{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T09:36:00Z","timestamp":1792056960715,"version":"4.4.0"},"reference-count":101,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2025,7,20]],"date-time":"2025-07-20T00:00:00Z","timestamp":1752969600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Obesity is currently one of the most critical public health problems. Although there is no doubt that obesity is a significant risk factor for developing metabolic disorders, this relationship is not completely straightforward. On the one hand, some patients affected by obesity are metabolically unhealthy, while others are metabolically healthy; on the other hand, metabolic syndrome (MetS) can also occur in people with a normal body weight. A commonly used tool for diagnosing obesity is the body mass index (BMI), but the search for better anthropometric measures is ongoing due to the significant limitations of this measure. Obesity can lead to MetS and cardiovascular diseases (CVDs). Adipose tissue dysfunction is the fundamental mechanism linking obesity and cardiometabolic diseases, which is rooted in the disturbed secretion of adipokines. The visceral adiposity index (VAI) is calculated based on the BMI, waist circumference (WC), blood triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C) concentrations. It was proposed in 2010 by Amato et al. as a parameter indicating adipose tissue dysfunction and cardiometabolic risk. According to the research conducted so far, some data confirm a relationship between the VAI value and the risk of developing prediabetes, diabetes, insulin resistance, fatty liver disease, MetS, CVD, and chronic kidney disease. Further research is needed to support the implementation of VAI assessment in routine clinical practice. The purpose of this paper is to present the results of a narrative literature review summarizing current knowledge regarding the VAI and its usefulness in clinical practice for assessing cardiometabolic risk.<\/jats:p>","DOI":"10.3390\/nu17142374","type":"journal-article","created":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T07:56:14Z","timestamp":1753084574000},"page":"2374","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":44,"title":["The Visceral Adiposity Index and Its Usefulness in the Prediction of Cardiometabolic Disorders"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0039-8306","authenticated-orcid":false,"given":"Grzegorz K.","family":"Jakubiak","sequence":"first","affiliation":[{"name":"Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 41-808 Zabrze, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4100-8765","authenticated-orcid":false,"given":"Georgian","family":"Badicu","sequence":"additional","affiliation":[{"name":"Department of Physical Education and Special Motricity, Transilvania University of Brasov, 500068 Bra\u0219ov, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stanis\u0142aw","family":"Surma","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Clinical Pharmacology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ewa","family":"Waluga-Koz\u0142owska","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 41-808 Zabrze, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Artur","family":"Chwalba","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 41-808 Zabrze, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7551-9371","authenticated-orcid":false,"given":"Natalia","family":"Pawlas","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 41-808 Zabrze, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3404","DOI":"10.1093\/eurheartj\/ehab518","article-title":"Obesity and cardiovascular health: The size of the problem","volume":"42","author":"Rosengren","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Wiechert, M., and Holzapfel, C. (2021). Nutrition concepts for the treatment of obesity in adults. Nutrients, 14.","DOI":"10.3390\/nu14010169"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"9987352","DOI":"10.1155\/2021\/9987352","article-title":"Oxidative stress in association with metabolic health and obesity in young adults","volume":"2021","author":"Jakubiak","year":"2021","journal-title":"Oxid. Med. Cell. Longev."