CLINICAL TRIAL article
Front. Nutr.
Sec. Nutrition and Metabolism
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1599603
Diagnostic value and Mediation Effects of the Visceral Adiposity Index, Triglyceride-Glucose Index, and Platelet-to-HDL Ratio in Young Overweight and Obese Chinese Adults
Provisionally accepted
- 1First Affiliated Hospital, Guangxi Medical University, Nanning, China
- 2Department of Rehabilitation Medicine, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, Guangxi Zhuang Region, China
- 3Department of Radiology, First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, Guangxi Zhuang Region, China
- 4Department of Cardiology, First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi Zhuang Region, China
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Background Evidence on the combined diagnostic and mediating effects of visceral adiposity index (VAI), triglyceride-glucose index (TyGi), and Platelet-to-HDL ratio (PHR) in young overweight and obese adults with metabolic syndrome (MetS) is limited. Methods Overweight or obese patient from the Integrated Diagnosis and Treatment Center for Obesity were enrolled. Multivariable logistic regression was used to assess associations between the three markers and MetS severity. Receiver operating characteristic (ROC) analysis evaluated their diagnostic value, and mediation analysis explored their interrelationships. Results Among 331 young adults (median age: 31 years; 60% female), the MetS prevalence was 30.2%. Levels of VAI, TyGi, and PHR were significantly higher in participants with MetS and were strongly associated with MetS severity. Their areas under the curve (AUCs) (VAI: 0.825, TyGi: 0.807, PHR: 0.683) outperformed that of waist circumference (0.604). While the combined use of all three markers yielded the highest AUC, it did not significantly exceed that of VAI alone. Mediation analysis revealed complex interrelationships: TyGi had the strongest total effect on MetS (43.3%, p<0.05), with substantial mediation by VAI (58.6%) and PHR (10.4%). The effect of VAI (12.2%) was partly mediated by TyGi (30.8%, p<0.05), whereas the influence of PHR (7.5%, p<0.05) was largely mediated by VAI (68.6%) and TyGi (61.3%). Conclusions VAI, TyGi, and PHR are valuable diagnostic markers for MetS in young overweight and obese Chinese adults, with VAI showing the strongest predictive performance. Their interplay highlights the need for integrated interventions targeting visceral adiposity, insulin resistance, and inflammation to mitigate MetS progression.
Keywords: Overweight, metabolic syndrome, ROC, Mediation effects, young adults
Received: 11 Apr 2025; Accepted: 20 Aug 2025.
Copyright: © 2025 Chen, Peng, Chen, Yuan, Long and A. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Huihe Chen, First Affiliated Hospital, Guangxi Medical University, Nanning, China
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