Hormonal
The Visceral Adiposity Index (VAI) is a superior surrogate marker for arterial stiffness compared to BMI or waist circumference, as it remains an independent predictor of increased brachial-ankle pulse wave velocity (baPWV) even after adjusting for confounding factors.
If you are concerned about heart health and obesity, relying solely on your weight (BMI) or waist size may be misleading. A more comprehensive index (VAI) that includes blood lipid levels (Triglycerides and HDL) alongside your waist and weight provides a better assessment of arterial stiffness risk, even if you appear metabolically healthy.
The multivariate regression analysis revealed a negative but weak effect of BMI... but failed to demonstrate any significant effect of WC on baPWV while VAI was a positive independent indicator of baPWV (b = 0.023, P = 0.022).
Why this rating
Cross-sectional study with a large sample size (n=5,158) but limited by lack of causal inference and use of baPWV (not gold standard).
Source
Visceral Adiposity Index May Be a Surrogate Marker for the Assessment of the Effects of Obesity on Arterial Stiffness
Fan Yang et al. · PLoS ONE · 2014
DOI 10.1371/journal.pone.0104365
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