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Jakubiak, G.K., Osadnik, K., Lejawa, M., Osadnik, T., Go\u0142awski, M., Lewandowski, P., and Pawlas, N. (2021). \u201cObesity and insulin resistance\u201d is the component of the metabolic syndrome most strongly associated with oxidative stress. Antioxidants, 11.","DOI":"10.3390\/antiox11010079"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1159\/000442721","article-title":"Obesity management task force of the European Association for the Study of Obesity. European guidelines for obesity management in adults","volume":"8","author":"Yumuk","year":"2015","journal-title":"Obes. Facts."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Czapla, M., Surma, S., Kwa\u015bny, A., and Lewandowski, \u0141. (2024). Association of body mass index with outcomes in patients with heart failure with reduced ejection fraction (HFrEF). Nutrients, 16.","DOI":"10.3390\/nu16152473"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1038\/oby.2011.38","article-title":"A better index of body adiposity","volume":"19","author":"Bergman","year":"2011","journal-title":"Obesity"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2264","DOI":"10.1002\/oby.20408","article-title":"Relationships between body roundness with body fat and visceral adipose tissue emerging from a new geometrical model","volume":"21","author":"Thomas","year":"2013","journal-title":"Obesity"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Krakauer, N.Y., and Krakauer, J.C. (2012). A new body shape index predicts mortality hazard independently of body mass index. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0039504"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Belarmino, G., Torrinhas, R.S., Sala, P., Horie, L.M., Damiani, L., Lopes, N.C., Heymsfield, S.B., and Waitzberg, D.L. (2018). A new anthropometric index for body fat estimation in patients with severe obesity. BMC Obes., 5.","DOI":"10.1186\/s40608-018-0202-8"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"920","DOI":"10.2337\/dc09-1825","article-title":"Visceral Adiposity Index: A reliable indicator of visceral fat function associated with cardiometabolic risk","volume":"33","author":"Amato","year":"2010","journal-title":"Diabetes Care"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1640","DOI":"10.1161\/CIRCULATIONAHA.109.192644","article-title":"Harmonizing the metabolic syndrome: A joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity","volume":"120","author":"Alberti","year":"2009","journal-title":"Circulation"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1507\/endocrj.EJ22-0280","article-title":"Relationship between obstructive sleep apnea, insulin resistance, and metabolic syndrome: A nationwide population-based survey","volume":"70","author":"Kim","year":"2023","journal-title":"Endocr. J."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Bowden, R.G., Richardson, K.A., and Richardson, L.T. (2022). Uric acid and metabolic syndrome: Findings from national health and nutrition examination survey. Front. Med., 9.","DOI":"10.3389\/fmed.2022.1039230"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1429","DOI":"10.1007\/s00592-022-01945-5","article-title":"Heart rate thresholds for cardiovascular risk and sympathetic activation in the metabolic syndrome","volume":"59","author":"Seravalle","year":"2022","journal-title":"Acta Diabetol."},{"key":"ref_16","first-page":"e127445","article-title":"Inflammatory markers and atherogenic coefficient: Early markers of metabolic syndrome","volume":"20","author":"Shoaibinobarian","year":"2022","journal-title":"Int. J. Endocrinol. Metab."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e2022078","DOI":"10.4178\/epih.e2022078","article-title":"The association between metabolic syndrome and heart failure in middle-aged men and women: Population-based study of 2 million individuals","volume":"44","author":"Kim","year":"2022","journal-title":"Epidemiol. Health"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Zhou, Y., Fu, L., Sun, J., Zhu, Z., Xing, Z., Zhou, S., Tai, S., and Wang, Y. (2021). Association between metabolic syndrome and an increased risk of hospitalization for heart failure in population of HFpEF. Front. Cardiovasc. Med., 8.","DOI":"10.3389\/fcvm.2021.698117"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e13945","DOI":"10.1111\/eci.13945","article-title":"The impact of metabolic syndrome on chronic kidney disease development. Insights from a big prospective study","volume":"53","author":"Fanaei","year":"2022","journal-title":"Eur. J. Clin. Investig."