The visceral adiposity index predicts the development of type 2 diabetes mellitus in patients with established coronary artery disease

Abstract Introduction The visceral adiposity Index (VAI) is a reliable biomarker of insulin resistance and is associated with the metabolic syndrome as well as with type 2 diabetes (T2DM). Purpose The purpose of the study was to investigate the power of VAI to predict the development of T2DM in patients with established coronary artery disease (CAD). Methods We prospectively recorded incident diabetes over 8 years in 918 consecutive non-diabetic Caucasian patients with angiographically proven CAD. Diabetes was diagnosed according to ADA criteria. Prediabetes was identified based on the following parameters: HbA1c levels ranging from 5.7% to 6.4%, fasting plasma glucose concentrations between 100 and 125 mg/dL, or a 2-hour post-oral glucose tolerance test (OGTT) plasma glucose concentration between 140 and 199 mg/dL. Results At baseline, 63.7% of our non-diabetic CAD patients had prediabetes; the VAI was significantly higher in patients with than in those without prediabetes (1.8±1.4 vs. 2.2±2.3 mg/dl; p=0.017). During follow-up, diabetes was newly diagnosed in 144 patients, i.e. in 15.7% of the study population. The VAI predicted incident diabetes both univariately (OR 1.36 1.14-1.62; p0.001) and after multivariate adjustment including baseline prediabetes (OR 1.19 1.01-1.40; p=0.038). Conclusion We conclude that the incidence of diabetes is high in patients with established CAD and that the VAI strongly and independently predicts the development of diabetes in this population.