This study aimed to elucidate the correlation of Visceral Adiposity Index (VAI) with prostate cancer (PCa) among men aged 40 years and older in the United States.

Analysis included multivariate linear and logistic regression, smoothing curve fitting, and threshold effect evaluation using 2003-2010 National Health and Nutrition Examination Survey (NHANES) data. The stability of this relationship across demographic groups was assessed via subgroup analyses and interaction tests.

Among 2,768 participants, those with elevated VAI displayed lower total prostate-specific antigen (tPSA) levels and reduced PCa risk. Each VAI unit elevation corresponded to a 0.075 ng/mL tPSA reduction [-0.075 (-0.145, -0.005)] and 18.8% PCa risk reduction [0.812 (0.687, 0.960)]. Top-quartile VAI individuals exhibited 0.282 ng/mL reduced tPSA [-0.282 (-0.557, -0.007)] and 49.7% reduced PCa risk [0.503 (0.282, 0.896)] relative to bottom-quartile counterparts. This inverse relationship was more pronounced in men ≥70 years. Moreover, VAI-tPSA in other races demonstrated a U-shaped pattern, with a 2.09 inflection point. At the same time, a Mexican American subgroup exhibited an inverted U-shape for VAI and PCa risk, with a 1.42 inflection point.

In men aged ≥70, VAI indicates an inverse PCa relationship. However, PSA-based PCa screening may be influenced in visceral-obese individuals aged <70.

Inflammatory changes in perivascular adipose tissue are associated with atherosclerotic lesions in the adjacent artery and can also be used as a marker in patient workup. While adipocyte size is known to be closely related to adipose tissue dysfunction and inflammation, it has not been widely studied in perivascular adipose tissue obtained from healthy human subjects without clinical atherosclerosis. In this cross-sectional study, we addressed this issue by measuring adipocyte size and defining its relationship to cardiovascular risk factors in a healthy cohort of living kidney donors. The presence of cardiovascular risk factors was established by a standardized questionnaire, clinical measurements and body composition analyses. Adipocyte size was measured in the perivascular depot. The proportions of various macrophage subtypes were determined by flow cytometry. To confirm the results, the proportion of CD68  +  macrophages was additionally assessed by immunohistochemistry. A correlation and principal component analyses were performed to explore associations. Adipocyte size in perivascular adipose tissue correlated with markers of lipid metabolism, inflammation, and glucose metabolism. Further, the positive correlation with the pro-inflammatory subpopulation of macrophages suggests a strong local effect of perivascular adipose tissue. Perivascular adipocyte size was associated with cardiovascular risk factors and markers of inflammation in a healthy cohort of living kidney donors. This further supports the local role of adipose tissue dysfunction and inflammation in early atherosclerosis development and detection.

Objective: This review examines the evolution of obesity evaluation methods, from traditional anthropometric indices to advanced imaging techniques, focusing on their clinical utility, limitations, and potential for personalized assessment of visceral adiposity and associated metabolic risks.

Methods: A comprehensive analysis of existing literature was conducted, encompassing anthropometric indices (BMI, WC, WHR, WHtR, NC), lipid-related metrics (LAP, VAI, CVAI, mBMI), and imaging technologies (3D scanning, BIA, ultrasound, DXA, CT, MRI). The study highlights the biological roles of white, brown, and beige adipocytes, emphasizing visceral adipose tissue (VAT) as a critical mediator of metabolic diseases.

Conclusion: Although BMI and other anthropometric measurements are still included in the guidelines, indicators that incorporate lipid metabolism information can more accurately reflect the relationship between metabolic diseases and visceral obesity. At the same time, the use of more modern medical equipment, such as ultrasound, X-rays, and CT scans, allows for a more intuitive assessment of the extent of visceral obesity.

This study aimed to assess whether novel anthropometric indices-Visceral Adiposity Index (VAI), Conicity Index (CI), and Lipid Accumulation Product (LAP)-could predict Cardiovascular Disease (CVD) risk in individuals with Type 2 Diabetes Mellitus (T2DM).

A methodological study was conducted with 371 hospitalized T2DM patients aged 19-64 at Bandırma Education and Research Hospital. Anthropometric measurements, including waist circumference and Body Mass Index (BMI), were used to calculate VAI, CI, and LAP. The 10-year CVD risk was estimated using the Systematic Coronary Risk Estimation (SCORE) model, and Receiver Operating Characteristic (ROC) curves assessed the predictive performance of the indices.

The mean SCORE risk was significantly higher in individuals aged ≥ 65 years (p < 0.001), with 70.4 % classified as high-risk. ROC analysis showed that VAI, CI, and LAP had limited discriminatory ability, with Area Under the Curve (AUC) values of 0.454, 0.563, and 0.468, respectively. No significant correlation was found between these indices and the SCORE model in both age groups.

VAI, CI, and LAP do not adequately predict CVD risk in T2DM patients, suggesting that traditional risk assessment methods may remain more reliable for this population.

Suicidal ideation (SI) poses a significant public health challenge, and understanding its predictors, especially modifiable factors like visceral obesity, is essential for prevention. The purpose of this study is to investigate the association between the visceral adiposity index (VAI) and suicidal ideation (SI) among adults in the United States.

A cross-sectional study using NHANES data from 2005-2018 included adults aged 18 and above with complete SI and VAI data. Suicidal thoughts were evaluated using item 9 from the Patient Health Questionnaire-9 (PHQ-9), while VAI was calculated using gender-specific formulas based on waist circumference, body mass index (BMI), total triglycerides (TG), and high-density lipoproteins (HDL-C). Multivariate logistic regression analysis was implemented after adjusting for several factors to assess the relationship between VAI and SI. Additionally, subgroup analysis and interaction testing were employed to investigate the consistency of this relationship with other demographic parameters.

Our study included a cohort of 15,830 participants, of whom 3.59% exhibited signs of suicidal ideation. Following multivariate logistic regression analysis, we observed a significant positive association between VAI and SI (odds ratio [OR] = 1.03; 95% CI 1.01, 1.04; P = 0.0057), which remained significant after adjusting for various confounding factors. Moreover, utilizing a two-segment linear regression approach, we uncovered a nonlinear relationship between VAI and SI, demonstrating a U-shaped pattern with a critical point at 5.28.

Elevated levels of VAI were consistently associated with an increased probability of SI, and this association remained consistent across various demographic variables. Level of evidence Level V-cross-sectional observational study.

Cardiovascular-kidney-metabolic (CKM) syndrome, a newly defined cluster of interrelated cardiometabolic disorders, poses a global health burden. While physical activity (PA) is a cornerstone of metabolic health, its relationship with early CKM progression remains unclear. This study aims to explore the nonlinear dose-response evidence between PA and early CKM syndrome and highlights the potential PA thresholds to maximise metabolic health benefits, providing theoretical support for personalized PA guidelines.

Using data from the National Health and Nutrition Examination Survey (NHANES) 2007-2018, we analyzed 12,068 participants with early CKM (stages 0-2). Moderate-to-vigorous physical activity (MVPA) was quantified as metabolic equivalent of task (MET)*min/week. Restricted cubic splines, weighted logistic regression, and mediation analyses were employed to assess MVPA-CKM relationships and mediating roles of obesity-related indicators. Subgroup analyses evaluated heterogeneity across demographics and other core covariates.