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"7197","DOI":"10.3390\/cimb45090455","article-title":"The intestinal microbiome and the metabolic syndrome-how its manipulation may affect metabolic-associated fatty liver disease (MAFLD)","volume":"45","author":"Malnick","year":"2023","journal-title":"Curr. Issues Mol. Biol."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Romero-Garc\u00eda, T., V\u00e1zquez-Jim\u00e9nez, J.G., S\u00e1nchez-Hern\u00e1ndez, R., Olivares-Reyes, J.A., and Rueda, A. (2025). Insulin resistance, Ca2+ signaling alterations and vascular dysfunction in prediabetes and metabolic syndrome. Front. Physiol., 16.","DOI":"10.3389\/fphys.2025.1535153"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1080\/13813455.2020.1724157","article-title":"Assessment of insulin resistance and metabolic syndrome in young reproductive aged women with polycystic ovarian syndrome: Analogy of surrogate indices","volume":"128","author":"Rashid","year":"2022","journal-title":"Arch. Physiol. Biochem."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Jakubiak, G.K. (2024). Cardiac troponin serum concentration measurement is useful not only in the diagnosis of acute cardiovascular events. J. Pers. Med., 14.","DOI":"10.3390\/jpm14030230"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Starzak, M., Stanek, A., Jakubiak, G.K., Cholewka, A., and Cie\u015blar, G. (2022). Arterial stiffness assessment by pulse wave velocity in patients with metabolic syndrome and its components: Is it a useful tool in clinical practice?. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph191610368"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Mu\u0107ka, S., Miodo\u0144ska, M., Jakubiak, G.K., Starzak, M., Cie\u015blar, G., and Stanek, A. (2022). Endothelial function assessment by flow-mediated dilation method: A valuable tool in the evaluation of the cardiovascular system. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph191811242"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"154838","DOI":"10.1016\/j.metabol.2021.154838","article-title":"Current trends in epidemiology of cardiovascular disease and cardiovascular risk management in type 2 diabetes","volume":"123","author":"Yun","year":"2021","journal-title":"Metabolism"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"American Diabetes Association (2018). Economic costs of diabetes in the U.S. in 2017. Diabetes Care, 41, 917\u2013928.","DOI":"10.2337\/dci18-0007"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1093\/cvr\/cvaf045","article-title":"Upfront lipid-lowering combination therapy in high cardiovascular risk patients: A route to effective atherosclerotic cardiovascular disease prevention","volume":"121","author":"Banach","year":"2025","journal-title":"Cardiovasc. Res."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Jakubiak, G.K., Pawlas, N., Cie\u015blar, G., and Stanek, A. (2020). Chronic lower extremity ischemia and its association with the frailty syndrome in patients with diabetes. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17249339"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Jakubiak, G.K., Pawlas, N., Cie\u015blar, G., and Stanek, A. (2021). Pathogenesis and clinical significance of in-stent restenosis in patients with diabetes. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph182211970"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1055\/a-1922-7052","article-title":"Adipose tissue dysfunction: Impact on metabolic changes?","volume":"54","author":"Morais","year":"2022","journal-title":"Horm. Metab. Res."