Visceral adiposity index as a predictor of NAFLD: A prospective study with 4‐year follow‐up

Abstract Background & Aims Although evidence indicates that visceral adipose tissue is associated with nonalcoholic fatty liver disease ( NAFLD ), it is unclear whether the visceral adiposity index ( VAI ) can predict the onset of NAFLD . This study aimed to determine whether the VAI is an independent risk factor of NAFLD and whether there is a dose‐response relationship. Methods We explored the relationship between VAI levels and NAFLD in a health check‐up cohort established in 2012. There were 4809 subjects with baseline data and results from 4 follow‐up examinations. The diagnosis of NAFLD was established by demonstration of increased hepatic echogenicity with ultrasound and exclusion of alcohol overconsumption with questionnaires. We divided the subjects into 4 groups according to baseline VAI levels and used the Cox hazard regression model to estimate NAFLD risk by VAI quartile at baseline by adjusting for potential confounding factors. A Kaplan‐Meier survival analysis was used to compare the risk of NAFLD incidence among individuals in each VAI quartile. Results The 4‐year cumulative incidence of NAFLD in this cohort was 13.9%. The hazard ratios (95% confidence intervals, 95% CI ) for NAFLD in the second, third and fourth VAI quartiles compared with the first quartile were 1.42 (95% CI : 1.24‐1.64), 1.73 (95% CI : 1.51‐1.99) and 2.13(95% CI : 1.86‐2.45) respectively. The Kaplan‐Meier survival analysis suggested that higher VAI levels predict higher incidences of NAFLD in a dose‐dependent relationship. Conclusions Our findings suggest that the VAI level is an independent risk factor of NAFLD and there is a dose‐response relationship between VAI level and NAFLD risk.