Abstract
Visceral obesity (VO) is a critical risk factor for metabolic disorders and cardiovascular diseases. Although DXA, CT, or MRI are reliable tools for measuring visceral adiposity, their routine use is limited by cost and accessibility. The triglyceride-glucose (TyG) index, a surrogate marker of insulin resistance, has shown potential as a cost-effective predictor of VO in type 2 diabetes mellitus (T2DM). However, its relationship with visceral adiposity in generally healthy populations remains unclear. A total of 2921 healthy adults (825 males, 2096 females) without serious metabolic, cardiovascular, or endocrine diseases were included. Anthropometric measurements (including body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR)) and blood analyses (fasting plasma glucose, triglycerides) were performed. Visceral adipose tissue (VAT) mass and volume were measured using DXA. Logistic regression identified independent factors of VO, defined as VAT mass or volume ≥ 85th percentile by sex. ROC curve analyses assessed the predictive ability of TyG and its related indices. Visceral adiposity increased with ascending TyG quartiles in both sexes, showing a dose-dependent manner. Individuals with VO exhibited higher TyG than those without VO in males (8.95 vs. 8.39) and females (8.81 vs. 8.20). TyG was positively correlated with visceral adiposity and identified as an independent risk factor of VO, with stronger associations in females (OR = 3.512, 95%CI: 2.538-4.861) compared to males (OR = 1.575, 95%CI: 1.002-2.477). ROC analyses showed TyG index had a significant predictive value for VO in males (AUC = 0.733) and females (AUC = 0.791). Combining TyG with BMI, WC, and WHtR, further improved predictive accuracy for VO in females (AUC = 0.930 for TyG-BMI, AUC = 0.929 for TyG-WC, and AUC = 0.926 for TyG-WHtR). TyG index is a significant predictor of VO, particularly in females. Combining TyG with BMI, WC, or WHtR enhances its predictive accuracy, making it a simple, low-cost and valuable screening tool for early identification of individuals at risk of VO.