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Elevated Visceral Adiposity Index is associated with increased risk of diabetic kidney diseaseHigh visceral fat levels linked to higher risk of kidney disease

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Key Takeaway
Note that elevated Visceral Adiposity Index is associated with increased diabetic kidney disease risk but cannot replace UACR or eGFR.

This meta-analysis evaluated the association between the Visceral Adiposity Index (VAI) and the risk of diabetic kidney disease (DKD) in a population of 58,312 participants. The analysis found that rising VAI is associated with an increased risk of DKD, with an Odds Ratio (OR) of 1.23 (95% CI: 1.14-1.33) and a Hazard Ratio (HR) of 1.12 (95% CI: 1.09-1.16).

Regarding the predictive performance of VAI for DKD, the meta-analysis reported an Area Under the Curve (AUC) of 0.74 (95% CI: 0.70-0.77). The sensitivity was 0.64 (95% CI: 0.55-0.73) and the specificity was 0.72 (95% CI: 0.63-0.79). The authors noted that the predictive accuracy of VAI is moderate.

Clinically, VAI may serve as a complementary tool in resource-limited settings for identifying risk. However, the authors emphasize that VAI cannot replace established standard metrics such as UACR and eGFR for managing diabetic kidney disease. The findings are based on observational data and do not imply a direct causal relationship.

Living with diabetes often means managing multiple risks to your health at once. One of the most serious concerns is how the condition affects the kidneys over time. New data from a large study of over 58,000 people suggests that a specific type of body fat, known as visceral adiposity, plays a significant role in this risk.

Researchers looked at the Visceral Adiposity Index, or VAI. This is a way to measure fat stored deep inside the body. They found that as these fat levels rose, the risk of developing diabetic kidney disease also increased. While the tool showed a clear link, its ability to predict the disease is currently considered moderate.

It is important to know that this finding is about a connection, not a direct cause. While this measurement could be a helpful extra tool for doctors, especially in areas with fewer resources, it cannot replace the current standard tests used to monitor kidney health. Talk to your doctor about how these factors affect your specific health plan.

What this means for you:
Higher levels of internal body fat are linked to an increased risk of kidney disease in people with diabetes.

Common questions

What is the Visceral Adiposity Index (VAI)?

The Visceral Adiposity Index, or VAI, is a way to measure fat stored deep inside the body. The study found that higher VAI scores are associated with an increased risk of diabetic kidney disease. While it can be a helpful tool for doctors, it is not a replacement for standard kidney tests.

How many people were included in this study?

The study included a large group of 58,312 participants with diabetic kidney disease. This large sample size helped researchers identify a clear link between rising fat levels and increased risk, even though the tool's predictive accuracy is currently considered moderate.

Can this test replace my current kidney tests?

No, this measurement cannot replace the current standard tests used to monitor kidney health, such as UACR and eGFR. It is intended to be a complementary tool, especially in settings where resources are limited, rather than a replacement for standard care.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedSep 2026
View Original Abstract ↓
ObjectiveThe predictive value of the Visceral Adiposity Index (VAI) for diabetic kidney disease (DKD) is unclear. This study systematically reviews the association of elevated VAI with DKD, as well as its predictive performance.MethodsPubMed, Cochrane Library, Embase, Web of Science, CNKI, Wanfang, VIP, and CBM were searched until December 1, 2025, for studies investigating VAI and DKD. The pooled outcomes and effect measures included odds ratio (OR), hazard ratio (HR), area under the curve (AUC), sensitivity (SEN), specificity (SPEC), and diagnostic 2×2 tables. Additional analyses encompassed sensitivity analysis, heterogeneity assessment, and publication bias evaluation. Statistical analyses were enabled by Stata MP 15.1.ResultsNineteen studies on 58,312 participants were encompassed. Meta-analysis demonstrated that rising VAI was significantly associated with an elevated DKD risk (OR = 1.23, 95% CI: 1.14-1.33; HR = 1.12, 95% CI: 1.09-1.16). The pooled diagnostic performance of VAI for predicting DKD showed an AUC of 0.74 (95% CI: 0.70-0.77), with a SEN of 0.64 (95% CI: 0.55-0.73) and a SPEC of 0.72 (95% CI: 0.63-0.79).ConclusionsAn increased VAI is associated with an elevated DKD risk and serves as an independent predictor. However, its predictive accuracy remains moderate. It cannot yet replace existing standards (such as urinary albumin-to-creatinine ratio (UACR) and the estimated glomerular filtration rate (eGFR)), but may serve as a complementary tool in resource-limited settings. Future research should explore whether combining VAI with other relevant indicators enhances the prediction of DKD risk.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024587271.
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