A L-shaped association between MVPA and early CKM risk was identified (p-non-linear < 0.001). Before the lowest point (6872 MET*min/week), any incremental increase in MVPA was associated with a reduction in early CKM risk, and moderate MVPA (600 - 12,600 MET*min/week) exerts a protective effect. Up to the threshold of 12,600 MET*min/week, MVPA continued to exhibit protective effects. The mediating effect of all the obesity-related indicators was not significant (p > 0.05). Protective effects of moderate PA were consistent across the majority subgroups, whereas an attenuation or even reversal of this protective effect was observed at excessive MVPA levels (> 12,600 MET*min/week), where outcomes statistically indistinguishable from those observed at MVPA levels below 600 MET*min/week.

This study reveals an L-shaped association between MVPA and early CKM risk. The findings highlight the protective effects of moderate MVPA (600 - 12,600 MET*min/week) while demonstrating that higher MVPA (> 12,600 MET*min/week) may attenuate or even reverse these benefits.

To investigate the relationship between four metabolic indices-visceral adiposity index (VAI), lipid accumulation product (LAP), triglyceride glucose (TyG) index, and cholesterol-HDL-glucose (CHG) index-and the presence of diabetic nephropathy (DN) and diabetic retinopathy (DR) in patients with long-standing type 2 diabetes mellitus (T2DM).

This prospective cross-sectional study included 175 T2DM patients with disease duration >10 years who attended an endocrinology outpatient clinic between July 2021 and January 2022. DR was assessed via fundus photography, and DN was defined using the urinary albumin-to-creatinine ratio and eGFR. VAI, LAP, TyG, and CHG indices were calculated using anthropometric and biochemical parameters. Logistic regression was used to identify independent predictors.

The mean age was 60 ± 10.1 years; 63.4% were female. DR and DN were observed in 50.3% and 38.9% of patients, respectively. VAI, LAP, and TyG were significantly higher in patients with DN but not with DR. CHG was elevated in both DN and DR (P < 0.05), and was the only independent predictor of DN (P = 0.005). Notably, CHG was significantly higher in proliferative vs non-proliferative DR (P = 0.009), unlike the other indices.

While VAI, LAP, and TyG were associated only with nephropathy, CHG was linked to both DN and DR. Its integration of glycemic and lipid parameters may offer greater sensitivity for microvascular risk stratification in T2DM.

The study was designed to determine and compare the cardiometabolic risk in premenopausal and postmenopausal women.

Data were collected using cross-sectional and correlational study. In this study, the sociodemographic characteristics, anthropometric measurements, and biochemical parameters of menopausal women were examined.

The average age of menopausal women is higher compared to premenopausal women. Menopausal duration, number of children, daily cigarette consumption, body weight, body mass index (BMI), waist circumference, hip circumference, waist-to-hip ratio, systolic and diastolic blood pressure, fasting blood glucose, hemoglobin, AST (aspartate aminotransferase), and Framingham risk score are higher in menopausal women compared to premenopausal women. Conversely, height, HDL (high-density lipoprotein) level, LDL (low-density lipoprotein) level, TSH (thyroid-stimulating hormone), ALT (alanine aminotransferase), HbA1c (glycated hemoglobin), serum albumin, and visceral adiposity index (VAI) values are lower in menopausal women compared to premenopausal women.

These findings indicate changes in the metabolic profiles of menopausal women. This study could serve as an important resource for assessing the health status of menopausal women and for implementing appropriate measures.

not applicable.

In individuals with type 2 diabetes mellitus (T2DM), impairments in aortic elastic functions due to vascular remodeling and changes in cardiac morphology and function are observed from the time of diagnosis.

This study investigated alterations in aortic elastic functions in newly diagnosed T2DM patients using transthoracic echocardiography (TTE) and explored their association with various body composition parameters.

A total of 273 newly diagnosed diabetic patients (144 females; mean age: 50.7±12.2 years) and 139 control subjects without any detected diseases (90 females; mean age: 47.1±8.5 years) were included in the study. Echocardiographic parameters and aortic elastic properties were evaluated using TTE. Body composition indices, including Body Mass Index, Waist-to-Hip Ratio, Tri-Ponderal Mass Index (TMI), Visceral Adiposity Index, Body Shape Index, Body Roundness Index, Body Adiposity Index, and Cardiometabolic Index were calculated for all participants.

When aortic elastic parameters were evaluated, aortic strain and aortic distensibility were significantly lower in Group 1 compared to Group 2, while the aortic stiffness index was significantly higher in Group 1. Aortic elastic parameters were significantly correlated with most of all body composition indices except for BSI, with the highest correlation observed with TMI (AS; rho=0.490, ASI; rho=0.456, AD; 0.516; p<0.001).

In newly diagnosed T2DM patients, aortic elastic functions are impaired at the time of diagnosis compared to the normal population. Among body composition indices; the most significant association was found with TMI. TMI may be considered a potential screening tool not only for evaluating aortic elastic functions but also for identifying other atherosclerotic processes.

To explore the association between Chinese visceral adiposity index (CVAI) and the risk of nephrolithiasis.

This cross-sectional study analyzed data from 78 438 Chinese adults who underwent ultrasound examinations during health screening at the Health Examination Center of Affiliated Hospital of Yangzhou University. The subjects were divided into quartiles based on CVAI (Q1 group-Q4 group). Multivariate logistic regression models were utilized to evaluate the association between CVAI and nephrolithiasis risk, followed by subgroup analyses to further explore potential relationships. The performance of CVAI in predicting the risk of nephrolithiasis was evaluated using receiver operating characteristic (ROC) curves.

Increased CVAI was significantly associated with a higher risk of nephrolithiasis, with prevalence rising from 3.36% in the Q1 group to 10.67% in the Q4 group (P<0.01). In adjusted models, CVAI was positively correlated with the prevalence rate of nephrolithiasis (OR=1.002, 95%CI: 1.001-1.004, P<0.01). The risks of nephrolithiasis in the Q2, Q3, and Q4 groups were 1.196-fold (95%CI: 1.009-1.010, P<0.01), 1.260-fold (95%CI: 1.109-1.433, P<0.01), and 1.316-fold (95%CI: 1.125-1.539, P<0.01) higher than that in the Q1 group, respectively. Subgroup analysis revealed that CVAI demonstrated positive correlations with the risk of nephrolithiasis in male participants, individuals aged <60 years, the hypertension group, populations with or without diabetes mellitus, and the normal body mass index subgroup. Genders and age had an interaction effect on the correlation between CVAI and the risk of nephrolithiasis development (both P<0.05). The ROC curve analysis demonstrated that CVAI exhibited superior diagnostic efficacy compared to waist circumference, body mass index, visceral adiposity index, weight-adjusted waist index, cardiometabolic index and body shape index, with an area under the curve of 0.622.

In Chinese adults, CVAI is positively associated with the risk of nephrolithiasis development, which may serve as a potential predictive marker for nephrolithiasis.

The menopausal transition is accompanied by metabolic changes in women. This study explores the Chinese visceral adiposity index (CVAI) as a potential indicator of menopausal status to aid in disease prevention.

A cohort of 404 premenopausal Chinese women aged 45 years and above, from the China Health and Retirement Longitudinal Study (CHARLS), was included. CVAI was calculated from the 2011 survey data, menopausal status was collected in the 2018 survey, representing a 7-year longitudinal follow-up. The cross-sectional study cohort from the National Health and Nutrition Examination Survey (NHANES) included 3577 women aged 40-60 with CVAI and self-reported menopausal status from 2003 to 2020. Logistic regression models were estimated the odds ratio (OR) of the menopause data and 95% confidence intervals (CIs).

