The correlation between visceral fat area to skeletal muscle mass ratio and multi-organ insulin resistance in Chinese population with obesity: a cross-sectional study

Abstract Background: Insulin resistance (IR) is an important risk factor for obesity and cardiometabolic diseases, and our previous findings have demonstrated that visceral fat area to skeletal muscle mass ratio (VSR) is significantly and positively associated with the risk of cardiometabolic diseases. Hence, this study aimed to the relationship between VSR and multi-organ IR, and provide a new approach to improve body composition, reduce the risk of cardiometabolic diseases in patients with obesity, and also set the basis for VSR to increase the incidence of cardiometabolic diseases. Methods: The present study included 398 patients who underwent anthropometric measurements, body composition assessment and biochemical measurements. Body composition was assessed using a bioelectrical impedance analysis method (Inbody770). Spearman correlation analysis was used to investigate the correlation between VSR and homeostatic model assessment for insulin resistance (HOMA-IR) as well as multi-organ IR, including homeostasis model assessment adiponectin (HOMA-AD), adipose tissue insulin resistance (ADIPO-IR), 1/hepatic insulin sensitivity (HISI). We established a new predictive model that included indicator of visceral obesity for IR in previous study, and incorporated the New Model into the present study. Logistic regression was used to analyze the odds ratio (OR) of VSR on the risk of multi-organ IR. The predictive value of VSR for HOMA-IR and New Model were evaluated using the receiver operating characteristic (ROC) curve and the optimal cut-off point was also calculated. Results: VSR was significantly associated with HOMA-IR, HOMA-AD, ADIPO-IR, 1/HISI, and New Model ( p <0.001). With the increase of VSR, the OR increased significantly for HOMA-IR and New Model, this association remained even after adjustment of other possible confounding variables( p <0.05). Then all multi-organ IR indicators were quantified, compared to the lowest quartile group, increased VSR was more likely to exacerbate the risk of IR in the highest quartile ( p trend <0.001). The area under the curve for predicting IR using VSR for HOMA-IR and New Model was 0.88 for men and 0.85 for women and 0.73 for men and 0.76 for women respectively. Conclusions: There was a significant correlation between VSR and multi-organ IR, and the risk of multi-organ IR increased with increasing VSR. Registration number and date: ChiCTR2100044305, March 16, 2021.