Association of Chinese Visceral Adiposity Index with Nonalcoholic Fatty Liver Disease in Individuals with type 2 Diabetes Mellitus: A Cross Sectional Study

Background: Chinese visceral adiposity index (CVAI), a reliable indicator of visceral adiposity, was associated with type 2 diabetes mellitus (T2DM) in Chinese population. However, little is known regarding association between CVAI and presence of nonalcoholic fatty liver disease (NAFLD) in T2DM patients. Here, we investigated whether CVAI could identify NAFLD among T2DM patients. Methods: A total of 504 T2DM patients were recruited in this cross-sectional survey. Anthropometric and biochemical parameters were measured. NAFLD was diagnosed by abdominal ultrasonography. Binary logistic regression was used to assess association between CVAI and occurrence of NAFLD in T2DM patients. The predictive power of CVAI for NAFLD was analyzed by receiver operating characteristic curve (ROC) method. Results: CVAI levels were significantly elevated in T2DM patients with NAFLD (102.68±32.34 vs 133.10±28.44, P <0.001). Compared with the lowest CVAI quartile, the highest quartile showed worse metabolic features, including waist circumference, body mass index, liver enzymes and lipid parameters ( P <0.01). The incidence of NAFLD among T2DM patients increased significantly across CVAI quartiles (36.5%, 57.9%, 78.6%, 86.5%, respectively, P <0.001). Binary logistic regression analysis adjusted for multiple factors showed that the odds ratio of having NAFLD was 9.004 (95%CI, 4.441-18.256) in the highest CVAI quartile. ROC analyses showed that the area under the curve of CVAI for diagnosing NAFLD was 0.756 (95% confidence interval: 0.716-0.792), which was better than visceral adiposity index, waist-to-hip ratio and waist-to-height ratio( P<0.05 ). The cut-off value of CVAI for identifying NAFLD in Chinese T2DM population was 111.975 (sensitivity = 0.761, specificity = 0.627). Conclusions: Elevated CVAI levels were independently associated with presence of NAFLD in T2DM patients. CVAI might be a reliable and convenient index for incident NAFLD in T2DM patients.