VAI was strongly associated with the presence of MetS in a large Iranian population and demonstrated good discriminatory ability, with a stronger association in women than in men, and optimal cut-off values of 2.42 overall, 2.08 in men, and 2.69 in women.
Metabolic syndrome was present in 40.7% of participants overall, with a substantially higher prevalence in women than in men.
VAI was significantly higher in individuals with MetS compared to those without MetS.
Each one-unit increase in VAI was associated with significantly higher odds of MetS in the overall population in the fully adjusted model.
The association between VAI and MetS was significantly stronger in women than in men.
VAI demonstrated good discriminatory ability for identifying MetS in the total population and in both sexes separately.
Optimal VAI cut-off values for identifying MetS differed between the overall population and by sex.
VAI was most strongly associated with triglycerides and HDL-C among the individual MetS components, but also showed significant associations with elevated fasting plasma glucose and blood pressure.
The authors caution that part of the VAI–MetS association may reflect shared components between VAI's calculation and the MetS definition, and call for prospective studies and external validation before clinical application.
This research suggests that the Visceral Adiposity Index (VAI) — a simple score calculated from waist circumference, body mass index, triglycerides, and HDL cholesterol using sex-specific formulas — is strongly linked to metabolic syndrome (MetS) in a large Iranian population of over 10,500 adults. Metabolic syndrome, a cluster of conditions including high blood sugar, high blood pressure, excess abdominal fat, and abnormal cholesterol levels, was found in about 41% of participants overall, affecting more than half of the women in the study but only about a quarter of the men. People with MetS had roughly double the VAI score of those without it. The study found that for every one-unit increase in VAI, the odds of having MetS were about 2.4 times higher after accounting for other factors, with the association being notably stronger in women (about 3.2 times higher odds) than in men (about 1.9 times higher odds). VAI also performed well at distinguishing who had MetS from who did not, with accuracy scores (AUC of ~0.84) considered 'good' by medical standards. The researchers identified specific VAI thresholds — 2.42 for the general population, 2.08 for men, and 2.69 for women — that could potentially be used as screening cut-off points. This research suggests VAI could be a useful, low-cost tool for flagging individuals at higher cardiometabolic risk, particularly because it also correlated significantly with elevated blood sugar and blood pressure — not just the cholesterol-related components it shares with the MetS definition. However, because this was a single-time-point (cross-sectional) study conducted in one Iranian region, and because VAI's formula overlaps with some MetS criteria, the authors emphasize that longer-term studies and testing in other populations are needed before VAI can be reliably used in clinical practice.
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Upload Your LabsLetafatkar N, Amini-Salehi E, Hashemi S, Hassanipour S, Jafari M, Ghaffari S, et al.. (2026). Association Between Visceral Adiposity Index and Metabolic Syndrome and Its Components: Evidence From the PERSIAN Guilan Cohort Study.. Endocrinology, diabetes & metabolism. https://doi.org/10.1002/edm2.70341