Visceral Adiposity Index and Lipid Accumulation Product Index: Two Alternate Body Indices to Identify Chronic Kidney Disease among the Rural Population in Northeast China

Abstract

We aimed to compare the relative strength of the association between anthropometric obesity indices and chronic kidney disease (CKD). Another objective was to examine whether the visceral adiposity index (VAI) and lipid accumulation product index (LAPI) can identify CKD in the rural population of China. There were 5168 males and 6024 females involved in this cross-sectional study, and 237 participants (2.12%) suffered from CKD. Obesity indices included body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), VAI and LAPI. VAI and LAPI were calculated with triglyceride (TG), high-density lipoprotein (HDL), BMI and WC. VAI = [WC/39.68 + (1.88 × BMI)] × (TG /1.03) × (1.31/ HDL) for males; VAI = [WC/36.58 + (1.89 × BMI)] × (TG/0.81) × (1.52/HDL) for females. LAPI = (WC-65) × TG for males, LAPI = (WC-58) × TG for females. CKD was defined as an estimated glomerular filtration rate (eGFR) of less than 60 mL/min per 1.73 m2. The prevalence of CKD increased across quartiles for WHtR, VAI and LAPI. A multivariate logistic regression analysis of the presence of CKD for the highest quartile vs. the lowest quartile of each anthropometric measure showed that the VAI was the best predictor of CKD in females (OR: 4.21, 95% CI: 2.09–8.47, p < 0.001). VAI showed the highest AUC for CKD (AUC: 0.68, 95% CI: 0.65–0.72) and LAPI came second (AUC: 0.66, 95% CI: 0.61–0.70) in females compared with BMI (both p-values < 0.001). However, compared with the traditional index of the BMI, the anthropometric measures VAI, LAPI, WC, and WHtR had no statistically significant capacity to predict CKD in males. Our results showed that both VAI and LAPI were significantly associated with CKD in the rural population of northeast China. Furthermore, VAI and LAPI were superior to BMI, WC and WHtR for predicting CKD only in females.

Visceral adiposity index as a useful tool for the assessment of cardiometabolic disease risk in women aged 65 to 74

“…In a study conducted in a rural Chinese population, VAI was found to be a better predictor of CKD among women than BMI and WC. However, the same relationship was not found in men . In another study conducted in China, the VAI score was positively correlated with the albumin‐to‐creatinine ratio and was inversely related to eGFR .…”

“…However, the same relationship was not found in men. 30 In another study conducted in China, the VAI score was positively correlated with the albumin-tocreatinine ratio and was inversely related to eGFR. 31 It is worth noting that impaired kidney function is associated not only with an increased risk of end-stage renal disease but also with a significantly higher risk of CVD.…”

Are visceral adiposity index and lipid accumulation product reliable indices for metabolic disturbances in patients with type 2 diabetes mellitus?

“…The majority of previous studies reported VAI and LAP to be reliable indices in prediction of many metabolic disturbances …”

“…Even though a large number of studies in adult population indicate VAI and LAP as reliable markers of cardiometabolic risk advantageous over BMI and WC, there are another ones that report the opposite …”

“…Furthermore, higher VAI and LAP were associated with metabolic syndrome (MetS), with the presence of DM2, and with chronic kidney disease (CKD), showing even better discriminative power in relation to cardiometabolic risk than anthropometric parameters alone …”