In the CHARLS cohort, the adjusted OR for menopause in the fourth quartile of CVAI compared to the first quartile was 5.23 (95% CI: 1.59, 17.17; P for trend: 0.005). Additionally, a significant difference in the association between menopausal status and CVAI was found between rural and urban populations (P for interaction = 0.029). Moreover, in the NHANES cohort, the CVAI and the menopausal status were associated after adjustment (OR: 1.02, 95% CI: 1.002, 1.037, P: 0.029). In the stratified analysis, the association of CVAI with the status of menopause was observed among other ethnicities which including Asians (OR: 1.092, 95% CI: 1.012, 1.178, P: 0.025). Finally, a nomogram was developed to facilitate the clinical assessment of menopause based on the CVAI.

The CVAI demonstrated a significant association with the odds of menopausal status in both Chinese and the US populations, suggesting its potential as a correlative marker for menopausal status, but the associational strength may vary by population.

Hypothyroidism increases the risk of cardiovascular disease. In recent years, it has been suggested that the Visceral Adiposity Index (VAI) and the Plasma Atherogenicity Index (PAI) may serve as markers of cardiovascular risk. This study aimed to investigate the potential utility of VAI and PAI as predictors of increased cardiovascular risk in patients with hypothyroidism.

A retrospective analysis was conducted on 134 participants, including 85 hypothyroid patients and 49 individuals with normal thyroid function who visited the Family Medicine Clinic of Konya Training and Research Hospital between March 2016 and June 2017. Sociodemographic characteristics, anthropometric measurements, blood lipid profiles, and thyroid hormone levels were analyzed for all participants. VAI and PAI levels were calculated.

Among the participants, 111 (82.8%) were female, and 23 (17.2%) were male. In the hypothyroid group, triglycerides (TG) (p=0.001), Visceral Adiposity Index (VAI) (p<0.001), and Plasma Atherogenic Index (PAI) (p<0.001) were significantly higher, in contrast high-density lipoprotein (HDL) (p<0.001) was substantially lower than in the control group. Patients were divided into three categories based on PAI levels: low, moderate, and high risk. Compared to the moderate-risk group, the high-risk group had higher weight (p=0.007), BMI (p=0.012), WC (p=0.001), TG (p<0.001), VAI (p<0.001), and PAI (p<0.001), but lower HDL (p<0.001). PAI showed a positive correlation with age, weight, BMI, WC, systolic and diastolic blood pressure, thyroid-stimulating hormone (TSH), TG, total cholesterol, and VAI, and a negative correlation with HDL.

This study demonstrates that cardiovascular risk is increased in hypothyroid patients, VAI and PAI are reliable markers for assessing cardiovascular disease risk in this population. These findings may aid primary care physicians in early identification and management of cardiovascular risk in hypothyroid patients. Limitations include the retrospective design and limited male representation in the sample.

Despite the accumulating evidence from cellular and animal studies, the role of circulating Sestrin2, a stress-inducible antioxidant protein, in human cardiometabolic health remains largely unexplored. Hence, the current study aimed to investigate the association between circulating Sestrin2 and cardiometabolic risk factors in healthy and diabetic individuals.

This cross-sectional study leveraging data and plasma samples from the Qatar Biobank investigated the relationship between plasma Sestrin2 levels and various cardiometabolic indices in 326 healthy and 518 diabetic subjects.

The study found that Sestrin2 levels were significantly lower in diabetic individuals compared to healthy controls (5.49 ng/mL vs 8.25 ng/mL, p < 0.001). In the healthy cohort, higher Sestrin2 levels were associated with a favorable metabolic profile, indicated by lower odd ratios (OR) of high glycated hemoglobin (OR: 0.33), Homeostatic Model Assessment for Insulin Resistance score (OR: 0.58), visceral adiposity index (OR: 0.46), lipid accumulation product (OR: 0.49), atherogenic index of plasma (OR: 0.42) and metabolic syndrome (OR: 0.23). Conversely, in the diabetic cohort, higher Sestrin2 levels were paradoxically linked to increased triglycerides (OR: 1.57), the product of triglyceride glucose and waist circumference (OR: 1.8), body fat (OR: 1.72), waist circumference (OR: 1.82), waist-to-hip ratio (OR: 1.96) and metabolic syndrome (OR: 1.48).

These findings suggest that Sestrin2 may play a complex and context-dependent role in metabolic regulation, potentially serving as a protective factor in healthy individuals but contributing to metabolic dysfunction in the context of established diabetes. Further research is needed to elucidate the underlying mechanisms and implications for targeted interventions.

Existing evidence linking visceral adiposity index (VAI) to osteoarthritis (OA) remains limited and requires further investigation. This study aimed to evaluate the potential relationship between higher VAI scores and an increased risk of OA.

A retrospective cross-sectional analysis was conducted using data from 9,464 participants aged 50 and older, sourced from the 2011 to 2018 National Health and Nutrition Examination Survey (NHANES). The VAI was categorized into three tertiles, with the first tertile (T1) representing the lowest VAI and third tertile (T3) the highest. Weighted logistic regression was employed to examine the association between VAI and OA. To explore potential non-linear relationships, smoothed curve fitting and threshold effect analyses were performed. Subgroup analyses were performed to validate these findings.

The average age of the study population was 63.16 ± 9.05 years, and 47.22% were male. After adjusting for confounding factors, a statistically significant positive correlation was observed between VAI and OA risk (OR = 1.03, 95% CI: 1.01-1.06, P < 0.01). Participants in the highest VAI tertile exhibited a 35% greater likelihood of developing OA compared to those in the lowest tertile (OR = 1.35, 95% CI: 1.06-1.70, P = 0.015). Furthermore, multivariate restricted cubic spline (RCS) regression analysis revealed a non-linear relationship (non-linear P < 0.05) with a threshold effect at a VAI value of 3.9. Subgroup analyses showed no significant interaction effects (all P-values for interaction > 0.05).

This study highlights a significant association between elevated VAI and an increased risk of developing OA in individuals aged 50 and older. These results emphasize the potential of the VAI as a risk factor for OA and warrant further research to explore its role in prevention and management strategies in older populations.

We assessed the associations of visceral adiposity indexes such as Chinese Visceral Adiposity Index (CVAI), Visceral Adiposity Index (VAI), Lipid Accumulation Product (LAP), waist circumference (WC), and waist-hip ratio (WHR) with overall and specific cancer incidence in a Chinese population.

332,297 individuals from the Taiwan MJ cohort (1996-2007) were included. We utilized multivariable Cox proportional hazards models to examine associations of baseline visceral adiposity indexes and cancer incidences. Sex-specific CVAI, VAI, and LAP were calculated, incorporating WC and triglycerides levels. CVAI and VAI also included body mass index and high-density lipoprotein, with CVAI further incorporating age.

Higher CVAI was consistently associated with higher overall cancer incidence, with HRs of 1.45 (95% CI: 1.2-1.76) and 2.03 (95% CI: 1.52-2.72) for males and females, respectively, comparing the fifth quintile to the first. The HRs for WC were 1.27 (95% CI: 1.08-1.49) and 1.19 (95% CI: 1.01-1.40) for males and females, WHR was significantly associated with cancer risk in males (HR:1.28; 95% CI: 1.13-1.45), and LAP was significantly associated with cancer risk in females (HR: 1.25; 95% CI: 1.04-1.5). VAI was not associated with overall cancer incidence.

CVAI is a superior clinical biomarker for predicting cancer incidence in the Chinese population compared to traditional visceral obesity indices.