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Parasiliti-Caprino, M., Bollati, M., Merlo, F.D., Ghigo, E., Maccario, M., and Bo, S. (2022). Adipose tissue dysfunction in obesity: Role of mineralocorticoid receptor. Nutrients, 14.","DOI":"10.3390\/nu14224735"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2515","DOI":"10.12688\/f1000research.8971.1","article-title":"Dysfunctional adipose tissue and low-grade inflammation in the management of the metabolic syndrome: Current practices and future advances","volume":"5","author":"Schalkwijk","year":"2016","journal-title":"F1000Res"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1016\/j.numecd.2022.11.023","article-title":"Role of adipokines (omentin and visfatin) in coronary artery disease","volume":"33","author":"Ali","year":"2022","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1186\/s12933-022-01457-0","article-title":"Asprosin induces vascular endothelial-to-mesenchymal transition in diabetic lower extremity peripheral artery disease","volume":"21","author":"You","year":"2022","journal-title":"Cardiovasc. Diabetol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"539","DOI":"10.3892\/etm.2021.9969","article-title":"Impact of adipose tissue in chronic kidney disease development (Review)","volume":"21","author":"Miricescu","year":"2021","journal-title":"Exp. Ther. Med."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Wang, X., Rao, H., Liu, F., Wei, L., Li, H., and Wu, C. (2021). Recent advances in adipose tissue dysfunction and its role in the pathogenesis of non-alcoholic fatty liver disease. Cells, 10.","DOI":"10.3390\/cells10123300"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Stanek, A., Bro\u017cyna-Tkaczyk, K., and My\u015bli\u0144ski, W. (2021). The role of obesity-induced perivascular adipose tissue (PVAT) dysfunction in vascular homeostasis. Nutrients, 13.","DOI":"10.3390\/nu13113843"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1515\/jbcpp-2022-0230","article-title":"Cellular cross talk between epicardial fat and cardiovascular risk","volume":"33","author":"Patel","year":"2022","journal-title":"J. Basic Clin. Physiol. Pharmacol."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Farkhondeh, T., Llorens, S., Pourbagher-Shahri, A.M., Ashrafizadeh, M., Talebi, M., Shakibaei, M., and Samarghandian, S. (2020). An overview of the role of adipokines in cardiometabolic diseases. Molecules, 25.","DOI":"10.3390\/molecules25215218"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Aljafary, M.A., and Al-Suhaimi, E.A. (2022). Adiponectin system (rescue hormone): The missing link between metabolic and cardiovascular diseases. Pharmaceutics, 14.","DOI":"10.3390\/pharmaceutics14071430"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Recinella, L., Orlando, G., Ferrante, C., Chiavaroli, A., Brunetti, L., and Leone, S. (2020). Adipokines: New potential therapeutic target for obesity and metabolic, rheumatic, and cardiovascular diseases. Front. Physiol., 11.","DOI":"10.3389\/fphys.2020.578966"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Kirichenko, T.V., Markina, Y.V., Bogatyreva, A.I., Tolstik, T.V., Varaeva, Y.R., and Starodubova, A.V. (2022). The role of adipokines in inflammatory mechanisms of obesity. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms232314982"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Clemente-Su\u00e1rez, V.J., Redondo-Fl\u00f3rez, L., Beltr\u00e1n-Velasco, A.I., Mart\u00edn-Rodr\u00edguez, A., Mart\u00ednez-Guardado, I., Navarro-Jim\u00e9nez, E., Laborde-C\u00e1rdenas, C.C., and Tornero-Aguilera, J.F. (2023). The role of adipokines in health and disease. Biomedicines, 11.","DOI":"10.3390\/biomedicines11051290"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Datta, S., Koka, S., and Boini, K.M. (2025). Understanding the role of adipokines in cardiometabolic dysfunction: A review of current knowledge. Biomolecules, 15.","DOI":"10.3390\/biom15050612"},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Xia, M.F., Chen, Y., Lin, H.D., Ma, H., Li, X.M., Aleteng, Q., Li, Q., Wang, D., Hu, Y., and Pan, B.S. (2016). A indicator of visceral adipose dysfunction to evaluate metabolic health in adult Chinese. Sci. Rep., 6.","DOI":"10.1038\/srep38214"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1089\/met.2019.0078","article-title":"Association of visceral adiposity surrogates with impaired fasting glucose in nonobese individuals","volume":"18","author":"Li","year":"2020","journal-title":"Metab. Syndr. Relat. Disord."