Relationship Between Visceral Adiposity Index and Early Microvascular Changes in Type 2 Diabetes

Abstract

Background: Visceral adipose dysfunction may contribute to diabetic microvascular injury through insulin resistance, dyslipidaemia, inflammation, oxidative stress, and endothelial dysfunction. Objective: To determine the association between Visceral Adiposity Index and early retinal or renal microvascular involvement among adults with type 2 diabetes mellitus. Methods: This hospital-based cross-sectional analytical study included 180 adults with type 2 diabetes. Demographic, anthropometric, biochemical, urinary albumin-to-creatinine ratio, and funduscopic data were collected. Visceral Adiposity Index was calculated using sex-specific equations incorporating waist circumference, body mass index, triglycerides, and high-density lipoprotein cholesterol. The primary outcome was the presence of early diabetic retinopathy, microalbuminuria, or both. Group comparisons, correlation analysis, and multivariable logistic regression were performed. Results: Participants had a mean age of 52.4 ± 8.7 years, and 95 (52.8%) were male. Early diabetic retinopathy was present in 43 (23.9%), microalbuminuria in 51 (28.3%), and at least one microvascular outcome in 70 (38.9%). Mean Visceral Adiposity Index was 4.68 ± 1.62 among participants with microvascular involvement and 2.99 ± 1.18 among those without involvement, corresponding to a mean difference of 1.69 (95% CI: 1.25–2.13) and Hedges’ g of 1.23. Each one-unit increase in the index was associated with 48% higher adjusted odds of microvascular involvement. Conclusion: Higher Visceral Adiposity Index was associated with early retinal and renal microvascular abnormalities, particularly microalbuminuria. It may complement, but not replace, standard renal and retinal assessment