The visceral adiposity index (VAI) reliably measures body fat distribution and related dysfunctions. However, its association with sleep disorders among US adults remains unclear.

This study analyzed cross-sectional data from the 2005 to 2018 National Health and Nutrition Examination Survey (NHANES) for adults aged 18 and older. We used multivariable logistic regression to evaluate the association between VAI and sleep disorders and applied restricted cubic splines to assess potential non-linear relationships. Additionally, subgroup analyses by gender, age, and race were conducted to explore the VAI-sleep disorder association across different populations.

This study included 14,021 adults aged 18 +. In Model 1, adjusted for gender and age, each unit increase in VAI was associated with a 5% higher risk of sleep disorders (OR = 1.05; 95% CI = 1.02-1.07). In Model 2, which adjusted for all potential confounders, each unit increase in VAI was linked to a 3% higher risk (OR = 1.03; 95% CI = 1.00-1.05). When treating VAI as a categorical variable, those in the highest quartile (Q4) had a 21% higher risk of sleep disorders compared to those in the lowest quartile (Q1) (OR = 1.21; 95% CI 1.03-1.41). Restricted cubic spline analysis revealed a positive linear relationship between VAI and sleep disorder prevalence. Subgroup analysis found stronger associations in males and non-Hispanic white individuals.

While causality cannot be confirmed, this cross-sectional study shows a significant positive linear association between higher VAI and the risk of sleep disorders among U.S. adults.

Polycystic ovary syndrome (PCOS) is associated with an increased risk of cardiovascular diseases (CVD). Plant-based diets are associated with reduced CVD risk factors. This study aimed to explore the associations between dietary phytochemical index (DPI) and asymmetric dimethylarginine (ADMA), lipid profile, atherogenic indices, and other metabolic biomarkers in women with PCOS.

In this cross-sectional study, 150 females aged 18-45 years diagnosed with PCOS were recruited. An interviewer-administered questionnaire was applied to gather the relevant demographic characteristics, detailed clinical information, and lifestyle habits of participants. A validated semi-quantitative food frequency questionnaire was used to assess dietary intake, and DPI was calculated accordingly. We used multiple linear regression to determine the association between serum concentrations of ADMA, total testosterone, sex hormone-binding globulin (SHBG), fasting serum glucose (FSG), insulin, and lipid profile, as well as atherogenic indices across quartiles of DPI.

There was a negative correlation between the DPI and serum levels of ADMA (p-trend = 0.022), triglycerides (TG) (p-trend = 0.003), oxidized low-density lipoprotein cholesterol (ox-LDL) (p-trend = 0.001), insulin (p-trend = 0.045) and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) (p-trend = 0.018). Moreover, there was a tendency for visceral adiposity index (VAI) (p-trend = 0.005) and atherogenic index of plasma (AIP) (p-trend = 0.001) to decrease as the quartile categories of DPI increased. No significant regular trend was found for serum levels of FSG, SHBG, total testosterone, other lipid profiles, and lipid accumulation product (LAP).

These findings suggest that adherence to a phytochemical-rich diet decrease the CVD risk factors in PCOS patients.

Insulin resistance plays a pivotal role in the progression of type 2 diabetes mellitus (T2DM). An in-depth investigation into the role of insulin resistance scores in evaluating T2DM combined with metabolic-associated fatty liver disease (MAFLD) and liver fibrosis holds significant importance for clinical decisions and personalized treatment.

The study screened patients with diabetes from Taizhou Central Hospital from June 2020 to May 2024. In conjunction with the National Health and Nutrition Examination Survey (NHANES) database, various statistical methods such as logistic regression analysis, restricted cubic spline, and receiver operating characteristic curves were employed to complete data analysis.

This study encompassed 3776 patients with T2DM, including 1074 diagnosed with MAFLD. Insulin resistance scores in the MAFLD group were significantly elevated. Compared with nonfibrotic patients, those with T2DM and liver fibrosis exhibited notably higher Chinese visceral adiposity index (CVAI) scores and notably lower triglyceride-glucose index and visceral adiposity index scores; the incidence of hypertension, coronary heart disease, stroke, and peripheral arterial disease were significantly elevated. Among other insulin resistance scores, the CVAI score demonstrated the highest value for correlating with the MAFLD and liver fibrosis in patients with T2DM. The NHANES database, encompassing data from 6763 individuals, validated the aforementioned findings, further affirming that the CVAI score exhibited optimal consistency with the risk of T2DM with MAFLD and liver fibrosis.

The insulin resistance scores were significantly elevated in T2DM combined with MAFLD. The CVAI score demonstrated the best predictive effect on MAFLD and liver fibrosis.

Sexual dysfunction in men and women is an important clinical issue; infection and inflammation can cause social, medical, and psychological problems that have a profound impact on sexual and reproductive health worldwide.

We set out to identify sexual dysfunctions in men and women that arise from infection and inflammation and propose meaningful interventions, as evaluated by the Fifth International Consultation on Sexual Medicine (ICSM) held in June 2024 in Madrid (Spain).

We searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) for published peer-reviewed journal articles and ClinicalTrials.gov and the World Health Organization's (WHO's) International Clinical Trials Registry Platform for prospective trials. This manuscript represents the opinions of 10 experts from 6 countries developed in a consensus process after completing the literature review, which produced a list of recommendations graded as weak or strong. This document was presented for peer review and debate in a public forum, and revisions were made based on the recommendations of chairpersons of the 5th ICSM.

Infections, and in particular sexually transmitted infections (STIs), dramatically affect the sexual and reproductive health of individuals and couples, irrespective of sexual orientation and gender. Similarly, non-communicable chronic diseases (NCDs), through the common pathogenetic mechanism of inflammation, can directly impair the ability to copulate, reproduce, and enjoy sexual life.

This expert consensus recommends prioritizing early detection, comprehensive treatment approaches, and preventive measures to mitigate the effects of infection and inflammation on sexual health, both for the patient and the couple. These insights provide a foundation for improving patient outcomes and fostering global awareness of the interconnections between infection, inflammation, and sexual dysfunction.

The distribution of body fat plays a critical role in the pathogenesis of type 2 diabetes mellitus (T2DM). However, the specific metabolic profiles and biomarkers that distinguish the different obesity phenotypes in T2DM remain to be fully elucidated. Bile acids (BAs), which are recognized as pivotal signaling molecules in the regulation of glucose and lipid metabolism, warrant further investigation to characterize their profiles across different obesity phenotypes. Understanding the clinical significance of these BAs in the management of T2DM is essential and merits thorough exploration.

In this cross-sectional study conducted at the Zhangjiang Community Health Service Center in Shanghai, ninety-nine elderly participants were recruited and categorized into four groups: non-diabetic controls (NC), T2DM with lean phenotype (TN), T2DM with overweight phenotype (TO), and T2DM with abdominal obesity phenotype (TA). Biochemical indices, visceral adiposity indices, and bile acid (BA) profiles were analyzed and compared across the groups.

Healthy individuals exhibited lower triglyceride levels, waist-to-hip ratio (WHR), visceral adiposity index (VAI), and Chinese visceral adiposity index (CVAI), as well as higher HDL-c level and total BA levels compared to T2DM patients. T2DM patients with different obesity phenotypes displayed distinct BA profiles. Specifically, the TN group showed higher levels of conjugated DCA BA species, GDCA, and TDCA, compared to the TO group. These BA species are essential for regulating lipid and glucose metabolism. In contrast, the TA group exhibited higher ratios of 12α-hydroxylated BAs to non 12α-hydroxylated BAs, taurine-conjugated BAs to glycine-conjugated BAs, and higher levels of LCA compared to the TO group. Additionally, CVAI was positively associated with unconjugated SBAs, CA-7S, and DLCA.

