Computed Tomography reference values for visceral obesity and increased metabolic risk in a Caucasian cohort

  • Michelle R. Baggerman
    Correspondence
    Corresponding author. Department of Intensive Care Medicine, Maastricht UMC+, P. Debyelaan 25, 6229 HX, Maastricht, the Netherlands. . T: +31 (0)43 3876393.
    Affiliations
    Maastricht UMC+, Department of Intensive Care Medicine, P. Debyelaan 25, Maastricht, the Netherlands

    Maastricht University, School for Nutrition and Translational Research in Metabolism (NUTRIM), Universiteitssingel 40, Maastricht, the Netherlands

    Laurentius Hospital, Department of Intensive Care Medicine, Monseigneur Driessenstraat 6, Roermond, the Netherlands
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  • Ingeborg M. Dekker
    Affiliations
    Amsterdam UMC, Department of Nutrition and Dietetics, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands
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  • Bjorn Winkens
    Affiliations
    Maastricht University, Care and Public Health Research Institute (CAPHRI), Methodology and Statistics, P. Debeyeplein 1, Maastricht, the Netherlands
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  • Steven WM. Olde Damink
    Affiliations
    Maastricht University, School for Nutrition and Translational Research in Metabolism (NUTRIM), Universiteitssingel 40, Maastricht, the Netherlands

    Maastricht UMC+, Department of Surgery, P. Debyelaan 25, Maastricht, the Netherlands

    RWTH University Hospital Aachen, Department of General, Visceral and Transplantation Surgery, Pauwelsstraße 30, Aachen, Germany
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  • Peter JM. Weijs
    Affiliations
    Amsterdam UMC, Department of Nutrition and Dietetics, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands

    Amsterdam UMC, Department of Intensive Care Medicine, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands

    Amsterdam University of Applied Sciences, Department of Nutrition and Dietetics, Dr. Meurerlaan 8, Amsterdam, the Netherlands
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  • Marcel CG. van de Poll
    Affiliations
    Maastricht UMC+, Department of Intensive Care Medicine, P. Debyelaan 25, Maastricht, the Netherlands

    Maastricht University, School for Nutrition and Translational Research in Metabolism (NUTRIM), Universiteitssingel 40, Maastricht, the Netherlands

    Maastricht UMC+, Department of Surgery, P. Debyelaan 25, Maastricht, the Netherlands
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Open AccessPublished:January 13, 2022DOI:https://doi.org/10.1016/j.clnesp.2022.01.009
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      Highlights

      • Visceral Adipose Tissue Index (VATI) is associated with metabolic risk.
      • The amount of VATI and increased metabolic risk differs per gender.
      • VATI is a better predictor for metabolic risk than BMI.
      • To define visceral obesity, it is important to use gender and ethnicity specific reference values.

      Summary

      Background

      Visceral obesity is associated with the metabolic syndrome. The metabolic risk differs per ethnicity, but reference values for visceral obesity for body composition analyses using Computed Tomography(CT) scans in the Caucasian population are lacking. Therefore, the aim of this study was to define gender specific reference values for visceral obesity in a Caucasian cohort based upon the association between the amount of visceral adipose tissue(VAT) and markers of increased metabolic risk.

      Methods

      Visceral Adipose Tissue Area Index(VATI cm2/m2) at the level of vertebra L3 was analyzed using CT scans of 416 healthy living kidney donor candidates. The use of antihypertensive drugs and/or statins was used as an indicator for increased metabolic risk. Gender specific cut-off values for VATI with a sensitivity ≥80% were calculated using receiver operating characteristic(ROC) curves.

      Results

      In both men and women who used antihypertensive drugs, statins or both, VATI was higher than in those who did not use these drugs(p≤0.013). In males and females respectively, a value of VATI of ≥38.7 cm2/m2 and ≥24.9 cm2/m2 was associated with increased metabolic risk with a sensitivity of 80%. ROC analysis showed that VATI was a better predictor of increased metabolic risk than BMI (area under ROC curve (AUC)=0.702 vs AUC=0.556 in males and AUC=0.757 vs AUC=0.630 in females).

      Conclusion

      Gender and ethnicity specific cut-off values for visceral obesity are important in body composition research, although further validation is needed. This study also showed that quantification of VATI is a better predictor for metabolic risk than BMI.

      Keywords