Is bioimpedance visceral adiposity better in assessing glycemic dysregulation risk than classic anthropometrics in real-world setting? A cross-sectional real-world data analysis, a part of Lublin Comorbidity of Adiposity Study (LUCAS 1.2)

Objective: Visceral fat accumulation, as opposed to general or abdominal fat, is a distinct cardiometabolic health risk marker. This study aimed to assess and prevalidate the clinical value of visceral fat rating (VFR), obtained via bioelectrical impedance analysis (BIA), as an indicator associated with prediabetes and type 2 diabetes mellitus (T2DM) in real-world settings, compared to traditional anthropometric parameters such as body mass index (BMI) and waist circumference (WC). Materials and Methods: This retrospective cross-sectional study analyzed real-world data from 650 patients (513 women) with overweight or obesity admitted to the Department of Endocrinology, Diabetology, and Metabolic Diseases, between July 2020 and December 2023. Anthropometric parameters, including percentage body fat (PBF) and VFR, were measured using a Tanita BIA device. Venous blood samples were collected to measure glycated hemoglobin (HbA1c) levels. Statistical analyses included ANOVA, post-hoc testing, and effect size evaluation using Cohen’s d and Fisher’s Z-index. Results: The study involved 650 patients with overweight or obesity, including 513 women. VFR significantly differentiated patients across Normal Glucose Metabolism (NGM), Prediabetes, and T2DM groups with high effect sizes. Among women, VFR and WC were the most effective markers, while BMI and PBF showed limited differentiation. Among men, VFR was the strongest differentiator in the NGM vs. T2DM comparison. VFR correlated strongly, almost linearly, with HbA1c, outperforming traditional anthropometrics. Conclusions: VFR, measured via BIA, demonstrates substantial potential as a reliable and practical marker associated with glycemic dysregulation in real-world clinical settings, outperforming BMI and WC. Further standardization of VFR in evidence-based medicine is warranted.