These results revealed that T2DM patients with different obesity phenotypes exhibit distinct BA profiles. Specific BAs, particularly GDCA, TDCA, and LCA, are closely associated with adiposity indices and may serve as crucial signaling molecules in modulating visceral adiposity, serum lipid profiles, and glucose homeostasis in obese T2DM patients. These BA species play a pivotal role in the pathogenetic process underlying diabetes and various forms of obesity. Furthermore, their significance highlights their potential contributors to drug development and as therapeutic targets for T2DM patients with specific obesity subtypes.

Background/Objectives: Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly recognized in inflammatory bowel disease (IBD) patients due to chronic inflammation and metabolic disturbances. However, reliable non-invasive biomarkers for MASLD prediction in this population are lacking. This study evaluated the predictive value of metabolic scores and lipid ratios for MASLD onset in IBD patients. Methods: An observational retrospective study was conducted on 358 IBD patients at the "Renato Dulbecco" Teaching Hospital in Catanzaro, Italy, in a period between 1 January 2021 and 31 December 2024. Clinical and laboratory data, including metabolic scores and lipid ratios, were analyzed using the chi-square and Kruskal-Wallis tests as appropriate. Post hoc comparisons were conducted using Dunn's test. Receiver operating characteristic analysis assessed their predictive accuracy for MASLD. p < 0.05 was considered significant. Results: IBD-MASLD patients had a significantly higher body mass index (BMI, 27 ± 4 vs. 22 ± 2 kg/m2; p < 0.001), waist circumference (100 ± 11 vs. 85 ± 4 cm; p < 0.001), other anthropometric parameters, metabolic scores, and lipid ratios than IBD-only patients. The metabolic score for insulin resistance [METS-IR, area under curve (AUC = 0.754)] and waist circumference (AUC = 0.754) exhibited the highest predictive accuracy, followed by the lipid accumulation product (LAP, AUC = 0.737), BMI (AUC = 0.709), and triglyceride/high-density lipoprotein (TG/HDL, AUC = 0.701). Insulin resistance scores, including the homeostasis model assessment of insulin resistance (AUC = 0.680) and triglyceride-glucose index (AUC = 0.674), were of moderate predictive use. The visceral adiposity index (AUC = 0.664) and low-density lipoprotein/high-density lipoprotein (AUC = 0.656) showed lower discriminative ability, while the fibrosis-4 index (AUC = 0.562) had the weakest diagnostic performance. Conclusions: Our findings suggest that MASLD in IBD is primarily driven by cardiometabolic dysfunction. The introduction of the METS-IR, LAP, and TG/HDL into clinical assessments of IBD patients could prove useful in preventing liver and cardiovascular complications in this setting.

The aim of the study was to assess the relationship between anthropometric indices and the concentration of hormonal parameters in relation to problematic Internet use or even addiction. The study was conducted in 2020-2021 on a group of 427 men aged 18-30 (24.82 ± 3.83) who declared that they used the Internet and played computer games and/or online games, including gambling. Participation in the study was voluntary and anonymous. Anthropometric indices, HOMA-IR as well as biochemical and hormonal parameters were calculated. Lipid Accumulation Product (LAP) and Visceral Adiposity Index (VAI) positively correlate with both the moderate (LAP r = 0.41; p = 0.000), (VAI r = 0.043; p = 0.000) and high degree (LAP r = 0.40; p = 0.004), (VAI r = 0.37; p = 0.004) in the IUT. In multivariate logistic regression, a correlation between testosterone (TT) in the anthropometric indices- LAP, VAI and Body Adiposity Index (BAI)-and the moderate and high degrees in the IUT questionnaire is found. Our study highlights the usefulness of anthropometric indices in assessing hormone distribution and glucose metabolism. VAI can be used as a marker for estimating the risk of metabolic disorders. Serotonin, together with LAP and VAI, increases with the degree of Internet use in the IUT questionnaire, which predisposes to cardiovascular problems. Internet addiction is an important independent risk factor for clinicians to use in assessment along with physical activity and psychosocial problems, but they also indicate the risk of fertility problems in increasingly younger men due to hormonal disorders.

Dietary advanced glycation end products (AGEs) have been implicated in promoting insulin resistance. However, their impact on insulin resistance in a mixed population made up of males and females remains controversial. The aim of this study was to evaluate whether the relationship between dietary AGEs and insulin resistance may be sex-dependent.

195 males and 239 females were included in this cross-sectional study. Study participants underwent anthropometric and metabolic assessments. AGE intake was estimated using food frequency questionnaires and databases reporting AGE content in individual food items. The relationship between AGE intake and insulin resistance, estimated using HOMA-IR, was assessed using Pearson correlation test. The predictive power of dietary AGEs towards HOMA-IR was investigated using stepwise linear regression.

AGE intake correlated positively with HOMA-IR in females (p < 0.01) but not in male study participants (p > 0.05). Moreover, AGE intake was able to increase the predictive power of BMI towards insulin resistance in females but not males. Instead, anthropometric variables were the only discriminants able to predict insulin resistance in males.

Dietary AGEs exert a sex-dependent effect on insulin resistance as their intake is associated with and able to predict HOMA-IR in females but not males. This suggests that females may be more susceptible to the deleterious impact of these glycotoxins on insulin sensitivity. Nevertheless, considering this study not involving a nutritional intervention to directly elucidate whether the effect of AGEs on insulin resistance is sex-dependent, further studies are warranted to confirm the present findings.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a significant cause of chronic liver disease globally, and the rising prevalence of MASLD is occurring in parallel with the global aging population. The use of non-invasive biomarker tools to rule-in or rule-out hepatic steatosis is important in large epidemiological studies in this field. While the Fatty Liver Index (FLI) is the best validated tool in older adults, not all studies will have the necessary parameters for steatosis identification. This retrospective post-hoc analysis of the ASPirin in Reducing Events in the Elderly (ASPREE) study involved 16,703 Australian adults aged ≥70 years. Using the FLI as the 'gold standard' index, we evaluated the correlation with other indices: the Dallas Steatosis Index (DSI), Framingham Steatosis Index, ZJU index (ZJU), Hepatic Steatosis Index (HSI), Lipid Accumulation Product (LAP), and Visceral Adiposity Index (VAI), as well as age- and sex-adjusted outcome measures including mortality, major adverse cardiovascular events (MACE), atrial fibrillation (AF), and persistent physical disability. Of the non-FLI indices, the DSI and FSI had the highest percentage of participants correctly classified as having MASLD (97.7% and 93.8% respectively). The FSI, LAP, and VAI were associated with MACE. The FSI and FLI were predictive of incident AF. The FLI, DSI, FSI, LAP and VAI were associated with physical disability. No MASLD score was associated with increased mortality. Indeed, MASLD defined by the ZJU and HSI were both inversely associated with mortality. As such, we've demonstrated that the FSI and DSI are the most accurate scores for identifying MASLD in older adults when compared to the FLI as the gold standard. The FSI is associated with MACE, AF, and persistent physical disability, lending support to its use in identifying older persons with MASLD when the FLI is unable to be calculated.

