Abstract: Objective To investigate the association between visceral adiposity index （VAI） and blood glucose variation in the prediabetic population through a cohort study. Methods Based on the China Health and Retirement Longitudinal Study （CHARLS）, middle-aged and elderly Prediabetic people who participated in the baseline survey in 2011 and follow-up in 2015 were included. The association between VAI and the development to diabetes or the return to normoglycemia in the prediabetic population was analyzed by multiple logistic regression model. Results During follow-up, 309 （14.29%） developed to diabetes, 1 369 （63.29%） remained prediabetes, and 485 （22.42%） returned to normoglycemia. After adjusting for covariates, multiple logistic regression showed that the risk of development to diabetes increased by 6% for every standard deviation increase in VAI; compared with Q₄ （2.76-35.31） group, Q₁ （0.03-0.93）, Q₂ （0.94-1.54）, and Q₃ （1.55-2.75） groups all reduced the risk of diabetes, and the values of OR and 95% CI were （0.51, 95% CI： 0.35-0.74）, （0.53, 95% CI： 0.37-0.75）, and （0.69, 95% CI： 0.49-0.97）, respectively; only the Q₁ （0.03-0.93） group increased the probability of returning to normoglycemia （OR=1.43, 95% CI： 1.04 - 1.95）.Conclusions VAI is strongly associated with the development of prediabetes, only low VAI increases the probability of returning to normoglycemia.

Key words: Visceral adiposity index, Prediabetes, Middle-aged and elderly, Blood glucose, Cohort study