Visceral adiposity index showed strong and consistent associations with renal dysfunction specifically in Chinese male T2DM patients, while female associations were primarily mediated through confounding pathways, highlighting critical sex-specific differences.
Key Findings
Results
The study population of 1,335 Chinese type 2 diabetes mellitus patients showed significantly higher age, blood pressure, and fasting glucose in the eGFR decline group compared to the normal group.
Cross-sectional study of 1,335 type 2 diabetes mellitus patients
Median age of the study population was 54 years; 67.04% were male
Primary outcome was renal dysfunction defined as eGFR < 60 mL/min/1.73 m²
Differences in age, blood pressure, and fasting glucose between eGFR groups were all statistically significant (p < 0.05)
Results
Multiple visceral adiposity indices were significantly elevated in the eGFR decline group despite similar body mass index levels between groups.
Thirteen visceral adiposity indices were evaluated through correlation analysis, overall population regression modeling, and sex-stratified approaches
Significantly elevated indices in the eGFR decline group included waist-to-hip ratio, lipid accumulation product, Chinese visceral adiposity index, visceral adiposity index, body roundness index, relative fat mass, and metabolic score for visceral fat
Body mass index levels were similar between the eGFR decline and normal groups
This finding suggests composite visceral adiposity measures capture risk not reflected by BMI alone
Results
After confounder adjustment, only the visceral adiposity index maintained statistical significance in the total population correlation analysis.
Comprehensive correlation analysis revealed substantial attenuation of associations after confounder adjustment
Visceral adiposity index maintained significance in the total population with adjusted r = -0.075, p = 0.007
All other visceral adiposity indices lost significance after full adjustment in the total population
Results
Multivariate regression confirmed visceral adiposity index as the most robust independent predictor of eGFR in the total population.
Visceral adiposity index regression coefficient was β = -1.63, 95% CI: -2.75 to -0.50, p = 0.0048
Models were progressively adjusted for demographic characteristics, lifestyle factors, clinical parameters, and medications
The negative beta coefficient indicates higher visceral adiposity index was associated with lower eGFR
Results
Sex-stratified analyses revealed that visceral adiposity index demonstrated independent predictive value for renal dysfunction exclusively in males.
In males, visceral adiposity index association: β = -2.41, 95% CI: -3.84 to -0.98, p = 0.001
All female associations with visceral adiposity indices became non-significant after full adjustment
Female associations were described as 'primarily mediated through confounding pathways'
The sex-specific difference was described as a 'profound' finding of the sex-stratified analyses
Conclusions
The study supports integration of composite visceral adiposity indices into routine clinical assessment specifically for male diabetic patients for renal risk stratification.
Authors recommend population-specific and gender-tailored approaches in renal risk stratification
Findings emphasize the clinical utility of composite adiposity measures over single measures like BMI
The study highlights insufficiently explored sex-specific relationships between visceral adiposity and renal dysfunction in Chinese populations
Authors conclude that visceral adiposity index is the most clinically relevant composite adiposity index for this purpose in Chinese male T2DM patients
Liu S, Ma L, Niu Y, Ma R, Qi T, Shi B. (2026). Sex-specific association of visceral adiposity index with renal dysfunction in chinese type 2 diabetes: A cross-sectional study.. PloS one. https://doi.org/10.1371/journal.pone.0343375