This study compares the association of eight insulin resistance (IR)-related markers (triglyceride-glucose index (TyG), TyG-body mass index (TyG-BMI), TyG-waist circumference (TyG-WC), TyG-waist-to-height ratio (TyG-WHtR), triglycerides-to-high-density lipoprotein cholesterol ratio (TG/HDL), lipid accumulation product (LAP), visceral adiposity index (VAI), and estimated glucose disposal rate (eGDR)) with cardiovascular disease (CVD).

Spearman's coefficients were used for correlations between IR-related markers. Predictive capacities were evaluated using receiver operating characteristic (ROC) curve analysis, Akaike Information Criterion, and Bayesian Information Criterion were calculated. Multivariable-adjusted Cox regression models and restricted cubic spline (RCS) analysis were performed to explore associations between IR-related markers and CVD.

In Pearson correlation analysis, TyG-WC and TyG-WHtR had a correlation coefficient of 0.95, while TG/HDL ratio and VAI had a correlation coefficient of 0.97. Regarding predictive capacity across different glycemic states, eGDR showed the best performance among the 8 IR-related markers, particularly in predicting stroke. According to Cox regression analysis, with each unit increase in TyG, TyG-BMI, TyG-WC, and TyG-WHtR, the risk of heart disease increased by 24.1%, 0.4%, 0.1%, and 17.56%, respectively; and the risk of stroke increased by 69.3%, 0.6%, 0.2%, and 36.5%, respectively. Additionally, TG/HDL ratio, VAI, and LAP exhibited nonlinear associations with heart disease and stroke risk. For each unit increase in eGDR, the risks of heart disease and stroke decreased by 21% and 14.2%, respectively.

eGDR is the most effective marker for predicting CVD, especially stroke, across all glycemic states. Modified TyG indices provide better predictive value than TyG alone.

Visceral adiposity index (VAI) vividly reflects body fat distribution through comprehensively integrating body mass index, sex, waist circumference, triglycerides, and high-density lipoprotein cholesterol. While VAI is an established predictor of various clinical outcomes, its relationship with premature mortality and life expectancy remains unclear.

To explore the association between VAI and premature mortality or life expectancy in a nationally representative cohort of US adults.

This study included adults who participated in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018, linked to the National Death Index through December 31, 2019. Data were analyzed from August to October, 2024. VAI was categorized into quartiles from the lowest Q1 to the highest Q4. Primary endpoints were premature mortality (death before 80 years of age) and life expectancy.

A total of 43,672 participants (women: 22,164; men: 21,508) aged > 20 years were included. Over a median follow-up of 9.2 years (IQR: 4.9-13.8), 3,187 premature deaths were documented. Higher VAI quartiles were significantly associated with increased multi-adjusted premature mortality risk compared to Q1 (Q3 vs. Q1: hazard ratio [HR], 95% confidence interval [CI]: 1.30, 1.05 to 1.61; Q4 vs. Q1: 1.68, 1.34 to 2.11). This association was particularly pronounced in women (Q3 vs. Q1: 1.53, 1.01 to 2.30; Q4 vs. Q1: 2.36, 1.52 to 3.68), with significant linear trends (P < 0.001). Estimated life expectancy at age 40 years was 41.45 (95% CI: 41.24 to 41.66), 41.32 (41.11 to 41.53), 40.55 (40.35 to 40.75), and 39.26 (39.08 to 39.45) years in Q1, Q2, Q3, and Q4 of VAI, respectively. By sex, estimated life expectancy at age 40 in Q4 was reduced by 3.33 years in women and 1.24 years in men, compared to Q1. By race and ethnicity, it was shortened by 3.90 years in Black participants and 1.68 years in White participants in Q4 group, compared to Q1.

In this nationwide cohort study, higher VAI was significantly associated with an increased risk of premature mortality and reduced life expectancy at age 40 among US adults. These associations we heterogeneous by sex, race and ethnicity, more pronounced in women and Black participants.

Objective: Various insulin resistance (IR) indices have been developed to assess cardiovascular (CVS) risk. We compared the association between ten IR indices and cardiac, renal, and vascular end-organ measures in a predominantly young (age 45.0 ± 18.3 years) South African Black population. Methods: We assessed the relationships between ten IR indices (homeostatic model assessment for IR [HOMA-IR], quantitative insulin sensitivity check index [QUICKI], metabolic score for IR [METS-IR], triglyceride-glucose index [TyG], TyG-body mass index [TyG-BMI], TyG-waist circumference [TyG-WC], TyG-waist-to-height ratio [TyG-WHtR], triglyceride to high-density cholesterol concentration [TyG-HDL], lipid accumulation product [LAP], visceral adiposity index [VAI]) and end-organ measures in 779 community participants of African ancestry. Results: HOMA-IR and QUICKI were the only IR indices consistently associated with end-organ measures (left ventricular [LV] mass index, p ≤ 0.005; LV relative wall thickness, p < 0.0001; early-to-late mitral velocity, p ≤ 0.01; E/e', p ≤ 0.002; e', p < 0.0001; pulse wave velocity, p = 0.036 (HOMA-IR only); glomerular filtration rate [GFR], p < 0.0001), independent of confounders. Furthermore, HOMA-IR was consistently higher, and QUICKI lower, in those with compared to those without end-organ damage (LV hypertrophy [p ≤ 0.03], concentric LV [p < 0.03], and reduced GFR [p ≤ 0.008]), independent of confounders. Importantly, the associations between HOMA-IR or QUICKI and end-organ measures were independent of additional CVS risk factors, including adiposity measures, and were replicated in the participants without diabetes mellitus (n = 669) and in the participants without high blood pressure (n = 505). Conclusions: In a predominantly young community of African ancestry, of ten recommended IR indices, only HOMA-IR and QUICKI were consistently associated with end-organ damage independent of CVS risk factors.

Consuming functional foods alongside the energy-restricted diet can be a great ally in weight loss and improving cardiometabolic risk factors. Whether Brazil nut (BN) consumption in the context of energy restriction affects them remains to be answered. We aimed to evaluate the effect of BN within an energy-restricted diet on cardiometabolic risk markers among women. This is an eight-week, quasi-experimental, controlled nutritional intervention study. The women were allocated into two energy-restricted (-500 kcal/d) groups: a control free of BN (n=29) and a BN-group (BNG) (n=27) with 2 units/day of BN (~ 347 µg of selenium). Both groups had similar weight loss, but in the BNG, the serum selenium increased by 276.7% and apolipoprotein A1 increased by 27.4%. In addition, BNG had a more pronounced reduction in liver enzymes, and presented the most preserved percentages of lean and fat-free mass in relation to the control group. Consuming 2 units/day of BN in an 8-week weight loss intervention improved cardiometabolic risk markers in women. Our results suggest that regular consumption of BN during energy-restricted diets may be a strategy to minimize adiposity, preserve lean mass, improve serum selenium status, lipid, and liver metabolism markers, and, consequently, help obesity management and its comorbidities.

