Visceral Adiposity Index is Associated With Silent Brain Infarct in a Healthy Population

Abstract Background Visceral adiposity index (VAI) is a novel indicator of the mass and function of visceral adipose tissue, and it has been associated with metabolic disease, cardiovascular disease, and subclinical atherosclerosis; however, there is limited information about its association with cerebrovascular diseases, especially in subclinical pathology. In this study, we evaluated the relationship between VAI and silent brain infarct (SBI) in a healthy population. Methods We evaluated a consecutive series of healthy volunteers over the age of 40 between January 2006 and December 2013. SBI was defined as an asymptomatic, well-defined lesion with a diameter ≥ 3 mm with the same signal characteristics as the cerebrospinal fluid on T1- or T2 weighted images. VAI was calculated using sex-specific equations as described in previous studies, and was based on a number of parameters including waist circumference, triglycerides, high-density lipoprotein cholesterol, and body mass index. Results A total of 2,596 subjects were evaluated (mean age 56y, male sex: 54%), and SBI was found in 218 (8%) participants. In multivariable analysis, VAI (adjusted odds ratio [aOR] = 1.30; 95% confidence interval [CI] = 1.03–1.66; P = 0.030) remained a significant predictor of SBI after adjustment for confounders. On the other hand, visceral adipose tissue area on computed tomography did not show any statistical significance with SBI. The close relationship between VAI and SBI was prominent only in females (aOR = 1.44; 95% CI = 1.00-2.07; P = 0.048). In the evaluation between VAI and the burden of SBI, VAI showed a positive dose-response relationship with the number of SBI lesions (P for trend = 0.037). Conclusions High VAI was associated with a higher prevalence and burden of SBI in a neurologically healthy population, especially in females. Our findings indicate that VAI could be used as a simple and convenient predictor for SBI.