ATTICA study


Background: Visceral adiposity index (VAI) is a novel marker of visceral adipose tissue accumulation and dysfunction. The study aim was to explore the association of VAI with the 10-year type 2 diabetes mellitus (T2DM) incidence in apparently healthy individuals and compare its T2DM predictive ability against common anthropometric indices. Methods: In 2001 to 2002, the ATTICA study (Greece) recruited a random sample of 1514 and 1528 CVD-free men (18-87 years old) and women (18-89 years old), respectively. Sociodemographic, lifestyle, clinical, and biochemical characteristics of participants were measured at baseline, and the 10-year follow-up was performed during 2011 to 2012. After excluding participants with diabetes at baseline and participants without complete follow-up information regarding diabetes status and/or baseline VAI values, the working sample consisted of 1049 participants. In this sample, the predictive value of baseline VAI value was studied in relation to 10-year diabetes incidence. Results: One hundred thirty-three incident cases of diabetes were documented (10-year incidence: 12.7%). In the fully adjusted model, VAI significantly increased diabetes risk by 22% (OR per 1-unit increase =1.22; 95%CI, 1.09-1.37). Markers of oxidative stress and inflammation were found to, at least partly, mediate this relationship. Also, a moderating effect of menstruation status was revealed among women. VAI showed the highest predictive ability and contributed the most, along with waist-to-height ratio, to the correct classification of participants who developed diabetes. Conclusions: The present findings suggest that VAI may be a useful index for predicting long-term diabetes development and may exhibit better predictive ability to commonly used anthropometric indices.

Publication DOI:
Divisions: College of Health & Life Sciences > Aston Medical School
Additional Information: This is the peer reviewed version of the following article: Koloverou, E, Panagiotakos, DB, Kyrou, I, et al. Visceral Adiposity Index (VAI) outperforms common anthropometric indices in predicting 10‐year diabetes risk: results from the ATTICA study. Diabetes Metab Res Rev. 2019;e3161, which has been published in final form at  This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.
Uncontrolled Keywords: VAI,anthropometric indices,prognostic markers,type 2 diabetes,visceral adiposity index,Internal Medicine,Endocrinology, Diabetes and Metabolism,Endocrinology
Publication ISSN: 1520-7560
Last Modified: 20 May 2024 07:29
Date Deposited: 02 Apr 2019 14:06
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Related URLs: https://onlinel ... .1002/dmrr.3161 (Publisher URL)
http://www.scop ... tnerID=8YFLogxK (Scopus URL)
PURE Output Type: Article
Published Date: 2019-09-01
Published Online Date: 2019-03-25
Accepted Date: 2019-03-21
Authors: Koloverou, E.
Panagiotakos, D.b.
Kyrou, I. (ORCID Profile 0000-0002-6997-3439)
Stefanadis, C.
Chrysohoou, C.
Georgousopoulou, E.n.
Skoumas, I.
Tousoulis, D.
Pitsavos, C.



Version: Accepted Version

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