Background/Objectives: This study compared metabolic syndrome (MetS) features in patients with Prader-Willi syndrome (PWS) to those in age-, BMI-, and gender-matched subjects with essential obesity (EOB). Methods: Thirty-two PWS patients (23 females, 9 males; median age 31.6 years; BMI 42.0 kg/m2) underwent several assessments, including anthropometric measurements, body composition via bio-impedance analysis, basal metabolic rate (BMR) using indirect calorimetry, and blood sampling. Results: Their data were compared to a matched EOB group (23 females, 9 males; median age 31.4 years; BMI 43.5 kg/m2). The study groups (PWS and EOB) were subsequently divided into two subgroups based on the International Diabetes Federation criteria for the definition of MetS. Results showed that individuals with PWS had significantly lower (p < 0.001) body weight (BW, -20.9%), height (-8.9%), fat-free mass (FFM, -23.5%), and fat mass (FM, -19.2%) in absolute terms compared to EOB subjects. However, the relative percentages of FFM and FM were similar. Absolute BMR was 25.5% (p < 0.001) lower in the PWS group; however, this difference disappeared when adjusted for FFM or body weight (BW). Metabolic outcomes were broadly similar between the groups, except for higher fasting glucose (+7.3%) and HbA1c levels (+7.9%), and lower fasting insulin (-29.0%) in PWS patients. Conclusions: Moreover, PWS subjects exhibited higher total cholesterol (+9.6%) and HDL-cholesterol (+19.8%), suggesting a more favourable lipid profile and no extra risk beyond severe obesity.

Metabolic score for visceral fat (METS-VF) as an effective marker of visceral obesity has been correlated with non-alcoholic fatty liver disease (NAFLD). This study aims to explore the correlation between METS-VF and both all-cause mortality and cardiovascular disease (CVD)-related mortality among individuals with NAFLD.

A cohort of 6,759 subjects diagnosed with NAFLD was selected from the NHANES during the period from 1999 to 2018. Within this cohort, the prognostic utility of METS-VF for predicting CVD-related and all-cause mortality was assessed.

There was a total of 1254 all-cause deaths (18.6%) and 418 CVD-related deaths (6.2%) at a median follow-up for 9.3 years. Multivariate Cox regression analysis and restricted cubic splines analysis indicated that METS-VF can exhibit a positive non-linearly correlation with CVD mortality (HR: 4.15, 95% CI: 2.31-7.44, p < 0.001) and all-cause mortality (HR: 5.27, 95% CI: 3.75-7.42, p < 0.001), with an identified inflection point at 7.436. Subgroup analyses further revealed a stronger correlation between METS-VF and all-cause mortality among subjects without diabetes. Furthermore, the areas under the curve (AUC) for 1-, 3-, 5-, and 10-year survival rates were 0.756, 0.740, 0.747 and 0.746 for all-cause mortality, and 0.774, 0.751, 0.746 and 0.758 for CVD mortality, respectively, which performs better than the other obesity and IR related index.

Elevated METS-VF independently contributes to an increased risk of both all-cause and CVD mortality in individuals with NAFLD.

Not applicable.

The association between body roundness index (BRI) and all-cause mortality and the occurrence of cardiovascular disease (CVD) in patients with diabetes is unknown. This study aimed to determine the association between BRI and all-cause/CVD mortality in a diabetic cohort.

A total of 8227 individuals with diabetes from the 1999-2018 National Health and Nutrition Examination Survey (NHANES) database were included. Multifactorial Cox regression models were used to analyze the association between BRI and mortality in patients with diabetes. Multivariate-adjusted restricted cubic spline (RCS) regression was used to test for nonlinearity.

During a median follow-up of 7.25 years, a total of 27.22% died, with 9.18% of these deaths due to CVD. After fully adjusting for potential confounders, BRI remained significantly associated with all-cause/CVD mortality in the diabetic population. The restricted cubic splines revealed no significant nonlinear relationship between BRI and all-cause mortality (P = 0.29) or CVD mortality (P = 0.73). BRI was better associated with all-cause/CVD mortality in patients with diabetes compared to other body metabolic indices.

In patients with diabetes, we found an association between BRI and all-cause/CVD mortality.

Background and Aims: Visceral adipose tissue (VAT) is a key cardiometabolic risk factor. This study evaluates the association between VAT and adiposity indices and identifies reliable predictors of increased VAT. Methods: This cross-sectional study utilized data from 4696 participants in the National Health and Nutrition Examination Survey 2011-2018. VAT was measured via dual-energy X-ray absorptiometry. Adiposity indices included body mass index (BMI), waist circumference (WC), lipid accumulation product, visceral adiposity index, body shape index, body roundness index, and metabolic score for visceral fat (METS-VF). Correlation analysis, receiver operating characteristic curve analysis, and multivariate adaptive regression splines (MARS) modeling evaluated the performance of indices and identified key predictors of VAT. Results: All adiposity indices were significantly correlated with VAT (P < 0.001). Among them, METS-VF demonstrated the highest predictive performance for increased VAT (>130 cm2) followed by WC. Optimal cutoff values for METS-VF were 7.1 [areas under the curve (AUC): 0.887, 95% confidence interval (CI): 0.873-0.899] in men and 7.5 (AUC: 0.904, 95% CI: 0.891-0.916) in women. For WC, the cutoff values were 99.5 cm (AUC: 0.866, 95% CI: 0.851-0.879) in men and 96 cm (AUC: 0.883, 95% CI: 0.869-0.896) in women. MARS modeling identified race, age, WC, BMI, glucose, high-density lipoprotein cholesterol, and triglycerides as significant predictors of VAT, achieving an R2 of 75.2%. Conclusion: METS-VF demonstrated the highest predictive value among the indices evaluated for predicting increased VAT. It may serve as a valuable tool in assessing visceral obesity and associated cardiometabolic risks.

Various anthropometric indices have been proposed to assess central obesity and predict metabolic syndrome (MetS). However, their ability to predict MetS has not been evaluated in the Nepali adult population. This study compared the predictive potential of 12 novel and traditional anthropometric indices for MetS and its components among Nepali adults.

This cross-sectional study, conducted between January 2022 and June 2023, involved 1,116 adult participants (424 females, 692 males) aged 30-86 years from Gandaki Province, Nepal. Twelve anthropometric indices were calculated from the primary anthropometric and metabolic parameters. MetS was defined according to the modified NCEP-ATP III criteria. Logistic regression models were used to assess the strength of associations between these indices and MetS. Receiver operating characteristic (ROC) curve analysis was used to determine the predictive potential of these indices for MetS and its components. AUC differences between various index pairs were also calculated.

The overall prevalence of MetS in our study participants was 52.7%. The VAI demonstrated the best performance in predicting MetS (AUC: 0.865 for females, 0.882 for males), followed by LAP (AUC: 0.848 for females, 0.866 for males). The WHR showed good performance (AUC: 0.749 for females, 0.722 for males). BMI, the well-known traditional measure of body adiposity, demonstrated lower predictive ability (AUC: 0.586 for females, 0.571 for males). The optimal cutoffs were as follows: VAI > 2.37 for females, > 1.71 for males; LAP > 37.21 for females, > 47.74 for males; WHR > 0.97 for females, > 0.98 for males; and BMI > 23.10 for females, > 23.90 for males. BAI exhibited the poorest diagnostic performance for MetS prediction in both sexes (AUC < 0.555). Both the VAI and LAP were strongly positively associated (p < 0.001) with increased odds of MetS in both females (OR: 16.03, 95% CI: 9.77-26.31) and males (OR: 24.88, 95% CI: 16.51-37.48).

Among Nepali adults, the VAI and LAP outperform traditional anthropometric indices in predicting MetS and its components, suggesting their potential as effective screening tools for early detection. These findings contribute to the development of population-specific screening strategies for MetS in resource-limited settings such as Nepal, potentially enhancing early detection and prevention of cardiometabolic disorders.

