This study explored the association between the visceral adiposity index (VAI) and metabolic syndrome (MetS) in children with type 1 diabetes mellitus (T1DM). The study was conducted between September 2023 and March 2024 at a tertiary pediatric endocrinology clinic in Türkiye. Metabolic syndrome was defined using criteria of the World Health Organization and the International Diabetes Federation. The classification threshold was set at a cut-off value of 1.77. Metabolic syndrome occurred in 22.5% of children by World Health Organization criteria and 8.6% by International Diabetes Federation criteria. Higher visceral adiposity index values were linked to abdominal fat and adverse lipid findings. The VAI significantly predicted MetS (odds ratio: 13.29, P = .001), with an area under the curve of 0.830. The VAI is a simple and effective tool for early identification of MetS risk in children with T1DM .
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