Visceral adiposity index is closely associated with albuminuria in the Chinese population with prediabetes: results from the REACTION study

Abstract Background Visceral obesity is a major health issue and a risk factor for atherogenic state. It has been reported to be a crucial link between albuminuria and cardiovascular diseases (CVD). However, there is limited available data on the relationship between visceral obesity and albuminuria. Therefore, we aimed to explore the association between visceral obesity and albuminuria in the Chinses population with prediabetes. Methods This cross-sectional study included 24871 prediabetic participants aged over 40 years from seven centers across China. Visceral adiposity index (VAI), which has been confirmed as a simple and reliable indicator of visceral adiposity distribution and dysfunction, is determined based on the measurements of anthropometric indices and lipid parameters. Increased albuminuria was defined as urinary albumin-creatinine ratio (UACR)≥30 mg/g, indicating kidney damage. Propensity score matching was used to reduce the bias and multiple logistic regression model was performed to evaluate the association between visceral obesity and albuminuria in the population with prediabetes. Results Participants with increased UACR had increased VAI, age, blood pressure, triglycerides, poor glycemic control, and decreased estimated glomerular filtration rate (eGFR). The prevalence of CVD was higher in the increased UACR group. Multiple logistic regression analysis showed that VAI quartiles was positively associated with increased risk of albuminuria (Q2: odds rate (OR):1.10, 95% confidence intervals [CI]: 0.96-1.25; Q3: OR:1.16, 95%CI 1.01-1.32; Q4: OR:1.26, 95%CI 1.10-1.44, P for trend=0.001). Stratified analysis revealed that the association of VAI level with increased albuminuria risk was also observed in people who were young, women, overweight or obese, with poor control of blood pressure, and eGFR≥ 90 mL/min per 1.73 m 2 . Conclusions Visceral obesity assessed by VAI was significantly associated with increased albuminuria in the Chinese population with prediabetes.