East Asian populations, which account for approximately 20% of the global population, have become central to the worldwide rise of metabolic diseases over the past few decades. The prevalence of metabolic disorders, including type 2 diabetes mellitus, hypertension and metabolic dysfunction-associated steatotic liver disease, has escalated sharply, contributing to a substantial burden of complications such as cardiovascular disease, chronic kidney disease, cancer and increased mortality. This concerning trend is primarily driven by a combination of genetic predisposition, unique fat distribution patterns and rapidly changing lifestyle factors, including urbanization and the adoption of Westernized dietary habits. Current advances in genomics, proteomics, metabolomics and microbiome research have provided new insights into the biological mechanisms that might contribute to the heightened susceptibility of East Asian populations to metabolic diseases. This Review synthesizes epidemiological data, risk factors and biomarkers to provide an overview of how metabolic diseases are reshaping public health in East Asia and offers insights into biological and societal drivers to guide effective, region-specific strategies.

Metabolic syndrome (MetS) is increasingly viewed as a pressing concern for public health globally. The objective of this study was to compare the predictive ability of 17 anthropometric indices for the risk of MetS in Chinese residents, to explore the differences in the predictive effect of the indices between different sexes, and to identify the optimal predictive indices of MetS for men and women.

This research utilized a cross-sectional study involving 5479 residents in Shandong Province, China. According to the subjects' working curve (ROC), TyG-WHtR, TyG-WC, METS-VF, CVAI, and LAP with the area under the curve (AUC) greater than 0.850 were included in the follow-up. To explore the associations between indices and the prevalence of MetS, three logistic regression models were employed. The dose-response relationship between the indices and the risk of MetS was performed by the Restricted cubic spline (RCS) curves.

The prevalence of MetS in this study is approximately 45.56%. The multivariate logistic regression showed the predictive capacity of the TyG-WC and METS-VF for MetS was superior in males, while only METS-VF in females. Furthermore, there is a non-linear relationship between MTES-VF and MetS risk both in men and women (non-linearity p < 0.001). The potential for the risk of MetS increased when the METS-VF exceeded 6.67 in males or 6.30 in females. In addition, in the male population, TyG-WC is non-linearly related to MetS risk (non-linear p < 0.001), and the risk of MetS may increase when TyG-WC is higher than 750.40.

TyG-WC and METS-VF have a good predictive value for the risk of MetS in the Chinese male population, with TyG-WC being better than METS-VF. For females, METS-VF could be regarded as the most reliable indicator.

The prevalence of obesity has increased rapidly worldwide over the past few decades and remains a recognized public health concern. However, studies exploring visceral adiposity index (VAI), a sex-specific indicator reflecting visceral fat distribution and function, and long-term mortality are limited. This study aimed to investigate the association of VAI with long-term all-cause mortality among general adults in the United States.

This cohort study used data from the National Health and Nutrition Examination Survey (NHANES) 1999-2018. Participants were linked to National Death Index mortality data through December 31, 2019. Weighted Cox proportional hazards regression model was used to calculate hazard ratios (HRs) and 95% CIs, and restricted cubic spline (RCS) was also conducted.

A total of 21,943 US adults (weighted mean age, 46.9 years; 10,921 males [weighted, 49.1%]) were included. During 211,473 person-years of follow-up (median follow‑up: 9.3 years), 3326 total deaths occurred. After multivariable adjustments, compared with the 3rd quintile (Q3) of VAI, participants in the 2nd (Q2) and 5th (Q5) quintiles were at a significantly higher risk of all-cause mortality (HR 1.16 [95% CI, 1.00-1.34] and HR 1.15 [95% CI, 1.01-1.31], respectively). RCS revealed a U-shaped relationship of log2-transformed VAI to all-cause mortality (P for nonlinearity < 0.001), with an inflection point of 0.824. Subgroup analysis indicated that there was a significant interaction of VAI with age on all-cause mortality (P for interaction = 0.005). Higher VAI levels were associated with higher all-cause mortality in younger adults (Q5 vs. Q3, HR 1.56 [95% CI, 1.12-2.18], P = 0.009) rather than older adults (Q5 vs. Q3, HR 1.05 [95% CI, 0.91-1.22], P = 0.497).

In the nationally representative cohort of US adults, VAI was nonlinearly associated with long-term all-cause mortality and the association showed age-related disparities. A higher VAI was related to a higher mortality risk in younger adults. These findings underscore the importance of appropriate VAI for long-term health outcomes, especially for young adults.

The Cardiac Metabolic Index (CMI) is a comprehensive metabolic indicator, but studies on its relationship with Diabetic Kidney Disease (DKD) are limited. We aim to explore the association between CMI and DKD.

We obtained participant-related data from the National Health and Nutrition Examination Survey (NHANES), including complete information on DKD, CMI, and other covariates. We employed weighted multivariable logistic regression models, restricted cubic spline (RCS) regression analysis, subgroup analyses, and interaction tests to explore the relationship between CMI and DKD. Additionally, we utilized receiver operating characteristic (ROC) curves to compare the performance of CMI in identifying DKD relative to a body shape index (ABSI), body roundness index (BRI), visceral adiposity index (VAI), and lipid accumulation product (LAP) indices.

According to the logistic regression analysis, a positive correlation between CMI and DKD was observed among the 2371 participants included in the study (OR: 1.40, 95% CI: 1.19-1.66). RCS analysis indicated that this relationship is nonlinear. When CMI was converted from a continuous variable to quartiles, the prevalence of DKD in the highest quartile group showed a significant 84% increase compared to the lowest quartile group (OR: 1.84, 95% CI: 1.24-2.72). The area under the ROC curve of CMI for identifying DKD was 0.67, outperforming other indices. The results of subgroup analyses and interaction tests were stable.

Elevated CMI is associated with an increased risk of DKD and can serve as a low-cost screening tool, allowing physicians to potentially identify high-risk diabetic patients early and implement timely interventions to slow the progression of DKD.

Insulin resistance (IR) is a complex abnormality and associated with hypertension. We aimed to assess the associations of six alternate IR measures and risk of hypertension, and to compare the predictive values for hypertension. We assessed 11,223 non-hypertensive Chinese adults enrolled in The Rural Chinese Cohort Study during 2007-2008. Six surrogate IR indexes were new visceral adiposity index (NVAI), Chinese visceral adiposity index (CVAI), weight-adjusted waist index (WWI), lipid accumulation product (LAP), triglyceride glucose (TyG) index, and visceral adiposity index (VAI). The relative risks (RR) and 95% confidence intervals (95% CI) of the six IR indicators and hypertension were estimated by using modified Poisson regression models with three adjusted models. During a median follow-up of 11.1 years, 3373 (30.05%) study participants developed hypertension. The cumulative incidence of hypertension showed an increasing trend with higher levels of all six IR surrogates. Significant associations of all the IR measures with incident hypertension were found in fully adjusted model, and the highest quartile group RRs (95% CIs) for hypertension were, 2.19 (1.88-2.55), 1.60 (1.42-1.81), 1.38 (1.25-1.53), 1.47 (1.31-1.65), 1.18 (1.04-1.34) and 1.25 (1.08-1.44) for NVAI, CVAI, WWI, LAP, TyG index and VAI, respectively, compared with lowest quartile group. Further, NVAI had the maximum predictive power for hypertension among six IR measures with the largest AUC of 0.706 (0.697-0.714). NVAI, CVAI, WWI, LAP, and TyG index were all independently associated with greater risk of incident hypertension, among which NVAI is the most powerful predictor for hypertension in rural Chinese adults. Association of the surrogate insulin resistance indexes with the risk of hypertension.