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1055\/s-0043-120440","article-title":"Visceral adiposity index was a useful predictor of prediabetes","volume":"126","author":"Gu","year":"2018","journal-title":"Exp. Clin. Endocrinol. Diabetes"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1016\/j.dsx.2020.06.045","article-title":"Predictive performance of traditional and novel lipid combined anthropometric indices to identify prediabetes","volume":"14","author":"Nayak","year":"2020","journal-title":"Diabetes Metab. Syndr."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Ram\u00edrez-V\u00e9lez, R., P\u00e9rez-Sousa, M.\u00c1., Gonz\u00e1lez-Ru\u00edz, K., Cano-Gutierrez, C.A., Schmidt-RioValle, J., Correa-Rodr\u00edguez, M., Izquierdo, M., Romero-Garc\u00eda, J.A., Campos-Rodr\u00edguez, A.Y., and Triana-Reina, H.R. (2019). Obesity- and lipid-related parameters in the identification of older adults with a high risk of prediabetes according to the American Diabetes Association: An analysis of the 2015 Health, Well-Being, and Aging Study. Nutrients, 11.","DOI":"10.3390\/nu11112654"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1111\/jdi.13685","article-title":"Association between visceral adiposity index and risk of prediabetes: A meta-analysis of observational studies","volume":"13","author":"Wang","year":"2022","journal-title":"J. Diabetes Investig."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Huang, L., Liao, J., Lu, C., Yin, Y., Ma, Y., and Wen, Y. (2025). The non-linear relationship between the visceral adiposity index and the risk of prediabetes and diabetes. Front. Endocrinol., 16.","DOI":"10.3389\/fendo.2025.1407873"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"e093598","DOI":"10.1136\/bmjopen-2024-093598","article-title":"Sex- and age-specific body composition indices as predictors of new-onset type 2 diabetes mellitus in Koreans: A nationwide cohort study","volume":"15","author":"Park","year":"2025","journal-title":"BMJ Open"},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"He, J., and Chen, L. (2025). Perspective from NHANES data: Synergistic effects of visceral adiposity index and lipid accumulation products on diabetes risk. Sci. Rep., 15.","DOI":"10.1038\/s41598-024-84034-7"},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Benbaibeche, H., Bounihi, A., Saidi, H., Koceir, E.A., and Khan, N.A. (2025). Cardiometabolic markers in Algerian obese subjects with and without type 2 diabetes: Adipocytokine imbalance as a risk factor. J. Clin. Med., 14.","DOI":"10.3390\/jcm14051770"},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"D\u00edaz-Ortega, J.L., Caballero-Vidal, J., Yupari-Azabache, I.L., Sevilla, J.M.A., and Conde-Parada, N.E. (2025). Predictive capacity of different indicators of adiposity for metabolic syndrome in adults in the city of Trujillo, Peru. Medicina, 61.","DOI":"10.3390\/medicina61030419"},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Ferreira, J.R.S., Libardi, M.C., do Prado, C.B., Zandonade, E., Bezerra, O.M.P.A., and Salaroli, L.B. (2025). Predicting metabolic syndrome by lipid accumulation product, visceral adiposity index and body roundness index in Brazilian rural workers. BMC Public Health, 25.","DOI":"10.1186\/s12889-025-21624-8"},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Li, J., Qiao, J., Li, Y., Qin, G., Xu, Y., Lao, K., Wang, Y., Fan, Y., Tang, P., and Han, L. (2025). Metabolic disorders in polycystic ovary syndrome: From gut microbiota biodiversity to clinical intervention. Front. Endocrinol., 16.","DOI":"10.3389\/fendo.2025.1526468"},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Keyif, B., and Yavuzcan, A. (2025). Visceral and dysfunctional adiposity indices as predictors of insulin resistance and metabolic syndrome in women with polycystic ovary syndrome: A cross-sectional study. Medicina, 61.","DOI":"10.3390\/medicina61030424"},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Jafari, A., Ilaghi, M., Najafipour, H., and Shadkam, M. (2025). Assessing three novel composite anthropometric-metabolic indices for predicting 10-year incidence of metabolic syndrome: Findings from the kerman coronary artery disease risk factors study (KERCADRS). Hormones, 1\u20139.","DOI":"10.1007\/s42000-024-00622-2"},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Jiang, K., Luan, H., Pu, X., Wang, M., Yin, J., and Gong, R. (2022). Association between visceral adiposity index and insulin resistance: A cross-sectional study based on US adults. Front. Endocrinol., 13.","DOI":"10.3389\/fendo.2022.921067"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1507\/endocrj.EJ19-0517","article-title":"The association of the visceral adiposity index with insulin resistance and beta-cell function in Korean adults with and without type 2 diabetes mellitus","volume":"67","author":"Sung","year":"2020","journal-title":"Endocr. J."