Significant positive correlations were found between VAI and the cardiovascular risk and metabolic syndrome-related factors, plasminogen activator inhibitor-1 (PAI-1), uric acid, and HOMA-IR and an inverse association with adiponectin and Ad/Lep.<h4>Conclusions</h4>Our observations indicate that VAI is a useful tool to assess cardiometabolic risk and adipose tissue functionality in young adult males with overweight and obesity. This evidence concerns the gene SERPINE1 and metabolic syndrome.