Background. Visceral adiposity plays a key role in the development of insulin resistance (IR), so surrogate index that can indicate visceral obesity may have higher predictive value for IR. This study aimed to establish and validate a new predictive model including indicator of visceral obesity for IR. Methods. The study population consisted of two cohorts. The derivation cohort was a group of 667 patients with newly diagnosed type 2 diabetes and the population undergoing a routine health checkup was the validation cohort. The predictive model was established by the logistic regression analysis. Its value for predicting IR was compared with other surrogate indices by the receiver operating characteristic curve. Results. The odds ratio (OR) of age, visceral fat area (VFA), triglyceride (TG), fasting plasma glucose (FPG), and alanine aminotransferase (ALT) for IR was 1.028 (95% CI, 1.008–1.048) ( P < 0.01 ), 1.016 (95% CI, 1.009–1.023) ( P < 0.001 ), 1.184 (95% CI, 1.005–1.396) ( P < 0.05 ), 1.334 (95% CI, 1.225–1.451) ( P < 0.001 ), and 1.021 (95% CI, 1.001–1.040) ( P < 0.05 ). The formula of the predictive model was (0.0293 × age + 1.4892 × Ln VFA + 0.4966 × Ln TG + 2.784 × Ln FPG + 0.6906 × Ln ALT)/2. The area under the curve was the largest among all the previously reported predictors. Conclusions. This study established and validated a predicting model for IR and confirmed its predictive value in comparison with other surrogate indicators, which will offer a simple and effective tool to measure IR in future large population studies.

Background Growing evidence has revealed that using BMI for assessment of obesity and cardiometabolic risk has some limitations. Visceral adiposity and skeletal muscle loss may be both correlated with cardiometabolic outcomes. This study aimed to explore the associations between the visceral fat area to skeletal muscle mass ratio (VSR) and the risk of several cardiometabolic diseases including metabolic associated fatty liver disease (MAFLD), hyperglycemia, hypertension, dyslipidemia and hyperuricemia in a young and middle-aged Chinese natural population and further elucidate the differences of these associations between male and female. Methods A total of 5158 participants were included in this study. Body composition, anthropometrical and biochemical measurements were performed. The associations between VSR and cardiometabolic diseases were analyzed. Results Both in male and female, VSR was positively associated with the five cardiometabolic diseases and with the increase of VSR by one quartile, the ORs increased significantly for all the five cardiometabolic diseases (P trend<0.001). With regard to the highest versus the lowest quartile of VSR, the ORs for MAFLD, hyperglycemia, hypertension, dyslipidemia and hyperuricemia were 17.23 (95% CI, 12.52–23.71), 15.47 (95% CI, 7.1-33.72), 5.12 (95% CI, 3.88–6.76), 3.16 (95% CI, 2.33–4.28) and 1.89 (95% CI, 1.42–2.51) in male, respectively. In female, the corresponding ORs were 41.15 (95% CI, 25.80-65.63), 21.62 (95% CI, 7.87–59.36), 9.64 (95% CI, 6.88–13.53), 9.34 (95% CI, 6.63–13.14) and 6.58 (95% CI, 3.45–12.56). The results of restricted cubic splines showed there were significant positive non-linear relationships between VSR and the risk of MAFLD, dyslipidemia, hyperglycemia and hypertension in both sex (P for non-linearity < 0.05). The risk was relatively flat until when VSR reached 3.078 cm2/kg in men and 4.750 cm2/kg in women and started to increase rapidly afterwards. In men, however, the risk slowed down after VSR value got to around 4 cm2/kg and the curve became flat and even tended to decline. Conclusions VSR was positively associated with cardiometabolic diseases regardless of sex. As VSR increased, the risk of cardiometabolic diseases was significantly higher in women than in men. Women should be more alert to the risk of cardiometabolic diseases caused by the increase of VSR.