},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"\u0160t\u011bp\u00e1nek, L., Hor\u00e1kov\u00e1, D., Cibi\u010dkov\u00e1, \u013d., Vaverkov\u00e1, H., Kar\u00e1sek, D., Nakl\u00e1dalov\u00e1, M., and Zapletalov\u00e1, J. (2019). Can visceral adiposity index serve as a simple tool for identifying individuals with insulin resistance in daily clinical practice?. Medicina, 55.","DOI":"10.3390\/medicina55090545"},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Habibullah, M., Jemmieh, K., Ouda, A., Haider, M.Z., Malki, M.I., and Elzouki, A.N. (2024). Metabolic-associated fatty liver disease: A selective review of pathogenesis, diagnostic approaches, and therapeutic strategies. Front. Med., 11.","DOI":"10.3389\/fmed.2024.1291501"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1999","DOI":"10.1053\/j.gastro.2019.11.312","article-title":"MAFLD: A consensus-driven proposed nomenclature for metabolic associated fatty liver disease","volume":"158","author":"Eslam","year":"2020","journal-title":"Gastroenterology"},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Wang, Y., Fu, C., Jin, H., Yang, Y., Li, X., and Liu, K. (2025). Lipid metabolism indicators provide tools for the diagnosis of non-alcoholic fatty liver disease: Results of a nationwide survey. Front. Endocrinol., 15.","DOI":"10.3389\/fendo.2024.1468228"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"e058517","DOI":"10.1136\/bmjopen-2021-058517","article-title":"Role of age, gender and ethnicity in the association between visceral adiposity index and non-alcoholic fatty liver disease among US adults (NHANES 2003-2018): Cross-sectional study","volume":"12","author":"Li","year":"2022","journal-title":"BMJ Open"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1186\/s12944-022-01636-8","article-title":"Diagnostic accuracy of the visceral adiposity index in patients with metabolic-associated fatty liver disease: A meta-analysis","volume":"21","author":"Yi","year":"2022","journal-title":"Lipids Health Dis."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"5545227","DOI":"10.1155\/cjgh\/5545227","article-title":"Anthropometric indices and metabolic dysfunction-associated fatty liver disease in males and females living with severe obesity","volume":"2025","author":"Dugas","year":"2025","journal-title":"Can. J. Gastroenterol. Hepatol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"e3052","DOI":"10.1002\/dmrr.3052","article-title":"Visceral adiposity index as a useful tool for the assessment of cardiometabolic disease risk in women aged 65 to 74","volume":"34","author":"Uruska","year":"2018","journal-title":"Diabetes Metab. Res. Rev."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1186\/s42506-025-00188-w","article-title":"Association of novel visceral obesity indices with 10-year risk of major cardiovascular events in patients with type 2 diabetes mellitus","volume":"100","author":"Tawfik","year":"2025","journal-title":"J. Egypt. Public Health Assoc."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1186\/s12944-023-01831-1","article-title":"Association of visceral adiposity index with asymptomatic intracranial arterial stenosis: A population-based study in Shandong, China","volume":"22","author":"Zhao","year":"2023","journal-title":"Lipids Health Dis."},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Chen, Q., Zhang, Z., Luo, N., and Qi, Y. (2023). Elevated visceral adiposity index is associated with increased stroke prevalence and earlier age at first stroke onset: Based on a national cross-sectional study. Front. Endocrinol., 13.","DOI":"10.3389\/fendo.2022.1086936"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"1202","DOI":"10.1016\/j.numecd.2022.01.031","article-title":"Association between visceral adiposity index and incident stroke: Data from the China Health and Retirement Longitudinal Study","volume":"32","author":"Cui","year":"2022","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Chang, Y., Zhang, L., Li, Y., Wang, D., Fang, Q., and Tang, X. (2023). Derivation and validation of a new visceral adiposity index for predicting short-term mortality of patients with acute ischemic stroke in a Chinese population. Brain Sci., 13.","DOI":"10.3390\/brainsci13020297"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"2141","DOI":"10.1016\/j.ijcard.2013.01.275","article-title":"Visceral adiposity and risk of coronary heart disease in relatively lean Chinese adults","volume":"168","author":"Zhang","year":"2013","journal-title":"Int. J. Cardiol."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1080\/07853890.2016.1183258","article-title":"Increased risk of subclinical atherosclerosis associated with high visceral adiposity index in apparently healthy Korean adults: The Kangbuk Samsung Health Study","volume":"48","author":"Park","year":"2016","journal-title":"Ann. Med."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1186\/1758-5996-6-143","article-title":"Visceral adiposity index score indicated the severity of coronary heart disease in Chinese adults","volume":"6","author":"Han","year":"2014","journal-title":"Diabetol. Metab. Syndr."},{"key":"ref_79","first-page":"280","article-title":"Visceral adiposity index is associated with the increased Syntax score in patients with type 2 diabetes mellitus","volume":"20","author":"Candemir","year":"2022","journal-title":"Metab. Syndr. Relat. Disord."},{"key":"ref_80","first-page":"382","article-title":"Visceral adiposity index score is the better predictor of clinical and coronary angiographic severity assessment than other adiposity indices in patients with acute coronary syndrome","volume":"28","author":"Biswas","year":"2019","journal-title":"Mymensingh. Med. J."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"716","DOI":"10.33963\/KP.a2023.0112","article-title":"Association between the visceral adiposity index and the coronary artery calcification score and atherosclerotic plaque morphology","volume":"81","author":"Doganay","year":"2023","journal-title":"Kardiol. Pol."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1016\/j.numecd.2020.01.013","article-title":"Association between coronary atherosclerosis and visceral adiposity index","volume":"30","author":"Bagyura","year":"2020","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1089\/met.2024.0128","article-title":"Association between two novel visceral obesity indicators and heart failure among US adults: A cross-sectional study","volume":"23","author":"Luo","year":"2025","journal-title":"Metab. Syndr. Relat. Disord."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"1182","DOI":"10.1093\/eurjpc\/zwad099","article-title":"Visceral adiposity index and the risk of heart failure, late-life cardiac structure, and function in ARIC study","volume":"30","author":"Xu","year":"2023","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_85","doi-asserted-by":"crossref","unstructured":"Zhou, D., Lin, S., Liu, Z., Yuan, J., Ren, H., Tan, H., Guo, Y., and Jiang, X. (2025). Metabolic syndrome, left ventricular diastolic dysfunction and heart failure with preserved ejective fraction. Front. Endocrinol., 16.","DOI":"10.3389\/fendo.2025.1544908"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"e70006","DOI":"10.1111\/fcp.70006","article-title":"Dual ETA-ETB receptor antagonism improves metabolic syndrome-induced heart failure with preserved ejection fraction","volume":"39","author":"Lockwood","year":"2025","journal-title":"Fundam. Clin. Pharmacol."},{"key":"ref_87","doi-asserted-by":"crossref","unstructured":"Shi, Y., Liu, C., Yang, C., Qiao, W., Liu, Y., Liu, S., and Dong, G. (2023). A rat model of metabolic syndrome-related heart failure with preserved ejection fraction phenotype: Pathological alterations and possible molecular mechanisms. Front. Cardiovasc. Med., 10.","DOI":"10.3389\/fcvm.2023.1208370"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1002\/clc.23976","article-title":"Association between visceral adiposity index and heart failure: A cross-sectional study","volume":"46","author":"Zhang","year":"2023","journal-title":"Clin. Cardiol."},{"key":"ref_89","doi-asserted-by":"crossref","unstructured":"Wu, M., Lai, W., Huo, X., Wang, Q., Zhou, Y., and Gao, D. (2025). Association of visceral adiposity index (VAI) with prognosis in patients with metabolic syndrome and heart failure with reduced ejection fraction. BMC Cardiovasc. Disord., 25.","DOI":"10.1186\/s12872-025-04591-1"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1590\/1516-3180.2015.01452111","article-title":"Visceral adiposity index and prognosis among patients with ischemic heart failure","volume":"134","author":"Vogel","year":"2016","journal-title":"Sao Paulo Med. J."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/j.tem.2025.01.006","article-title":"Do weight loss interventions challenge the obesity paradox in heart failure?","volume":"36","author":"Yurista","year":"2025","journal-title":"Trends Endocrinol. Metab."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"3616","DOI":"10.1002\/ehf2.14961","article-title":"Obesity paradox in patients with reduced ejection fraction eligible for device implantation\u2014An observational study","volume":"11","author":"Merkel","year":"2024","journal-title":"ESC Heart Fail."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1038\/s41366-025-01716-6","article-title":"Cachectic biomarkers as confounders behind the obesity paradox in patients with acute decompensated heart failure","volume":"49","author":"Miura","year":"2025","journal-title":"Int. J. Obes."},{"key":"ref_94","doi-asserted-by":"crossref","unstructured":"Shi, Y., Yu, C., Hu, L., Li, M., Zhou, W., Wang, T., Zhu, L., Bao, H., Li, P., and Cheng, X. (2022). Visceral adiposity index and sex differences in relation to peripheral artery disease in normal-weight adults with hypertension. Biol. Sex Differ., 13.","DOI":"10.1186\/s13293-022-00432-4"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.1016\/j.numecd.2020.03.019","article-title":"Predictive power of novel and established obesity indices for outcome in PAD during a five-year follow-up","volume":"30","author":"Zierfuss","year":"2020","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"252","DOI":"10.4274\/MMJ.galenos.2023.07455","article-title":"Novel predictor of the AF development in patients with OSAS: Importance of visceral adipose index","volume":"38","author":"Ozkan","year":"2023","journal-title":"Medeni Med. J."},{"key":"ref_97","first-page":"522","article-title":"Visceral adiposity index and prognostic nutritional index in predicting atrial fibrillation after on-pump coronary artery bypass operations: A prospective study","volume":"36","author":"Engin","year":"2021","journal-title":"Braz. J. Cardiovasc. Surg."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"e3424","DOI":"10.1002\/dmrr.3424","article-title":"Visceral adiposity index is closely associated with urinary albumin-creatinine ratio in the Chinese population with prediabetes","volume":"37","author":"Wang","year":"2021","journal-title":"Diabetes Metab. Res. Rev."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/s12933-022-01464-1","article-title":"Association of visceral adiposity index with incident nephropathy and retinopathy: A cohort study in the diabetic population","volume":"21","author":"Wu","year":"2022","journal-title":"Cardiovasc. Diabetol."},{"key":"ref_100","doi-asserted-by":"crossref","unstructured":"Zhao, X., Sun, J., Xin, S., and Zhang, X. (2025). Study on the association between visceral adiposity index and diabetic kidney disease in hospitalized patients with type 2 diabetes mellitus in China. Front. Endocrinol., 16.","DOI":"10.3389\/fendo.2025.1549954"},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"e3602","DOI":"10.1002\/dmrr.3602","article-title":"Associations between visceral adiposity index and incident nephropathy outcomes in diabetic patients: Insights from the ACCORD trial","volume":"39","author":"Zhou","year":"2022","journal-title":"Diabetes Metab. Res. Rev."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/14\/2374\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:13:00Z","timestamp":1760033580000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/14\/2374"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,20]]},"references-count":101,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2025,7]]}},"alternative-id":["nu17142374"],"URL":"https:\/\/doi.org\/10.3390\/nu17142374","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,20]]}}}